what is the difference between data collection and assessment? who does what?
data collection:yes or no
assessment: the extend.
what is the role
... [Show More] of pct prior to treatment initiation?
data collection notify nurse of any abnormalities
what is the role of the licensed nurse prior to treatment initiation?
nurse assessment
when us a pre-treatment assessment by the licensed nurse required?
if vitals were abnormal
when is post treatment assessment by the licensed nurse required?
up normalities during treatment.
note about bp
squeezing the auto blood pressure cuff to speed deflation can damage machine internal bp module.
why do we document in the medical record? 4 reasons
1.proof that care was rendered
2.provide data continuity
3.permnent legal record
4.communication tool
list 6 occurrences when to chart?
1.change from baseline assessment
2.change in patient condition
3.procedure for treatment
4.medication given
5.patient teaching
6.care plan review and intervention
pre-treatment data collection/ assessment
before treatment intuition
assessment within one hour if pt is stable for nurse
post treatment data collection/assessment
post treatment only
what are possible consequence of proof or incomplete documentation?
poor or incomplete documentation can open an attack on your care
what are the 6 items included in charting administered
1.medication dosage
2.data and time
3.route for administeration
4.pt response
5.signiture of teammate adminsteration
6.allergies always check the allergy screen in screen in falcon for a list of your pt.
how do you document charting errors
single line sign and date
what does SMART communication stand for
Simple and clear
Meaningful
Actual
Read
Teach
what are the 5 w's to be used when completing an AOR
what
where
who
when
why
what are the four consequence of sodium loading during dialysis
.thirst
2.fuid intalle
3.idwg;headaches +hypertenstion
4.ufr
what treatment factors decreases K?
not waiting 3-5 minutes after giving Heprin
what factors influence V?
on average a persons body composed of 50-55 % water.
a person height weight sex,age and amputation are included in calculating V
lab draw mistakes that would falsely increase kt/v?
not waiting 15 second
when is post treatment blood sample draw too high?
waiting only 5 seconds between lowering the blood pump speed and drawing post treatment blood sample would cause the kt/v reading to be too high
is it okay for pt to come off early on lab day?
If pt wants to get off early educate pt risk involved.and still draw lab and re-draw on full treatment (every time)
what is important when monitoring weight and bp?
acute patient only-keep pt wet and avoid hypotensive episodes.
what do you need to consider in regards to their vascular access?
follow p and p to prevent infection
why is it important to know what caused your patients CRF?
its important to know to help inquire about possible problem during data collection and assessment.
what is the purpose of uf profilling?
purpose of uf profiling the way fluid removed during treatment allow time for vascular refilling
what are consequence if patient is consistently fluid overloaded(hypervolemia)?
hypertension, left ventricular hypertrophy, cardiovascular disease
what can cause hypovolemia ?
attempting to remove large amount of fluid weight for patient can lead to hypovolemia
what are conductivity and ph alarm causes?
machine conductivity ad manual reading can be no greater or less then 0.4 difference.
after test use phenix meter to:
measure ph in dialysate to verify acid base balance with acceptable range
what are temperature alarm causes?
hemolysis occurs at 42 Celsius or higher.
power appropriate intervention
1.remove venous line from air detector clamp before starting Hand cracked.
2.be delight watching for air
venous pressure high alar causes
more positive cinck in tubing/clamp,infilteration,venous stenosis.
clotting in venous drip chamber
the reasonable and prudent standard of care for nephrology nursing: key concept
when supervising non license personal.it is the responsibility of the license nurse to ensure also teammate meet standard of care.
what role does Davita p&P play?
policy is guide lines principle "the why"
what are the risk of doing it your way ?
civil liability
what makes dialysis patient more susceptible to HAIs?
weakened immune system
prolong accès to pt blood
why are dialysis pt at increased risk for acquiring a HAI at the facility?
contact transmition
wha tis the most common transmition route for HAIs?
contact transition
what is the most important intervention you can do to prevent HAIs?
hand hygiene
wha tis the most common infectious complication in hemodialysis pt?
1.vascular access infection
2.per cdc the most common factor contributing to bacteriumia is use of cvc.
what germ causes the most common infections in hemodialysis pt?
MRSA
MRSA can remain on service for days.
being most favorable to survival
why is wearing gloves important?
function of gloves decrease the risk of hand contamination.
successful lab draws know the 20 tips
follow the order of draw
to prevent specimens from being contaminated with other tube additive
double labeling tubes prohibits processing
what is rule of spinning samples?
balance, spin tubes of same kind size fill level and should be placed opposite of each other.
what are signs and symptoms of hyperkalemia
high potassuim-muscle weakness, abnormal heart rate
what are signs and symptoms of hypokalemia
low potassium-muscle cramp abnormal heart rate cold
how can you prevent contributing to blood loss?
1.adequte heparinzation
giving heprin
why are patients anemic ?
lack of (ego)erythropoietin
what is pericarditis? what is included in its treatment ?
no heparin
hold or decrease heparin
peripheral neuropathy
check temperature of bathwater
don't walk bare feet
frequent foot check
what are the 4 key elements affected in CKD-MBD?
1.calcium
2.phosphorous
3.parathyroid hormone
4.vitment D
what does the acronym DARN stand for?
desire
ability
reason
need
when should the communication style directing be used?
when training to perform procedure
what are the 3 core communication skills to be used within the communication styles
asking, lisening,involving
what is the best way to help pt successful change behavior?
the best way to help pt successfully change behavior is to inspire behavioral change through support, compassion and empathy.
summarizing skill
includes main aspect of what the pt said during the entire communication
writing reflex
in automatic intervention of health care practitioner who absorbs a pt doing something detrimental reflex.
is there an order to work through the 5 stages of grief?
NO
what is KDQOL 36?
kidney disease quality of care of life
it is an assessment tool used for social workers to identify barriers
what is KDQOL used for?
social worker complies result and develops goals with the pt
are social workers available to caregiver?
social worker available for caregivers strangling to meet demands of pt treatment regiment
4 transport machisms that play role in hemodialysis
1.ultrafilteration
2.convection
3.diffustion
4.osmosis
what is ultrafilteration?
controlled fluid removed by manipulation.removes fluid only
what is convection?
salutes are dragged with water. saluts and water
what is diffusion ?
particles move from high concentration to low construction.only particles
what is osmosis ?
fluid from lower to high.zuccni
what are the kidney endocrine function?
1.produce renin.regulate
2.erythropoetin
3.activiation of fitment d which convert (calibrated bone disease
what is the function of bicarbonate?
diffusion of bicarb from dialysate to blood helps normalize body ph
consequence of organ stunning?
hypotension can have many adverse affects includes impaired tissue prevention of vital organs.
muscle cramps intervention
decrease or turn off uf offer to stretch we don't want to dialoged clot.
fever and chills defention
any temperature greater then 100 fahernhit or increase over baseline of 2 fahrnihit with symptoms. [Show Less]