DAVITA FINAL EXAM _ ALL QUESTIONS AND CORRECT ANSWERS
Explain the four transport mechanisms that play a role in ● Ultrafiltration: Fluid is pushed through a semipermeable membrane.
hemodialysis ● Convection: Or solute drag means that solutes move with the water across the
semipermeable membrane. In this way, convection adds to the clearance achieved
through diffusion as solutes are dragged along with the ultrafiltrate.
● Diffusion: Is the movement of dissolved particles across a semipermeable
membrane from the side with the higher concentration to the side with the lower
concentration. This difference in solute concentration on each side of the membrane
is called concentration gradient. The higher the concentration gradient, the faster
diffusion occurs. Once the concentration of a dissolved particle is the same on both
sides of the semipermeable membrane, diffusion stops.
● Osmosis: Is a chemical process by which dissolved chemicals will migrate from
an area of high concentration to one of low
concentration. Essentially if you dissolve something in a liquid, the dissolved
compounds (called solutes) will spread out until there is an equal concentration of
solute everywhere.
What are the kidneys excretory functions To normalize electrolytes, remove wastes, provide fluid and nutrient balance
What is the function of the acid concentration Provides the concentration gradient for diffusion and helps normalize electrolytes
What is the function of bicarbonate Buffers the acid concentrate
Signs and symptoms of hyperkalemia > 5.5 mEq: extreme muscle weakness, abnormal heart rhythm, possible cardiac
arrest
Signs and symptoms of hypokalemia < 3.5 mEq: fatigue, muscle weakness, paralysis, respiratory failure, cardiac
instability, arrhythmias, cardiac arrest
What are the kidneys endocrine functions Renin secretion, Erythropoeitin secretion, Vit D Activation
How do we replace normal endocrine kidney functions Provide medications
How much of normal kidney function is replaced by 15%
hemodialysis
What is uremia and how does it affect the body? Uremia is a buildup of wastes in the blood due to kidney failure and affects all body
systems.
What are the most common causes of CKD in the usa? Diabetes
Hypertension
Polycystic Kidney Disease
Outline the treatment goals for a patient with CKD -slowing the progression of ckd
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects of ckd on patients' lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Stuvia 2026-2027
, DAVITA FINAL EXAM _ ALL QUESTIONS AND CORRECT ANSWERS
Why is it important to know what caused your patients So the nurse and PCT can inquire about possible problems during data collection
CKD and assessment
Why is sodium balance important? Leads to volume expansion, increased cardiac output, increased peripheral
vascular resistance, and increased blood pressure
Signs and symptoms of fluid imbalance Edema, hypertension, shortness of breath
Systemic effects of CKD what would you advise for a Use hyper-fatted soaps and lotions, monitor patient for changes in motor function
patient who complains of: dry itchy skin, peripheral and inform RN and physician of any bleeding problems/constipation/diarrhea
neuropathy(nerve pain in extremities) and gi problems
What is the consequences of prolonged fluid overload and Left ventricular hypertrophy
hypertension
What is Percarditis? Inflammation of the membrane (pericardial sac) around the heart
What is a common cause of hypertension in dialysis fluid overload
patients
Left ventricular hypertrophy leads to Ischemic heart disease, arrhythmia, myocardial infarction, and sudden death
Why are dialysis patients anemic? 1. the lifespan of their red blood cell is 60 days 1/2 of the normal 120 days.
What can you do to avoid contributing to lower hemoglobin Verify correct Erythropoietin Stimulating Agent (ESA) dose is administered, rinse
and blood loss in dialysis patients back until venous line is pink tinged, and avoid repeat lab draws
What are the 4 key elements contributing to CKD-mineral 1. Calcium
bone disorder(MBD) 2. Phosphorus
3. PTH
4. Vitamin D (Calcitriol)
What are the symptoms of CKD-MBD in addition to bone Soft tissue calcification, itching, muscle weakness, pathological fractures, tendon
disease ruptures, compression of vertebrae, atherosclerosis, heart disease
What is your role in CKD-MBD management report symptoms urge patients to take meds (home & treatment)
*report noncompliance problems related to nonadherence
Define the term AKI - Term incorporates a wide spectrum of kidney issues
- Includes acute kidney failure as well as less catastrophic kidney function changes
- May dialyze in an out-patient facility until kidney function recovers
Give 3 examples of pre-, intra- and post-renal causes of Pre: Obstruction, volume depletion, impaired cardiac function.
AKI Intra: ischemic ATN, sepsis, SIRS, septic shock, anaphylaxis drugs, Goodpasture
Syndrome, Acute Glomerulonephritis, Trauma, open heart surgery.
Post: Obstruction, Oliguric, bladder rupture, pregnancy.
