FRESENIUS EXAM Questions With Correct Answers Latest Updated 2024 (GRADED)

FRESENIUS EXAM Questions With Correct Answers Latest Updated 2024 (GRADED) What is a pre-dialysis evaluation? - Answer 1) Review of the patient's health. 2) Compares current health status to previous evaluations. Why is pre-dialysis evaluations needed? - Answer 1) To determine if the patient is stable to receive treatment. 2) Determine if there has been a change in health status. 3) Provides a baseline date to plan for a safe treatment. Describe Universal precautions - Answer Steps we take with all patient contact to decrease the risk of spreading infection to protect our patient and ourselves. What are the 3 C's? - Answer 1) Condition (objective) 2) Complaints (subjective) 3) Changes (objective) What should you look for with: Ambulation - Answer Gait changes, use of assistive devices, ROM, energy level. What should you look for with: Mental status and mood - Answer A&O x 3, any changes in usual mood (Alert and orientation) Person, place, time (situation) A&Ox4 What should you look for with: Skin - Answer Color, integrity, temperature, edema What should you look for with: Vital signs - Answer Weight, BP, HR, respiration's, temperature What is EDW? Estimated Dry weight - Answer A patient's wt with excess fluid removed When is a RN required to assess a pre-treatment wt? - Answer If the patient pretreatment wt is 4 kg above EDW. What does a blood pressure measure? - Answer Measurement of the pressure of force of blood against the walls of the arteries. When do you report a blood pressure to the RN? - Answer SBP 100 or 180 DBP 100 When do you report a heart rate to a RN? - Answer New onset of HR 60 or 100 or a irregular beat When do you report a respiratory rate to the Rn? - Answer A respiratory rate of 24 breaths per minute True or False Does a dialysis patient maintain an average temperature? - Answer False! When do you report a temperature to the RN? - Answer Temperature 96 & or = to 100 degrees Name some important complaints you need to report to the RN? (10) - Answer 1) Dizziness 2) Chest pain 3) SOB (shortness of breath) 4) Any new complaints 5) A visit to the ER or a hospital stay 6) Weakness 7) Numbness or tinglinng 8) Fever or chills 9) Depression/sadness 10) Pain What changes do you report to the RN? - Answer New medications or visit to ER or hospital stay. What are the ABC's of the patients assessment? - Answer A) Access B) Breathing C) Cardiac What to look for with: Access - Answer Bruises, redness, drainage, swelling, bruit, thrill, pain, bleeding What to look for with: Breathing - Answer Rate, rhythm, quality, SOB, breath sounds What to look for with: Cardiac - Answer Skin color and turgor, heart sounds, pulse rate, rhythm & quality, edema, pain, SOB Why do patients expreience crackles (rales) breath sounds? - Answer Indicates fluid or congestion in lungs Name some reasons for an abnormal heart rate? - Answer Can indicate chemical imbalances or adverse effects from medications. Names some places fluid can get trapped? (Edema) - Answer Abdomen, lungs, feet, legs, hands,and face What are the ranges for pitting edema? - Answer 1-4 cm What do you do when you have a red light as a complaint? - Answer Do not start the treatment until the RN has done a full assessment on the patient. Dialysis Prescription and Pre-treatment safety checks: Name what verifies the correct patient's dialysis prescription? (11) - Answer 1) patient Identity 2) prescribed dialyzer 3) prescribed dialysate 4) special attention orders 5) SVS or UF profiling 6) prescribed heparin dose 7) OLC volume/test entered 8) prescribed dialysate rate 9) prescribed base sodium 10) prescribed bicarbonate 11) prescribed needle size Name important information programmed into the machine. (6) - Answer 1) Prescribed treatment time 2) UF goal entered correctly 3) Prescribed BFR 4) Prescribed DFR 5) OLC volume 6) Na modeling or UF profile Name the final dialysis machine safety checks. (5) - Answer 1) Dialysate temperature 2) Dialysate pH & conductivity 3) NS doubled clamped 4) Alarm & pressure holding test passed 5) Final check on blood circuit What is a priority and major reason why we monitor our patients? - Answer Patient safety As fluid shifts during dialysis what changes can occur? - Answer Blood pressure, fluid and electrolyte