DaVita - PCT Study Guide Complete
Questions & Solutions(RATED A)
Chlorine/Chloramine testing: - ANSWER When: R/O runs 15 mins before patient shift
every 4 hours
Where: After Primary carbon tank sample port
Acceptable result: Less than or equal to 0.1 mg/L
Action if results are too high post primary tank: Repeat the test
Define the term AKI - ANSWER - Term incorporates a wide spectrum of kidney issues
- Includes acute kidney failure as well as less catastrophic kidney function changes
- May dialyze in an out-patient facility until kidney function recovers
Give examples of pre-renal causes of AKI - ANSWER - Obstruction
- Volume Depletion
- Impaired Cardiac Function
Give examples of intra-renal causes of AKI - ANSWER - Ischemic ATN
- Sepsis
- SIRS
- Septic Shock
- Anaphylaxis Drugs
- Goodpasture Syndrome
- Acute Glomerulonephritis
- Trauma
- Open Heart Surgery
Give examples of post-renal causes of AKI - ANSWER - Obstruction
- Oliguric
- Bladder Rupture
- Pregnancy
How do you help in restoring kidney function? - ANSWER Find the cause of the AKI
How do you protect kidneys from further injury? - ANSWER Avoid substances to the
kidney which may be toxic (radiographic contrast, amphotericin B, low dose aspirin,
NSAIDS)
What is important when monitoring weight and BP? - ANSWER Keep a little extra fluid
on them so it is available to the kidneys when they start filtering/ultrafiltrating on their
own
AKI patients are at increased risk for which complications? - ANSWER - Hypovolemia
- Hypotension
,What do you need to consider in regards to their (AKI patients') vascular access? -
ANSWER Patients will typically have a dialysis catheter, so be careful to avoid catheter
related infections
Explain the difference between AKI and CKD - ANSWER Eliminating the cause of the
AKI can often lead to the return of kidney function. You cannot eliminate the cause of
CKD which is HTN, Diabetes, and genetic disorders (PKD)
Outline the treatment goals for a patient with CKD - ANSWER - Slowing the progression
of CKD
- Managing comorbidities and complications
- Controlling symptoms
- Minimizing the effects of CKD on patients' lifestyles
- Kidney replacement therapy modality education
- Encouraging patients to actively participate in their healthcare
What are the most common causes for CKD in the USA? - ANSWER - DM
- HTN
- PKD
Why it is important to know what caused your patient's CKD? - ANSWER So the nurse
and PCT can inquire about possible problems during data collection and assessment
In Kt/V, what is 'K'? - ANSWER Clearance of urea
What treatment factors decrease 'K'? - ANSWER - Inadequate coagulation
- Decreased BFR
- Poor priming
- Not following eP&P
- Patient not staying on TX as prescribed
What treatment factors increase 'K'? - ANSWER - Increased BFR
- Correct DFR
- Correct dialyzer
- Correct target weight-amputation factor
In Kt/V, what is 't'? - ANSWER Time of dialysis session
What factors influence 't'? - ANSWER Running prescribed TX time
- Follow physician orders
- Encourage pt. to run entire TX [Getting off early will impact time (missing tx also
impact tx time)]
In Kt/V, what is 'V'? - ANSWER - Volume of urea distribution
- Volume of patient's body water in which urea is distributed
, What factors influence 'V'? - ANSWER - Amputation
- Height
- Sex
- Age
- Type of access (less efficient access reduces the volume process of a patient's blood)
Suggested BFR for 17 gauge needles - ANSWER 200-250
Suggested BFR for 16 gauge needles - ANSWER 250-350
Suggested BFR for 15 gauge needles - ANSWER 350-450
Suggested BFR for 14 gauge needles - ANSWER 450+
Procedure for Post BUN lab draw - ANSWER 1. Turn off UFR or decrease it to 50
2. Decrease DFR to 300 or put in bypass
3. Decrease BFR to 100
4. Wait 15 secs for all access types and draw post
Lab draws mistakes that would falsely increase Kt/V - ANSWER - BFRs not reduced
- Waiting only 5 seconds
- Drawing post BUN from venous line
Lab draws mistakes that would falsely decrease Kt/V - ANSWER - Accidently diluting
pre tx Arterial BUN blood sample with saline
- Waiting longer than 15 seconds to draw blood sample
What is the difference between data collection and assessment? - ANSWER
Assessment - Nurse
− Determining depth of edema
− Rate, rhythm, quality of heart sounds
− Respiration rate, difficulty, identifying unusual sounds
Data Collection - PCT
- Noting presence of edema
- Heart rate and rhythm
- Respiration rate, recognizing unusual sounds
- Machine parameters, safety checks
What is the role of the PCT prior to treatment initiation? - ANSWER Complete data
collection and notify the RN if there are any abnormal findings prior to initiation of tx
What is the role of the licensed nurse prior to treatment initiation? - ANSWER - Assess
abnormal findings from data collection
- Determine appropriate interventions (based on physician orders)
