Download Acute Kidney Injury (AKI) and Hemodialysis: Questions and Answers and more Exams Clinical Medicine in PDF only on Docsity!
Davita's Final Exam Questions and
Answers 100% Pass
Intra-renal causes of Acute Kidney Injury (AKI) ✔✔Sepsis, trauma, anaphylaxis, drugs, acute glomerulus
Knowing what caused your patients' renal failure ✔✔Is important to figure about possible problems during data collection and assessment
A patient with acute kidney injury (AKI) dialyzes in the out-patient facility. In regards to the patient's target weight, why is being "wet" better than being too dry? ✔✔Being wet helps avoid hypovolemia and hypotensive episodes
The excretory function of the kidneys include ✔✔removes access water, urea, and metabolic waste from the blood.
Acid concentrate replaces the excretory function of normal kidney function by ✔✔Normalizing electrolytes
Ultrafiltration is defined as ✔✔controlled fluid removal by manipulation of hydrostatic pressure
The endocrine functions of the kidneys are ✔✔Renin and erythroprotein secretion; activation of vitamin D
The dialysis prescription, nursing assessments, interventions, and follow ups help us to provide the highest quality treatment for every patient, every time. Despite our efforts, dialysis replaces only ______percent of normal kidney function. ✔✔15%
You are assisting a patient to step onto the scale by holding the patient's hand. Such a casual contact ✔✔Requires wearing gloves and hand hygiene afterwards
Which statement is true about sinks used for handwashing? ✔✔Handwashing sinks must be dedicated for handwashing purpose only and should remain clean
The most common infectious complication for hemodialysis patients is ✔✔The use of catheters
What is one method surveyors use to verify infection control training and education? ✔✔Documentation of infection control training in teammate's file or transcript
Per the Centers for Disease Control and Prevention (CDC), which is the most common factor contributing to bacterial infections in dialysis patients? ✔✔Contact transmission
Upon completing machine set up and before treatment initiation it is important to verify the prescription and machine settings: ✔✔Both B and C
What should be done to the heparin infusion line if a patient does not have maintenance (hourly) heparin prescribed? ✔✔Clamp and knot the heparin line.
What type of blood/dialysate flow within the dialyzer increases the rate of diffusion providing optimal dialysis for patients? ✔✔Counter- current flow
When is a pre-treatment assessment by the licensed nurse required? Check all that apply: ✔✔Select All options.
A PCT greets a patient and the patient reports feeling short of breath. The PCT notices that the patient's lips are a blue hue. The PCT would: ✔✔Not start treatment, immediately notify the nurse
In those states that do not require a nursing assessment to be completed prior to treatment initiation, the PCT would be required to report abnormal patient data collection findings ✔✔to the nurse prior to treatment initiation
For patients' with Acute Kidney Injury (AKI) which statement is correct? ✔✔A nursing assesment prior to tx initiation is always required
How do you verify that the patient is stable and safe for discharge after the dialysis treatment? ✔✔Evaluate the effectiveness of the treatment by comparing data to pre-dialysis findings
PCT's notify the nurse if there are any unusual findings
The patient is using a central venous catheter (CVC) for dialysis and has a new arteriovenous fistula (AVF) present in his lower arm. What observation/assessment should you perform for the AVF? ✔✔checking for the bruitand thrill every time treatment day
Can you document patient vital signs under another teammate already signed into the computer? ✔✔No, log into the computer system under your credentials and document
The PCT notes that a patient still has considerable edema in her legs when performing the post- treatment data collection. In addition to informing the nurse, what should the PCT document? ✔✔Document the swelling and that RN was informed.
