Fresenius PCT exam 2-Questions Solved
100% Correct \Verified Answers
how is a large/major blood leak treated? - Answer dialysate will apear bloody or
blood tinged. do not return blood.
what are the two most commonly changed electrolytes in dialysate/ - Answer potassium
and calcium- makes changes based on pt's current monthly lab results
steps for treating an infiltrated access - Answer 1. establish that infiltration has occurred
2. sto pdialysis turn off blood pump, clamp bloodlines.
3. notify rn
4. disconnect bloodlines from fistula lines and recirculate blood. flush non-
infiltrated needle with normal saline
5. if infiltration occurred after heparin administration: cap end of needle and secure
(to be removed at end of tx). apply ice
6. if fistula is infiltrated, rest fistula for one treatment when ordered by
nephrologist. next cannulation should be above infiltrate
7. instruct pt to apply ice for 24 hours and watch for complications such as (pain,
reoccurrance of bleeding, elevated temp, additional swelling, absence of a thrill)
8.
,What are the functions of a healthy kidney? - Answer REGULATE,
SYNTHESIS, ENDOCRINE:
Regulate fluid balance, blood volume, electrolytes, acid-base balance,
synthesize calcitrol (active vitamin D), secrete erythropoietin and release renin
what is the glomerular filtration rate in the five stages of kidney disease? - Answer flow
rate of filtered fluid through the kidney
stage 1: 90+
stage 2:60-89
stage 3: 30-59
stage 4: 15-29
stage 5: <15
what are the types and stages of kidney failure? - Answer acute renal failure: sudden
onset, severe, usually reversible. can be caused by drug toxicity, dehydration, or
motor vehicle accident
Chronic renal failure: slow onset, progressive, permanent. can be caused by diabetes,
hypertension, or genetic disease such as glomerulonephritis or nephrosclerosis
what are the signs and symptoms of renal failure or uremia? - Answer elevated serum
levels of BUN/Creatinine, phosphorus, potassium. anemia, nerve damage, yellow-gray
appearance of skin, fluid overload, dyspnea, edema, hypertension, proteinuria, uremia,
lethargy, weakness, headache, itching, fatigue, nausea restlessness, mental change,
loss of appetite.
, what is anemia and how is it treated? - Answer lack of RBC (decreased or lack of
erythropoietin production). iron binds with hemoglobin in RBC and transports oxygen.
it is treated using erythropoieting stimulating agents and usually administered IV.
which of the functions of healthy kidneys are replaced by dialysis? - Answer removal
of waste products and regulation of fluid balance. dialysis does not regulate endocrine
production
list briefly and describe three modalities of treatment for end stage renal disease -
Answer Hemodialysis: uses vascular access to draw blood from patient and send to
dialyzer and into semipermeable membrane where diffusion removes waste products
and ultrafiltration removes fluid. provides approximately 15% of the normal function
of the kidney.
peritoneal dialysis: continuous cycling peritoneal dialysis and continuous ambulatory
peritoneal dialysis. both types use permanent catheter in highly vascularized peritoneal
cavity. dialysate is infused into peritoneal space and allowed to dwell and then drained.
excess fluid and waste is removed through osmosis and diffusion
what is the difference between hemodialysis and peritoneal dialyisis? - Answer Hemo:
outpatient, dialyzer is used to remove waste from blood via diffusion and fluid is
removed through ultra filtration.
peritoneal: home setting, peritoneal membrane is the semipermeable membrane that
filters waste and fluid removal occurs via osmotic pressure and concentration
gradients caused by the dextrose solution and dwell times.
when is it known that a patient has developed sensitivity to a dialyzer? - Answer seen
within the first half hour of treatment. sneezing, itching, pain at access site, chest pain,
rashing, hives, fever are symptoms.
alarm conditions - Answer Blood: blood leak, air detector, venous/arterial
pressure, TMP. stops the blood pump therefor blood is not cleaned and no
ultrafiltration. potential for clotting due to stagnant blood
100% Correct \Verified Answers
how is a large/major blood leak treated? - Answer dialysate will apear bloody or
blood tinged. do not return blood.
what are the two most commonly changed electrolytes in dialysate/ - Answer potassium
and calcium- makes changes based on pt's current monthly lab results
steps for treating an infiltrated access - Answer 1. establish that infiltration has occurred
2. sto pdialysis turn off blood pump, clamp bloodlines.
