2025 DAVITA FINAL EXAM | ALL
QUESTIONS AND CORRECT ANSWERS |
VERIFIED ANSWERS | LATEST EXAM |
ALREADY GRADED A+
Explaingthegfourgtransportgmechanismsgthatgplaygagroleginghemodialysisg-gans-
●gUltrafiltration:gFluidgisgpushedgthroughgagsemipermeablegmembrane.
●gConvection:gOrgsolutegdraggmeansgthatgsolutesgmovegwithgthegwatergacrossg
thegsemipermeablegmembrane.gIngthisgway,gconvectiongaddsgtogthegclearancega
chievedgthroughgdiffusiongasgsolutesgaregdraggedgalonggwithgthegultrafiltrate.
●gDiffusion:gIsgthegmovementgofgdissolvedgparticlesgacrossgagsemipermeablegm
embranegfromgthegsidegwithgtheghighergconcentrationgtogthegsidegwithgtheglower
gconcentration.gThisgdifferencegingsolutegconcentrationgongeachgsidegofgthegme
mbranegisgcalledgconcentrationggradient.gTheghighergthegconcentrationggradient,g
thegfastergdiffusiongoccurs.gOncegthegconcentrationgofgagdissolvedgparticlegisgth
egsamegongbothgsidesgofgthegsemipermeablegmembrane,gdiffusiongstops.
●gOsmosis:gIsgagchemicalgprocessgbygwhichgdissolvedgchemicalsgwillgmigrategfr
omgangareagofghighgconcentrationgtogonegofglow
concentration.gEssentiallygifgyougdissolvegsomethinggingagliquid,gthegdissolvedgco
mpoundsg(calledgsolutes)gwillgspreadgoutguntilgtheregisgangequalgconcentrationgo
fgsolutegeverywhere.
Whatgaregthegkidneysgexcretorygfunctionsg-gans-
Tognormalizegelectrolytes,gremovegwastes,gprovidegfluidgandgnutrientgbalance
Whatgisgthegfunctiongofgthegacidgconcentrationg-gans-
Providesgthegconcentrationggradientgforgdiffusiongandghelpsgnormalizegelectrolytes
Whatgisgthegfunctiongofgbicarbonateg-gans-Buffersgthegacidgconcentrate
Signsgandgsymptomsgofghyperkalemiag-gans-
>g5.5gmEq:gextremegmusclegweakness,gabnormalgheartgrhythm,gpossiblegcardiac
garrest
,Signsgandgsymptomsgofghypokalemiag-gans-
<g3.5gmEq:gfatigue,gmusclegweakness,gparalysis,grespiratorygfailure,gcardiacginst
ability,garrhythmias,gcardiacgarrest
Whatgaregthegkidneysgendocrinegfunctionsg-gans-
Reningsecretion,gErythropoeitingsecretion,gVitgDgActivation
Howgdogwegreplacegnormalgendocrinegkidneygfunctionsg-gans-
Providegmedications
Howgmuchgofgnormalgkidneygfunctiongisgreplacedgbyghemodialysisg-gans-15%
Whatgisguremiagandghowgdoesgitgaffectgthegbody?g-gans-
Uremiagisgagbuildupgofgwastesgingthegbloodgduegtogkidneygfailuregandgaffectsg
allgbodygsystems.
WhatgaregthegmostgcommongcausesgofgCKDgingthegusa?g-gans-Diabetes
Hypertension
PolycysticgKidneygDisease
OutlinegthegtreatmentggoalsgforgagpatientgwithgCKDg-gans--
slowinggthegprogressiongofgckd
-managinggcomorbiditiesgandgcomplications
-controllinggsymptoms
-minimizinggthegeffectsgofgckdgongpatients'glifestyles
-kidneygreplacementgtherapygmodalitygeducation
-encouraginggpatientsgtogactivelygparticipategingtheirghealthcare
WhygisgitgimportantgtogknowgwhatgcausedgyourgpatientsgCKDg-gans-
SogthegnursegandgPCTgcanginquiregaboutgpossiblegproblemsgduringgdatagcollect
iongandgassessment
Whygisgsodiumgbalancegimportant?g-gans-
Leadsgtogvolumegexpansion,gincreasedgcardiacgoutput,gincreasedgperipheralgvasc
ulargresistance,gandgincreasedgbloodgpressure
Signsgandgsymptomsgofgfluidgimbalanceg-gans-
Edema,ghypertension,gshortnessgofgbreath
SystemicgeffectsgofgCKDgwhatgwouldgyougadvisegforgagpatientgwhogcomplainsg
of:gdrygitchygskin,gperipheralgneuropathy(nervegpaingingextremities)gandggigproble
msg-gans-Useghyper-
fattedgsoapsgandglotions,gmonitorgpatientgforgchangesgingmotorgfunctiongandginf
ormgRNgandgphysiciangofganygbleedinggproblems/constipation/diarrhea
, Whatgisgthegconsequencesgofgprolongedgfluidgoverloadgandghypertensiong-gans-
Leftgventricularghypertrophy
WhatgisgPercarditis?g-gans-
Inflammationgofgthegmembraneg(pericardialgsac)garoundgthegheart
Whatgisgagcommongcausegofghypertensiongingdialysisgpatientsg-gans-
fluidgoverload
Leftgventricularghypertrophygleadsgtog-gans-
Ischemicgheartgdisease,garrhythmia,gmyocardialginfarction,gandgsuddengdeath
Whygaregdialysisgpatientsganemic?g-gans-
1.gtheglifespangofgtheirgredgbloodgcellgisg60gdaysg1/2gofgthegnormalg120gdays.