shifts. Who is responsible for monitoring patients? - Answer Everyone! FRESENIUS EXAM ALREADY GRADED A+ The PCT must take what action when he or she identifies a potential problem? - Answer Immeddiate The RN must respond to what from patients and the PCT? - Answer Complaints or PCT notifications to assess the patient Why does a pateint's face and vascular access need to be visible at all times? (3) - Answer 1) It is a CMS requirement 2) Identify any changes in the patient's awareness 3) A covered access can result in major blood loss What are "Red Flags" to report to the RN? (5) - Answer 1) Severe hypertesnion (SBP 200) 2) Severe hypotension (SBP 80) 3) New onset of pulse 60 or 100 4) Irregular heart rate 5) Temperature or = to 100 degress What should the RN do when notified about "red Flags" - Answer 1) Assess the patient 2) Provide intervention 3) Report to the physician based on clinical judgment Name 4 non-verbal behaviors that may indicate a change in the patient status or discomfort: - Answer 1) Restlessness 2) Grimacing 3) Excessive yawning 4) Is patient alert, drowsy,sleepy Name 5 changes you should educate your patient to report immediately? - Answer 1) Discomfort at needle site 2) Muscle cramps 3) Headaches, dizziness, blurred vision 4) Nausea, vomiting 5) Fever, chills, chest pain, and SOB Name 4 machine reading we verify at every safety check? - Answer 1) BFR 2) DFR 3) AP (not more than-250) 4) VP (not more that 1/2 the bfr rate) Describe what the arterial pressure reading reflect? - Answer Refers to the pressure in the system from the patient;s vascular access to the blood pump. What are the potential compliactions of a high arterial pressure? (2) - Answer Inadequate dialysis and hemolysis Name 5 reasons for a high arterial pressure? - Answer 1) A kink in the arterial line FRESENIUS EXAM ALREADY GRADED A+ 2) Poor cardiac status 3) Blood pump speed to much for vascular access 4) High hematocrit / increase blood viscosity 5) High BFR through a small needle gauge What can a low arterial pressure indicate? - Answer 1) A line separation 2) Air 3) A decrease blood pump speed 4) A wet transducer Describe what the venous pressure reading reflects? - Answer The pressure in the circuit after the dialyzer and before it re-enter the patient. Name 5 causes for low venous pressure? - Answer 1) Blood line separation 2) Needle dislodgement 3) Decrease BFR 4) Clotting before the monitoring site 5) Wet transducer What can cause high venous pressure? (5) - Answer 1) occlusion in the lines between the monitoring site and venous needle, 2) poor position 3) an infiltration of venous needle 4) poor CVC function 5) clotting in the access or dialyzer What is the most important function of the dialysis treatment? - Answer Fluid removal How can fluid removal be monitored? - Answer Critline monitor or CLM Describe the 3 profiles that the CLM provides? - Answer 1) Profile A 2) Profile B 3) Profile C What does profile A look like? - Answer Profile shows a flat or a positive slope indicating UF and plasma refilling were equivalent during treatment. -An increase in the UFR may be appropriate What does profile B look like? - Answer Profile shows a gradual slope indicating the best compromised between a high UFR and prevention of symptoms during treatment What does profile C look like? - Answer Profile-shows a steep slope indicating a rapid decrease in blood volume and the patient is more likely to experience complications and intervention is required. FRESENIUS EXAM ALREADY GRADED A+ What does KT/V mean - Answer K= Clearance T= Time V= Volume What is the goal that FMC uses to calculate adequacy by KT/V - Answer 1.4 Describe the AMP lights meaning? Red - Answer The machine is in alarm mode Describe the Amp light meaning? Yellow - Answer means take action, the treatment will not meet our goal of 1.4 spKt/V Describe the Amp light meaning? Green - Answer means the patient will meet our goal of 1.4 spKt/V or above Monitoring the ECC includes (10) - Answer 1) The entire circuit is visible 2) Lines allow the patient position to change 3) All connections are correct & secure 4 )Lines secure in machine guides 5 )venous line in venous clamp 6) Chambers are filled adequately 7) NS is double clamped and contains at least 300 ml's 8) Hansen's are correctly connected to the dialyzer 