3. notify rn
4. disconnect bloodlines from fistula lines and recirculate blood. flush non-
infiltrated needle with normal saline
5. if infiltration occurred after heparin administration: cap end of needle and secure
(to be removed at end of tx). apply ice
6. if fistula is infiltrated, rest fistula for one treatment when ordered by
nephrologist. next cannulation should be above infiltrate
7. instruct pt to apply ice for 24 hours and watch for complications such as (pain,
reoccurrance of bleeding, elevated temp, additional swelling, absence of a thrill)
8.
,What are the functions of a healthy kidney? - Answer REGULATE,
SYNTHESIS, ENDOCRINE:
Regulate fluid balance, blood volume, electrolytes, acid-base balance,
synthesize calcitrol (active vitamin D), secrete erythropoietin and release renin
what is the glomerular filtration rate in the five stages of kidney disease? - Answer flow
rate of filtered fluid through the kidney
stage 1: 90+
stage 2:60-89
stage 3: 30-59
stage 4: 15-29
stage 5: <15
what are the types and stages of kidney failure? - Answer acute renal failure: sudden
onset, severe, usually reversible. can be caused by drug toxicity, dehydration, or
motor vehicle accident
Chronic renal failure: slow onset, progressive, permanent. can be caused by diabetes,
hypertension, or genetic disease such as glomerulonephritis or nephrosclerosis
what are the signs and symptoms of renal failure or uremia? - Answer elevated serum
levels of BUN/Creatinine, phosphorus, potassium. anemia, nerve damage, yellow-gray
appearance of skin, fluid overload, dyspnea, edema, hypertension, proteinuria, uremia,
lethargy, weakness, headache, itching, fatigue, nausea restlessness, mental change,
loss of appetite.
, what is anemia and how is it treated? - Answer lack of RBC (decreased or lack of
erythropoietin production). iron binds with hemoglobin in RBC and transports oxygen.
it is treated using erythropoieting stimulating agents and usually administered IV.
which of the functions of healthy kidneys are replaced by dialysis? - Answer removal
of waste products and regulation of fluid balance. dialysis does not regulate endocrine
production
list briefly and describe three modalities of treatment for end stage renal disease -
Answer Hemodialysis: uses vascular access to draw blood from patient and send to
dialyzer and into semipermeable membrane where diffusion removes waste products
and ultrafiltration removes fluid. provides approximately 15% of the normal function
of the kidney.
peritoneal dialysis: continuous cycling peritoneal dialysis and continuous ambulatory
peritoneal dialysis. both types use permanent catheter in highly vascularized peritoneal
cavity. dialysate is infused into peritoneal space and allowed to dwell and then drained.
excess fluid and waste is removed through osmosis and diffusion
what is the difference between hemodialysis and peritoneal dialyisis? - Answer Hemo:
outpatient, dialyzer is used to remove waste from blood via diffusion and fluid is
removed through ultra filtration.
peritoneal: home setting, peritoneal membrane is the semipermeable membrane that
filters waste and fluid removal occurs via osmotic pressure and concentration
gradients caused by the dextrose solution and dwell times.
when is it known that a patient has developed sensitivity to a dialyzer? - Answer seen
within the first half hour of treatment. sneezing, itching, pain at access site, chest pain,
rashing, hives, fever are symptoms.
alarm conditions - Answer Blood: blood leak, air detector, venous/arterial
pressure, TMP. stops the blood pump therefor blood is not cleaned and no
ultrafiltration. potential for clotting due to stagnant blood
