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Your patient is complaining of cramps and you have already administered 100 ML saline bolus, but the patient is still cramping. Which of the following is not an acceptable intervention - correct answer ✅Applying a glove filled with hot water What is the correct procedure for drawing a post BUN lab specimen at the completion of the dialysis treatment - correct answer ✅Turn off or decrease to 50 ml/hr, decrease DFR to 300 ml/min or place in bypass, reduce BFR to 100 ml/min, wait 15 seconds and draw the sample from the arterial line Per Davita policy, prior to each medication, preparation, the medication, preparation, surface area: - correct answer ✅Is to be disinfected with a 1:100 bleach solution or approved disinfectant How long may a vascular Access clamp stay in place before checking your bleeding has stopped? - correct answer ✅5-10 minutes Your facility experiences a power outage and you're required to manually rinse back your patience. What must you do prior to using
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the handcrank? - correct answer ✅Replace the normal saline bag with a full new one to comply with safety requirements. Your patient complains of pain at the Venus needle site, tingling around the lips and difficulty breathing. These are signs and symptoms of? - correct answer ✅A disinfectant infusion An opened multidose vial, maybe kept for - correct answer ✅28 DAYS Lavender tubes: - correct answer ✅Must be inverted a minimum of 8 to 10 times to properly mix in avoiding clotting To make a 1:10 bleach solution for cleaning gross blood spills you would combine: - correct answer ✅1 part bleach with 9 parts water
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Your immediate intervention for a patient experience an anaphylactic reaction is - correct answer ✅Stop the blood pump and do not return the blood Attention to infection control, proper hand, hygiene, cleaning, and disinfection procedures are of upmost importance in the dialysis setting. Which of the following statement is true? - correct answer ✅MRSA bacteria can survive on surfaces especially plastic and vinyl for days Over-the-counter medications: - correct answer ✅Do not require an order but should be approved by the nephrologist The patient's face, vascular. Access site and bloodline connections should be visible to staff member throughout the dialysis treatment. This is: - correct answer ✅CMS requirement Intervention for a patient complaining of chest pain/angina include
correct answer ✅
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Your patience calculated UF goal exceeds the maximum UFR ordered by the nephrologist. What is the correct response in regards to fluid removal - correct answer ✅ Why do we measure the pH of the dialysis solution? - correct answer ✅To verify it's acid base balance is within the acceptable range Mr. howe arrives for his dialysis treatment and tells the PCT he is short of breath and feels wiped out. The data collection shows the following: current weight: 64 KG target weight: 60 KG BP - 188/ temperature - 98 Fahrenheit. What action should be taken before initiation of treatment - correct answer ✅Abnormal findings documented and reported to the nurse Positive finding a patient who has fallen or has witnessed a Patient fall will? - correct answer ✅
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You evaluate dialysate for a blood leak with serum blood leak test strips. At the end of the patient's treatment, you notice that you left the bottle strips lying on top of the machine. You should. - correct answer ✅Discard the bottle; the heat from the machine most likely degraded the reactivity of the strips Cleaning and disinfecting priming buckets, after each treatment: - correct answer ✅Is required to decrease gram-negative bacterial growth which may occur in solutions such as water Proper functioning of independent meters to check dialysis conductivity of pH must be verified: - correct answer ✅Prior to daily use Mrs. Boomerstein pulls out a 2 - cup size container with fresh strawberries during dialysis. As she savers the first fruit, she smiles and tells you she can eat a lot more potassium during dialysis because it won't harm her. What is your appropriate response? - correct answer ✅You explain the Mrs. Boomerstein that the potassium in food eaten during dialysis is not dialyzed off
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When the lab receives a laboratory test, to put double labeling: - correct answer ✅The double labeled specimen will be rejected at the lab for patient safety Mrs. Murphy's heart rate is irregular period which method of taking her blood pressure will provide the most accurate reading? - correct answer ✅Taking manual bp is more accurate A patient with acute kidney injury dialyzes in the outpatient clinic. What can the PCT do to protect the patients kidney from further injury and help restore kidney function - correct answer ✅Avoid hypovalemia and hypotensive episodes which cause a decrease in the blood supply to the kidney injuries To prevent information of aneurysms in pseudoaneurysm, so following should be practice - correct answer ✅Good needle rotating sites Mr. Gump eats a piece of pizza during the last half hour of his treatment. When you ask him if you remember to bring his phosphate binders , he replies he'll be home soon enough to take the burner then. What is your correct -
