Fresenius CCHT Exam With Accurate Solution 2023

Fresenius CCHT Exam With Accurate Solution 2023 What bleach solution must all surfaces be cleaned with? - 1:100 What bleach solution is used to disinfect large blood spills? - 1:10 What is aseptic technique? - A set of practices and procedures performed under carefully controlled conditions with the goal of minimizing contamination by pathogens. List three blood borne pathogens that may be found in a dialysis unit? - Hep B, Hep C & HIV What is an exposure incident? - A blood/body fluid splash or spray occurring to the eyes, nose or mouth or to non-intact skin. A contaminated sharps injury is also considered an exposure incident. What steps should you take during an exposure incident? - 1. Wash/rinse the area 2. Report incident to the clinical manager or charge nurse (if CM not present) 3. Seek medical treatment w/in 1-2 hrs (exposure tx and counseling) 4.OSHA documentation and workman's comp documentation as applies Why are Hep B patients dialyzed in isolation rooms? - -Hep B is extremely contagious -It can live outside the body for up to 7 days Why are Hep C patients dialyzed in the clinic area and not in isolation? - -Hep C is not as contagious as Hep B -It does not survive very long on the outside of the body What blood test indicates infection with Hep B? - HbsAg is the test for the Hep B antigen. This indicates actual viral presence. Which blood test indicates the presence of immunity against Hep B? - HbsAb is the test for the antibodies. It indicates the presence of immunity against Hepatitis B. Which vaccine provides long-term immunity to Hep B? - Multiple injections of either Recombivax or Engerix vaccine. They help produce Hep B antibodies How is TB spread? - Airborne droplets from infected individuals How do you prevent TB in the clinic? - Active TB patients cannot dialyze in clinics. Pt must have 3 consecutive negative sputum cultures before the can return dialyzing in clinic. What are VRE & MRSA? - VRE: a group of gram-negative bacteria that lve in he intestinal tract that can cause infection anywhere in the body. They are resistant to several antibiotics. VRE can survive outside of the body on surfaces for as long as seven days. MRSA: different varieties staph bacteria. They are normally found on the skin or in the nose of about 1/3 of people. When a person is infected they are resistant to antibiotics commonly used to treat ordinary staph infections. MRSA can survive outside the body for as long as 7 days. What precautions do you take while caring for a MRSA/VRE patient? - They do not need isolation but should be seated in the same area as others infected. Proper designated PPE should be worn specifically for those patients. HANDWASHING only 40-60 seconds. They need to have their own bp cuff, stethoscope, tourniquet etc. Open wounds/ dressing should never be changed in the clinic. CVC dressings should be disposed of in sharp container. What are the anatomical structures of the urnary system in order of urine flow? - 1. 2 Kidneys 2. 2 Ureters 3. Bladder 4. Urethra What are the functions of a healthy kidney? - -remove waste -remove fluids -regulate pH -regulate electrolytes What are the hormonal functions of the kidneys? - -release renin to help regulate or control BP, potassium and sodium -production of erythropoietin: stimulates RBC production -regulation of calcium/phosphorus balance through activation of Vitamin D What is the nephron and what is its function? - It is the functional unit of the kidney. It filters blood from the urine. What is the glomerulus and what is its function? - It is at the beginning of the nephron, it's a network of capillaries that performs the first step of filtering the blood. It filters water and solutes into Bowman's capsule. What two functions of healthy kidneys can be replaced by dialysis? - -fluid removal -cleaning of wastes What is the difference between acute renal failure and chronic renal failure? - Acute: sudden rapid onset; severe but often reversible Chronic: slow, progressive and premanent What are three common causes of renal failure? - 1.Diabetic nephropathy or glomeruloscerosis 2. Hypertension 3. Glomerulonephritis What are classic signs and symptoms of renal failure or uremia? - -Elevated serum levels of BUN/Creatinine, potassium, phosphous -Anemia -Fluid overload -Lethargy -Weakness -Headache -Edema -Yellow-Gray appearance of the skin -High BP - Itching -Loss of appetite -Fatigue -Nausea -Restlessness -Mental Changes -SOB -Proteinuria -Nerve Damage What is GFR? - It describes the flow rate of filtered fluid through the kidney. What are the 5 stages of GFR? - 1. Normal kidney function but urine or other abnormalities point to kidney disease: 90% + 2. Mildly reduced kidney function, urine or other abnormalities point to kidney disease: 60-89% 3. Moderately reduced kidney function: 30-59% 4. Severely reduced kidney function: 15-29 % 5. Very severely reduced kidney function (CKD): 15% What is homeostasis when referred to a dialysis patient? - When pt's electolytes are kept within certain ranges. It is the steady internal state of equilibrium in the body. Which is regulated by a working kidney or a dialyzer. What are the kidneys four functions? - 1. Excretory: rid body of wastes, fluids and electrolytes 2. Regulatory: maintaining acid/base balance 3. Filtration: nephrons retain some things and filter out and reabsorb others 4. Endocrine: hormonal production What does renal failure/uremia do to the digestive tract? - Causes nausea/vomiting/diarrhea, loss of appetite What does renal failure/uremia do to the skin? - dry, itchy, darkened What does renal failure/uremia do to the cardiovascular system? - -Potassium causes muscle weakness including heart weakness which can lead to arrhythmias, cardiac arrest and death -Erythropoietin leads to RBC production in the bone marrow (primary cause of anemia in ESRD patients) -Fluid can cause increased BP and edema What does renal failure/uremia do to the skeletal system? - With Calcitriol there is decreased absorption of calcium from the gut. The parathyroid hormone (PTH) also rises as a result. In order to keep blood Ca within a normal range, Ca is taken from the bones (due to elevated PTH) causing weak and brittle bones. Ca then combines with Phosphorus and deposits in soft tissue. What does renal failure/uremia do to the lungs? - Fluid in the lungs causes shortness of breath and also puts the patient at risk for pulmonary infection.