Which statement is true regarding the "Reasonable and Prudent" Standard of Care? ✔✔When supervising pt care technicians an other non-licensed personnel, it is the resposibility of the licensed nurse to ensure these teammates
Performing a procedure "your way" rather than following the dialysis facility's policies & procedures (P&P) ✔✔Lead to civil liability in the event of an adverse pt outcome
The maximum ultra-filtration (UF) rate should not exceed ______ because it may lead to hypotensive episodes which increases the risk of organ stunning or mortality. ✔✔An UFR > ml/hr/Kg
What amount of fluid weight is considered excessive? ✔✔5% of target weight is considered excessive
The patient's treatment time is 3 hours. He has brought a 10 oz. cup of coffee (300 ml), has an IV antibiotic of 100ml to be administered during treatment, and prime/rinseback of 400ml. The
physicians order reads to remove 2.2 liters of fluid. What is the hourly UF removal goal? ✔✔1000 ml/hr
A patient's target weight is: ✔✔prescribed and determined by physicians order
What are the three steps included in the vascular access assessment? ✔✔look, listen and feel
Scrubbing of each hub as part of CVC care is done for: ✔✔15 seconds
The nephrologist has prescribed a 400 blood flow rate (BFR) for your patient. You would expect the physician order to also include ✔✔15 gauge needle for the prescribed BFR
You listen to your patient's arteriovenous graft (AVG) and hear a whistling sound. ✔✔outflow stenosis
To prevent the formation of aneurysms and pseudoaneurysms the following should be practiced ✔✔Good needlesites rotation and complete needle site clotting techniques
Which of the following factors would influence the 't' of the Kt/V formula? ✔✔Shortened treatment time
Which of the following factors would decrease the K of the Kt/V formula? ✔✔Inadequate anticoagulation
When the lab receives a laboratory test tube with double labeling: ✔✔The double labed specimen will be rejected at the laboratory for pt safety
Prior to treatment termination the PCT adjusts the machine parameters in order to draw the Kt/V lab for adequacy. How long should they wait prior to drawing the lab to ensure an accurate result? ✔✔15 seconds
What steps are performed to replace fluid removed and prevent clotting during the recirculation of blood in the extracorporeal circuit when there has been a treatment interruption (i.e. patient using the restroom)? ✔✔The saline infusion line is open and if the patient is recieving an intradialytic heperin infusion via the dialyzer machine, the heperin pump is on
Per DaVita policy, intradialytic treatment monitoring and data collection in the in-center hemodialysis treatment setting should be performed every ✔✔30 minutes
The waiting time after administration of the initial heparin loading dose prior to initiation of hemodialysis is ✔✔3-5 minutes
Which statement is true regarding the administration of Normal Saline? ✔✔the teammate must remain with the patient to monitor their progress until administration is complete and lines are securely clamp.
Prior to use, how should the medication preparation surface area be disinfected? ✔✔with 1: bleach solution and disposible wipes
What must be completed prior to medication preparation? ✔✔All of the above
Your patient asks whether it is OK to take an over-the-counter cold remedy. What is your appropriate response? ✔✔Lets ask your nephrologist what they recommend to treat your cold symptoms
Water treatment is needed in the dialysis setting to: ✔✔Meet renal networks standards
starting her treatment. Which patient complication would the PCT and RN suspect Cynthia is most likely suffering from? ✔✔Hyperkalymia
The dialysis team prevents additional blood loss by ✔✔providing appropiate heparin dose per physician order using good cannulation and proper rinseback after tx.
A pyrogenic reaction will most likely occur at what time during the treatment? ✔✔within 45 to 75 minutes
Which of the following is a sign of hemolysis ✔✔Cherry red colored blood in the venous line
In the event of a patient experiencing a seizure, the dialysis treatment should be ✔✔Discontinued if the seisure is severe or the pt does not respond to tx.
A recommended intervention for muscle cramps is ✔✔Turning the ultrafiltration (UFR) off.
Per DaVita policy, fever is defined as ✔✔Any temperature < than 100 degrees F or increase over baseline of 2 degrees F with symptoms.
The patient position used for a suspected air embolism is ✔✔Trendelenburg, on the left
Your immediate intervention for a patient experiencing an anaphylactic reaction is ✔✔Stop the blood pump, discontinue tx, and do not return blood
Interventions for a patient complaining of chest pain include ✔✔decrease BFR, decrease ultrafiltration rate (UFR), take vital signs and administer oxygen.
What problems will cause a more positive (less negative) pre-pump arterial pressure ✔✔Seperation of blood tubing from arterial access
What is the most likely reason for a blood leak detector alarm during recirculation? ✔✔Air bubbles,malfuction, or a leak in the membrane of the dialyzer causing blood to leak in to the dialysate
What is an appropriate intervention(s) with an air/foam detector alarm? ✔✔Look at the circuit, do not return blood with air in system, fix problem.
Poor wound healing is directly related to ✔✔Inadequate protein intake
Per physician order and based on individual patient needs, Chronic Kidney Disease Mineral & Bone Disorder (MBD) is treated with ✔✔Phosphate binders, vitamin D, and Calcitriol
Phosphate binders are prescribed to prevent phosphorus in meals from being absorbed. When is the best time to take them?Correct ✔✔With a meal
The definition of Health Literacy is ✔✔Understand basic health information
If you notice that a patient's caretaker is struggling to meet the demands of the patient's treatment regime you should ✔✔Notify the social worker because she/he is there for pts and their families
The Psychosocial Assessment completed by the social worker: ✔✔Notify the social worker because she/he is there for pts and their families
The Clinical Pyramid includes: ✔✔The fundamentals, complex programs, and quality of life
DaVita Quality Index (DQI) success is achieved ✔✔All of the above
What can be the most likely result if the surveyor sees a patient with a covered vascular access? ✔✔An immediate jeopardy
To assist in survey readiness you should ✔✔All of the above
A surveyor asks you a question. Which of the following statements would be a good answer? ✔✔I dont know the answer, but I will find out.
