Final Version of DaVita test (solved)
what treatment factors decrease K in the Kt/v to decrease? - ANSWER not waiting 3-5 minutes after heparin,
... [Show More] decreasing BFR, DFR, and BVP
what factors influence "V" in Kt/v - ANSWER accurate data entry by nurses in snappy, sex age, weight, and amputation
what are the needle gauges and prescribed blood flow rates? - ANSWER they are inversely related
17g 200-250
15g 250-350
15g 350-400
14 g 400 - 450
what is the procedure for post BUN lab draw? - ANSWER if pt wants off early, still draw the labs and educate patient about the risks. Redraw next time a pt runs full tx to show pt difference
what lab draw mistakes would falsely increase Kt/V - ANSWER not waiting the full 15 seconds
What is important when monitoring weight and BP in AKI patients? - ANSWER keep patients wet (hydrated) and avoid hypotensive episodes = cause renal ischemia
What do you need to consider in regards to CVCs? - ANSWER follow P&P b/c the risk of infection is so high
Why is it important to know what caused a patients chronic renal failure? - ANSWER we need to know about possible problems during data collection and assessment
What is the role of the PCT prior to tx initiation? - ANSWER assessment of pt if any abnormal findings or if the pt is in an acute condition
what happens in the BP cuff is the wrong size - ANSWER loose BP--> high reading
tight BP --> low reading
why is it so bad to squeeze the BP cuff if its connected to the machine? - ANSWER it can damage the internal BP mechanism
Why is it so important that we document in the medical record? - ANSWER it provides data for continuity and planning of care
when do pre-treatment data collection and assessment take place? - ANSWER collection: before tx
assessment: w/in 1 hr if pt is stable
when is post-treatment data collection and assessment performed? - ANSWER post treatment-- not before treatment or when they are disconnected
what are the consequences of poor or incomplete documentation - ANSWER can open attack on your care
What are the six items needed in charting meds? - ANSWER 1. med/dosage
2. date/time
3. route
4. reason (remember this!)
5. pt response
6. signature
What are the 5 Ws to be used when completing an AOR? - ANSWER who
what
when
where
why
how
What are the 4 consequences of sodium loading during dialysis? - ANSWER 1. increased thirst
2. increased fluid intake
3. increased intradialytic weight gain = htn
4. increased UFR
what is the purpose of UF profiling? - ANSWER change the way fluid is remodeled during the tx and allows for vascular refilling
what are the consequences of hypovolemia during tx? - ANSWER attempting to remove a lot of fluid --> hypovolemia during tx --> loss of renal function, ischemia, and increased mortality rate
what must the machine's conductivity and pH reading supposed to be? - ANSWER machine and manual conductivity: w/in +/-0.4
pH range: 6.9 - 7.6, measured to verify acid/base balance is in acceptable range
at what temperature does hemolysis occur? - ANSWER 42 degrees C
What do we do in a power outage? - ANSWER remove venous line from air detector, clamp, before starting hand crank and be diligent in watching for air in blood lines
what causes a high venous pressure alarm? - ANSWER kink in tubing, clotting in venous drip chamber, infiltration, venous stenosis
what are the risks of doing things "your way" and not the P&P way? - ANSWER it can lead to civil liabiliy
what makes dialysis pts more susceptible to healthcare acquired infections? - ANSWER prolonged access to pts blood, and immunocompramised
why are dialysis pts at an increased risk for acquiring HAIs at the facility? - ANSWER contact transmission
what is the most common transmission route for HAIs - ANSWER contact transmission--> hands
what is the most important invention you can do to prevent HAIs? - ANSWER handwashing
what is the most common infectious complication in hemodialyisis pts? - ANSWER per the CDC, the most common factor contributing to bacteremia is use of CVCs
What germ causes the most common infections in hemodialysis pts? - ANSWER MRSA which can remain on surfaces for days w/ plastic vinyl being most favorable to their survival
why is wearing gloves so important? - ANSWER decrease risk of hand contamination and prevent transfer of organisms already on hands
what is the correct procedure in regards to your hands when you have causal contact w/ a pt - ANSWER no gloves but must perform hand hygiene before care on pts
Successful lab draw must knows - ANSWER follow order the lab draws to prevent specimen from being contaminated w/ other tube additives, double labeling tubes prohibits processing
rules for spinning samples - ANSWER only spin tube of some kind of size and fill level and should be placed opposite of each other
