مريض في أول جلسة غسيل كلوي له، والبولة عنده مرتفعة جداً. قرب نهاية الجلسة صار عنده صداع وغثيان وتشوش. ما التفسير الأرجح؟

In his first dialysis session with very high urea, a client develops headache, nausea and confusion near the end. What is the most likely explanation?

1. A catheter infection that has spread to the blood
2. Hypoglycaemia from fasting before the session
3. Disequilibrium syndrome from rapid solute removal
4. An allergy to the dialyser membrane material

Answer: C) Disequilibrium syndrome from rapid solute removal. Rapid urea removal makes water shift into brain cells, causing cerebral oedema. Early sessions are therefore shorter and slower.