The nurse is caring for a client receiving hemodialysis who complains of a headache and nausea. The nurse completes a neurological assessment and notes mental status changes and restlessness. The nurse suspects which complication of hemodialysis?

Rationale: A. An air embolism typically presents with sudden chest pain, dyspnea, hypotension, and possibly cyanosis. It is a life-threatening emergency related to air entering the vascular system. Neurological symptoms like mild restlessness and headache are not the primary early signs, making this option less likely. B. Disequilibrium syndrome occurs during or shortly after hemodialysis due to rapid removal of solutes, leading to cerebral edema. Early manifestations include headache, nausea, vomiting, restlessness, confusion, and mental status changes. The client’s symptoms match this presentation, making it the correct answer. C. Dialysis encephalopathy is a rare, chronic complication associated with aluminum toxicity. It develops gradually over time and presents with speech disorders, dementia, seizures, and personality changes—not acute symptoms during dialysis. D. Clotting of the graft site would present with decreased or absent bruit and thrill at the access site and possibly reduced dialysis efficiency. It does not cause neurological symptoms such as headache, nausea, or altered mental status.