Bonent CDC Questions and Answers 100% Pass

Bonent CDC Questions and Answers 100% Pass How to manage Pericarditis: controlled heparinization, increased frequency of dialysis, use of anti-inflammatory drugs A pt telephones the clinic to c/o s.o.b. this symptom is indicative of what? fluid overload Which organization is primarily concerned with providing the unit staff with educational oppotunities? Council of Nephrology Nurses and Technicians of the National Kidney Foundation All of these are essential to the successful completion of a research project:. review literature in the problem area, problem definition, obtaining permission of the unit manager and study subjects When a pyrogenic reaction occurs, the water tx system should be cultured for: gram-negative bacteria If a dialysys machine has been disinfected with formaldehyde, it is important to test the for residual formaldehyde after rinsing to minimize the risk of : pt exposure to formaldehyde In hemodialysis, the most commonly used volume expander is 0.9% NaCI. If this solution has the same effective osmolality as body fluids it is called: Isotonic A possible sequela of hep B is : Pancreatitis in the event of a MAJOR fire is discovered in an area occupied by pt's the first action should be to: remove the pt's The greatest impact on the efficiency and safety of a hemodialysis tx is : educated and motivated staff and properly maintained equipment Homeostasis is best defined as : the steady state of internal enviroment Decreased glomerular filtration rate of the kidney may be due to all of the following: shock, dehydration, cardiac decompensation Hemolysis of red blood cells will occur will occur if: Hyperthermic fluid is delivered to the dialyzer The goal of anticoagulation in dialysis is to maintain the degree of anticoagulation at: 1.5 to 2 times the baseline clotting studies The normal kidneys compensate for fluid loss by retaining: Sodium and water The primary reason for anemia in chronic renal failure is: decreased erythropoietin production Performance of a creatinine clearance test requires: a timed urine collection and a serum creatinine measurement A cause of hemolysis during dialysis: Improper dialysate preparation Hypertension may be influenced by: Nephrectomy, fluid overload, sodium retention Correct needle placement is important in the initiation of dialysis to minimize the risk of: recirculation, inadequate blood flow, hematoma formation Cylers used for peritoneal dialysis are automatic exchange devices which: regulate instillation and drainage of the dialysis solution The K in Kt/V stands for: Kidney A pt's venous needle falls out the first thing the tech should do is: turn off the blood pump, clamp the venous line, and put pressure on the puncture site The following are potential problems associated with use of bicarbonate dialysis: increase in bacterial growth, dangerous electrolyte concentrations due to concentrate mix ups, precipitation of calcium and magnesium in the delivery system The role of renal dietician is best described as: counseling pt's on the optimum diet for their needs and assisting them in following good dietary habits The half life of heparin is 40-90 mins. The elimination of heparin in dialysis pt's is similar to that of the nonuremic populations. The following is true regarding the effect of heparin in a dialysis tx: the "rebound effect" of heparin metabolism increases the incidence of bleeding in this population Constipation is a common problem for dialysis patients. The primary reason for this is: Medications such as phosphate binders or ferrous sulfate All of th folowing are relevant factors in ensuring accuracy of the clotted line: Temp of the ACT tube, volume of blood in the ACT tube, prompt admixing 0f blood and clotting reagent What is a mannitol used for? To support blood pressure by expanding volume To minimize the risk of injury to improper dialysate, oone step which must be taken by each facility using bicarbaonate is to: use key coded/color coded systems for concentrate containers and concentrate uptake lines The tech is setting up a dialyser, the test for residual sterilant is positive after a 500 cc normal saline had been infused by recirculation, the technician should find this as: Abnormal, rinsing and retesting should be continued per protocol With subclavian catheters, poor blood flow can be caused by all of the following: Vascular spasms, an incorrect cannula lumen size, or incorrect placement of the cannula inside the host vessel The procedure most likely ordered after placement of a subclavian catheter is: a chest X-ray to verify catheter placement Complications associated with arteriovenous fistula for hemodialysis access include all of the following: Thrombosis, infection, stenosis, arterial steal syndrome The total pressure in the blood circuit is a result of all the following: Blood flow rate controlled by the blood pump, resisteance to the flow is the blood circuit, and diameter of the fistula needle, Minimal heparinization should be considered for pt's who have a history of: Menstrual flow, Pericarditis, Active ulcer For a pt's tx session, the blood pump is set at 250ml/mm. The Tech notices that the bloodlines appear to be "jumping". The pre-pump arterial reads -250. In this situation the tech should: Administer a bolus of saline because volume depletion has caused the arterial system to collapse When the hemodialysis machine detects a blood leak, there will be an audio and visual alarm and the: Blood pump will stop The dextrose load from peritoneal dialysis solution can cause: Hyperglycemia Two and one half hours into hemodialysis tx, a pt experiences a drop in his bp. The LEAST common cause of hypotension during dialysis is: Increased dietary intake of sodium An often overlooked pt monitoring technique is: Observing the pt for yawning, warmth, and restlessness The following lab findings is NOT affected by dietary intake andis used as an indicator of renal failure: Creatinine level Clotting of vascular access