Dialysis Final Exam Questions and Answers

Where is an arteriovenous fistula placed? - Answer- In the arm What types of lines can be used for dialysis? - Answer- Central or femoral How does dialysis work? - Answer- It is an ultrafiltration-like procedure in which blood goes through the machine and solute is taken from an area of high concentration to an area of low concentration (pulls it out of the blood) What usually happens to SCr after dialysis? - Answer- It drops - but then it goes back up What happens if a patient skips dialysis? - Answer- Over a few days, toxins build up and they have to go in for dialysis; may need several sessions in a row to get back to normal What is something you should always ask when giving dialysis to a patient? - Answer- What kind of filter they need What is the main concept behind using dialysis? - Answer- To filter the blood What is hemodialysis? - Answer- Dialysis that uses some type of vascular access What is intermittent hemodialysis? - Answer- Hemodialysis that is not continuous (ex. MWF schedule) What is continuous hemodialysis? - Answer- Hemodialysis that acts like a kidney, and the patient is hooked up continuously What is CRRT? - Answer- Continuous renal replacement therapy What kind of patients might get continuous hemodialysis? - Answer- Patients in the ICU, and those who are healthy and just need toxins removed acutely Is continuous hemodialysis meant for chronic use? - Answer- No What is peritoneal dialysis? - Answer- Catheters are inserted into the peritoneal space - 1 that goes in and 1 that goes out; dialysate fluid is inserted and let set for 3-4 hours while it removes toxins from the blood What are the 2 types of peritoneal dialysis? - Answer- Continuous ambulatory peritoneal dialysis & automated peritoneal dialysis How well does peritoneal dialysis work? - Answer- Not very well Is hemodialysis good for long-term use? - Answer- No, it is a temporary fix & patients usually end up going on to intermittent hemodialysis Are patients more likely to have infections with hemodialysis or peritoneal dialysis? - Answer- Peritoneal dialysis What are the pros and cons of peritoneal dialysis? - Answer- It is better for patient convenience, but doesn't work well How often is peritoneal dialysis used? - Answer- Very rare in the acute setting; not many drugs use this Are smaller or larger molecules filtered more easily? - Answer- Smaller How much does urea weigh, and how easily is it filtered? - Answer- 60 daltons - easily filtered How much do aminoglycosides weigh, and how easily are they filtered? - Answer- < 500 daltons - easily filtered How much does theophylline weigh, and how easily is it filtered? - Answer- < 500 daltons - easily filtered What is continuous ambulatory peritoneal dialysis? - Answer- Dialysis the patient can perform on their own at home while they carry on with their daily activities What is a dialyzer? - Answer- The membrane/filter that blood runs through As surface area of a filter increases, what also increases? - Answer- Thickness What is a low flux filter? - Answer- A "standard" filter What is a high flux filter? - Answer- Filter with larger surface area; is more expensive; able to filter larger molecules What type of filter is used in most hospitals? - Answer- High flux At what point do patients start being considered for dialysis? - Answer-