NEW 2022-2023 DAVITA PCT EXAM WITH GRADED A+
Number 1 & 2 cause of (CKD) chronic kidney diease - answer1- diabetes 2-hypertension
In (AKI) acute
... [Show More] kidney injury it is better to keep patients? - answertoo wet, rather than too dry with fluid removal goals
3 sub-groups of ckd? - answer1-pre-renal-interferes w/ BF to the kidneys, causes-injuries/renal artery clot
2-intra-renal-damages nephron directly, causes-diabetes/hypertension/PKD
3-post-renal-any condition interfering w/ urine leaving the bladder, causes-kidney stones/enlarged prostate
Acceptable conductivity range of dialysate? - answer13-15.5ms
+/- 0.4
Acceptable PH range of bicarb? - answer6.9-7.6 PH
Hemodialysis (HD) replaces approximately how much of normal kidney function? - answer15%
In patients w/ kidney failure, what is recommended to use if they are having issues w/ their skin, such as dryness? - answerhyper fatted/super fatted soaps and lotions
There is no specific tx for a patient w/ peripheral neuropathy, but it is recommended that a patient should? - answernot walk barefoot check feet for cuts test bath water to ensure it is not too hot
Filtration - answerfluid passing through a semi-permeable membrane, controlled by hydrostatic pressure
EX. coffee filter
Ultrafiltration (UF) - answercontrolled fluid removal by manipulation of hydrostatic pressure
Convection - answersolutes dragged across the semi-permeable membrane along w/ the fluid
Diffusion - answerthe process by which particles (solutes) move from an area of higher concentration to an area of lower concentration
normal acid-base balance of the body? - answer7.35-7.45 PH
How do kidneys control blood pressure? - answerrenin-angiotensin system
Erythropoiesis - answerfunction of the kidneys that control the production of red blood cells
3 functions of normal working kidneys? - answer1-endocrine system-
a. renin-angiotensin-BP regulation
b. erythropoiesis-RBC production, activation of vitamin D3 & serum Ca regulation
2-acid concentration- maintain normal body PH, excreting acids & reabsorbing bicarbonates
3-excretory functions- waste removal, acid-base balance, fluid/electrolyte balance
Anemia medications? - answerepogen
IV iron
2 most common causes of death for a dialysis patient? - answer1-heart attack
2-infection
Healthcare-associated infection (HAI) are mainly routed by? - answercontact transmission of infection hands/surfaces
Most common infectious complications among HD patients? - answervascular access infections
How long can MRSA bacteria remain on a surface? - answerfor days, especially on plastic/vinyl
Breakdown product of chlorine that causes hemolysis? - answerchloramines
Hemolysis - answerthe rupture or destruction of red blood cells blood is visibly cherry red kool-aid colored
Chlorine + Chloramines = - answerhemolysis
What does the water softener remove? - answercalcium and magnesium
How often is carbon filter monitoring done? CM130 - answertakes chlorine samples every 5 minutes
When do you test the carbon filter monitoring? - answerPrior to the first tx of the day, then within every 4 hours
*RO must run 15 min. prior to testing
What are the limits for carbon filter monitoring? - answer0.1mg/L or less
What does reverse osmosis (RO) remove? - answerorganic/inorganic contaminants bacteria/endotoxins
Primary device used for water purification in dialysis? - answerReverse Osmosis
3 responses to final water quality alarm? - answer1-put all machines in bypass mode
2-notify RN, FA, Biomed
3-if water quality cannot be restored, terminate all treatments
D.A.R.N. - answerDesire
Ability
Reasons
Need
W.E. C.A.R.E - answerWelcome
Empathize
Connect
Actively listen
Respect
Encourage
Fever-when to notify RN - answera rise in the temperature of the body greater than 100 degrees F or an increase over baseline of 2 degrees F w/ symptoms
Dialysis Disequilibrium Syndrome (DDS) - answerrare but life threatening complication during initial stage of hemodialysis
prevention-slowing rate of HD. HD can lead to excess fluid in brain, cerebral edema signs/symptoms-headache, restlessness, seizure
How a patient is to be positioned if they have an air embolism? - answerleft side Trendelenburg
NFACT - answerNew fistula assessment and cannulation team
NFACT defines an intermediate cannulator as? - answerat least 6 months of AVF cannulation experience & at least 10 successful cannulations on established fistulas
When cannulating, the tips of the needles should be at least - answer1.5" or the width of 2 fingers apart
Kt/V - answerK= clearance
T= time
V= volume
Kt/V goal - answerequal to 1.2 or higher
Factors in Kt/V that influence V (volume)? - answerheight weight sex amputations needle gauge suggested BFR
Factors in Kt/V that influence T (time)? - answerlonger blood/dialysate contact time more frequent tx extra tx
TX factors that decrease K (volume)? - answerDFR
UF goal BVP adequate anti-coagulation
How do you estimate the blood volume removed (BVR)? - answerBFR x minutes dialyzed=estimated BVR
What is the wait time for heparin bolus prior to starting tx? - answer3-5 minutes [Show Less]