Davita Exam 2024 Questions and
Correct Answers Rated A+
Explain the four transport mechanisms that play a role in hemodialysis
-ANSWER-● Ultrafiltration: Fluid is pushed through a semipermeable
membrane.
● Convection: Or solute drag means that solutes move with the water
across the semipermeable membrane. In this way, convection adds to
the clearance achieved through diffusion as solutes are dragged along
with the ultrafiltrate.
● Diffusion: Is the movement of dissolved particles across a
semipermeable membrane from the side with the higher concentration
to the side with the lower concentration. This difference in solute
concentration on each side of the membrane is called concentration
gradient. The higher the concentration gradient, the faster diffusion
occurs. Once the concentration of a dissolved particle is the same on
both sides of the semipermeable membrane, diffusion stops.
● Osmosis: Is a chemical process by which dissolved chemicals will
migrate from an area of high concentration to one of low
concentration. Essentially if you dissolve something in a liquid, the
dissolved compounds (called solutes) will spread out until there is
an equal concentration of solute everywhere.
What are the kidneys excretory functions -ANSWER-To normalize
electrolytes, remove wastes, provide fluid and nutrient balance
What is the function of the acid concentration -ANSWER-Provides the
concentration gradient for diffusion and helps normalize electrolytes
What is the function of bicarbonate -ANSWER-Buffers the acid
concentrate
,Signs and symptoms of hyperkalemia -ANSWER-> 5.5 mEq: extreme
muscle weakness, abnormal heart rhythm, possible cardiac arrest
Signs and symptoms of hypokalemia -ANSWER-< 3.5 mEq: fatigue,
muscle weakness, paralysis, respiratory failure, cardiac instability,
arrhythmias, cardiac arrest
What are the kidneys endocrine functions -ANSWER-Renin secretion,
Erythropoeitin secretion, Vit D Activation
How do we replace normal endocrine kidney functions -ANSWER-
Provide medications
How much of normal kidney function is replaced by hemodialysis -
ANSWER-15%
What is uremia and how does it affect the body? -ANSWER-Uremia is
a buildup of wastes in the blood due to kidney failure and affects all
body systems.
What are the most common causes of CKD in the usa? -ANSWER-
Diabetes
Hypertension
Polycystic Kidney Disease
Outline the treatment goals for a patient with CKD -ANSWER--slowing
the progression of ckd
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects of ckd on patients' lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Why is it important to know what caused your patients CKD -
ANSWER-So the nurse and PCT can inquire about possible problems
during data collection and assessment
,Why is sodium balance important? -ANSWER-Leads to volume
expansion, increased cardiac output, increased peripheral vascular
resistance, and increased blood pressure
Signs and symptoms of fluid imbalance -ANSWER-Edema,
hypertension, shortness of breath
Systemic effects of CKD what would you advise for a patient who
complains of: dry itchy skin, peripheral neuropathy(nerve pain in
extremities) and gi problems -ANSWER-Use hyper-fatted soaps and
lotions, monitor patient for changes in motor function and inform RN
and physician of any bleeding problems/constipation/diarrhea
What is the consequences of prolonged fluid overload and
hypertension -ANSWER-Left ventricular hypertrophy
What is Percarditis? -ANSWER-Inflammation of the membrane
(pericardial sac) around the heart
What is a common cause of hypertension in dialysis patients -
ANSWER-fluid overload
Left ventricular hypertrophy leads to -ANSWER-Ischemic heart
disease, arrhythmia, myocardial infarction, and sudden death
Why are dialysis patients anemic? -ANSWER-1. the lifespan of their
red blood cell is 60 days 1/2 of the normal 120 days.
What can you do to avoid contributing to lower hemoglobin and blood
loss in dialysis patients -ANSWER-Verify correct Erythropoietin
Stimulating Agent (ESA) dose is administered, rinse back until venous
line is pink tinged, and avoid repeat lab draws
What are the 4 key elements contributing to CKD-mineral bone
disorder(MBD) -ANSWER-1. Calcium
2. Phosphorus
, 3. PTH
4. Vitamin D (Calcitriol)
What are the symptoms of CKD-MBD in addition to bone disease -
ANSWER-Soft tissue calcification, itching, muscle weakness,
pathological fractures, tendon ruptures, compression of vertebrae,
atherosclerosis, heart disease
What is your role in CKD-MBD management -ANSWER-*report
symptoms * urge patients to take meds (home & treatment)
*report noncompliance problems related to nonadherence
Define the term AKI -ANSWER-- Term incorporates a wide spectrum
of kidney issues
- Includes acute kidney failure as well as less catastrophic kidney
function changes
- May dialyze in an out-patient facility until kidney function recovers
Give 3 examples of pre-, intra- and post-renal causes of AKI -
ANSWER-Pre: Obstruction, volume depletion, impaired cardiac
function.
Intra: ischemic ATN, sepsis, SIRS, septic shock, anaphylaxis drugs,
Goodpasture Syndrome, Acute Glomerulonephritis, Trauma, open
heart surgery.
Post: Obstruction, Oliguric, bladder rupture, pregnancy.
Explain the difference between AKI and CKD -ANSWER-Eliminating
the cause of the AKI can often lead to the return of kidney function.
You
cannot eliminate the cause of CKD which is HTN, Diabetes, genetic
disorders (PKD)
Outline the treatment goals for a patient with AKI dialyzing in the out-
patient facility -ANSWER-- Find cause of AKI to restore function
- Careful to avoid catheter related infections
Correct Answers Rated A+
Explain the four transport mechanisms that play a role in hemodialysis
-ANSWER-● Ultrafiltration: Fluid is pushed through a semipermeable
membrane.
