DVU FINAL EXAM PCT UPDATED QUESTIONS AND
ANSWERS
What are the consequences of organ stunning on the heart? - CORRECT ANSWER✅✅✅Acute stress
on cardiovascular system, development of LV region wall motion abnormalities, triggers arrythmias, can
lead to cardiac failure
What are the consequences of organ stunning on the gut? - CORRECT ANSWER✅✅✅Releases
endotoxin into circulation, inflammation
What are the consequences of organ stunning on the kidneys? - CORRECT ANSWER✅✅✅Causes
fibrosis, loss of RRF
What are the consequences of organ stunning on the brain? - CORRECT ANSWER✅✅✅Causes
multiple sites with white matter injury
Define muscle cramps - CORRECT ANSWER✅✅✅Painful muscle contractions in extremities or
abdomen
What are the causes of muscle cramps? - CORRECT ANSWER✅✅✅Rapid of excessive fluid removal,
hypo osmolality, tissue hypoxia/ischemia, electrolyte disorders or imbalances: low sodium, calcium,
potassium, magnesium, any local irritating factor or metabolic abnormality of a muscle
What is the intervention for muscle cramps? - CORRECT ANSWER✅✅✅Turn off UF or reduce fluid
removal to acceptable limits, discuss longer treatment times with MD
What can you do to prevent muscle cramps? - CORRECT ANSWER✅✅✅Educate patient on
acceptable fluid weight gains between treatments, lower UFR, longer treatment time with MD order
Define fever and chills - CORRECT ANSWER✅✅✅Any temperature > 100 degrees or increase over
baseline of 2 degrees with symptoms
,What are the causes of fever and chills during dialysis? - CORRECT ANSWER✅✅✅Systemic
infections, access infections
What are the symptoms of fever and chills? - CORRECT ANSWER✅✅✅Nausea/vomiting, headache,
hypotension, tachycardia, hot flushed skin, and dry mucus membranes
What are the interventions for fever and chills? - CORRECT ANSWER✅✅✅Nurse must assess and
evaluate patient for possible cause of fever. If ordered by physician, obtain blood cultures per procedure
and send to lab. Provide comfort measures and administer antipyretics as ordered. Administer
antibiotics as ordered. Schedule patient for permanent access evaluation.
How can you prevent fever and chills? - CORRECT ANSWER✅✅✅Avoid use of femoral catheters,
evaluate teammates technique
What is a pyrogenic reaction? - CORRECT ANSWER✅✅✅Pyrogenic (fever) reaction is caused by
pyrogens, such as endotoxins
What are the causes of a pyrogenic reaction? - CORRECT ANSWER✅✅✅Break in water treatment or
if there is an endotoxin in a reprocessed dialyzer
What are the symptoms of a pyrogenic reaction? - CORRECT ANSWER✅✅✅Chills, shaking fever,
hypotension, vomiting, muscle pain
What is the intervention for a pyrogenic reaction? - CORRECT ANSWER✅✅✅Stop treatment, obtain
cultures and LAL's from dialyzers, dialysate per policy. Notify charge nurse and physician and implement
orders received. Document occurrences, treatment, and patient response. Sequester dialyzer, blood
lines for possible testing. Place in red bag. Label with patient name, date, and "NOT FOR PATIENT USE."
Store in lab refrigerator.
How can you prevent a pyrogenic reaction? - CORRECT ANSWER✅✅✅Proper water treatment and
disinfection of equipment. Proper reuse procedures. Proper preparation of dialysate. Proper machine
set up and priming.
, Define seizures - CORRECT ANSWER✅✅✅Involuntary muscle spasms and loss of consciousness
What are the causes of seizures in dialysis patients during treatment? - CORRECT
ANSWER✅✅✅Sever hypotension, dialysis disequilibrium syndrome, or an adverse reaction to a
problem such as the use of improperly prepared dialysate. Electrolyte/ acid base balance or imbalance,
hypotension, hypovolemia, hypoglycemia, hypoxemia, intracranial bleeding hastened by heparin,
removal of anticonvulsants by HD, hemodynamic instability including rapid change in BP, severe
hypertension, too rapid transfusion
What are the symptoms of seizures? - CORRECT ANSWER✅✅✅Change in level of consciousness,
twitching and jerking movements of the extremities.
What is the intervention for seizures? - CORRECT ANSWER✅✅✅A licensed nurse will assess a
patient to determine cause and intervention to protect the patient from harm. In general, intervention
includes: reduction of UFR and administration of NS if hypotensive, D/C dialysis if no response. O2
administration, termination of HD in severe cases, provision of airway support, obtaining labs for
glucose, calcium and other electrolytes with MD orders.
How can you prevent seizures? - CORRECT ANSWER✅✅✅Dialysis should not have been initiated
without notifying a nurse and a nursing assessment- including notifying the nephrologist.
What is dialysis disequilibrium syndrome? - CORRECT ANSWER✅✅✅A condition in which rapid or
drastic changes in the patients extracellular fluid affect the brain.
