DAVITA FINAL QUESTIONS WITH CORRECT ANSWERS GRADED A+

AKI - acute kidney injury: encompasses a wide spectrum of kidney issues. Some kidney function. Includes acute renal failure and renal function changes. Can dialyze in outpatient setting. Pre-renal causes of AKI - Not directly happening in kidney, but before. Volume depletion, obstruction, cardiac issues (impaired function). Intra-renal causes of AKI - nephritis, dye, antibiotics, sepsis/septic shock, ischemia, trauma, kidney stones Post-renal causes of AKI - bladder, prostate, obstruction, cancer/tumor, pregnancy How do you help in restoring kidney fucntion? - treat the cause How do you protect kidneys from further injury? - Avoid toxic substances (dye/medication) What is important when monitoring weight and BP? (AKI) - Dont pull too much fluid (keep them wet), dont want to become hypotensive AKI patients are at increased risk for which complication? - hypotension, hypokalemia What do you need to consider in regard to AKI access? - catheter, avoid infection Explain the difference between AKI and CKD - CKD is irreversible Eliminate cause of AKI -- normal kidney function Treatment goals for a patient with CKD - -Slow progression of CKD -Manage comorbidities and complications -Control symptoms -Minimize effects on lifestyle -Renal replacement therapy modality education -Encourage patients to actively participate in healthcare Most common causes of CKD - Diabetes Hypertension Polycystic kidney disease Why is it important to know what caused your patients CKD - monitor and treat (can't reverse) What is Kt/V - how well blood is cleaned What is K? - clearance (urea) What treatment factors decrease K? - Wrong size dialyzer, heparin, poor priming, cutting treatment, decreased BFR What treatment factors increase K? - Increased BFR, correct dialyzer, correct dialysate flow rate, correct target weight including amoutations What is T - time What factors influence T - longer blood/dialysate contact time, more frequent treatments or extra treatments Staying for whole treatment and not missing any What is v - volume (of urea distribution, volume of body water) What factors influence V? - height, weight, sex, age, amputations Needle gauge and suggested BFR - 17g = 200-250 16g= 250-350 15= 350-450 14= 450 Procedure for post BUN lab draw - -turn off or decrease UF to 50 -decrease DFR to 300 or place machine in bypass -reduce BFR to 100 -wait 15s -obtain from arterial line Lab mistakes that would falsely increase Kt/V - -drawing while BFR is at subscribed rate -Not waiting enough time before drawing -drawing from venous blood line Lab mistakes that would falsely decrease Kt/V - -diluting pre-treatment BUN with saline -waiting too long between decreased speed and drawing Data collection - PCT Facts, recorded #s, observations Data assessment - nurse