Davita Exam Prep Questions with 100% Correct Solutions

what is the correct procedure for residual bleach testing after chemical disinfection loops and equipment fluid pathways? - Residual bleach testing is performed after bleach disinfection and prior to use To avoid bacterial proliferation rapid reproduction within the extracorporeal circuit once primed the recirculation of saline within the dialyzer and blood lines should not exceed _______________ prior to initiating the hemodialysis treatment - 2 hours Why is strikethrough of an external pressure transducer protector of concern? - Fluid could have entered the machine and contaminated the internal pressure transducer protector providing a reservoir for microorganism and causing subsequent patient blood infections Machine alarm test are performed - Before the initiation of each patient treatment Which is a true statement regarding the monitoring testing and verification of conductivity prior to each patient treatment for all fresenius machine models and the B Braun system - The B Braun machine conductivity is verified on the ENDLE machine screen manual conductivity testing with an independent meter must be within +/-0.4 MS of the theoretical conductivity TCD for both the B braun and fresenius machines What is the safe range for Dialysate pH - Between 6.9 and 7.6 The transport mechanism when particles move from an area of higher solute concentration to an area of lower solute concentration is called - Diffusion If a patient with acute kidney injury AKI dialyzes in the outpatient facility one task of the patient care teammate is to monitor blood pressure and weight closely why is this important - Hypokalemia and hypotensive episodes can cause renal ischemia and can further damage the kidneys During dialysis the movement of bicarbonate from the dialysate into the blood - Helps normalize body pH Ultrafiltration is defined as - controlled fluid removal by manipulation of hydrostatic pressure Your role and anemia management includes - Rinsing back as much of the patient's blood as you can at the termination of each treatment A common reason of how hepatitis B is transmitted from patient to a healthcare worker is - Needlestick injuries Hemodialysis patients are at increased risk for contracting hepatitis B - True To prepare a 1:100 bleach solution you would - Add 1 part bleach to 99 parts water Handwashing at a designated clean sink would be performed for a minimum of - 20 seconds Contact transmission is the most important route through which infections are spread contact transmission is defined as - Transmission of micro organisms through healthcare workers hands According to the policy and procedure gowns - Must be fully snapped up or tied at the neck and waist and wrist covered Appropriate personal protective equipment PPE should be worn whenever there is a potential for contact with blood or bodily fluids hazardous chemicals contaminated equipment and environment - Gloves gowns and face mouth nose and eye protection A 1:10 bleach solution is used to - Clean up visible blood or gross blood spills Timmy is caring for a patient with active C diff infection are required to - Perform hand hygiene using only soap and water I sudden decrease in blood pressure of equal to or greater than _____________ can be an indication that the patient is losing intravascular fluid too quickly - 20 mmHg Because a pre-pump arterial pressure that becomes too negative can cause Hemo lysis Davita policy states that the arterial pressure must not exceed - -260 mmHg What needle size should be used for a blood flow rate BFR a prescription of 400 ml/min - 15 gauge Once rinse back is complete what should be done before removing a patient's venous needles - Check the patient's blood pressure Before collecting the post treatment blood urea nitrogen BUN adequacy lab in order to ensure that you are drawing a non-recirculated blood which port should be used - Arterial blood line port Before collecting the post treatment blood urea nitrogen BUN adequacy lab in order to ensure that you are drawing non-recirculated blood you must do what with the blood flow right BRF - Reduce the blood flow rate to 100 ml/min for 15 seconds Before drawing the post treatment blood urea nitrogen BUN adequacy lab adjustments for the dialysis flow rate DRF must include - Decrease DRF to 300 ml/min or lowest setting allowed or place into bypass Which of the following factors would include the K of the KT/V formula - Blood volume process BVP To ensure the accurate results when drawing blood urea nitrogen BUN adequacy lab for post treatment you should - Turn off or decrease the ultra filtration rate UFR to 50 ml/hr Preventing hypotensive episodes during the dialysis treatment is important because hypotension is associated with - A higher mortality rate What common symptoms