Fresenius Nurse Final Exam Part 2 Questions and
Correct Verified Answers, Graded A+
What must be evaluated and documented pre-tx? ✔✔ 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? ✔✔ 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? ✔✔ 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 ✔✔ 96.4-98.9
What is the recommended interdialytic weight gain? ✔✔ 1.5-2.0 kg/day
Signs and symptoms that EDW is too low (Too much fluid is being removed): ✔✔
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): ✔✔
Htn, headaches, SOB, edema, distended neck veins
What is AW and how is it calculated? ✔✔ 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? ✔✔ 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 ✔✔ Adequacy of Dialysis
How can we measure how well we clean our patients' blood? ✔✔ 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 _______ ✔✔ 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? ✔✔ 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? ✔✔ UKM (Urea Kinetic Modeling)
In addition to UKM, these are two other methods of determining adequacy. ✔✔ kt/V and
URR
Why is measuring the adequacy of the dialysis tx so important? ✔✔ When the tx is
more effective, patients live longer and have fewer health problems.
What does Kt/v stand for? ✔✔ 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? ✔✔ ~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.
What is FMCNA's goal for spKt/v and eKt/v? ✔✔ Minimum 1.4 L for spKt/v and 1.2 L for
eKt/v
OLC stands for ✔✔ On Line Clearance
Correct Verified Answers, Graded A+
What must be evaluated and documented pre-tx? ✔✔ 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? ✔✔ 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? ✔✔ 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 ✔✔ 96.4-98.9
What is the recommended interdialytic weight gain? ✔✔ 1.5-2.0 kg/day
Signs and symptoms that EDW is too low (Too much fluid is being removed): ✔✔
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): ✔✔
Htn, headaches, SOB, edema, distended neck veins
What is AW and how is it calculated? ✔✔ 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? ✔✔ 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 ✔✔ Adequacy of Dialysis
How can we measure how well we clean our patients' blood? ✔✔ 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 _______ ✔✔ 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? ✔✔ 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? ✔✔ UKM (Urea Kinetic Modeling)
In addition to UKM, these are two other methods of determining adequacy. ✔✔ kt/V and
URR
Why is measuring the adequacy of the dialysis tx so important? ✔✔ When the tx is
more effective, patients live longer and have fewer health problems.
What does Kt/v stand for? ✔✔ 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? ✔✔ ~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.
What is FMCNA's goal for spKt/v and eKt/v? ✔✔ Minimum 1.4 L for spKt/v and 1.2 L for
eKt/v
OLC stands for ✔✔ On Line Clearance