- Contact physician if needed
Questions & Solutions(RATED A)
Chlorine/Chloramine testing: - ANSWER When: R/O runs 15 mins before patient shift
every 4 hours
Where: After Primary carbon tank sample port
Acceptable result: Less than or equal to 0.1 mg/L
Action if results are too high post primary tank: Repeat the test
Define the term AKI - ANSWER - Term incorporates a wide spectrum of kidney issues
- Includes acute kidney failure as well as less catastrophic kidney function changes
- May dialyze in an out-patient facility until kidney function recovers
Give examples of pre-renal causes of AKI - ANSWER - Obstruction
- Volume Depletion
- Impaired Cardiac Function
Give examples of intra-renal causes of AKI - ANSWER - Ischemic ATN
- Sepsis
- SIRS
- Septic Shock
- Anaphylaxis Drugs
- Goodpasture Syndrome
- Acute Glomerulonephritis
- Trauma
- Open Heart Surgery
Give examples of post-renal causes of AKI - ANSWER - Obstruction
- Oliguric
- Bladder Rupture
- Pregnancy
How do you help in restoring kidney function? - ANSWER Find the cause of the AKI
How do you protect kidneys from further injury? - ANSWER Avoid substances to the
kidney which may be toxic (radiographic contrast, amphotericin B, low dose aspirin,
NSAIDS)
What is important when monitoring weight and BP? - ANSWER Keep a little extra fluid
on them so it is available to the kidneys when they start filtering/ultrafiltrating on their
own
AKI patients are at increased risk for which complications? - ANSWER - Hypovolemia
- Hypotension
,What do you need to consider in regards to their (AKI patients') vascular access? -
ANSWER Patients will typically have a dialysis catheter, so be careful to avoid catheter
related infections
Explain the difference between AKI and CKD - ANSWER Eliminating the cause of the
AKI can often lead to the return of kidney function. You cannot eliminate the cause of
CKD which is HTN, Diabetes, and genetic disorders (PKD)
Outline the treatment goals for a patient with CKD - ANSWER - Slowing the progression
of CKD
- Managing comorbidities and complications
- Controlling symptoms
- Minimizing the effects of CKD on patients' lifestyles
- Kidney replacement therapy modality education
- Encouraging patients to actively participate in their healthcare
What are the most common causes for CKD in the USA? - ANSWER - DM
- HTN
- PKD
Why it is important to know what caused your patient's CKD? - ANSWER So the nurse
and PCT can inquire about possible problems during data collection and assessment
In Kt/V, what is 'K'? - ANSWER Clearance of urea
What treatment factors decrease 'K'? - ANSWER - Inadequate coagulation
- Decreased BFR
- Poor priming
- Not following eP&P
- Patient not staying on TX as prescribed
What treatment factors increase 'K'? - ANSWER - Increased BFR
- Correct DFR
- Correct dialyzer
- Correct target weight-amputation factor
In Kt/V, what is 't'? - ANSWER Time of dialysis session
What factors influence 't'? - ANSWER Running prescribed TX time
- Follow physician orders
- Encourage pt. to run entire TX [Getting off early will impact time (missing tx also
impact tx time)]
In Kt/V, what is 'V'? - ANSWER - Volume of urea distribution
- Volume of patient's body water in which urea is distributed
, What factors influence 'V'? - ANSWER - Amputation
- Height
- Sex
- Age
- Type of access (less efficient access reduces the volume process of a patient's blood)
Suggested BFR for 17 gauge needles - ANSWER 200-250
Suggested BFR for 16 gauge needles - ANSWER 250-350
Suggested BFR for 15 gauge needles - ANSWER 350-450
Suggested BFR for 14 gauge needles - ANSWER 450+
Procedure for Post BUN lab draw - ANSWER 1. Turn off UFR or decrease it to 50
2. Decrease DFR to 300 or put in bypass
3. Decrease BFR to 100
4. Wait 15 secs for all access types and draw post
Lab draws mistakes that would falsely increase Kt/V - ANSWER - BFRs not reduced
- Waiting only 5 seconds
- Drawing post BUN from venous line
Lab draws mistakes that would falsely decrease Kt/V - ANSWER - Accidently diluting
pre tx Arterial BUN blood sample with saline
- Waiting longer than 15 seconds to draw blood sample
What is the difference between data collection and assessment? - ANSWER
Assessment - Nurse
− Determining depth of edema
− Rate, rhythm, quality of heart sounds
− Respiration rate, difficulty, identifying unusual sounds
Data Collection - PCT
- Noting presence of edema
- Heart rate and rhythm
- Respiration rate, recognizing unusual sounds
- Machine parameters, safety checks
What is the role of the PCT prior to treatment initiation? - ANSWER Complete data
collection and notify the RN if there are any abnormal findings prior to initiation of tx
What is the role of the licensed nurse prior to treatment initiation? - ANSWER - Assess
abnormal findings from data collection
- Determine appropriate interventions (based on physician orders)
- Contact physician if needed
