Davita final exam 2024 COMPLETE EXAM QUESTIONS
AND VERIFIED ANSWERS| 100% ACCURATE
SOLUTIONS|ALREADY GRADED A+
Explain the four transport mechanisms that play a role in hemodialysis -
✔✔ANSW✔✔..● Ultrafiltration: Fluid is pushed through a semipermeable membrane.
● Convection: Or solute drag means that solutes move with the water across the
semipermeable membrane. In this way, convection adds to the clearance achieved
through diffusion as solutes are dragged along with the ultrafiltrate.
● Diffusion: Is the movement of dissolved particles across a semipermeable membrane
from the side with the higher concentration to the side with the lower concentration. This
difference in solute concentration on each side of the membrane is called concentration
gradient. The higher the concentration gradient, the faster diffusion occurs. Once the
concentration of a dissolved particle is the same on both sides of the semipermeable
membrane, diffusion stops.
● Osmosis: Is a chemical process by which dissolved chemicals will migrate from an
area of high concentration to one of low
concentration. Essentially if you dissolve something in a liquid, the dissolved
compounds (called solutes) will spread out until there is
an equal concentration of solute everywhere.
What are the kidneys excretory functions - ✔✔ANSW✔✔..To normalize electrolytes,
remove wastes, provide fluid and nutrient balance
State 3 ways we can contribute to sodium loading during dialysis - ✔✔ANSW✔✔..1.
Broth
2. Normal saline, hypertonic saline
3. Increased sodium in dialysate (high setting in machine or sodium modeling)
What are the consequences if a patient is consistently fluid overload -
✔✔ANSW✔✔..Lvh increased central venous pressure, hypertension, increased
mortality, pulmonary edema, increased hospitalization rate
What is the difference between an arteriovenius fistula(AVF) and an arteriovenius graft
(AVG) - ✔✔ANSW✔✔..AVF-connection of the patients native artery to native vein
,AVG-uses artificial or biological material and requires 2 connections
What is the point where an artery and a vein are connected to create an AVF? -
✔✔ANSW✔✔..anastomosis
Describe the four AVF evaluations for maturation based on the KDOQI Rule of 6's -
✔✔ANSW✔✔..• 600 ml flow through access (on Doppler)
• 0.6 cm in depth under the skin
• 0.6 cm diameter (width of pencil eraser)
• 6-8 weeks post op maturation (some AVF will take longer- however notifying vascular
surgeon is
essential if access in not maturing)
Describe the teammate's cannulation level based on Cannulator Competency
Classifications. - ✔✔ANSW✔✔..Beginner cannulator
Less then 6 months experience and less than 10 successful cannulations on
established vascular accesses
Proficient cannulator
Greater than 6 months experience and cannulation of greater than 10 successful
cannulations
Expert cannulator
Experienced and skilled teammate. Has completed all the expert cannulation program
training, expert cannulation skills documented
What is the difference between a tunneled and a non-tunneled CVC - ✔✔ANSW✔✔..•
Tunneled CVC has a cuff that the skin grows to for anchoring to the patient - it is kept in
place longer. Sutures used at placement- but can be removed after site healed.
• Non-tunneled CVC (often referred to as temporary) are held in place by only sutures-
no cuff present
Once the heparin loading dose is administered, when can the hemodialysis treatment
be initiated? - ✔✔ANSW✔✔..A minimum of 3-5 minutes after heparin administration
Definition of newly mature AVF - ✔✔ANSW✔✔..new fistula has post op surgical exam,
meets the rules of 6's, can be cannulated by NFACT trained teammates
What is the function of the acid concentration - ✔✔ANSW✔✔..Provides the
concentration gradient for diffusion and helps normalize electrolytes
What is the function of bicarbonate - ✔✔ANSW✔✔..Buffers the acid concentrate
, Signs and symptoms of hyperkalemia - ✔✔ANSW✔✔..> 5.5 mEq: extreme muscle
weakness, abnormal heart rhythm, possible cardiac arrest
Signs and symptoms of hypokalemia - ✔✔ANSW✔✔..< 3.5 mEq: fatigue, muscle
weakness, paralysis, respiratory failure, cardiac instability, arrhythmias, cardiac arrest
What are the kidneys endocrine functions - ✔✔ANSW✔✔..Renin secretion,
Erythropoeitin secretion, Vit D Activation
How do we replace normal endocrine kidney functions - ✔✔ANSW✔✔..Provide
medications
How much of normal kidney function is replaced by hemodialysis - ✔✔ANSW✔✔..15%
What is uremia and how does it affect the body? - ✔✔ANSW✔✔..Uremia is a buildup of
wastes in the blood due to kidney failure and affects all body systems.
What are the most common causes of CKD in the usa? - ✔✔ANSW✔✔..Diabetes
Hypertension
Polycystic Kidney Disease
Outline the treatment goals for a patient with CKD - ✔✔ANSW✔✔..-slowing the
progression of ckd
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects of ckd on patients' lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Why is it important to know what caused your patients CKD - ✔✔ANSW✔✔..So the
nurse and PCT can inquire about possible problems during data collection and
assessment
Why is sodium balance important? - ✔✔ANSW✔✔..Leads to volume expansion,
increased cardiac output, increased peripheral vascular resistance, and increased blood
pressure
Signs and symptoms of fluid imbalance - ✔✔ANSW✔✔..Edema, hypertension,
shortness of breath
Systemic effects of CKD what would you advise for a patient who complains of: dry itchy
skin, peripheral neuropathy(nerve pain in extremities) and gi problems -
✔✔ANSW✔✔..Use hyper-fatted soaps and lotions, monitor patient for changes in motor
function and inform RN and physician of any bleeding problems/constipation/diarrhea
AND VERIFIED ANSWERS| 100% ACCURATE
SOLUTIONS|ALREADY GRADED A+
Explain the four transport mechanisms that play a role in hemodialysis -
✔✔ANSW✔✔..● Ultrafiltration: Fluid is pushed through a semipermeable membrane.
