Davita Quiz Questions with Correct Solutions Rated A+

Acute Kidney Injury RIFLE acronymn - Risk Injury Failure Loss End-stage Renal disease Patients with AKI always require - An assessment prior to initiation of treatment What are the 3 sub groups of AKI - Pre, Intra and Post renal Pre Renal AKI example - decreased BF to kidney Intra Renal AKI example - injury to kidney Post renal example - Reduced urine flow out of kidney Main treatment goals of AKI - Restore kidney function Protect from further injury 3 sub groups of CKD - Pre, Intra and Post CKD Pre Renal CKD example cause - prolonged shock Intra Renal CKD example cause - diabetes HTN Medications Lupus Post Renal CKD example cause - Stones Tumor BPH Treatment Goals of Chronic kidney d disease - Slow progression of CKD Mangage co-morbities and symptoms What is the K in Kt/V - clearance of urea What is the t in Kt/V - time of dialysis session What is the v in Kt/V - total volume of patients body water (surface area) What factors influence K - Surface area of dialyzer Adequate anticoagulation BFR DFR BVP *Proper Priming* Factors influencing T - More frequent or longer treatments Factors influencing V - Amputations Height Weight Sex What is the Goal for Urea Reduction Ratio (URR) - 65% or greater What is the the BFR & Arterial pressure for a 17 gauge needle - 200-250 ml/min NO greater than -150 What is the BFR & Arterial Pressure for a 16 gauge needle - 250-350 ml/min No greater than -200 What is the BFR & Arterial Pressure for 15 gauge needle - 350-450 ml/min No greater than -220 What is the BFR & Arterial Pressure for a 14 gauge needle - 450+ ml/min No greater than -260 Steps for Drawing a Post BUN lab - -Turn off or decrease UF to 50 ml/hr -Place in bypass or decrease DFR to 300 -Reduce BFR to 100 -Wait 15 seconds -Obtain from arterial line Accidentally diluting the pre treatment with saline would cause the Kt/V to be falsely - Low Drawing a post BUN without decreasing the BFR would cause the Kt/V to be falsely - High Waiting only 5 seconds between lowering the blood pump speed and drawing a post BUN would cause the Kt/V to be falsely - High Drawing the post BUN from the venous line would cause a reading falsely - High Waiting longer than 15 seconds between decreasing BFR and drawing lab would cause a reading falsely - Low Purpose of Data Collection - -Obtain baseline information for planning dialysis treatment -Monitor PT and verifying theyre stable post treatment What is the role of the PCT prior to treatment initiation? - Collect data and report any abnormal findings to the nurse What is one thing you should never do to the blood pressure cuff - Squeeze the air out of it What is considered an abnormal systolic and diastolic BP - SBP: greater than 180 or less than 90 DBP: greater than 100 -Or an increase or decrease of 20 mm Hg with signs and symptoms of hypotension What is considered an abnormal HR - outside of 60-100 What is considered an abnormal resp rate - Greater than 24 or Shortness of breath What is considered an abnormal temperature - Greater than 100 or an increase of 2 degrees from baseline What is the saying for assessing a vascular access and what are you looking for - Look, Listen, Feel -Looking for swelling, pain, redness, blood flow What level of pain on a scale to 10 is considered abnormal - 4 or greater It is considered abnormal if after a dialysis treatment a patient weighs more or less than (blank) kgs - 1 Abnormal BP post dialysis treatment - SVP: greater than 140 or less than 90 DBP: greater than 90 or less than 50 What is the purpose of Davita Quality Index - To encourage continual improvement across a broad range of disease managment processes What is the purpose of documentation - -Proof that care was rendered -Provides data continuity -Permanent legal record -Communication tool When do we as nurses need to document - -When there is a change from baseline -Change in patient condition -Procedure or treatment -Meds given and the PT response -Patient teaching -Care plan review and interventions