9) Transducer are dry and unclamped 10) Heparin is infusing at the prescribed rate 30 minute checks include - Answer 1) vital signs 2) vascular access 3) machine checks (if the patient becomes unstable this must be done evey 5 minutes until the patient becomes stable) Name the safety check information that is documeted in Chairside: (7) - Answer 1) vascular access is secure, visible, no bleeding or infiltration 2) B/P and pulse 3) BFR and DFR 4) AP and VP 5) UF rate and UF removed 6) rate of heparin infusion 7) Most recent KCEN and Amp light status Effective documentation should be? (7) - Answer 1) Objective 2)legible 3) specific FRESENIUS EXAM ALREADY GRADED A+ 4) unaltered 5) consistent 6) chronological Name who is responsible to document in the patient's medical record? (6) - Answer 1) Nephrologist 2) RN 3) LPN 4) PCT/CCHT 5) RD 6) SW Name 3 locations where we provide documentation? - Answer 1) Chairside 2) eCube 3) Paper chart Why is documentation important? - Answer Communication, evidence of care rendered & patient response, the chart is a legal document. Diffusion is? - Answer The movement of solutes from and arena of HIGH solute concentration to area of LOW solute concentration across a semi permeable membrane. Osmosis is? - Answer The movement of water from an area of LOW solute concentration to an area of HIGH solute concentration. Filtration is? - Answer Movement of a solution through a semipermeable membrane. Ultrafiltration is? - Answer filtration using pressure. What are the goals of hemodialysis? (3) - Answer 1) removal of waste products 2) regulation of fluid balance 3) correction of electrolyte and acid/base imbalance Identify seven components of the hemodialysis prescription - Answer 1) treatment time 2) type of dialyzer 3) blood flow rate 4) dialysate flow rate 5) dialysate composition 6) needle size 7 anticoagulation Identify four components of the extra-corporeal circuit. - Answer 1) Arterial line 2) Venous line 3) Needles 4) Dialyzer FRESENIUS EXAM ALREADY GRADED A+ Biocompatibility is? - Answer a term to describe a dialyzer membrane that is more like the human body and less likey to cause an immune response. Dialyzers with more surface area allows? - Answer More removal of solutes. Transmembranes pressure affects? - Answer Fluid removal Pressure on the blood side is positive Pressure on the dialysate side is negative Define countercurrent flow? - Answer Blood flows one way while the dialysate flows the opposite wasy. What is the advantages of countecurrent? - Answer Allows more net diffusion. Dialyzer clearance is the amount of what? - Answer Blood cleared of a given solute in one minute at agiven BFR and DFR Identify five factors that affect dialyzer clearance? - Answer 1) BFR 2) DFR 3) Dialyzer characteristics 4) Treatment time and frequency 5) Anticoagulation Dialysate is composed of - Answer 1) Treated water 2) acidified concentrate (acid) 3) bicarbonate concentrate Is dialysate clean or sterile - Answer Clean identify five electrolytes in the acid concentrate? - Answer 1) sodium 2) potassium 3) calcium 4) magnesium 5) chloride Kidney failure causes what to build up and leads to what? - Answer 1) acid 2) metabolic acidosis What componet of the dialysate treats metabolic acidosis? - Answer bicarbonate Identify the two sources of the bicarbonate in final dialysate? - Answer 1) bicarbonate concentrate 2) Acetate in the acide concentration Two electrolytes that are part of the doctor's dialysate and are highlighted on the acid concentrate label are? - Answer Potassium and calicum FRESENIUS EXAM ALREADY GRADED A+ Alarms to monitor the dialysate to ensure it is safe to use: - Answer 1) conductivity alarm 2) temperature alarm What is conductivity? - Answer a measure of the ability of a solution to conduct an electrical charge Is verification of the conducitivy and pH required? - Answer Yes, before initiating treatment using a independent meter What verifies the conductivity and and pH? (2) - Answer 1) Phoenix meter 2) Precision PH control paper When does the phoenix meter need to be calibrated and verified? - Answer At the start of every treatment day. What is an acceptable pH range on a phoenix meter? - Answer 6.9-7.6 What is an acceptable pH range when using a pH test strip? - Answer 7.0-7.4 What are the two autoflow setting? - Answer 1) A 1.5