Which statement about transporting dialysis patients is correct?

• A. Keep the arm with the fistula elevated above the kidneys
• B. Provide no IV fluids
• C. Dialysis patients require careful titration of IV fluids
• D. Dialysis patients generally require large amounts of IV fluids

Answer: (C)

Fluid management during transport of dialysis patients hinges on balancing perfusion with the risk of fluid overload. Dialysis reshapes a patient’s fluid status, and their kidneys aren’t able to regulate fluids the way a healthy person’s would. Because of this, IV fluids must be given only if needed, and in careful, incremental amounts with close monitoring.

Giving IV fluids in small, controllable amounts allows you to treat signs of inadequate perfusion (like low blood pressure or dizziness) without overloading the circulatory system, which could lead to edema or pulmonary complications after dialysis. Conversely, dumping a large volume of IV fluid can overwhelm a patient who has recently undergone dialysis and may already be euvolemic or even volume overloaded. So the best approach is to titrate fluids based on vitals and clinical status, adjusting as you reassess.

The other options aren’t appropriate: some patients do require IV fluids at times, so “no IV fluids” isn’t universally correct; dialysed patients aren’t suited to large, routine fluid loads; and the idea of elevating the fistula arm above the kidneys isn’t a standard or practical requirement for transport care.