NURSING Dialysis questions and answers 100% verified.

NURSING Dialysis questions and answers 100% verified. Who first described Dialysis? - correct answers.Thomas Graham in 1854 Who first described renal failure? - correct answers.Richard bright Who was the first MD to perform HD(hemodialysis) on a patient? - correct answers.George Haas 1924 Who is considered the father of dialysis? - correct answers.Willem Kollf Why is Willem Kollf considered the father of dialysis? - correct answers.He is responsible for the first artificial dialyzer and blue print for the first Dialysis machine What regulatory function does the kidneys serve in the body? - correct answers.The kidneys regulate fluid balance, electrolyte balance, and Acid/Base balance What hormonal function do the kidneys serve? - correct answers.-RBC production(erythropoietin) -Blood pressure (renin/prostoglandins/bradykinin) -Vitamin D activation What is Chronic Kidney Disease(CKD)? - correct answers.Chronic kidney disease is anything that damages the kidneys over a period of time. Does CKD require dialysis? - correct answers.No, the kidneys are damaged but still function. What will most patients with CKD eventually lead to? - correct answers.End Stage Renal Disease (ESRD) What is ESRD? - correct answers.This is when the kidneys do not function well enough to sustain life. What needs to happen for someone with ESRD to sustain life? - correct answers.The person needs a Kidney Transplant or Dialysis to sustain life. What are some causes of CKD and ESRD? - correct answers.- Diabetes - High Blood Pressure - Nephritis - Medications(nephrotoxic) - Injuries - PKD(polycystic kidney disease) What are some goals of hemodialysis? - correct answers.-Remove excess fluid from the blood -balance blood electrolytes -rid the body of unwanted waste How is hemodialysis achieved? - correct answers.It uses a semipermeable membrane, diffusion, osmosis, ultrafiltration and convection to clean the blood. How do we know a patient is ready for dialysis? - correct answers.The MD will at the GFR less than 15 require dialysis Can a patient going through Acute Renal Failure(ARF) go through dialysis? - correct answers.Yes, to regain function. How do we know if an ARF patient is regaining function? - correct answers.The MD will look at the electrolytes, GFR and creatinine to determine if the patient is stable enough. (not in our scope of practice but good to know) In- Center Hemodialysis - correct answers.Im guessing this a walk-in dialysis place How many times does a patient come in for treatment at a dialysis center? - correct answers.3 times a week for 3-4 hours What must the patient have in order to revive dialysis? - correct answers.Must have an access point for dialysis such as a AV fistula, Graft, or Central Venous Catheter(CVC). What happens during dialysis? - correct answers.A patient is hooked up to a Hemodialysis machine that circulates blood through an artificial kidney(dialyzer) What medications does a patient receive while at the center? - correct answers.Receives medication for hormones no longer secreted. What would a patient receive during dialysis to prevent clots? - correct answers.Heparin before and maybe during. How do we know what levels to run the dialysis machine at? - correct answers.Labs are monitored to adjust dose of dialysis and hormone medication. Who are the dialysis patients able to talk to while at the center? - correct answers.Dietician and Social worker each treatment. How many times does the patient see the NP? - correct answers.Weekly How many times does the patient see the MD? - correct answers.Monthly In-Patient Dialysis - correct hospital Who may require emergency dialysis when they come into the hospital? - correct answers.A patient with ARF/AKI may require emergency dialysis. What are 2 things that may require dialysis for a patient in the hospital? - correct answers.-Crushing injuries(potassium is to high) -Over doses- substance must dialyzable(lithium/ salicylic acid) What happens if a patient is non-compliant with out patient dialysis? - correct answers.They may go In patient for treatment because of fluid over-load Who are some people that may require in-patient dialysis? - correct answers.-Patients with other co-morbity - May run shorter more frequent treatments(2hours a day to pull more fluid off) - Patient is unstable and requires 1:1 care -Some not diagnosed with ESRD - Patient receiving first dialysis treatment What does the dialysis machine deliver to the patient? - correct answers.Delivers Dialysate and Dialysis quality water What does the dialysis machine monitor? - correct answers.-B/P -Monitors high and low pressures related to blood flow from the dialysis access What medication does the machine deliver while the patient is receiving dialysis? - correct answers.Heparin to prevent clotting What information does the machine collect? - correct answers.Collects data during HD treatment to be used to calculate the HD prescription for the patient Dialysis access - correct la, graft, cvc What are some advantages to a Artery Venous Fistula(AVF) - correct answers.