What are the symptoms of hyperkalemia? - ANSWER extreme muscle weakness abnormal HR, cardiac arrest
what are the symptoms of hypokalemia? - ANSWER fatigue, muscle weakness, respiratory failure
what is the primary cause of erythropoietin? - ANSWER primary cause
how can you prevent contributing to blood loss? - ANSWER --adequate heperanization
--ensure epo given
-- completely rinse back blood
--avoid repeat lab draws
what is pericarditis? what is included in its treatment? - ANSWER w/ dialysis hold or decrease heparin
systemic effects of CRF what should you do for a pt that complains of dry, itchy skin - ANSWER use hyperfatted soaps and lotions
what should you do for a pt that complains of peripheral neuropathy? - ANSWER educate pt not to walk barefoot, frequent foot checks, check temp of bathwater
What are the four key elements affected in CKD-MBD - ANSWER Ca2+
PO4
parathyroid hormone
vitamin D
what are the symptoms of CKD-MBD in addition to bone disease? - ANSWER soft-tissue calcification
what is the best way to help pts successfully change behaviors? - ANSWER inspire behavior change through support, compassion, and empathy
What does DARN stand for? - ANSWER desire, ability, reason, need
FYI from Meghan: know the questions at the end of the motivational interviewing hand out (one of the PCTs at Red Hawk told me this_) - ANSWER fyi
when should the communication style "directing" be used? - ANSWER best used when training to perform procedures
what are the three core communication skills to be used w/in the communication style? - ANSWER asking
listening
informing
what is the righting reflex? - ANSWER automatic intervention of a healthcare practitioner who observes pt doing something detrimental to his/her health
What is reflective listening? - ANSWER includes main aspects of what the pt said during the entire communication
what are the four transport mechanisms that play a role in hemodialysis? - ANSWER ultrafiltration
convection
diffusion
osmosis
what is important when monitoring pt weight and BP? - ANSWER keep patients wet and avoid hypotensive episodes b/c it can cause kidney injury
what do you need to consider in regards to their vascular access? - ANSWER follow P&P to prevent infections
why is it important to know what caused your patient's CRF? - ANSWER to inquire about possible problems during data collection and assessment
how often do we screen for Hep C? - ANSWER yearly for patients and teammates
tips to remember for successful lab draws - ANSWER 1) follow order of lab draws to prevent specimens from being contaminated with other tube additives
2) double labeling tubes prohibits processing
rules for spinning samples - ANSWER only spin tube of same kind, size, and fill level and should be placed opposite of each other
systemic effects of CRF what would you advise for a pt who complains of dry, itchy, skin - ANSWER hyperfatty soaps and lotions
systemic effects of CRF- what would you advise for a patient who complains of peripheral neuropathy? - ANSWER no walking barefoot, check water temp before baths
what would you advise for a patient who complains of psychological problems? - ANSWER depression, brain fogginess
what are the foru key elements affected in CKD-MBD - ANSWER Ca2+
Phosphorus
Calcitrol
Parathyroid
what are symptoms of CKD-MBD in addition to bone disease? - ANSWER soft tissue classification
what is your role in CKD-MBD in addition to bone disease? - ANSWER soft tissue calcification
what is your role in CKD-MBD management? - ANSWER pt education
how much normal kidney function is replaced by HD? - ANSWER 15%
What does DARN stand for? - ANSWER D-- desire
A-- ability
R-- reason
N--need
One component of the directing style is:
a) being in charge
b) seeing through the other person's eyes
c) understanding through listening - ANSWER a) being in charge
One component of the following style is
a) eliciting behavior through patient's own insights and motivations
b) giving instructions
c) understanding through listening - ANSWER c) understanding through listening
One component of the guiding style is
a) allowing to sort things out in one's own time
b) being a knowledgeable resource
c) expecting compliance - ANSWER b) being a knowledgeable resource
The three core communication skills used in motivational interviewing are?
a) monitoring, persuading, advising
b) explaining, comprehending, adapting
c) inquiring, directing, following
d) asking, listening, informing - ANSWER d) asking, listening, informing
The four guiding principles in motivational interviewing can be remembered by the acronym
a) GUIDe
b) RULE
c) PRINce
d) MOTIv - ANSWER b) RULE
The righting reflex is defined as - ANSWER the automatic intervention of a healthcare practitioner who observes a patient doing something detrimental to his/her health [Show Less]