● Convection: Or solute drag means that solutes move with the water
across the semipermeable membrane. In this way, convection adds to
the clearance achieved through diffusion as solutes are dragged along
with the ultrafiltrate.
● Diffusion: Is the movement of dissolved particles across a
semipermeable membrane from the side with the higher concentration
to the side with the lower concentration. This difference in solute
concentration on each side of the membrane is called concentration
gradient. The higher the concentration gradient, the faster diffusion
occurs. Once the concentration of a dissolved particle is the same on
both sides of the semipermeable membrane, diffusion stops.
● Osmosis: Is a chemical process by which dissolved chemicals will
migrate from an area of high concentration to one of low
concentration. Essentially if you dissolve something in a liquid, the
dissolved compounds (called solutes) will spread out until there is
an equal concentration of solute everywhere.
What are the kidneys excretory functions -ANSWER-To normalize
electrolytes, remove wastes, provide fluid and nutrient balance
What is the function of the acid concentration -ANSWER-Provides the
concentration gradient for diffusion and helps normalize electrolytes
What is the function of bicarbonate -ANSWER-Buffers the acid
concentrate
,Signs and symptoms of hyperkalemia -ANSWER-> 5.5 mEq: extreme
muscle weakness, abnormal heart rhythm, possible cardiac arrest
Signs and symptoms of hypokalemia -ANSWER-< 3.5 mEq: fatigue,
muscle weakness, paralysis, respiratory failure, cardiac instability,
arrhythmias, cardiac arrest
What are the kidneys endocrine functions -ANSWER-Renin secretion,
Erythropoeitin secretion, Vit D Activation
How do we replace normal endocrine kidney functions -ANSWER-
Provide medications
How much of normal kidney function is replaced by hemodialysis -
ANSWER-15%
What is uremia and how does it affect the body? -ANSWER-Uremia is
a buildup of wastes in the blood due to kidney failure and affects all
body systems.
What are the most common causes of CKD in the usa? -ANSWER-
Diabetes
Hypertension
Polycystic Kidney Disease
Outline the treatment goals for a patient with CKD -ANSWER--slowing
the progression of ckd
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects of ckd on patients' lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Why is it important to know what caused your patients CKD -
ANSWER-So the nurse and PCT can inquire about possible problems
during data collection and assessment
,Why is sodium balance important? -ANSWER-Leads to volume
expansion, increased cardiac output, increased peripheral vascular
resistance, and increased blood pressure
Signs and symptoms of fluid imbalance -ANSWER-Edema,
hypertension, shortness of breath
Systemic effects of CKD what would you advise for a patient who
complains of: dry itchy skin, peripheral neuropathy(nerve pain in
extremities) and gi problems -ANSWER-Use hyper-fatted soaps and
lotions, monitor patient for changes in motor function and inform RN
and physician of any bleeding problems/constipation/diarrhea
What is the consequences of prolonged fluid overload and
hypertension -ANSWER-Left ventricular hypertrophy
What is Percarditis? -ANSWER-Inflammation of the membrane
(pericardial sac) around the heart
What is a common cause of hypertension in dialysis patients -
ANSWER-fluid overload
Left ventricular hypertrophy leads to -ANSWER-Ischemic heart
disease, arrhythmia, myocardial infarction, and sudden death
Why are dialysis patients anemic? -ANSWER-1. the lifespan of their
red blood cell is 60 days 1/2 of the normal 120 days.
What can you do to avoid contributing to lower hemoglobin and blood
loss in dialysis patients -ANSWER-Verify correct Erythropoietin
Stimulating Agent (ESA) dose is administered, rinse back until venous
line is pink tinged, and avoid repeat lab draws
What are the 4 key elements contributing to CKD-mineral bone
disorder(MBD) -ANSWER-1. Calcium
2. Phosphorus
, 3. PTH
4. Vitamin D (Calcitriol)
What are the symptoms of CKD-MBD in addition to bone disease -
ANSWER-Soft tissue calcification, itching, muscle weakness,
pathological fractures, tendon ruptures, compression of vertebrae,
atherosclerosis, heart disease
What is your role in CKD-MBD management -ANSWER-*report
symptoms * urge patients to take meds (home & treatment)
*report noncompliance problems related to nonadherence
Define the term AKI -ANSWER-- Term incorporates a wide spectrum
of kidney issues
- Includes acute kidney failure as well as less catastrophic kidney
function changes
- May dialyze in an out-patient facility until kidney function recovers
Give 3 examples of pre-, intra- and post-renal causes of AKI -
ANSWER-Pre: Obstruction, volume depletion, impaired cardiac
function.
Intra: ischemic ATN, sepsis, SIRS, septic shock, anaphylaxis drugs,
Goodpasture Syndrome, Acute Glomerulonephritis, Trauma, open
heart surgery.
Post: Obstruction, Oliguric, bladder rupture, pregnancy.
Explain the difference between AKI and CKD -ANSWER-Eliminating
the cause of the AKI can often lead to the return of kidney function.
You
cannot eliminate the cause of CKD which is HTN, Diabetes, genetic
disorders (PKD)
Outline the treatment goals for a patient with AKI dialyzing in the out-
patient facility -ANSWER-- Find cause of AKI to restore function
- Careful to avoid catheter related infections
