Bonent exam questions and answers
In center hemo must be done - answer 3x a week for about 4 hours
Cons of in center HD - answer Most limitation on Diet, fluid than other modalities
Requires the most medication
Most symptoms
Patients who run 4 hour tx - answer 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 - answer 2 day no treatment weekend, the last 12 hours of the
2 days the risk of death triples
diastolic blood pressure - answer When the heart is at rest.
Benefits of nocturnal in center - answer You get 2x as many txs as standard because it is longer and
more gentle with fluid removal
Rarely cramp
Easy on heart
Fewer limitations on food and drink
Free days
72% better survival rate than standard in center
You check blood pressure with - answer Stethoscope and sphygmomanometer
Copyright © 2021 Pearson Education, Inc.
,2 Chapter 14: Voting and Apportionment
Nocturnal in center hemo must be done - answer 3x a weeks about 8 hours per tx
If BP site is below the heart.... - answer The reading will be to high
Benefits of nocturnal home hemo - answer 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.... - answer The reading will be to low
Home hemo must be done - answer 3x a week 4-6 hours per tx
Benefits of PD - answer 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
peritonitis - answer 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 - answer 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 - answer 1/2 cup
Copyright © 2021 Pearson Education, Inc.
,Short Daily Home Hemodialysis must be done - answer 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 - answer Higher reading
Nocturnal home hemomust be done - answer At home 3-7 nights a week 8 hours per tx
A no cuff that is to big for a patients arm ... - answer Lower reading
Why would someone want to do more HD than standard? - answer Longer or more frequent HD is
gentle and cause fewer symptoms and may help Pt live longer, home puts pt in charge
peritoneal dialysis - answer the lining of the peritoneal cavity acts as the filter to remove waste from
the blood through tiny blood vessels.
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 - answer The total
blood volume drops, from the water removal
regular respiration rate - answer 12-16 breaths per minute
In dialysis patients water may enter the lungs due to water weight gains this can cause - answer Sob or
trouble breathing
Copyright © 2021 Pearson Education, Inc.
, 4 Chapter 14: Voting and Apportionment
Payment for dialysis - answer 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 - answer Pay for performance, Cuts pay by 2% if measures aren't met. (Kt/v
and hemoglobin)
ESRD networks - answer Oversees quality of care, 18 mostly nonprofit organizations.
Renal physicians association(RPA) - answer 1993 nephrologist made first clinical practice guidelines,
including minimum dose of HD , when to start and stop HD and care for kidney disease for pt not on HD
National Kidney Foundation (NKF) - answer 1995, experts set guidelines for anemia, adequacy, and
vascular access
KDOQI - answer Kidney Disease Outcomes Quality Initiative, improves care and outcomes of all people
with kidney disease
Dialysis Outcomes and Practice Pattern Study - DOPPS - answer Help pts love longer by finding patterns
incenter that can be changed to improve outcome
state survey - answer An inspection of the facility by state surveyors for compliance with rules and
regulations of Medicare. If clinics don't follow they must make a plan of correction.
Continuous Quality Improvement (CQI) - answer Finding problems and fixing them. 4 step process
Copyright © 2021 Pearson Education, Inc.
In center hemo must be done - answer 3x a week for about 4 hours
Cons of in center HD - answer Most limitation on Diet, fluid than other modalities
Requires the most medication
Most symptoms
Patients who run 4 hour tx - answer 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 - answer 2 day no treatment weekend, the last 12 hours of the
2 days the risk of death triples
diastolic blood pressure - answer When the heart is at rest.
Benefits of nocturnal in center - answer You get 2x as many txs as standard because it is longer and
more gentle with fluid removal
Rarely cramp
Easy on heart
Fewer limitations on food and drink
Free days
72% better survival rate than standard in center
You check blood pressure with - answer Stethoscope and sphygmomanometer
Copyright © 2021 Pearson Education, Inc.
,2 Chapter 14: Voting and Apportionment
Nocturnal in center hemo must be done - answer 3x a weeks about 8 hours per tx
If BP site is below the heart.... - answer The reading will be to high
Benefits of nocturnal home hemo - answer 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.... - answer The reading will be to low
Home hemo must be done - answer 3x a week 4-6 hours per tx
Benefits of PD - answer 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
peritonitis - answer 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 - answer 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 - answer 1/2 cup
Copyright © 2021 Pearson Education, Inc.
,Short Daily Home Hemodialysis must be done - answer 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 - answer Higher reading
Nocturnal home hemomust be done - answer At home 3-7 nights a week 8 hours per tx
A no cuff that is to big for a patients arm ... - answer Lower reading
Why would someone want to do more HD than standard? - answer Longer or more frequent HD is
gentle and cause fewer symptoms and may help Pt live longer, home puts pt in charge
peritoneal dialysis - answer the lining of the peritoneal cavity acts as the filter to remove waste from
the blood through tiny blood vessels.
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 - answer The total
blood volume drops, from the water removal
regular respiration rate - answer 12-16 breaths per minute
In dialysis patients water may enter the lungs due to water weight gains this can cause - answer Sob or
trouble breathing
Copyright © 2021 Pearson Education, Inc.
, 4 Chapter 14: Voting and Apportionment
Payment for dialysis - answer 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 - answer Pay for performance, Cuts pay by 2% if measures aren't met. (Kt/v
and hemoglobin)
ESRD networks - answer Oversees quality of care, 18 mostly nonprofit organizations.
Renal physicians association(RPA) - answer 1993 nephrologist made first clinical practice guidelines,
including minimum dose of HD , when to start and stop HD and care for kidney disease for pt not on HD
National Kidney Foundation (NKF) - answer 1995, experts set guidelines for anemia, adequacy, and
vascular access
KDOQI - answer Kidney Disease Outcomes Quality Initiative, improves care and outcomes of all people
with kidney disease
Dialysis Outcomes and Practice Pattern Study - DOPPS - answer Help pts love longer by finding patterns
incenter that can be changed to improve outcome
state survey - answer An inspection of the facility by state surveyors for compliance with rules and
regulations of Medicare. If clinics don't follow they must make a plan of correction.
Continuous Quality Improvement (CQI) - answer Finding problems and fixing them. 4 step process
Copyright © 2021 Pearson Education, Inc.