Whatgcangyougdogtogavoidgcontributinggtoglowerghemoglobingandgbloodglossgin
gdialysisgpatientsg-gans-
VerifygcorrectgErythropoietingStimulatinggAgentg(ESA)gdosegisgadministered,grinse
gbackguntilgvenousglinegisgpinkgtinged,gandgavoidgrepeatglabgdraws
Whatgaregtheg4gkeygelementsgcontributinggtogCKD-
mineralgbonegdisorder(MBD)g-gans-1.gCalcium
2.gPhosphorus
3.gPTH
4.gVitamingDg(Calcitriol)
WhatgaregthegsymptomsgofgCKD-MBDgingadditiongtogbonegdiseaseg-gans-
Softgtissuegcalcification,gitching,gmusclegweakness,gpathologicalgfractures,gtendon
gruptures,gcompressiongofgvertebrae,gatherosclerosis,gheartgdisease
WhatgisgyourgrolegingCKD-MBDgmanagementg-gans-
*reportgsymptomsg*gurgegpatientsgtogtakegmedsg(homeg>reatment)
g*reportgnoncompliancegproblemsgrelatedgtognonadherence
DefinegthegtermgAKIg-gans--
gTermgincorporatesgagwidegspectrumgofgkidneygissues
-
gIncludesgacutegkidneygfailuregasgwellgasglessgcatastrophicgkidneygfunctiongchan
ges
-gMaygdialyzegingangout-patientgfacilityguntilgkidneygfunctiongrecovers
Giveg3gexamplesgofgpre-,gintra-gandgpost-renalgcausesgofgAKIg-gans-
Pre:gObstruction,gvolumegdepletion,gimpairedgcardiacgfunction.
Intra:gischemicgATN,gsepsis,gSIRS,gsepticgshock,ganaphylaxisgdrugs,gGoodpastur
egSyndrome,gAcutegGlomerulonephritis,gTrauma,gopengheartgsurgery.
QUESTIONS AND CORRECT ANSWERS |
VERIFIED ANSWERS | LATEST EXAM |
ALREADY GRADED A+
Explaingthegfourgtransportgmechanismsgthatgplaygagroleginghemodialysisg-gans-
●gUltrafiltration:gFluidgisgpushedgthroughgagsemipermeablegmembrane.
●gConvection:gOrgsolutegdraggmeansgthatgsolutesgmovegwithgthegwatergacrossg
thegsemipermeablegmembrane.gIngthisgway,gconvectiongaddsgtogthegclearancega
chievedgthroughgdiffusiongasgsolutesgaregdraggedgalonggwithgthegultrafiltrate.
●gDiffusion:gIsgthegmovementgofgdissolvedgparticlesgacrossgagsemipermeablegm
embranegfromgthegsidegwithgtheghighergconcentrationgtogthegsidegwithgtheglower
gconcentration.gThisgdifferencegingsolutegconcentrationgongeachgsidegofgthegme
mbranegisgcalledgconcentrationggradient.gTheghighergthegconcentrationggradient,g
thegfastergdiffusiongoccurs.gOncegthegconcentrationgofgagdissolvedgparticlegisgth
egsamegongbothgsidesgofgthegsemipermeablegmembrane,gdiffusiongstops.
●gOsmosis:gIsgagchemicalgprocessgbygwhichgdissolvedgchemicalsgwillgmigrategfr
omgangareagofghighgconcentrationgtogonegofglow
concentration.gEssentiallygifgyougdissolvegsomethinggingagliquid,gthegdissolvedgco
mpoundsg(calledgsolutes)gwillgspreadgoutguntilgtheregisgangequalgconcentrationgo
fgsolutegeverywhere.
Whatgaregthegkidneysgexcretorygfunctionsg-gans-
Tognormalizegelectrolytes,gremovegwastes,gprovidegfluidgandgnutrientgbalance
Whatgisgthegfunctiongofgthegacidgconcentrationg-gans-
Providesgthegconcentrationggradientgforgdiffusiongandghelpsgnormalizegelectrolytes
Whatgisgthegfunctiongofgbicarbonateg-gans-Buffersgthegacidgconcentrate
Signsgandgsymptomsgofghyperkalemiag-gans-
>g5.5gmEq:gextremegmusclegweakness,gabnormalgheartgrhythm,gpossiblegcardiac
garrest
,Signsgandgsymptomsgofghypokalemiag-gans-
<g3.5gmEq:gfatigue,gmusclegweakness,gparalysis,grespiratorygfailure,gcardiacginst
ability,garrhythmias,gcardiacgarrest
Whatgaregthegkidneysgendocrinegfunctionsg-gans-
Reningsecretion,gErythropoeitingsecretion,gVitgDgActivation
Howgdogwegreplacegnormalgendocrinegkidneygfunctionsg-gans-
Providegmedications
Howgmuchgofgnormalgkidneygfunctiongisgreplacedgbyghemodialysisg-gans-15%
Whatgisguremiagandghowgdoesgitgaffectgthegbody?g-gans-
Uremiagisgagbuildupgofgwastesgingthegbloodgduegtogkidneygfailuregandgaffectsg
allgbodygsystems.
