Hemodialysis Study Guide #2-Graded A
What treatment complication could cause hemolysis? - ANS-Inadequately treated water.
Signs and symptoms of hemolysis may include: - ANS-Translucent and cranberry
colored blood, chest pain, feeling of warmth, shortness of breath.
Hemolysis is a rupture or destruction of red blood cells and is a potentially life
threatening event. What interventions should be followed if hemolysis is suspected? -
ANS-Clamp lines, turn off blood pump, and notify the RN/MD.
Which of the following may result in clotting of the extracorporeal circuit? - ANS-Priming
dialyzer at 300ml/min, failure to respond to machine alarms, decreasing KECN values,
inadequate heparinization.
Which of the following answers below is indicative of a patient having immunity against
Hepatitis B? - ANS-HbsAb+.
What is the function of the water softener? - ANS-Remove calcium and magnesium ions
and replace with sodium ions.
Which value below would be an acceptable level for the total chlorine (TCL-1 log) test? -
ANS-0.08.
Mr. Spaghetti has an EDW of 112kg. Today, he came into treatment weighing 116kg.
He is receiving an antibiotic, vancomycin (150ml bag), due to a catheter related
infection. The saline rinseback at his unit is 400ml total. Which number below is Mr.
Spaghetti's target fluid removal goal? - ANS-4550ml.
Urea is a waste product that is removed from dialysis patients. It is a solute that cannot
be measured by the dialysis machine. Which electrolyte is used to estimate a patient's
clearance in place of urea? - ANS-Sodium.
ESRD patients should avoid or eat in limited quantities foods that are high in potassium,
phosphorus, and sodium. Which list of foods below would be inappropriate for a dialysis
patient? - ANS-Lunchmeat, cola, chocolate, tomatoes, oranges.
What is the minimum required RO percent rejection that is safe to use with patients? -
ANS-80%
What is the function of carbon tanks? - ANS-Remove chlorine and chloramines.
, What cannulating a patient it is important to rotate sites in order to avoid access
problems and prolong the life of the patient's access. It is also important to do the
following: - ANS-Ensure needle tips are 1 to 2 inches apart.
What are the appropriate steps for drawing a post BUN sample? - ANS-Turn UF and
DFR off, BFR to 100ml/min for 15 seconds, stop pump, clamp patient lines, collect
sample from arterial port.
Mrs. Velveeta began her treatment with the following vital signs: BP 180/90, HR=80,
Temp=98.6, R=20. The RN set her fluid removal goal for 2500ml to be removed in 3
hours 45 minutes. Thirty minutes into her treatment, Mrs. Velveeta's blood pressure
dropped down to 100/60, is having complaints of blurred vision, and is sweating
profusely. What is the appropriate intervention in this situation? - ANS-Administer
normal saline bolus, place patient in reclining position, turn the UF down or off, notify
the nurse.
What is the number 1 infection control practice known to reduce the transmission of
disease? - ANS-Handwashing.
Patients positive for hepatitis B must dialyze in an isolation room, what is the
appropriate practice for a patient with MRSA? - ANS-Patient must be placed in a low
traffic area as possible with dedicated equipment.
What is the functional unit of the kidney? - ANS-Nephrons.
What electrolyte below has the potential to cause cardiac dysrhythmias or cardiac
arrest? - ANS-Potassium.
What is difussion? - ANS-Movement of solutes from an area of higher concentration an
area of lower concentration.
In dialysis, ultrafiltration is used to remove fluid. Which description listed below is
consistent with the process of ultrafiltration? - ANS-Use of negative and positive
pressure to pull excess fluid.
What is the appropriate intervention for an air embolism? - ANS-Clamp venous line, turn
blood pump off, left side, trendelenburg.
Which intervention should NOT be used if an air embolism is suspected? - ANS-Right
side.
Falling KECNs are an indication that the patient is: - ANS-Clotting, inadequately
heparinized.
If the dialysis water system doesn't remove chlorines and chloramines, what adverse
event could occur during a patient's treatment? - ANS-Hemolysis.
