FRESENIUS PART 2 FINAL TEST (CLINICAL COMPLICATIONS HEMODIALYSIS) Questions and Answers

IN A NORMAL KIDNEY WHICH THREE COMPARTMENTS FLUID WOULD DISTRIBUTE - ANSWER-INTRAVASCULAR, INTERSTITIAL AND INTERCELLULAR WHERE CAN WE ONLY PULL FLUIDS FROM WITH CRF PATIENTS DURING DIALYSIS - ANSWER-INTRAVASCULAR S/S OF HYPOTENSION - ANSWER-YAWNING,DIZZINESS,LIGHTHEADEDNESS, N/V,BLURRED VISION IF A PATIENT HAVE HYPOTENSION S/S WHAT SHOULD YOU DO - ANSWER-CHECK THEIR B/P AND COMPARE IT TO THE PREVIOUS NOTIFY RN INTERVENTIONS FOR HYPOTENSION - ANSWER-PLACE PATIENT IN RECLINING POSITION OR TRENDELENBURG WITH FEET ELEVATED, TURN THE UF DOWN OR OFF , NOTIFY RN AND GIVE NORMAL SALINE WHAT COULD CAUSE HYPOTENSION - ANSWER-PATIENT EATS DURING OR BEFORE TREATMENT,IF PATIENT TOOK BP MEDS,OR NARCOTIC PAIN MEDS PRIOR TO TREATMENT , IF PATIENT GAIN A LOT BETWEEN TREATMENT OR HIS UFR EXCEEDS HOW FAST THEIR VASCULAR SYSTEM IS REFILLING CRAMPING CAUSED BY - ANSWER-SHIFTING OF ELECTROLYTES ATTEMPTING TO PULL A LARGE AMOUNT OF FLUID IN A SHORT PERIOD OF TIME OR GOING BELOW PATIENTS EDW EDW HAS TO - ANSWER-REEVALUATED ON A ONGOING BASIS SINCE THE PATIENT'S WEIGHT GOES UP AND DOWN JUST LIKE OURS DOES SVS MUST BE USED WITH A - ANSWER-MEDICAL DOCTORS ORDER SVS MUST BE STOP WHEN - ANSWER-30-45 MINS PRIOR TO END OF TREATMENT SO THAT THE IS NOT HYPERNATREMIC (HIGH SERUM SODIUM) POST TREATMENT FEVER & CHILLS CAUSES - ANSWER-CAUSE BY INFECTION, CONTAMINATED DIALYZER OR LINES , TOO COLD DIALYSATE COLD DIALYSATE SIGNS AND SYMPTOMS - ANSWER-SHAKING/SHIVERING, HIGH TEMP IF THE PATIENT STARTS SHAKING AND SHIVERING WHAT SHOULD YOU DO - ANSWER-TAKE THE PATIENT'S TEMP AND NOTIFY RN. CHEST PAIN (ANGINA) IS CAUSED BY - ANSWER-LACK OF OXYGEN TO THE HEART MUSCLES IF PATIENT COMPLAINS OF CHEST PAINS WHAT SHOULD YOU DO - ANSWER-NOTIFY THE NURSE, TURN THE BFR DOWN, TURN THE UF OFF, RN WILL ADMINISTER NITROGLYCERIN. IF THE PATIENT HAS A CARDIAC ARREST DURING TREATMENT WHAT SHOULD YOU DO WITH MACHINE - ANSWER-PULL IT AND THE BIOMED DEPT. MUST PUT IT THROUGH A FUNCTIONAL TEST BEFORE IT CAN BE USED ON ANOTHER PT . HYPOGLYCEMIA - ANSWER-IS LOW BLOOD SUGAR SIGNS AND SYMPTOMS OF LOW BLOOD SUGAR (HYPOGLYCEMIA) - ANSWER-FAINTNESS, DOUBLE VISION,IRRITABILITY,HUNGER,CAN PROCEED TO COMA AND DEATH HEMOLYSIS SIGNS AND SYMPTOMS - ANSWER-SHORTNESS OF BREATH,CHEST PAIN,BRIGHT RED TRANSLUCENT BLOOD IN CHAMBER. INTERVENTION FOR HEMOLYSIS - ANSWER-STOP TREATMENT,NOTIFY RN, DO NOT RETURN BLOOD HEMOLYZED BLOOD CONTAIN EXCESS AMOUNTS OF - ANSWER-POTASSIUM CAUSES OF HEMOLYSIS - ANSWER-HYPOTONIC DIALYSATE ,DIALYSATE TEMP GREATER THAN 105 F(40 CELSIUS ),KINKS IN THE BLOODLINE , ARTERIAL PRESSURE GREATER THAN -250 TO PREVENT HEMOLYSIS - ANSWER-TEST MACHINES PRIOR TO EACH TREATMENT,CONFIRM CONDUCTIVITY AND PH WITH INDEPENDENT METER/STRIP WHAT TO DO IF MACHINE KEEP FAILING TESTS - ANSWER-DO NOT USE IT DO NOT RUN PATIENT IF THEIR ARTERIAL PRESSURE IS ABOVE - ANSWER--250 TROUBLESHOOTING FOR HIGH ARTERIAL PRESSURE/VENOUS PRESSURE - ANSWER-CHECK NEEDLES , CHECK FOR KINKS , OR REDUCE BFR IF YOU HAVE TO WHAT YOU SHOULD DO IF AFTER YOU TROUBLE SHOOT ARTERIAL PRESSURE ISSUES - ANSWER-MAKE SURE YOU CHART ANY INTERVENTIONS OR MAKE ANY CHANGES FROM ORIGINAL DIALYSIS PRESCRIPTION AND NOTIFY RN DISEQUILIBRIUM SYNDROME - ANSWER-THIS WILL HAPPEN IF THE PATIENT'S BUN IS HIGH SUCH AS WITH A NEW PATIENT 1ST TREATMENT OR A PATIENT THAT HAS MISSED A NUMBER OF TREATMENTS SIGNS AND SYMPTOMS OF EQUILIBRIUM SYNDROME - ANSWER-NAUSEA ,VOMITING ,HEADACHE,HTN, CONFUSION AND RESTLESSNESS .NOTIFY RN AIR EMBOLISM - ANSWER-WHEN AIR GET INTO THE LINES AND INTO THE PATIENT BLOCKING THE BLOOD VESSELS SIGNS AND SYMPTOMS OF AIR EMBOLISM - ANSWER-SOB, COUGHING,CHEST PAIN TO PREVENT AIR EMBOLISM - ANSWER-TEST MACHINE PRIOR TO USE, DON'T USE IF FAIL, MAKE SURE THE AIR DETECTOR IS ARMED THROUGHOUT TREATMENT KEEP 300 CC IN BAG BLOOD LOSS CAUSES - ANSWER-CLOTTING IN THE EXTRACORPOREAL CIRCUIT WHAT CAUSES CLOTTING IN THE EXTRACORPOREAL CIRCUIT ( DIALYZER AND LINES) - ANSWER-BLOOD FLOW TOO LOW OR BLOOD PUMP HAS STOPPED OR AIR IN THE SYSTEM SIGNS OF CLOTTING - ANSWER-DARKENING OF THE BLOOD IN THE LINES/CHAMBERS, VP IS HIGH IF VENOUS LINE IS CLOT WHAT TO DO - ANSWER-CHANGE OUT VENOUS LINE