is sometimes treated with thrombolytic agents or systemic anticoagulants. Nurses and tech's administering hemodialysis treatments to pt's treated with such agents need to be aware of the following potential compication: Hemmorrhage Uremic pericarditis presents as: Dyspnea, chest pain, pericadial friction rub, and uremia The most effective tx for muscle cramping during dialysis tx is to inject a bolus of: Hypertonic saline into the injection port of the venous blood line Chloride is the primary anion in which body fluid compartment: Extracellular Two hours into tz a34 year old femae pt suddenly complains of chest pain, and difficulty breathing. The tech should immediately : check the extracorporeal circuit for the presesnce of air Hemodialysis is accomplished by combination of processes: Osmosis, diffusion, ultrafiltration The best way to establish hemostasis after dialysis is to apply: moderate pressure over the puncture site The BEST way to ensure that the tech's documentation on the pt's flow sheet is complete and accurate: Chart as soon as possible According to Federal law, the reused dialyzer MUST be labeled with the: Pt's name, the number of uses, and date of last reprocessing AAMI standards call for a test to be performed to verify dialyzer performance: For every dialyzer processed Chloramines are MOST EFFECTIVELY removed by the of the following components of the water tx system: Activated carbon According to federal law regarding the handiling of concentrated substances associated with dialyzer reuse, the following ppe should be used: Gloves, eye shield, repirators, and impervious apron Pyrogen reactions usually occur with 45-75 mins after the start of dialysis, the initial pt complaint is: Chills Water used for preparation of dialysis should be analyzed for levela of all chemicals: At least yearly Shortly after the Monday morning dialysis shift begins, three pt's on one side of the unit develop fever, chills and malase. The Nurse in charge suspects bacterial contamination of the water tx system and immediately pages the physician on call the tech should be instructed to do: put all machines in bypass, draw blood cultures, and take samples for cultures from the dialysate and water Key steps in the research process include all of the following: Analyzing data, developing the study design, eliminating unusual variation The best way to disinfect a hemodialysis machine to prevent heavy bacterial growth and build up in the blood detector, pressure reducer and blood pump is to: Use the proper concentrations of disinfecting agents over the recommended period of time The following is recommended by the CDC: Universal isolation practices and segregation of pt's positive for Hep B antigen System of water tx that removes pyrogens as well as solutes is called: Reverse Osmosis The following is responsible for the ultimate disposal of medical waste: the facility at which it originated The maximum allowable electrical leakage from the chassis of a dialysis machine is: 100 microamperes If a high venous pressure monitor alarm occurs during dialysis, the tech should first: Check for an obstruction in the blood system, distal to the monitor site The ultimate responsibilty for maintaining watr purity levels for water used for hemodialysis lies with: Medical Director In selecting a dialyzer for a hemodialysi pt, which of the following is LEAST important: Priming volume The JCAHO requires that dialysis personnel review which of the following annually: evacuation procedures, fire saftey, and cpr techniques One of the dialysate monitoring devices is a conductivity meter or probe that continuously monitors to indicate dialysate: Ionic concentration To prevent hemolysis, the thermal sensor and regulator of the dialysate delivery system should be maintianed to keep the dialysate within a temp range of: 37c to 1c Prior to each tx it is essential to check the sensitivity of the: blood leak alarm Te dextrose concentration of dialysate solution does NOT add to the total ionic content because it: is not ionized A pt complains of excruciating pain at the site of the venous needle when dialysis is begun with a reused dialyzer. The tech's FIRST response should be to: Clamp the venous line and stop the blood pump The destruction of red blood cells that causes the pigment to level the cell and enter the surrounding fluid is known as: Hemolysis When performing emergenct cardiopulmonary resuscitation, attention should be given to the victim's immediate needs in the following order: circulation, airway, breathing In selection and placement of a water treatment components for home hemodialysis installation, a water softener is undesirable as the final purification method because softened water is high in bacterial count and: Sodium Careful rinsing of a reused dialyzer prior to it's being used for a pt is done primarily to remove: residual disinfection solution A flushed sensation, headache, profound thirst and vomitting are all symptoms indicating that the dialysate water is in: magnesium Diffusion is best described as: particles, in solution, moving from an area of high concentration to an area of low concentration until equilibrium is reached Deionization is a type of water treatment used in dialysis that utilizes: Cation and anion exchanges The following element when present at excessive levels in water used in dialysis can induce nausea, vomiting, hypertension, and muscular weakness in a dialysis pt: chloride In treated water meeting AAMI standards, the maximum allowable colony count/ml of bacterial contamination is: 200 A hemodialysis patient who has volume-dependent hypertension will generally be able to control his blood pressure by: maintaining adequate fluid balance and following a proper sodium restriction diet Removal of fluid from the body is accomplished in peritoneal dialysis by the use of: A hyperosmotic dialysis fluid Normal Potassium levels are: 3.5-5.0 mEq/l Normal Sodium levels are: 135-145 mEq/l Normal Phosphous levels are: 2.5-4.5 mEq/l