Questions and Answers
what treatment factors decrease K in the Kt/v to decrease? - correct answer-not waiting 3-5 minutes
after heparin, decreasing BFR, DFR, and BVP
what factors influence "V" in Kt/v - correct answer-accurate data entry by nurses in snappy, sex age,
weight, and amputation
what are the needle gauges and prescribed blood flow rates? - correct answer-they are inversely related
17g 200-250
15g 250-350
15g 350-400
14 g 400 - 450
what is the procedure for post BUN lab draw? - correct answer-if pt wants off early, still draw the labs
and educate patient about the risks. Redraw next time a pt runs full tx to show pt difference
what lab draw mistakes would falsely increase Kt/V - correct answer-not waiting the full 15 seconds
What is important when monitoring weight and BP in AKI patients? - correct answer-keep patients wet
(hydrated) and avoid hypotensive episodes = cause renal ischemia
What do you need to consider in regards to CVCs? - correct answer-follow P&P b/c the risk of infection is
so high
Why is it important to know what caused a patients chronic renal failure? - correct answer-we need to
know about possible problems during data collection and assessment
What is the role of the PCT prior to tx initiation? - correct answer-assessment of pt if any abnormal
findings or if the pt is in an acute condition
what happens in the BP cuff is the wrong size - correct answer-loose BP--> high reading
tight BP --> low reading
why is it so bad to squeeze the BP cuff if its connected to the machine? - correct answer-it can damage
the internal BP mechanism
Why is it so important that we document in the medical record? - correct answer-it provides data for
continuity and planning of care
when do pre-treatment data collection and assessment take place? - correct answer-collection: before tx
assessment: w/in 1 hr if pt is stable
when is post-treatment data collection and assessment performed? - correct answer-post treatment--
not before treatment or when they are disconnected
what are the consequences of poor or incomplete documentation - correct answer-can open attack on
your care
What are the six items needed in charting meds? - correct answer-1. med/dosage
2. date/time
3. route
4. reason (remember this!)
5. pt response
6. signature
What are the 5 Ws to be used when completing an AOR? - correct answer-who
what
when
where
why
how
, What are the 4 consequences of sodium loading during dialysis? - correct answer-1. increased thirst
2. increased fluid intake
3. increased intradialytic weight gain = htn
4. increased UFR
what is the purpose of UF profiling? - correct answer-change the way fluid is remodeled during the tx
and allows for vascular refilling
what are the consequences of hypovolemia during tx? - correct answer-attempting to remove a lot of
fluid --> hypovolemia during tx --> loss of renal function, ischemia, and increased mortality rate
what must the machine's conductivity and pH reading supposed to be? - correct answer-machine and
manual conductivity: w/in +/-0.4
pH range: 6.9 - 7.6, measured to verify acid/base balance is in acceptable range
at what temperature does hemolysis occur? - correct answer-42 degrees C
What do we do in a power outage? - correct answer-remove venous line from air detector, clamp, before
starting hand crank and be diligent in watching for air in blood lines
what causes a high venous pressure alarm? - correct answer-kink in tubing, clotting in venous drip
chamber, infiltration, venous stenosis
what are the risks of doing things "your way" and not the P&P way? - correct answer-it can lead to civil
liabiliy
what makes dialysis pts more susceptible to healthcare acquired infections? - correct answer-prolonged
access to pts blood, and immunocompramised
why are dialysis pts at an increased risk for acquiring HAIs at the facility? - correct answer-contact
transmission
what is the most common transmission route for HAIs - correct answer-contact transmission--> hands
what is the most important invention you can do to prevent HAIs? - correct answer-handwashing
what is the most common infectious complication in hemodialyisis pts? - correct answer-per the CDC,
the most common factor contributing to bacteremia is use of CVCs
What germ causes the most common infections in hemodialysis pts? - correct answer-MRSA which can
remain on surfaces for days w/ plastic vinyl being most favorable to their survival
why is wearing gloves so important? - correct answer-decrease risk of hand contamination and prevent
transfer of organisms already on hands
what is the correct procedure in regards to your hands when you have causal contact w/ a pt - correct
answer-no gloves but must perform hand hygiene before care on pts
Successful lab draw must knows - correct answer-follow order the lab draws to prevent specimen from
being contaminated w/ other tube additives, double labeling tubes prohibits processing
rules for spinning samples - correct answer-only spin tube of some kind of size and fill level and should
be placed opposite of each other
What are the symptoms of hyperkalemia? - correct answer-extreme muscle weakness abnormal HR,
cardiac arrest
what are the symptoms of hypokalemia? - correct answer-fatigue, muscle weakness, respiratory failure
what is the primary cause of erythropoietin? - correct answer-primary cause
how can you prevent contributing to blood loss? - correct answer---adequate heperanization
--ensure epo given
-- completely rinse back blood
--avoid repeat lab draws
what is pericarditis? what is included in its treatment? - correct answer-w/ dialysis hold or decrease
heparin
systemic effects of CRF what should you do for a pt that complains of dry, itchy skin - correct answer-use
hyperfatted soaps and lotions