- patients own artery and vein are used - less risk for infection - less chance of clotting -can last for many years What size needles are usually used during dialysis? - correct answers.Needles range from 17 gauge to 14 gauge needles After an AVF fistula is put in how long does the patient have to wait before it can be used? - correct answers.The healing process can take up to 12 weeks What are some disadvantages of a AVF? - correct answers.- Appearance - Maturation time What are 2 locations for a AVF? - correct answers.Forearm AVF and Upper armAVF What are some advantages to a Artery Venous Graft(AVG)? - correct answers.- Can be used 1-2 weeks after placement What are some disadvantages of a AVG? - correct answers.- MUCH Higher risk for infection and clotting - Doesn't last as long as AVF What is the advantage of a CVC? - correct answers.- Can be used immediately after placement is confirmed - No bleeding time after treatment What are disadvantages of a CVC? - correct answers.- HIGH risk for infection - Increased risk for clotting - Does not always function properly - Cannot achieve BFR(blood flow rate), Patient does not receive good dialysis What is the dialyzer on a Hemodialysis machine? - correct answers.Acts as a artificial kidney to rid the blood of excess water and toxins What is the dialyzer made out of? - correct answers.Thousands of specials fibers made of a special material that acts as a semipermeable membrane that filters blood Can you use a dialyzer more than once? - correct answers.Most places discard the dialyzer after one use but you can reprocess the dialyzer in a process known as "RE-USE". How do we surround the blood with the dialysate in the dialyzer? - correct answers.A counter current flow is used If the dialyzer is re-used how is it cleaned? - correct answers.After each use, the patients dialyzer is sterilized with Renalin and other chemicals and then rinsed prior to next use What is Renalin? - correct answers.An Environmental Protection Agency (EPA) registered sterilant composed of hydrogen peroxide, peracetic acid, acetic acid, and water. Is the dialyzer a one size fits all for every patient? - correct answers.NO, comes in different sizes which have different surface areas. What does more surface area on a dialyzer cause? - correct answers.More surface area means more waste can be removed, which means better dialysis for the patient Does RBCs and proteins cross the membrane on the dialyzer? - correct answers.NO What is dialysate? - correct answers.It is a mixture of Dialysis quality water, an acid concentrate solution, and a bicarb solution to buffer the acid What is the acid concentration made of? - correct answers.Made of electrolytes: Calcium, Sodium, Potassium, Magnesium, Chloride, and Glucose What concentrations can change depending on the patients needs? - correct answers.Can have different concentrations of potassium and calcium depending on patients needs What is another name for Dialysate solutions? - correct answers.The Bath Dialysis Quality Water!!! - correct answers.WOOO YEAH YOU F*&%%S How much water makes up dialysate? - correct answers.90% How do we make dialysate water? - correct answers.Through a series of Filters. We treat the city water to remove particles like sand, silt, bacteria, viruses, endotoxins and other particles to protect the patients and equipment we use. How do we "soften" dialysate water? - correct answers.We soften the water by removing calcium and magnesium What is removed from the water that could cause hemolysis during HD? - correct answers.Chlorine and Chloramines are removed which could cause hemolysis if our patients are exposed to them. How are we sure we are getting the proper quality of water to the dialysis patient? - correct answers.Centers are set-up to monitor and check to make sure that only dialysis water is being used What do the nurses do during dialysis to check on the water? - correct answers.We check every 3 hors to make sure the carbon filters are functioning and removing the Chlorine and Chloramines What could happen if the chlorine and chloramines are not removed during HD? - correct answers.The patient can suffer hypotension, N/V, hemolysis, fever, and chills Who sets the standard for Dialysis water? - correct answers.The Association for the Advancement of Medical Instrumentation (AAMI) sets the standards of allowable contaminants in water used for Dialysis. What is the role of the dialysis nurse? - correct answers.-Assessment pre/post -prescription verification -intradialytic monitoring -med administrations -education(non-compliance) -referrals for co-morbidities What are 5 things we check pre and post assessment? - correct answers.1.) Pre-weight- IDWG-EDW 2.) Vitals