What are the causes of dialysis disequilibrium syndrome? - CORRECT ANSWER✅✅✅Urea transfers
more slowly from the brain tissue to the blood, so fluid is drawn into the brain causing swelling via
osmosis. This can occur in AKI patients of when BUN levels are very high, missed treatments
What are the symptoms of DDS? - CORRECT ANSWER✅✅✅Headache, hypertension, nausea,
restlessness, seizures, confusion, blurred vision
What is the intervention for DDS? - CORRECT ANSWER✅✅✅Decrease efficiency of dialysis with MD
order (decrease BFr and DFR, decrease treatment time, shorter more frequent treatments
ANSWERS
What are the consequences of organ stunning on the heart? - CORRECT ANSWER✅✅✅Acute stress
on cardiovascular system, development of LV region wall motion abnormalities, triggers arrythmias, can
lead to cardiac failure
What are the consequences of organ stunning on the gut? - CORRECT ANSWER✅✅✅Releases
endotoxin into circulation, inflammation
What are the consequences of organ stunning on the kidneys? - CORRECT ANSWER✅✅✅Causes
fibrosis, loss of RRF
What are the consequences of organ stunning on the brain? - CORRECT ANSWER✅✅✅Causes
multiple sites with white matter injury
Define muscle cramps - CORRECT ANSWER✅✅✅Painful muscle contractions in extremities or
abdomen
What are the causes of muscle cramps? - CORRECT ANSWER✅✅✅Rapid of excessive fluid removal,
hypo osmolality, tissue hypoxia/ischemia, electrolyte disorders or imbalances: low sodium, calcium,
potassium, magnesium, any local irritating factor or metabolic abnormality of a muscle
What is the intervention for muscle cramps? - CORRECT ANSWER✅✅✅Turn off UF or reduce fluid
removal to acceptable limits, discuss longer treatment times with MD
What can you do to prevent muscle cramps? - CORRECT ANSWER✅✅✅Educate patient on
acceptable fluid weight gains between treatments, lower UFR, longer treatment time with MD order
Define fever and chills - CORRECT ANSWER✅✅✅Any temperature > 100 degrees or increase over
baseline of 2 degrees with symptoms
,What are the causes of fever and chills during dialysis? - CORRECT ANSWER✅✅✅Systemic
infections, access infections
What are the symptoms of fever and chills? - CORRECT ANSWER✅✅✅Nausea/vomiting, headache,
hypotension, tachycardia, hot flushed skin, and dry mucus membranes
What are the interventions for fever and chills? - CORRECT ANSWER✅✅✅Nurse must assess and
evaluate patient for possible cause of fever. If ordered by physician, obtain blood cultures per procedure
and send to lab. Provide comfort measures and administer antipyretics as ordered. Administer
antibiotics as ordered. Schedule patient for permanent access evaluation.
How can you prevent fever and chills? - CORRECT ANSWER✅✅✅Avoid use of femoral catheters,
evaluate teammates technique
What is a pyrogenic reaction? - CORRECT ANSWER✅✅✅Pyrogenic (fever) reaction is caused by
pyrogens, such as endotoxins
What are the causes of a pyrogenic reaction? - CORRECT ANSWER✅✅✅Break in water treatment or
if there is an endotoxin in a reprocessed dialyzer
What are the symptoms of a pyrogenic reaction? - CORRECT ANSWER✅✅✅Chills, shaking fever,
hypotension, vomiting, muscle pain
What is the intervention for a pyrogenic reaction? - CORRECT ANSWER✅✅✅Stop treatment, obtain
cultures and LAL's from dialyzers, dialysate per policy. Notify charge nurse and physician and implement
orders received. Document occurrences, treatment, and patient response. Sequester dialyzer, blood
lines for possible testing. Place in red bag. Label with patient name, date, and "NOT FOR PATIENT USE."
Store in lab refrigerator.
How can you prevent a pyrogenic reaction? - CORRECT ANSWER✅✅✅Proper water treatment and
disinfection of equipment. Proper reuse procedures. Proper preparation of dialysate. Proper machine
set up and priming.
, Define seizures - CORRECT ANSWER✅✅✅Involuntary muscle spasms and loss of consciousness
What are the causes of seizures in dialysis patients during treatment? - CORRECT
ANSWER✅✅✅Sever hypotension, dialysis disequilibrium syndrome, or an adverse reaction to a
problem such as the use of improperly prepared dialysate. Electrolyte/ acid base balance or imbalance,
hypotension, hypovolemia, hypoglycemia, hypoxemia, intracranial bleeding hastened by heparin,
removal of anticonvulsants by HD, hemodynamic instability including rapid change in BP, severe
hypertension, too rapid transfusion
What are the symptoms of seizures? - CORRECT ANSWER✅✅✅Change in level of consciousness,
twitching and jerking movements of the extremities.
What is the intervention for seizures? - CORRECT ANSWER✅✅✅A licensed nurse will assess a
patient to determine cause and intervention to protect the patient from harm. In general, intervention
includes: reduction of UFR and administration of NS if hypotensive, D/C dialysis if no response. O2
administration, termination of HD in severe cases, provision of airway support, obtaining labs for
glucose, calcium and other electrolytes with MD orders.
How can you prevent seizures? - CORRECT ANSWER✅✅✅Dialysis should not have been initiated
without notifying a nurse and a nursing assessment- including notifying the nephrologist.
What is dialysis disequilibrium syndrome? - CORRECT ANSWER✅✅✅A condition in which rapid or
drastic changes in the patients extracellular fluid affect the brain.
What are the causes of dialysis disequilibrium syndrome? - CORRECT ANSWER✅✅✅Urea transfers
more slowly from the brain tissue to the blood, so fluid is drawn into the brain causing swelling via
osmosis. This can occur in AKI patients of when BUN levels are very high, missed treatments
What are the symptoms of DDS? - CORRECT ANSWER✅✅✅Headache, hypertension, nausea,
restlessness, seizures, confusion, blurred vision
What is the intervention for DDS? - CORRECT ANSWER✅✅✅Decrease efficiency of dialysis with MD
order (decrease BFr and DFR, decrease treatment time, shorter more frequent treatments