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correct answer ✅Improper calibration, lines occlusion, missing o ring During initial data collection, the PCT notice Mrs. Murphy has an irregular pulse. Which of the following actions should she take? - correct answer ✅Report to the nurse Which statement is true regarding fingernails? - correct answer ✅Fingernail length should not extend more than ¼ inch and traditional nail polish that is not chipped may be worn If bicarbonate is mixed for too long, CO2 is released from the solution as a result of overmixing. How would this change the final dialysate? - correct answer ✅Both the pH and conductivity would be out of range Mr. Fox comes for treatment after the long weekend and complains of having trouble moving, his legs feel paralyzed in his heart rate is 39 these symptoms could be related to - correct answer ✅Elevated serum potassium
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At what time do you perform water hardness testing? - correct answer ✅At the end of the treatment day The rope ladder cannulation with that allows cannulation sites to heal and increases the longevity of the access. How long does it take a cannulation site to heal? - correct answer ✅2 weeks You have been asked by the charge nurse to cannulate the new AVF of Mr. Smith, but the patient comes in 15 minutes late and it's time to take your break. Can you ask your fellow PCT to cannulate, Mr. Smith - correct answer ✅No. A task delegated by the licensed nurse to a non-licensed teammate cannot be re-delegated by this teammate Which statement is true regarding the flipping of needles - correct answer ✅when flipping needles the sharp edge of the entire bevel can cause extensive damage or scarring to the interior of the AV access.
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What is the most common infectious complication in hemodialysis patients - correct answer ✅Vascular access infection How long before initiating the hemodialysis tx should the initial loading dose of heparin be administered through the venous needle or port of the CVC to anticoagulate the pt? - correct answer ✅3-5 MINUITES Attempting to remove a large amount of fluid weight gain from the patient a. Should be supported through use of sodium modeling and hypertonic saline administration as needed to prevent hypotension b. Can lead to hypovolemia during the treatment which is associated with an increased mortality rate c. May require exceeding the physician ordered maximum UFR for the patient d. Can lead to unpleasant side effects such as muscle cramps which can be used as teaching tool to motivate patients to watch their fluid intake -
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correct answer ✅b. Can lead to hypovolemia during the treatment which is associated with an increased mortality rate The foot rest of a patient chair is torn and the inner foam is exposed. Can it still be used for patient treatments? - correct answer ✅NO. The torn surface no longer allows for effective cleaning and provides a potential for bacterial growth. Fever is defined as - correct answer ✅any temperature greater than 100 degrees or an increase over baseline of 2 degrees Fahrenheit w/ symptoms. Machine alarm test are performed: - correct answer ✅Before the initiation of each patient treatment Cleaning blood pressure cuffs between patients - correct answer ✅Removes microorganisms such as MRSA or VRE that may be colonized in a patient's axillary area Your patient returned from a weeklong vacation and one hour into the treatment he complains of a bad headache, his BP increased to
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To verify no anticoagulant or saline remains in the catheter limb prior to drawing a lab specimen from a CVC you should - correct answer ✅Remove the anticoagulant, then attach a 10 ml syringe to the arterial limb and gently flush blood back and forth a minimum of 5 times. What is your FIRST response when a water sample exceeds the allowable limit for chlorine/chloramines testing - correct answer ✅Repeat the test on a new water sample taken after the primary carbon tank What is the primary reason the pt should be in a comfortable supine position when performing PRE CVC care? - correct answer ✅The supine position increases pressure within central veins and diminishes the risk of an air embolism How do you determine if a blood pressure cuff is the right size for a patient? - correct answer ✅Use the S, M, and XL, markings on the cuff to determine if the cuff is the right fit.
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DaVita policy states to place a hypotensive patient into a flat supine position instead of Trendelenburg because: - correct answer ✅The Trendelenburg position can cause potential side effects and is no longer recommended for the treatment of hypotension Can priming a dialyzer with a pump speed higher than recommended influence adequacy? - correct answer ✅Yes, a pump speed that is too high can trap air bubbles in the fibers affecting clearance You check the water softener's brine tank and notice that the pellet salt level is below the water level. This means: - correct answer ✅pellet salt should be added until its level is above the water level One of the patients in your facility experiences a cardiac arrest. You are not assisting with the arrest procedure. What should you do? - correct answer ✅Reassure and monitor other patients
