FRESENIUS PCT FINAL EXAM ACTUAL QUESTIONS AND
SOLUTIONS RATED A+
✔✔Av graft advantages? - ✔✔Large surface area for cannulation
Technically easy to cannulate
Healing time is short
Variety shapes and configurations
Easy to implant, construct, and surgically repair
✔✔Av graft disadvantages? - ✔✔Increased rate of stenosis; increased clotting
Increased infection rates
Increased bleed time at the end of a treatment
Require replacement, especially if the cannulation sites
are not rotated
No collateral circulation develops
✔✔CVC advantages? - ✔✔Immediate use after verification of placement Higher
No need for patient to achieve hemostasis at the end of
treatment
✔✔CVC Disadvantages? - ✔✔Higher potential for air embolism
Prone to infection and clotting
Last option and sometimes only option for patients
Lower BFRs=increased treatment time to improve
adequacy
Long-term use can lead to major vessel stenosis
Reversing the lines will cause increased recirculation and decreased adequacy
✔✔Av fistula advantgates? - ✔✔Uses the patient's own vessels Length of time to
Requires one anastomosis Isometric exercises may aid in development
Longer life span Lower
Decreased rate of complications
Collateral circulation develops
✔✔Av fistuala disadvantages? - ✔✔Length of time to develop - generally 1-4 months
Lower blood flows are sometimes necessary when the
fistula is immature; results poor clearance
Collateral circulation develops
Isometric exercises may aid in development
✔✔BFR & Recommened Needle size? - ✔✔<300 mL/min 17 gauge
300 - 350 mL/min 16 gauge
>350 - 450 mL/min 15 gauge
>450 mL/min 14 gauge
, ✔✔Why should the needles sites be rotated? - ✔✔Needle sites should be rotated to
prevent weakening of the vessel walls and to prevent the formation of aneurysms and
scar tissue. Sites should also be rotated to allow time for the previously punctured areas
to heal
✔✔List signs and symptoms of vascular access infection? - ✔✔chills,
fever,
drainage and pain,
redness, swelling and warmth at the site
✔✔List four things you can teach a patient to prevent their access from clotting? - ✔✔1.
not to wear tight fitting clothing or jewelry on the access arm,
2. not to sleep on the access arm,
3. not to let anyone draw labs or check blood pressures in their access arm and,
4. not to carry heavy objects in their access arm.
✔✔Why is it important to determine which side is arterial and which side is venous? -
✔✔If the needles are connected to the wrong blood line, recirculation will prevent the
clearance to deliver an
adequate treatment.
✔✔How long should you clean the patients skin before cannulation with alcohol pad or
betadine? - ✔✔30 seconds, if betadine is use allow for it to dry 3-5 mins
✔✔What insertion angle should I use for cannulation? - ✔✔Bevel up - AV graft 45
degree angle - AV fistula 20-30 degree angle also depends on depth of access
✔✔What direction should the needles be placed for dialysis? - ✔✔Arterial needle can
go with or against the flow, and Venous needle has to go with the flow.
✔✔What is an infiltration and how is it treated? - ✔✔An infiltration is fluid seepage into
the surrounding tissue resulting in pain and swelling. Infiltrations are treated with
intermittent ice for 24 hours followed by intermittent heat and ice as needed.
✔✔Where should you place an arterial and a venous needle if it has infiltrated? - ✔✔A
new venous needle should be placed above the infiltration site. For an arterial infiltration
the needle may be placed either above or below the infiltrated site.
✔✔What is Heparin and why is it used in hemodialysis? - ✔✔Heparin is an
anticoagulant that prevents clotting
✔✔After the Heparin has been given, how long must you wait before initiating the
treatment? - ✔✔3 - 5-minute
SOLUTIONS RATED A+
✔✔Av graft advantages? - ✔✔Large surface area for cannulation
Technically easy to cannulate
Healing time is short
Variety shapes and configurations
Easy to implant, construct, and surgically repair
✔✔Av graft disadvantages? - ✔✔Increased rate of stenosis; increased clotting
Increased infection rates
Increased bleed time at the end of a treatment
Require replacement, especially if the cannulation sites
are not rotated
No collateral circulation develops
✔✔CVC advantages? - ✔✔Immediate use after verification of placement Higher
No need for patient to achieve hemostasis at the end of
treatment
✔✔CVC Disadvantages? - ✔✔Higher potential for air embolism
Prone to infection and clotting
Last option and sometimes only option for patients
Lower BFRs=increased treatment time to improve
adequacy
Long-term use can lead to major vessel stenosis
Reversing the lines will cause increased recirculation and decreased adequacy
✔✔Av fistula advantgates? - ✔✔Uses the patient's own vessels Length of time to
Requires one anastomosis Isometric exercises may aid in development
Longer life span Lower
Decreased rate of complications
Collateral circulation develops
✔✔Av fistuala disadvantages? - ✔✔Length of time to develop - generally 1-4 months
Lower blood flows are sometimes necessary when the
fistula is immature; results poor clearance
Collateral circulation develops
Isometric exercises may aid in development
✔✔BFR & Recommened Needle size? - ✔✔<300 mL/min 17 gauge
300 - 350 mL/min 16 gauge
>350 - 450 mL/min 15 gauge
>450 mL/min 14 gauge
, ✔✔Why should the needles sites be rotated? - ✔✔Needle sites should be rotated to
prevent weakening of the vessel walls and to prevent the formation of aneurysms and
scar tissue. Sites should also be rotated to allow time for the previously punctured areas
to heal
✔✔List signs and symptoms of vascular access infection? - ✔✔chills,
fever,
drainage and pain,
redness, swelling and warmth at the site
✔✔List four things you can teach a patient to prevent their access from clotting? - ✔✔1.
not to wear tight fitting clothing or jewelry on the access arm,
2. not to sleep on the access arm,
3. not to let anyone draw labs or check blood pressures in their access arm and,
4. not to carry heavy objects in their access arm.
✔✔Why is it important to determine which side is arterial and which side is venous? -
✔✔If the needles are connected to the wrong blood line, recirculation will prevent the
clearance to deliver an
adequate treatment.
✔✔How long should you clean the patients skin before cannulation with alcohol pad or
betadine? - ✔✔30 seconds, if betadine is use allow for it to dry 3-5 mins
✔✔What insertion angle should I use for cannulation? - ✔✔Bevel up - AV graft 45
degree angle - AV fistula 20-30 degree angle also depends on depth of access
✔✔What direction should the needles be placed for dialysis? - ✔✔Arterial needle can
go with or against the flow, and Venous needle has to go with the flow.
✔✔What is an infiltration and how is it treated? - ✔✔An infiltration is fluid seepage into
the surrounding tissue resulting in pain and swelling. Infiltrations are treated with
intermittent ice for 24 hours followed by intermittent heat and ice as needed.
✔✔Where should you place an arterial and a venous needle if it has infiltrated? - ✔✔A
new venous needle should be placed above the infiltration site. For an arterial infiltration
the needle may be placed either above or below the infiltrated site.
✔✔What is Heparin and why is it used in hemodialysis? - ✔✔Heparin is an
anticoagulant that prevents clotting
✔✔After the Heparin has been given, how long must you wait before initiating the
treatment? - ✔✔3 - 5-minute
