FRESENIUS NURSE FINAL EXAM
PART 2 QUESTIONS AND ANSWERS
What must be evaluated and documented pre-tx? - Correct Answers -Ambulation
status, mental status, pre-weight, bp sitting and standing if patient is able, temperature,
heart rate and rhythm, respirations, edema, GI status, skin color, access evaluation,
hospitalizations since last tx, any new complaints or life changes
What must be evaluated and documented during tx? - Correct Answers -Current time of
evaluation, bp, BFR, DFR, safety checks, arterial/venous pressures, fluid
removed/administered, access check-hemosafe device attached, patient's overall
status, interventions, changes in dialysis presecription
What must be evaluated and documented post-tx? - Correct Answers -Ambulation
status, mental status, changes in condition, post weight, bp sitting and standing,
temperature, heart rate and rhythm, respirations, edema, new complaints, evaluation of
access including presence of thrill, condition of dressing
Recommended body temperature range - Correct Answers -96.4-98.9
What is the recommended interdialytic weight gain? - Correct Answers -1.5-2.0 kg/day
Signs and symptoms that EDW is too low (Too much fluid is being removed): - Correct
Answers -Dizziness, nausea, vomiting, hypotension, cramps, fatigue that sometimes
persist until the next tx
Signs and symptoms that EDW is too high (Not enough fluid is being removed): -
Correct Answers -Htn, headaches, SOB, edema, distended neck veins
What is AW and how is it calculated? - Correct Answers -In the weight loss plan, AW
means "available weight", this is calculated by subtracting the EDW from the patient's
pre-tx weight
What makes up the goal for fluid removal? - Correct Answers -The AW (available
weight), priming and rinseback saline, and any other fluid the patient will receive during
the tx (oral fluids, saline rinses, packed cells, IDPN, IVPB medications etc. )
____________ is the measurement of how well we are cleaning wastes from our
patients' blood - Correct Answers -Adequacy of Dialysis
, How can we measure how well we clean our patients' blood? - Correct Answers -By
measuring the amount of wastes in the patient's blood before and after dialysis, we can
calculate the amount of clearance we achieve.
The following interventions improve the clearance of urea during hemodialysis:
1.Well functioning ___________
2.Proper ____ of the circuit
3.Optimal _________ (autoflow <1.5 or 2 as ordered> and ________ flow
4.Larger _______ and _______
5.Ensuring needle tips are at _______ inches aprt
6. longer _______ - Correct Answers -1. access
2. priming
3. dialysate & blood
4. dialyzer membrane and needle gauges
5. 1.5 to 2 inches
6. tx times
What are 2 consequences of improperly primed dialyzer? - Correct Answers -1. When
the # of fibers available to affect clearance is greatly reduced, the result is a less
effective tx for the patient.
2. Clotted fibers/ dialyzer will also result in a certain amount of blood loss for the patient,
resulting in a potential for reduced hgb level.
What is considered the best method currently available for determining tx effectiveness
and is mandatory in all FMC clinics? - Correct Answers -UKM (Urea Kinetic Modeling)
In addition to UKM, these are two other methods of determining adequacy. - Correct
Answers -kt/V and URR
Why is measuring the adequacy of the dialysis tx so important? - Correct Answers -
When the tx is more effective, patients live longer and have fewer health problems.
What does Kt/v stand for? - Correct Answers -K stands for the clearance (think k sound)
of urea, t is the time in minutes, and v is the total volume of waste (urea) that exist in the
patient
What is the difference between spKt/v and eKt/v and how is it determined? - Correct
Answers -~single pool or spKt/v is the amount of dialysis having been delivered upon
completion of the HD tx, it's the reduction from one pool of fluid (vascular space)
~double pool or eKt/v is the measured amount of dialysis accounting for the volume of
urea distribution in both intracellular and extracellular compartments representing the
amount of urea distribution of the entire body.
PART 2 QUESTIONS AND ANSWERS
What must be evaluated and documented pre-tx? - Correct Answers -Ambulation
status, mental status, pre-weight, bp sitting and standing if patient is able, temperature,
heart rate and rhythm, respirations, edema, GI status, skin color, access evaluation,
hospitalizations since last tx, any new complaints or life changes
What must be evaluated and documented during tx? - Correct Answers -Current time of
evaluation, bp, BFR, DFR, safety checks, arterial/venous pressures, fluid
removed/administered, access check-hemosafe device attached, patient's overall
status, interventions, changes in dialysis presecription
What must be evaluated and documented post-tx? - Correct Answers -Ambulation
status, mental status, changes in condition, post weight, bp sitting and standing,
temperature, heart rate and rhythm, respirations, edema, new complaints, evaluation of
access including presence of thrill, condition of dressing
Recommended body temperature range - Correct Answers -96.4-98.9
What is the recommended interdialytic weight gain? - Correct Answers -1.5-2.0 kg/day
Signs and symptoms that EDW is too low (Too much fluid is being removed): - Correct
Answers -Dizziness, nausea, vomiting, hypotension, cramps, fatigue that sometimes
persist until the next tx
Signs and symptoms that EDW is too high (Not enough fluid is being removed): -
Correct Answers -Htn, headaches, SOB, edema, distended neck veins
What is AW and how is it calculated? - Correct Answers -In the weight loss plan, AW
means "available weight", this is calculated by subtracting the EDW from the patient's
pre-tx weight
What makes up the goal for fluid removal? - Correct Answers -The AW (available
weight), priming and rinseback saline, and any other fluid the patient will receive during
the tx (oral fluids, saline rinses, packed cells, IDPN, IVPB medications etc. )
____________ is the measurement of how well we are cleaning wastes from our
patients' blood - Correct Answers -Adequacy of Dialysis
, How can we measure how well we clean our patients' blood? - Correct Answers -By
measuring the amount of wastes in the patient's blood before and after dialysis, we can
calculate the amount of clearance we achieve.
The following interventions improve the clearance of urea during hemodialysis:
1.Well functioning ___________
2.Proper ____ of the circuit
3.Optimal _________ (autoflow <1.5 or 2 as ordered> and ________ flow
4.Larger _______ and _______
5.Ensuring needle tips are at _______ inches aprt
6. longer _______ - Correct Answers -1. access
2. priming
3. dialysate & blood
4. dialyzer membrane and needle gauges
5. 1.5 to 2 inches
6. tx times
What are 2 consequences of improperly primed dialyzer? - Correct Answers -1. When
the # of fibers available to affect clearance is greatly reduced, the result is a less
effective tx for the patient.
2. Clotted fibers/ dialyzer will also result in a certain amount of blood loss for the patient,
resulting in a potential for reduced hgb level.
What is considered the best method currently available for determining tx effectiveness
and is mandatory in all FMC clinics? - Correct Answers -UKM (Urea Kinetic Modeling)
In addition to UKM, these are two other methods of determining adequacy. - Correct
Answers -kt/V and URR
Why is measuring the adequacy of the dialysis tx so important? - Correct Answers -
When the tx is more effective, patients live longer and have fewer health problems.
What does Kt/v stand for? - Correct Answers -K stands for the clearance (think k sound)
of urea, t is the time in minutes, and v is the total volume of waste (urea) that exist in the
patient
What is the difference between spKt/v and eKt/v and how is it determined? - Correct
Answers -~single pool or spKt/v is the amount of dialysis having been delivered upon
completion of the HD tx, it's the reduction from one pool of fluid (vascular space)
~double pool or eKt/v is the measured amount of dialysis accounting for the volume of
urea distribution in both intracellular and extracellular compartments representing the
amount of urea distribution of the entire body.
