Dialysis exam questions with correct answers

AKI pts are at increased r/f which complication - Answer- Infx due to CVC Why is it important to know what caused your pts AKI - Answer- To be able to recognize complications and how to tx. Ask pt during assessments and data collection Diabetes HTN PKD other Why don't you wank ALI pt to be hypotensive - Answer- Kidney would be further damaged Kt/V - Answer- A measurement of the removal of urea from the patient's blood over time KT/V....K is improved by - Answer- Adequate coagulation Priming by p&p Correct pump speed and UF goal in KT/V what is K? - Answer- Clearance of urea What treatment factors decrease k - Answer- Not waiting 3-5 min after administering Heparin to start tx Priming incorrectly BFR clotting Low dialysis flow rate What influences k clearance of urea - Answer- Adequate anticoagulantion Kt/V what is t - Answer- Time of dialysis session Kt/v what factors influence t - Answer- Blood contact time will be affected by time on machine Kt/v is less than 1.2 max is 1.8 More frequent or extra treatments Kt/v... what is v - Answer- Total volume of the pts body water in which area is distributed Kt/v... what influences v - Answer- A persons height weight sex age in amputations or included in calculating. On average a persons body is composed of 50 to 55% water 17 gauge needle - Answer- 200 - 250 bfr 16 gauge needle - Answer- 250 - 350 bfr Neurologist orders a BFR of 300. What gauge of needle to use - Answer- 16 15 gauge needle - Answer- 350 - 450 bfr 14 gauge needle - Answer- greater than 450 bfr Procedure for post BUN lab draws - Answer- UF off or decrease to 50 ml/hr Decrease DFR to 300 or bypass Reduce BFR to 100 Wait 15 seconds for AVF/AVG and CVC **take sample from arterial Lab draws mistakes that would falsely increase Kt/V - Answer- Not waiting 15 seconds or waiting only 5 seconds Not reducing BFR Drawling from venous blood line (came right out dialyzer) Lab draw mistakes that would falsely decrease Kt/V - Answer- Waiting longer than 15 seconds Diluting the pre-treatment arterial BUN blood sample with Saline When is a pre-treatment assessment by the licensed nurse required - Answer- AKI pt Every patient that the RN puts on When it is mandated by state. When the PCT performing a data collection notices abnormal findings. When the patient reports unusual symptoms to the nurse prior to treatment initiation. When the nurse observes unusual behavior in a patient entering the treatment floor. Cuff size too small would give what type of reading - Answer- False hypertension Cuff size too large would give what type of reading - Answer- False hypotension What is the purpose of DaVita Quality Index - Answer- Provides a powerful tool for assessing facility performance and improving the lives of patients. It does not contain every measure and aspect important to patient's health and well-being however, the component measures for DQI are selected to encourage continuous improvement across a broad range of disease managing process DQI success is achieved by - Answer- managing individual Patient First and allowing scores to follow knowing each team members role in improving dqi scores Why do we document in the medical record - Answer- proof of care data continuity permanent legal record communication What are the consequences and risks of hypovolemia during the treatment - Answer- Ischemia and damage to vital organs Loss of residual renal failure Increased mortality rate, less blood going to organs Prevent hypotension episodes- hypotension decreases blood flow to vital organs Can you exceed 13 ml/kg/hr? - Answer- No, reassess goal HTN is a sign of - Answer- Fluid overload, hypervolemia LVH (left ventricular hypertrophy) - Answer- increase in thickness of myocardial wall that occurs when the heart pumps against chronic outflow obstruction (e.g., aortic stenosis) Arterial pressure more negative (high alarm) cause - Answer- Occlusion, kink, clot, needle pressing on wall, clamp still clamped, sucking so hard causes hemolysis, hypotension, inflow stenosis INTERVENTION- stop tx assess problem trouble shoot Arterial pressure more positive(closer to zero) (low alarm) cause - Answer- Disconnect, lower flow rate, needle fell out, desperation of tubing, decrease in blood pump speed(BFR) INTERVENTION- stop to assess problem trouble shoot Arterial pulls hard/ works hard- working hard is a negative thing - Answer- Venous pushes/ positive- pushing is easier so it's a positive experience - Answer- venous pressure high alarm cause (further away from 0) - Answer- Infiltration, clot, kink, clamp, CVC not working well, clot in chamber, poor needle placement, increase in BFR Intervention- D/c tx, assess, trouble shoot Venous pressure low alarm cause (closer to 0) - Answer- Needle out, saline infusion, disconnect line, decrease in BFR( if BFR changes venous pressure will change Intervention- D/c tx, assess, trouble shoot Conductivity - Answer- 13-15.5 Myronel - Answer- +or-0.4 Acid - Answer- 6.9-7.6 If conductivity is off what will happen - Answer- Hemolysis What is the primary cause for conductivity - Answer- Sodium Why would a cooler bath be ordered - Answer- Increase BP during tx because it causes vasoconstriction What do you do in the event of a power failure - Answer- Figure out cause, terminate tx, return blood w/ hand, remove venous line from clamp, manually return blood and look for air bubbles Can a teammate caring for one or more HBsAg+ patients care simultaneously for susceptible patients - Answer- A teammate m