480- Complex Final Exam; Module 6 (Renal Disorders) New Update 2023

480- Complex Final Exam; Module 6 (Renal Disorders) New Update 2023 Review the passive process of osmosis - CORRECT ANSWER -dissolved substances, such as urea and creatinine, diffuse across the membrane from an area of greater concentration (blood) to an area of lesser concentration (dialysate) -water molecules move across the membrane by osmosis to the solution that contains fewer water molecules Describe how dialysate is formulation - CORRECT ANSWER -it is formulated with varying concentrations of *dextrose* or *sodium* to produce an osmotic gradient this pulls excess water from the circulatory system All forms of dialysis make use of the principles of _____ and _______ to: - CORRECT ANSWER -osmosis -diffusion to remove waste products and excess fluid from the blood A semipermeable membrane is the: - CORRECT ANSWER -dialysis circuit between the blood and the dialysate Venous Catheters - CORRECT ANSWER -dual-lumen catheters inserted into large central veins (femoral, int jug, subclav) are used for acutely ill patients who need: hemodialysis continuous venovenous hemofiltration (CVVH) continuous venovenous hemofiltration with dialysis (CVVH/D) acute dialysis chronic dialysis (who are waiting for permanent access [av fistula or graft] to mature) -tunneled dual-lumen often used as permanent access i Nursing Interventions for the Patient with Dialysis Vascular Access: dual-lumen venous catheter - CORRECT ANSWER -if in upper torso, such as subclavian or internal jugular position, verify central line catheter placement radiographically before use -do not inject IV fluids or medication into the catheter; both lumens of the catheter may be filled with concentrated heparin -do not unclamp the catheter unless preparing for dialysis therapy; this can cause blood to fill the lumen and clot -maintain sterile technique in handling vascular access -observe catheter exit site for signs of inflammation or catheter kinking Nursing care for catheters used for dialysis - CORRECT ANSWER -care must be taken to avoid accidental slippage and dislodgement during hemodialysis they are usually secured with sutures and sterile dressing -central venous catheters can be used for up to 3-4 weeks used tunneled dialysis catheters to reduce line-associated blood infections if hemodialysis will last longer than 3 weeks -pressure applied to puncture site after removal -maintain catheter patency Arteriovenous Fistulas - CORRECT ANSWER -anastomoses an artery and a vein, creating a fistula or artificial opening between them -benefits: avoidance of inserting a foreign object into body; infection is reduced -maintaining blood flow through fistula is priority