Coordinate the dialysis schedule and the post-dialysis assessment with the dialysis unit; time medications around dialysis per order.
Assess and protect the access (thrill/bruit; no BP/venipuncture; site care) and, for PD, perform exchanges and assess the effluent.
Track the dry weight and fluid-electrolyte balance between sessions and recognize overload, access loss, or peritonitis with escalation.
Teaching / training (to mastery)
Teach the resident/representative access protection and care, the fluid/sodium/potassium/phosphate plan, the dialysis schedule, and the warning signs (access change, overload, PD-effluent change), with teach-back.
Train CNAs on access-limb protection, accurate weights and intake/output, and reporting access changes, bleeding, overload signs, or a cloudy PD effluent, with documented understanding.