What treatment complication could cause hemolysis? - ANS-Inadequately treated water.
Signs and symptoms of hemolysis may include: - ANS-Translucent and cranberry
colored blood, chest pain, feeling of warmth, shortness of breath.
Hemolysis is a rupture or destruction of red blood cells and is a potentially life
threatening event. What interventions should be followed if hemolysis is suspected? -
ANS-Clamp lines, turn off blood pump, and notify the RN/MD.
Which of the following may result in clotting of the extracorporeal circuit? - ANS-Priming
dialyzer at 300ml/min, failure to respond to machine alarms, decreasing KECN values,
inadequate heparinization.
Which of the following answers below is indicative of a patient having immunity against
Hepatitis B? - ANS-HbsAb+.
What is the function of the water softener? - ANS-Remove calcium and magnesium ions
and replace with sodium ions.
Which value below would be an acceptable level for the total chlorine (TCL-1 log) test? -
ANS-0.08.
Mr. Spaghetti has an EDW of 112kg. Today, he came into treatment weighing 116kg.
He is receiving an antibiotic, vancomycin (150ml bag), due to a catheter related
infection. The saline rinseback at his unit is 400ml total. Which number below is Mr.
Spaghetti's target fluid removal goal? - ANS-4550ml.
Urea is a waste product that is removed from dialysis patients. It is a solute that cannot
be measured by the dialysis machine. Which electrolyte is used to estimate a patient's
clearance in place of urea? - ANS-Sodium.
ESRD patients should avoid or eat in limited quantities foods that are high in potassium,
phosphorus, and sodium. Which list of foods below would be inappropriate for a dialysis
patient? - ANS-Lunchmeat, cola, chocolate, tomatoes, oranges.
What is the minimum required RO percent rejection that is safe to use with patients? -
ANS-80%
What is the function of carbon tanks? - ANS-Remove chlorine and chloramines.
, What cannulating a patient it is important to rotate sites in order to avoid access
problems and prolong the life of the patient's access. It is also important to do the
following: - ANS-Ensure needle tips are 1 to 2 inches apart.
What are the appropriate steps for drawing a post BUN sample? - ANS-Turn UF and
DFR off, BFR to 100ml/min for 15 seconds, stop pump, clamp patient lines, collect
sample from arterial port.
Mrs. Velveeta began her treatment with the following vital signs: BP 180/90, HR=80,
Temp=98.6, R=20. The RN set her fluid removal goal for 2500ml to be removed in 3
hours 45 minutes. Thirty minutes into her treatment, Mrs. Velveeta's blood pressure
dropped down to 100/60, is having complaints of blurred vision, and is sweating
profusely. What is the appropriate intervention in this situation? - ANS-Administer
normal saline bolus, place patient in reclining position, turn the UF down or off, notify
the nurse.
What is the number 1 infection control practice known to reduce the transmission of
disease? - ANS-Handwashing.
Patients positive for hepatitis B must dialyze in an isolation room, what is the
appropriate practice for a patient with MRSA? - ANS-Patient must be placed in a low
traffic area as possible with dedicated equipment.
What is the functional unit of the kidney? - ANS-Nephrons.
What electrolyte below has the potential to cause cardiac dysrhythmias or cardiac
arrest? - ANS-Potassium.
What is difussion? - ANS-Movement of solutes from an area of higher concentration an
area of lower concentration.
In dialysis, ultrafiltration is used to remove fluid. Which description listed below is
consistent with the process of ultrafiltration? - ANS-Use of negative and positive
pressure to pull excess fluid.
What is the appropriate intervention for an air embolism? - ANS-Clamp venous line, turn
blood pump off, left side, trendelenburg.
Which intervention should NOT be used if an air embolism is suspected? - ANS-Right
side.
Falling KECNs are an indication that the patient is: - ANS-Clotting, inadequately
heparinized.
If the dialysis water system doesn't remove chlorines and chloramines, what adverse
event could occur during a patient's treatment? - ANS-Hemolysis.
