Bonent Exam Questions and Answers
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In center hemo must be done - ✔✔3x a week for about 4 hours
Cons of in center HD - ✔✔Most limitation on Diet, fluid than other
modalities
Requires the most medication
Most symptoms
Patients who run 4 hour tx - ✔✔Are 30% less likely to die than pts who run
shorter times
Each 30 mins extra of tx increase life by 7%
Patients are 50% more likely to die after - ✔✔2 day no treatment weekend,
the last 12 hours of the 2 days the risk of death triples
diastolic blood pressure - ✔✔When the heart is at rest.
Benefits of nocturnal in center - ✔✔You get 2x as many txs as standard
because it is longer and more gentle with fluid removal
Rarely cramp
Easy on heart
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Fewer limitations on food and drink
Free days
72% better survival rate than standard in center
You check blood pressure with - ✔✔Stethoscope and sphygmomanometer
Nocturnal in center hemo must be done - ✔✔3x a weeks about 8 hours per
tx
If BP site is below the heart.... - ✔✔The reading will be to high
Benefits of nocturnal home hemo - ✔✔Better protein level
Don't need binders
No fluid limits
Fewer symptoms
Less heart damage
Live as long as people who get a deceased kidney transplant
If BP site is above the heart.... - ✔✔The reading will be to low
Home hemo must be done - ✔✔3x a week 4-6 hours per tx
Benefits of PD - ✔✔Can do alone at home or work
Only need 1-2weeks of training
Allows for a more normal diet
Allows pt to feel more normal
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peritonitis - ✔✔inflammation of the peritoneum, this can scar the
peritoneum and make PD no longer possible, can be avoided by doing a
sterile exchange
2 types of PD - ✔✔Continuous ambulatory peritoneal dialysis (CAPD)
Automated peritoneal dialysis (APD)- uses cycled at night done 8-10 hours
during sleep
During in center HD how much blood is outside of body at a time - ✔✔1/2
cup
Short Daily Home Hemodialysis must be done - ✔✔5-6days a week for the
2.5-4 hour per tx
a bp cuff that is too small or to loose will cause a - ✔✔Higher reading
Nocturnal home hemomust be done - ✔✔At home 3-7 nights a week 8
hours per tx
A no cuff that is to big for a patients arm ... - ✔✔Lower reading
Why would someone want to do more HD than standard? - ✔✔Longer or
more frequent HD is gentle and cause fewer symptoms and may help Pt
live longer, home puts pt in charge
peritoneal dialysis - ✔✔the lining of the peritoneal cavity acts as the filter to
remove waste from the blood through tiny blood vessels.
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Placed in abdomen and sometimes chest wall
Dialysate sits in catheter for a few hours and excess water and waste flows
from BV to the dialysate. The dialysate is then drained and replaced.
(Exchange)
Pt can use a cycle mahjne while they sleep
Can also be done by hand 4xa day and can be done anywhere.
In dialysis patients the reason BP drops during or close to the end of tx is
because - ✔✔The total blood volume drops, from the water removal
regular respiration rate - ✔✔12-16 breaths per minute
In dialysis patients water may enter the lungs due to water weight gains this
can cause - ✔✔Sob or trouble breathing
Payment for dialysis - ✔✔Medicare pays for 80% of dialysis
Medicare makes rules a clinic must follow to provide coverage of tax.
Pt who don't have Medicare before CKD a pt must wait 3 months for it to
cover in center but it will cover home-hemo right away.
2011 change how they pay for dialysis and created a "bundle" (composite
rate, labs,drugs and home training)
Quality Incentive Program - ✔✔Pay for performance, Cuts pay by 2% if
measures aren't met. (Kt/v and hemoglobin)