DVU Final Exam PCT Comprehensive Questions and Answers 100% Already Graded A+ Excel

DVU Final Exam PCT Comprehensive Questions and Answers 100% Already Graded A+ Excel 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 How can you prevent DDS? - CORRECT ANSWER-Early recognition of mild symptoms. Decrease efficiency by: less efficient dialyzer, decreased treatment time, decreased BFR and DFR, and shorter, more frequent dilaysis treatment Blood loss - CORRECT ANSWER-Any loss of blood during the dialysis process. The fist covers a surface area of blood that equals 20 mL of blood. What are the causes of blood loss during treatment? - CORRECT ANSWER-Arterial of venous blood line separation, dialyzer leak or rupture, needle dislodgment, clotting of extracorporeal system What are the symptoms of blood loss? - CORRECT ANSWER-Blood on floor, chair, or clothing. Blood leak detector alarm. VP alarm if needle dislodgment or line separation. Circuit clotting, TMP alarm, visible clots in drip chamber.