Hemodialysis Exam with Complete
Solutions
What is hemodialysis? - ANSWER-most common renal replacement therapy used in
ESKD and kidney failure
Where may hemodialysis be preformed? - ANSWER--in-patient procedure on critically ill
patients
-out-patient for more stable patients
What happens during hemodialysis? - ANSWER--blood and dialysate run in different
directions
-toxins are diffused into the dialysate, leaving the patient's blood free from toxins/at least
reduced toxins
What is dialysate? - ANSWER-dialyzing solution that mimics human plasma
What is given during hemodialysis to prevent clotting? - ANSWER-anticoagulants
What type of anticoagulant is given during hemodialysis? - ANSWER-heparin
What is the antidote for heparin? - ANSWER-protamine sulfate
When HD is expected to be used for several weeks what type of catheter is used? -
ANSWER-subclavian dialysis catheter
What is a subclavian dialysis catheter? - ANSWER--a radiopaque tube that can be used
for hemodialysis
-Y-shaped tubing allows arterial outflow and venous return through a single catheter
What are the types of subclavian dialysis catheters? - ANSWER--Mahurkar catheter
-PermCath Catheter
What is a Mahurkar catheter? - ANSWER--made of polyurethane
-used for short-term access
What is a PermCath catheter? - ANSWER--made of silicone
-used for long-term access
What are the advantages of hemodialysis? - ANSWER--more efficient clearance
-short time needed for treatment
, What are possible complications of hemodialysis? - ANSWER--disequilibrium syndrome
-muscle cramps
-hemorrhage
-air embolus
-hemodynamic changes (hypotension, anemia)
-cardiac dysrhythmias
-infection
What is contraindicated in hemodialysis? - ANSWER-hemodynamically instability
What type of access is used in hemodialysis? - ANSWER--vascular route
What complications can occur with vascular access? - ANSWER--thrombosis (most
frequent)
-stenosis
-infections
-aneurysms
-ischemia
-heart failure
What are berry aneurysms? - ANSWER-small, berry-shaped outpouchings of the main
arteries that supply the brain
Why are berry aneurysms dangerous? - ANSWER--they are susceptible to rupture
-often lead to fatal bleeding within the brain
What medications should be given after HD treatment? - ANSWER--antibiotics
-vasoactive drugs
Why should antibiotic be given after HD treatment? - ANSWER--dialyzable
-can be partially removed from blood during dialysis
Why should vasoactive medications be given after HD treatment? - ANSWER--cause
hypotension during HD
What type of procedure is involved in hemodialysis? - ANSWER--complex
-specially trained registered nurse required
What are the nursing implications in hemodialysis? - ANSWER--vascular access care
-restrict diet
What does the survival rate of a patient on HD depend on? - ANSWER--age
-cause of kidney failure
-presence of other diseases (CAD, HTN, DM)
Solutions
What is hemodialysis? - ANSWER-most common renal replacement therapy used in
ESKD and kidney failure
Where may hemodialysis be preformed? - ANSWER--in-patient procedure on critically ill
patients
-out-patient for more stable patients
What happens during hemodialysis? - ANSWER--blood and dialysate run in different
directions
-toxins are diffused into the dialysate, leaving the patient's blood free from toxins/at least
reduced toxins
What is dialysate? - ANSWER-dialyzing solution that mimics human plasma
What is given during hemodialysis to prevent clotting? - ANSWER-anticoagulants
What type of anticoagulant is given during hemodialysis? - ANSWER-heparin
What is the antidote for heparin? - ANSWER-protamine sulfate
When HD is expected to be used for several weeks what type of catheter is used? -
ANSWER-subclavian dialysis catheter
What is a subclavian dialysis catheter? - ANSWER--a radiopaque tube that can be used
for hemodialysis
-Y-shaped tubing allows arterial outflow and venous return through a single catheter
What are the types of subclavian dialysis catheters? - ANSWER--Mahurkar catheter
-PermCath Catheter
What is a Mahurkar catheter? - ANSWER--made of polyurethane
-used for short-term access
What is a PermCath catheter? - ANSWER--made of silicone
-used for long-term access
What are the advantages of hemodialysis? - ANSWER--more efficient clearance
-short time needed for treatment
, What are possible complications of hemodialysis? - ANSWER--disequilibrium syndrome
-muscle cramps
-hemorrhage
-air embolus
-hemodynamic changes (hypotension, anemia)
-cardiac dysrhythmias
-infection
What is contraindicated in hemodialysis? - ANSWER-hemodynamically instability
What type of access is used in hemodialysis? - ANSWER--vascular route
What complications can occur with vascular access? - ANSWER--thrombosis (most
frequent)
-stenosis
-infections
-aneurysms
-ischemia
-heart failure
What are berry aneurysms? - ANSWER-small, berry-shaped outpouchings of the main
arteries that supply the brain
Why are berry aneurysms dangerous? - ANSWER--they are susceptible to rupture
-often lead to fatal bleeding within the brain
What medications should be given after HD treatment? - ANSWER--antibiotics
-vasoactive drugs
Why should antibiotic be given after HD treatment? - ANSWER--dialyzable
-can be partially removed from blood during dialysis
Why should vasoactive medications be given after HD treatment? - ANSWER--cause
hypotension during HD
What type of procedure is involved in hemodialysis? - ANSWER--complex
-specially trained registered nurse required
What are the nursing implications in hemodialysis? - ANSWER--vascular access care
-restrict diet
What does the survival rate of a patient on HD depend on? - ANSWER--age
-cause of kidney failure
-presence of other diseases (CAD, HTN, DM)
