if a pts labs change, what 2 electrolytes in the dialysate are most likely to change? - ANSWER-Calcium and Potassium
When it is suspected that a pt has
... [Show More] an air embolism, the first intervention should be to? - ANSWER-Clamp the lines. C.O.L.T. clamp venous, turn off pump, left side, Trendelenburg
Improperly primed dialyzers and bloodlines can increase risk of? - ANSWER-air embolism and clotting in the dialyzer
A nurse should be aware that multi vitamins - ANSWER-if water soluble should be taken After treatment
the 6 right of medication administration - ANSWER-drug, patient, dose, route, time, and documentation
A pt has had a stomach bug the last 2 days with nausea, vomiting, & diarrhea. the nurse should evaluate for signs & symptoms of? - ANSWER-Hypokalemia
a pt is 2.5 hours into a 3 hour treatment & is on the wrong bath, in addition to documenting the event in treatment record, which action is most appropriate? - ANSWER-notify RN immediately to obtain instructions, complete an adverse event report
If a pt who is to have dialysis is suspected of having active TB, the best course of action would be to? - ANSWER-ask pt to wear a mask & immediately call the physician
To properly collect a Post BUN sample, it is necessary to? - ANSWER-turn of ultrafiltration rate (UF)
treatment started on pt with CVC, as blood pump is turned up to 200 ml/min, foam begins to accumulate in the lines, pt begins to wheeze, & become SOB. The First action would be to? - ANSWER-Clamp venous line
the venous needle must Always be placed? - ANSWER-(Anterograde) with the flow
what pt must be dialyzed on a designated machine in a separate area & a designated bp cuff and stethoscope must be used if pt has? - ANSWER-MRSA
several pts with normal pre dialysis temps develop sudden chills and a spike in temp. this is most likely caused by? - ANSWER-presence of endotoxins in the diaysate
why does countercurrent flow within the dialyzer provide the most efficient clearance of solutes from the blood? - ANSWER-blood & dialysate flow in opposite directions allowing removal of waste throughout the surface area of the dialyzer.
pt arrives for treatment with complaints of SOB and swelling in her ankles. the pct notes that pre treatment heart rate in 48. the pct notifies the RN, what is the action the nurse must take initially? - ANSWER-verify the heart rate by taking the radial and apical pulses
according to FMC policy the safe level for Total Chlorine is? - ANSWER-less than 0.1 ppm (0.00 ppm - 0.09 ppm)
when should the catheter and blood line connections be assessed? - ANSWER-at least every half hour
A pt has fallen to the floor post dialysis outside the facility that results in a laceration. the incident is considered a/an? - ANSWER-Serious Adverse Event (SAE)
Bright cherry soda colored blood is noticed in the dialyzer. pt complains of SOB, headache, and burning at the needle site, in view of these finding the caregiver should? - ANSWER-Stop blood pump & DO Not return blood to pt. Hemolysis
studies by CDC prove that the single most important way to prevent spread of infection is to? - ANSWER-wash hands
KT/V is improved by? - ANSWER-priming dialyzer at BFR of 150 ml/min
pt is supine, breathing normally with eyes closed, all machine parameters are normal and extracorporeal circuit is intact. Based on these obsevations at this time, what would be the most appropriate documentation? - ANSWER-pt resting quietly, resp 18, no changes in vs, connections secure, no unusual findings
which would indicate the need to re evaluate the Heparin dose? - ANSWER-increased venous pressure at initiation of treatment. (increased VP = clotting)
if bicarbonate jugs are used the frequency for disinfecting jugs is? - ANSWER-weekly
Adverse events must be documented in the medical record, QAI, and? - ANSWER-in the Patient Safety Organization (PSO) analysis system
the following KECNs are noted: these results indicate a?
TIME KECN TIME KECN
00:15 268 01:45 243
00:45 254 02:15 240
01:15 242 02:45 238 - ANSWER-low clearance, need for further heparinization
when using On-Line clearance (OLC), the green light indicates the pt ? - ANSWER-is receiving adequate dialysis
what reading on the reverse osmosis (RO) machine indicates the level of water quality? - ANSWER-Total Dissolved Solids
pt presents with pulse of 44/min but doesn't appear to be in distress. what should be the dialysis techs immediate action be? - ANSWER-notify the RN
the pt exhibits signs of hemolysis. what is appropriate action to take? - ANSWER-turn off pump, clamp venous line
routine post dialysis treatment documentation on the pts record should include pts BP and temp when? - ANSWER-post reinfusion and prior to disconnection
what is the correct level of salt in the brine tank? - ANSWER-the top level of the salt pellets in the brine tank must be above the level of the brine solution in the tank
which of the following lab results indicate a person has a protection from acquiring Hepatitis B (HBV)? - ANSWER-HBsAB positive (HBV immune)
if the arterial pressure changes from -200 mmHg to -250 mmHg from the initiation of treatment, what would be a possible cause? - ANSWER-hypotension and vasoconstriction
the purpose of Hectorol is to? - ANSWER-Suppress PTH synthesis
when instructing pts with chronic kidney disease, who are receiving dialysis, the nurse should include the fact that? - ANSWER-elevated potassium levels may cause changes in heart rhythm
what is most likely to inhibit diffusion across the dialyzer membrane? - ANSWER-clotted fibers
the nurses assess a pt and finds the pts apical pulse is 48. when reviewing the pts previous treatments, the nurse notes the pt normally has a heart rate between 68-72 bpm. what should the nurse initially do? - ANSWER-contact the attending physician
pts on dialysis are frequently anemic because they have? - ANSWER-a decreased production of erythropoietin
one way to establish a pt has orthostatic hypotension is to obtain a pts? - ANSWER-sitting bp followed by a standing bp [Show Less]