● Convection: Or solute drag means that solutes move with the water across the
semipermeable membrane. In this way, convection adds to the clearance achieved
through diffusion as solutes are dragged along with the ultrafiltrate.
● Diffusion: Is the movement of dissolved particles across a semipermeable membrane
from the side with the higher concentration to the side with the lower concentration. This
difference in solute concentration on each side of the membrane is called concentration
gradient. The higher the concentration gradient, the faster diffusion occurs. Once the
concentration of a dissolved particle is the same on both sides of the semipermeable
membrane, diffusion stops.
● Osmosis: Is a chemical process by which dissolved chemicals will migrate from an
area of high concentration to one of low
concentration. Essentially if you dissolve something in a liquid, the dissolved
compounds (called solutes) will spread out until there is
an equal concentration of solute everywhere.
What are the kidneys excretory functions - ✔✔ANSW✔✔..To normalize electrolytes,
remove wastes, provide fluid and nutrient balance
State 3 ways we can contribute to sodium loading during dialysis - ✔✔ANSW✔✔..1.
Broth
2. Normal saline, hypertonic saline
3. Increased sodium in dialysate (high setting in machine or sodium modeling)
What are the consequences if a patient is consistently fluid overload -
✔✔ANSW✔✔..Lvh increased central venous pressure, hypertension, increased
mortality, pulmonary edema, increased hospitalization rate
What is the difference between an arteriovenius fistula(AVF) and an arteriovenius graft
(AVG) - ✔✔ANSW✔✔..AVF-connection of the patients native artery to native vein
,AVG-uses artificial or biological material and requires 2 connections
What is the point where an artery and a vein are connected to create an AVF? -
✔✔ANSW✔✔..anastomosis
Describe the four AVF evaluations for maturation based on the KDOQI Rule of 6's -
✔✔ANSW✔✔..• 600 ml flow through access (on Doppler)
• 0.6 cm in depth under the skin
• 0.6 cm diameter (width of pencil eraser)
• 6-8 weeks post op maturation (some AVF will take longer- however notifying vascular
surgeon is
essential if access in not maturing)
Describe the teammate's cannulation level based on Cannulator Competency
Classifications. - ✔✔ANSW✔✔..Beginner cannulator
Less then 6 months experience and less than 10 successful cannulations on
established vascular accesses
Proficient cannulator
Greater than 6 months experience and cannulation of greater than 10 successful
cannulations
Expert cannulator
Experienced and skilled teammate. Has completed all the expert cannulation program
training, expert cannulation skills documented
What is the difference between a tunneled and a non-tunneled CVC - ✔✔ANSW✔✔..•
Tunneled CVC has a cuff that the skin grows to for anchoring to the patient - it is kept in
place longer. Sutures used at placement- but can be removed after site healed.
• Non-tunneled CVC (often referred to as temporary) are held in place by only sutures-
no cuff present
Once the heparin loading dose is administered, when can the hemodialysis treatment
be initiated? - ✔✔ANSW✔✔..A minimum of 3-5 minutes after heparin administration
Definition of newly mature AVF - ✔✔ANSW✔✔..new fistula has post op surgical exam,
meets the rules of 6's, can be cannulated by NFACT trained teammates
What is the function of the acid concentration - ✔✔ANSW✔✔..Provides the
concentration gradient for diffusion and helps normalize electrolytes
What is the function of bicarbonate - ✔✔ANSW✔✔..Buffers the acid concentrate
, Signs and symptoms of hyperkalemia - ✔✔ANSW✔✔..> 5.5 mEq: extreme muscle
weakness, abnormal heart rhythm, possible cardiac arrest
Signs and symptoms of hypokalemia - ✔✔ANSW✔✔..< 3.5 mEq: fatigue, muscle
weakness, paralysis, respiratory failure, cardiac instability, arrhythmias, cardiac arrest
What are the kidneys endocrine functions - ✔✔ANSW✔✔..Renin secretion,
Erythropoeitin secretion, Vit D Activation
How do we replace normal endocrine kidney functions - ✔✔ANSW✔✔..Provide
medications
How much of normal kidney function is replaced by hemodialysis - ✔✔ANSW✔✔..15%
What is uremia and how does it affect the body? - ✔✔ANSW✔✔..Uremia is a buildup of
wastes in the blood due to kidney failure and affects all body systems.
What are the most common causes of CKD in the usa? - ✔✔ANSW✔✔..Diabetes
Hypertension
Polycystic Kidney Disease
Outline the treatment goals for a patient with CKD - ✔✔ANSW✔✔..-slowing the
progression of ckd
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects of ckd on patients' lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Why is it important to know what caused your patients CKD - ✔✔ANSW✔✔..So the
nurse and PCT can inquire about possible problems during data collection and
assessment
Why is sodium balance important? - ✔✔ANSW✔✔..Leads to volume expansion,
increased cardiac output, increased peripheral vascular resistance, and increased blood
pressure
Signs and symptoms of fluid imbalance - ✔✔ANSW✔✔..Edema, hypertension,
shortness of breath
Systemic effects of CKD what would you advise for a patient who complains of: dry itchy
skin, peripheral neuropathy(nerve pain in extremities) and gi problems -
✔✔ANSW✔✔..Use hyper-fatted soaps and lotions, monitor patient for changes in motor
function and inform RN and physician of any bleeding problems/constipation/diarrhea
