DAVITA EXAM MODULE 1 QUESTIONS WITH CORRECT ANSWERS

Ultrafiltration definition - (Fluid movement) Controlled fluid removal by manipulation of hydrostatic pressure Convection definition - (Particle/solute movement) Solutes are dragged across the semipermeable membrane along with fluid Diffusion definition - (Particle/solute movement) Particles move from an area of higher solute concentration to lower solute concentration Osmosis definition - (Fluid movement) fluid moves from lower solute concentration to higher solute concentration What are the kidney's excretory functions? - Water removal, electrolyte balance, toxin removal and acid base balance How do we replace normal excretory kidney functions? - By normalizing the electrolytes and providing fluid balance through ultrafiltration What is the function of the acid concentrate? - It provides the concentration gradient for diffusion What is the function of bicarbonate in the dialysate solution? - It buffers the acid concentrate What is the function of bicarbonate when it diffuses into the patient's blood? - It normalizes the patients body temp ph in the blood stream (7.35-7.45) Signs and symptoms of Hyperkalemia - Greater than 6.5 EXTREME muscles weakness and abnormal heart rhythm Signs and symptoms of Hypokalemia - Less than 3.5; fatigue, muscle weakness, irregular heart rhythm and cardiac instability What are the kidneys' endocrine functions? - Blood pressure regulation (Renin), Erythropoiesis (helps prevent anemia), and vitamin D activation (calcium/phosphorus) How do we replace normal endocrine kidney functions? - Give them their meds How much of normal kidney function is replaced by hemodialysis? - 15% What is uremia and what does it affect? - It's the build up of waste products in the blood due to kidney failure and it affects all body symptoms What are the most common causes for CKD in the USA? - Diabetes and hypertension Outline the treatment goals for a patient with CKD - Acid base balance, fluid removal, electrolyte balance and toxin removal Why is it important to know what caused your patients CKD - So the nurse and pct can inquire about possible problems during data collection and assessment Signs and symptoms of fluid balance - Hypertension (high BP), swelling or edema, and shortness of breathe Why is sodium balance important? - Sodium creates thirst which leads to volume expansion, increases the bp, LVH, leads to higher mortality rate Advice for a pt that complains of dry, itchy skin - Hyper fatty soaps and lotion, emotional support Peripheral neuropathy (nerve pain in the extremities) - Advise not to walk barefoot, bath water temp GI problems (nausea/vomiting) - Get nurse involved Psychological problems (anxiety/depression) - Get it up to the social worker What does hypertension lead to? - Left ventricular hypertrophy (LVH) What is pericarditis? - Inflammation of the membrane (pericardiosack) What is included in pericarditis treatment? - Decrease or stop heparin or give more dialysis Why are dialysis patients anemic? (Primary cause) - Lack of Erythropoietin Secondary causes of anemic pts - Inadequate dialysis and blood loss during treatment