Stuvia 2026-2027
Explain the four transport mechanisms that play a role in ● Ultrafiltration: Fluid is pushed through a semipermeable membrane.
hemodialysis ● Convection: Or solute drag means that solutes move with the water across the
semipermeable membrane. In this way, convection adds to the clearance achieved
through diffusion as solutes are dragged along with the ultrafiltrate.
● Diffusion: Is the movement of dissolved particles across a semipermeable
membrane from the side with the higher concentration to the side with the lower
concentration. This difference in solute concentration on each side of the membrane
is called concentration gradient. The higher the concentration gradient, the faster
diffusion occurs. Once the concentration of a dissolved particle is the same on both
sides of the semipermeable membrane, diffusion stops.
● Osmosis: Is a chemical process by which dissolved chemicals will migrate from
an area of high concentration to one of low
concentration. Essentially if you dissolve something in a liquid, the dissolved
compounds (called solutes) will spread out until there is an equal concentration of
solute everywhere.
What are the kidneys excretory functions To normalize electrolytes, remove wastes, provide fluid and nutrient balance
What is the function of the acid concentration Provides the concentration gradient for diffusion and helps normalize electrolytes
What is the function of bicarbonate Buffers the acid concentrate
Signs and symptoms of hyperkalemia > 5.5 mEq: extreme muscle weakness, abnormal heart rhythm, possible cardiac
arrest
Signs and symptoms of hypokalemia < 3.5 mEq: fatigue, muscle weakness, paralysis, respiratory failure, cardiac
instability, arrhythmias, cardiac arrest
What are the kidneys endocrine functions Renin secretion, Erythropoeitin secretion, Vit D Activation
How do we replace normal endocrine kidney functions Provide medications
How much of normal kidney function is replaced by 15%
hemodialysis
What is uremia and how does it affect the body? Uremia is a buildup of wastes in the blood due to kidney failure and affects all body
systems.
What are the most common causes of CKD in the usa? Diabetes
Hypertension
Polycystic Kidney Disease
Outline the treatment goals for a patient with CKD -slowing the progression of ckd
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects of ckd on patients' lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Stuvia 2026-2027
, DAVITA FINAL EXAM _ ALL QUESTIONS AND CORRECT ANSWERS
Why is it important to know what caused your patients So the nurse and PCT can inquire about possible problems during data collection
CKD and assessment
Why is sodium balance important? Leads to volume expansion, increased cardiac output, increased peripheral
vascular resistance, and increased blood pressure
Signs and symptoms of fluid imbalance Edema, hypertension, shortness of breath
Systemic effects of CKD what would you advise for a Use hyper-fatted soaps and lotions, monitor patient for changes in motor function
patient who complains of: dry itchy skin, peripheral and inform RN and physician of any bleeding problems/constipation/diarrhea
neuropathy(nerve pain in extremities) and gi problems
What is the consequences of prolonged fluid overload and Left ventricular hypertrophy
hypertension
What is Percarditis? Inflammation of the membrane (pericardial sac) around the heart
What is a common cause of hypertension in dialysis fluid overload
patients
Left ventricular hypertrophy leads to Ischemic heart disease, arrhythmia, myocardial infarction, and sudden death
Why are dialysis patients anemic? 1. the lifespan of their red blood cell is 60 days 1/2 of the normal 120 days.
What can you do to avoid contributing to lower hemoglobin Verify correct Erythropoietin Stimulating Agent (ESA) dose is administered, rinse
and blood loss in dialysis patients back until venous line is pink tinged, and avoid repeat lab draws
What are the 4 key elements contributing to CKD-mineral 1. Calcium
bone disorder(MBD) 2. Phosphorus
3. PTH
4. Vitamin D (Calcitriol)
What are the symptoms of CKD-MBD in addition to bone Soft tissue calcification, itching, muscle weakness, pathological fractures, tendon
disease ruptures, compression of vertebrae, atherosclerosis, heart disease
What is your role in CKD-MBD management report symptoms urge patients to take meds (home & treatment)
*report noncompliance problems related to nonadherence
Define the term AKI - Term incorporates a wide spectrum of kidney issues
- Includes acute kidney failure as well as less catastrophic kidney function changes
- May dialyze in an out-patient facility until kidney function recovers
Give 3 examples of pre-, intra- and post-renal causes of Pre: Obstruction, volume depletion, impaired cardiac function.
AKI Intra: ischemic ATN, sepsis, SIRS, septic shock, anaphylaxis drugs, Goodpasture
Syndrome, Acute Glomerulonephritis, Trauma, open heart surgery.
Post: Obstruction, Oliguric, bladder rupture, pregnancy.
Stuvia 2026-2027