WhatgaregthegmostgcommongcausesgofgCKDgingthegusa?g-gans-Diabetes
Hypertension
PolycysticgKidneygDisease
OutlinegthegtreatmentggoalsgforgagpatientgwithgCKDg-gans--
slowinggthegprogressiongofgckd
-managinggcomorbiditiesgandgcomplications
-controllinggsymptoms
-minimizinggthegeffectsgofgckdgongpatients'glifestyles
-kidneygreplacementgtherapygmodalitygeducation
-encouraginggpatientsgtogactivelygparticipategingtheirghealthcare
WhygisgitgimportantgtogknowgwhatgcausedgyourgpatientsgCKDg-gans-
SogthegnursegandgPCTgcanginquiregaboutgpossiblegproblemsgduringgdatagcollect
iongandgassessment
Whygisgsodiumgbalancegimportant?g-gans-
Leadsgtogvolumegexpansion,gincreasedgcardiacgoutput,gincreasedgperipheralgvasc
ulargresistance,gandgincreasedgbloodgpressure
Signsgandgsymptomsgofgfluidgimbalanceg-gans-
Edema,ghypertension,gshortnessgofgbreath
SystemicgeffectsgofgCKDgwhatgwouldgyougadvisegforgagpatientgwhogcomplainsg
of:gdrygitchygskin,gperipheralgneuropathy(nervegpaingingextremities)gandggigproble
msg-gans-Useghyper-
fattedgsoapsgandglotions,gmonitorgpatientgforgchangesgingmotorgfunctiongandginf
ormgRNgandgphysiciangofganygbleedinggproblems/constipation/diarrhea
, Whatgisgthegconsequencesgofgprolongedgfluidgoverloadgandghypertensiong-gans-
Leftgventricularghypertrophy
WhatgisgPercarditis?g-gans-
Inflammationgofgthegmembraneg(pericardialgsac)garoundgthegheart
Whatgisgagcommongcausegofghypertensiongingdialysisgpatientsg-gans-
fluidgoverload
Leftgventricularghypertrophygleadsgtog-gans-
Ischemicgheartgdisease,garrhythmia,gmyocardialginfarction,gandgsuddengdeath
Whygaregdialysisgpatientsganemic?g-gans-
1.gtheglifespangofgtheirgredgbloodgcellgisg60gdaysg1/2gofgthegnormalg120gdays.
Whatgcangyougdogtogavoidgcontributinggtoglowerghemoglobingandgbloodglossgin
gdialysisgpatientsg-gans-
VerifygcorrectgErythropoietingStimulatinggAgentg(ESA)gdosegisgadministered,grinse
gbackguntilgvenousglinegisgpinkgtinged,gandgavoidgrepeatglabgdraws
Whatgaregtheg4gkeygelementsgcontributinggtogCKD-
mineralgbonegdisorder(MBD)g-gans-1.gCalcium
2.gPhosphorus
3.gPTH
4.gVitamingDg(Calcitriol)
WhatgaregthegsymptomsgofgCKD-MBDgingadditiongtogbonegdiseaseg-gans-
Softgtissuegcalcification,gitching,gmusclegweakness,gpathologicalgfractures,gtendon
gruptures,gcompressiongofgvertebrae,gatherosclerosis,gheartgdisease
WhatgisgyourgrolegingCKD-MBDgmanagementg-gans-
*reportgsymptomsg*gurgegpatientsgtogtakegmedsg(homeg>reatment)
g*reportgnoncompliancegproblemsgrelatedgtognonadherence
DefinegthegtermgAKIg-gans--
gTermgincorporatesgagwidegspectrumgofgkidneygissues
-
gIncludesgacutegkidneygfailuregasgwellgasglessgcatastrophicgkidneygfunctiongchan
ges
-gMaygdialyzegingangout-patientgfacilityguntilgkidneygfunctiongrecovers
Giveg3gexamplesgofgpre-,gintra-gandgpost-renalgcausesgofgAKIg-gans-
Pre:gObstruction,gvolumegdepletion,gimpairedgcardiacgfunction.
Intra:gischemicgATN,gsepsis,gSIRS,gsepticgshock,ganaphylaxisgdrugs,gGoodpastur
egSyndrome,gAcutegGlomerulonephritis,gTrauma,gopengheartgsurgery.