would alert you that a patient's target weight may need to be decreased - Hypertension and peripheral edema Removing too much fluid during a treatment may cause - Hypovolemia Mrs. Thirty's target weight is 73 kg her pre-dialysis weight is 76.3 kg. Her last post-weight was 74.2 kg. What is Mrs. Thirsty's UF goal today not including the prime and rinse back - 3.3kg 76.3-73 What are three common symptoms would alert you that a patient's target weight may need to be increased - Excessive cramping, hypotension, dizziness * What may cause Hemolysis of a laboratory blood specimen - Placing the tube directly on top of the machine, placing the tube too close to the centrifuge, placing the tube directly on an ice pack When labeling a lab tube you should - Never double label tube as laboratory is unable to process the specimens, and never write on the label verify the correct date and requisition date in IT clinical system if incorrect prior to shipping Lavender tubes must be - inverted a minimum of 8 to 10 times to properly mix and avoid clotting What are the five rights of proper lab draws - Right requisition, label, patient, tube, collection date After collecting a blood specimen the vacutainer holder is _____________ after use - Discard it into the red biohazard sharps container Procedure provide a step-by-step series of actions, processes, or measures to be taken to implement or address of particular activity, system, or problem - True The pre-treatment patient assessment by licensed nurse is required - When it is mandated by the state, when the PCT performing the data collection notice is abnormal findings, when the nurse or PCT observed, or the patient reports unusual symptoms before treatment initiation Post treatment, a patient complains of a headache and there was a noted temperature increase to 98.8°F from the pre-treatment baseline of 96.6°F what follow up is required before the patient's discharge - This is considered a fever what should be investigated What is true regarding documentation of an abnormal treatment event - Document a description of the event, including licensed nurse notification, all the interventions taken, and the patient's response in the treatment record The purpose of documentation is to provide - Proof that care was rendered and provided data continually, a permanent legal record, a communication tool for healthcare team Why is it important post treatment to document the dialyzers appearance and hemostasis duration of the time it takes to stop actively bleeding after removal of the needles from the arteriovenous fistula (AVF)/ arteriovenous graft (AVG) - To evaluate heparin prescription, as those changes may be needed in relation to access streaking or clotting of the dialyze her in or prolonged bleeding greater than 20 minutes from the AVF/AVG A patient has an adverse reaction within minutes of the treatment initiation the patient pre-treatment data screen shows no patient information entered what should have occurred prior to initiating treatment according to the Davita policy and procedure - Pre-treatment data should never be entered prior to the treatment initiation A post treatment patient assessment - All of the ABOVE Is completed to verify that the patient is stable, to determine the patient's discharge status, and to evaluate the effectiveness of the treatment plan is compared to the patient's pre-treatment assessment findings requires the licensed nurse to notify the physician as needed of changes in patient status When using an automatic blood pressure cuff on a patient with an irregular heartbeat - The recorded blood pressure will be too low All pre-treatment data findings and machine safety checks are required to be entered into the IT clinical system before treatment initiation - True If a PCT documents the extent of a patient's edema as +3 the PCT is performing an assessment which is not within their scope of practice under local state or federal regulations - True Patient vital signs, well-being evaluation's, and machine checks must be performed a minimum of - Every 30 minutes This electrolyte plays a major role in muscle contraction and high or low levels can lead to weakness or cardiac arrest - Potassium For a patient who can stand a post treatment blood pressure reading of _________ is considered an abnormal finding and should be reported to a licensed nurse per Davita policy - Standing systolic BP greater than 140 mmHg or less than 90 mmHg and standing diastolic BP greater than 90 mmHg or less than 50 mmHg What is considered a normal heart rate - 60-100 bpm Which of the following is not an acceptable way of dressing cannulation sites post treatment - Rap and circle the access extremity with tape or gauze When cannulating Arteriovenous fistula/ arteriovenous graft the needles tip should be - At least 1.5 inches apart