James Bean, a patient 67 years of age, is 3 days postoperative after a coronary artery bypass graft operation.

1. James Bean, a patient 67 years of age, is 3 days postoperative after a coronary artery bypass graft operation. The patient has a history of hypertension, type 1 diabetes, coronary artery disease, and end-stage kidney disease, which is treated with hemodialysis three times per week. The patient has a left atriovenous (AV) shunt. The patient is taking the following medications:

• Sevelamer (Renagel): 2 capsules with each meal
• Vitamin D, B12, and iron supplements with meals
• Calcium carbonate (OS-Cal): 3 tablets with each meal
• Procrit (epoetin alfa): 100 U/kg/dose subcutaneously every Monday, Wednesday, and Friday (dialysis days)
• 70/30 NPH and regular insulin 30 U twice daily (Fingerstick blood sugars taken before meals and at bedtime and regular insulin given per sliding scale.)
• Coreg (carvedilol): 12.5 mg twice daily
• Lanoxin: 0.125 mg (every other day, on even days)
• Acetaminophen with Codeine No. 3: 1 to 2 tablets every 6 hours
• Diphenhydramine hydrochloride (Benadryl): 25 mg every 8 hours PRN for itching
• Docusate sodium (Colace): 100 mg b.i.d.

1.The patient is ordered to have daily dialysis. What is the rationale for this order?

2.The patient is going to hemodialysis at 9 am on an odd day. Which medication or medications should the nurse hold before sending the patient?

3.What nursing management considerations should be made for this patient?