Davita PCT Exam with 100% Correct Answers 2022-23

What is important when monitoring weight and BP for acute patients? - Correct answerkeep patients wet to avoid hypotensive episodes What do you need to consider in regards to acute patents vascular access? - Correct answer-Usually have a CVC - follow policy and procedure to prevent infections Why is it important to know what caused your patient's CKD? - Correct answer-to inquire about possible problems during data collection and assessments Kt/V: What is K? - Correct answer-clearance of urea What treatment factors decrease K? - Correct answer-not waiting 3-5 minutes after giving heparin with treatment initiation to prevent clotting What factors influence V (volume)? - Correct answer-sex, age, weight, height, amputations Needle gauge and suggested BFR - Correct answer-17: 200-250 16: 250-350 15: 350-450 14: 450 What do you do if a patient wants to get off early? - Correct answer-educate and document, still draw lab on habitual patients, MUST NOTIFY NURSE Lab draw mistakes that would falsely increase Kt/V - Correct answer-not waiting the full 15 seconds to draw the BUN What is the role of the PCT prior to treatment initiation? - Correct answer-DATA COLLECTION Squeezing the BP cuff can damage the machine: T/F - Correct answer-True 4 reasons we document in the medical record - Correct answer-1. proof that care was rendered 2. provides data continuity and planning of patient care 3. permanent legal record 4. communication tool Pre-treatment patient data collection/assessment - Correct answer-Data collection: before initiation Assessment: 30 minutes into treatment Post treatment data collection/assessments - Correct answer-after treatment -NOT DURING RINSEBACK What are possible consequences of poor or incomplete documentation - Correct answer-attack on your care What are the six items included in charting administered medications? - Correct answerREASON FOR ADMINISTERING What are the 5 W's to be used when completing an AOR - Correct answer-who should report an AOR what type of incident when should it be reported where should they be reported why What are the four consequences of sodium loading during dialysis? - Correct answerThirsty Increase Fluid Intake Increased intradialytic weight gain Increased ultrafiltration rate What is the purpose of UF profiling? - Correct answer-fit to the patient to prevent crashing and allow for vascular refill Why do we measure the pH in the dialysate - Correct answer-to verify acid-base balance is within an acceptable range Conductivity and pH alarm causes - Correct answer-no concentrate improper bicarb calcium or magnesium precipitate line of filter occlusion from debris improper calibration Temperature alarm causes - Correct answer-lower temperature, increases BP hemolysis occurs at 42 degrees calcium which releases potassium Power - Correct answer-the appropriate intervention is to remove venous line from air detector clamp before starting hand crank Arterial Pressure High alarm causes - Correct answer-separation of tubing Venous pressure high alarm causes - Correct answer-kink in tubing infiltration clotting in the venous drip chamber Davita Quality Index - Correct answer-the purpose of selecting the component measure for DQI is to encourage continuous improvement across a broad range of disease management processes DQI success is achieved by - Correct answer--managing individual patients first and allowing scores to follow -knowing each team members role and improving DQI scores -using the CQI (continuous quality improvement) process to help identify trends and make improvements (answer all of the above) Importance of P&P - Correct answer-when supervising non-licensed, assistive personnel, it is the responsibility of the licensed nurse to ensure these teammates also meet the standard of care What are the risks of doing it your way - Correct answer-it can lead to civil liability What makes dialysis patients more susceptible to HAIs? - Correct answer-they have weakened immune systems and prolonged access to blood Why are dialysis patients at increased risk for acquiring a HAI at the facility? - Correct answer-CONTACT TRANSMISSION what is the most common transmission route for HAIs? - Correct answer-contact transmission What is the most important intervention you can do to prevent HAIs? - Correct answerHand washing What is the most common infectious complication in hemodialysis patients? - Correct answer-Per the CDC, the most common factor contributing to bacteremia is CVC What germ causes the most common infections in hemodialysis patients? - Correct answer-MRSA Why is wearing gloves so important? - Correct answer-Decreases risk of hand contamination Who can use sinks designated for hand washing? - Correct answer-clean sinks must be dedicated for hand washing only What is the correct procedure in regards to your hands when you have casual contact with a patient? - Correct answer-don't need to have gloves but must perform hand hygiene before caring for patients Successful Lab draws - Correct answer-know the 20 tips -follow the order of the lan draws to prevent specimens from being contaminated with other tube additives -double labeling tubes prohibits processing rules for spinning samples - Correct answer-only spin tubes of same kind, size, and fill level and should be placed opposite of each other hyperkalemia - Correct answer-potassium above 6.5 extreme muscle weakness cardiac arrest What is the primary cause patients are anemic? - Correct answer-decreased production of Erythropoietin How can you print contributing to blood loss? - Correct answer-adequate heparinization What is pericarditis? - Correct answer-inflammation of sac around the heart What is included in pericarditis treatment? - Correct answer-RESTRICTION OF HEPARIN more/adequate dialysis What to use for Dry, itchy skin - Correct answer-hyper fatted soaps and lotions Peripheral neuropathy - Correct answer-educate patient about good shoes, look at feet, don't go barefoot -can't feel sores What are the four key elements affected in CKD-MBD? - Correct answer-calcium phosphorus parathyroid hormone calcitriol (vitamin D) What are symptoms of CKD-MBD in addition to bone disease? - Correct answer-severe itching, muscle weakness CALCIFICATION OF SOFT TISSUE What is your role in CKD-MBD management? - Correct answer-encourage patients to take binders with their food! talks to patients and listen to them!