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a patient is very anxious during an initial hemodialysis treatment and requires extra attention. when the treatment is completed, the patient offers a $20 tip. the technician should politely decline the tip which of the following statements by a hemodialysis patient suggests that the patient needs more education? i should stay on a low protein diet. the inner part of the kidney is the medulla a nephron is comprised of a glomerulus and a tubule
how much urine does a patient with healthy kidneys usually excrete in 24 hours? 1000 to 2000mL when removing soiled gloves, the first glove removed should be. grasped in the opposite gloved hand which of the following hormones is produced by the kidneys? erythropoietin at which stages of chronic kidney disease should a patient being dialysis? 5 which of the following is a genetic disorder that can lead to kidney failure? polycystic kidney disease which of the following complains by a patient may be an indication of uremia? itching
if a emergency ( such as a tornado ) occurs and patients need to be evacuated, which group of patient should be disconnected from dialysis machine first? patients able to ambulate independently for patients on hemodialysis a, 1 kg (2.2 lb.) increased in weight in 24 hours is approximately equivalent to fluid retention of 1.0 L. a patient has been advised to avoid foods high in phosphorus. food that the patient should be advised to limit include. dairy products a patient is scheduled for serum creatinine test and asks the technician about preparation the day before the test. the patient should be advised to. avoid excessive exercise which of the following ethnic group is most at risk for development of kidney failure? african american
a patient has buttonhole tracts for access. after the access is cleaned and prepped for treatment, what is the next step? use a crab picker/ aseptic tweezer to remove the scabs with buttonhole tracts, the technician should apply pressure as the needle are removed and then for 5 to 10 minutes if a buttonhole access frequently has long clots that are very difficult to remove, the most likely reason is failure to use 2-finger hold for needle removal a patient who had an AV fistula in the forearm developed an aneurysm and has had to have a new AV fistula created in the upper arm. the patient has a temporary catheter in place for dialysis until the fistula has matured. which of the following exercise may help strengthen the AV fistula? bicep curl with buttonhole access sites, what should the technician do to prevent '' hubbing "? leave 1/16 th to 1/8 inch of the needle exposed
maturation of a prosthetic arteriovenous graft usually takes 3 to 6 weeks the purpose of the negative germicide test is to ensure that the reprocessed dialyzer is free of germicides if a patient develops angina (chest pain) radiating to the neck, jaw, and left arm and the patient's blood pressure drops during treatment, the technician should notify the nurse and decreased blood flow rate and ultrafiltration the technician is reinforcing a patient's training regarding management of fluid intake. the patient, who still urinates, has a base of 1000 ml intake per day. if the patient urinates 500 ml in a 24-hour period , how much fluid is the patient allowed the following day? 1500ml the greatest risk of bacteremia (infection in the blood) is associated with which type of vascular access? dialysis catheter
the external surface of the hemodialysis machine should be cleaned and disinfected at least. after every patient when checking the water temperature in the system, the technician records the temperature at 78 F (25.5 C). in order for the reverse osmosis (RO) equipment that is partof the water treatment system to work properly, the water temperature must be maintained at 77' F to 82'F ( 25' C to 28'C ) when testing the chlorine levels in the water system, the water sample should be taken from the. first carbon tank when considering the chain of infection, the three most common reservoirs of interest include humans, environment and animals a solution is a mixture of solute and solvent
fluid the patient has develop a small aneurysm and asks the technician to cannulate the aneurysm for the hemodialysis treatment because another patient told this patient that it would be less painful that cannulation of the fistula. the best response is to advise the patient that cannulating an aneurysm may result i rupture. which of the following terms indicates a solution that has the same concentration of solutes as blood? isotonic a patient's potassium levels has been running high between dialysis treatment, so the patient has been working with the renal dietician to restrict potassium in the diet. which of the following fruits should the patient avoid? bananas during osmosis, which of the following movements takes place? fluid moves from an area of lower concentration to higher. a patient's granddaughter calls the dialysis center and asks for a progress report on her father, who is a patient in the center. the technician should.
state that patient information cannot be divulged if a hematoma forms at the access site where a needle infiltrated, the usual intervention is to apply cold compresses which of the following actions by a patient increases the risk of blood clots in a venous access? wearing a top with very tight- fitting long sleeves a patient experience a cardiac arrest with no pulse or respiration during hemodialysis. after the technician calls for help, the next action should be to stop dialysis, return blood, and flush access lines with normal saline. when auscultating a patient's AV fistula to listen for the bruit, if the technician notes that the bruit is very high pitched, this may indicate stenosis when using the buttonhole technique for vascular access for hemodialysis, the needles are placed in.
when inserting needles into a graft for hemodialysis, the needle tips be should be at least how far apart? 2.0 inches if a patient is undergoing hemodialysis and the technician notes that a bloodlines has separated and blood has pooled beneath the access site, the first intervention should be to stop the blood pump during hemodialysis, the technician would expect a patient's temperature to rise by about. 0.5 C approximately what percentage of the total blood volume circulate in the veins? 65% to 80% patient should be advised to avoid eating during hemodialysis because ingestion of food may result in hypotension
prior to using a reprocessed dialyzer, a recirculating rinse with NS should be completed with recirculating flow rate through the blood compartment and the dialysate compartment of at least. 200 mL/min for BFR and 200 mL/ min for DFR. if a hemodialysis patient test positive for hepatitis C virus (HCV), which of the following interventions does the KDIGO guidelines recommend when proving hemodialysis treatment? adherence to strict infection-control procedures if a dialyzer is to be reprocessed in 3 hours, the dialyzer must be refrigerated when documenting observations about a patient, which of the following is the most appropriate description? patient is sighing and rubbing hands together which of the following is the most common cause of hypotension developing during hemodialysis? removing excessive volume of fluid
kidney beans the primary purification process of the dialysis water is filtering with activated carbon if the dialysis center uses hemoclips on dialysis tubing to prevent disconnection, what other precautions should be utilized? visible access sites/line connections and documentation of integrity every 30 minutes if during hemodialysis, blood is evident in the used dialysate, this probably indicates tear in the membrane if a patient asks a question to which the technician does not know the answer, an appropriate response is I 'll find out for you '' during routine hemodialysis, a patient's blood pressure should monitored every 30 to 60 minutes
if a patient develops painful muscle cramps in the hands, feet, and abdomen shortly after hemodialysis begins, the most likely interventions is saline bolus and/or decreased ultrafiltration rate. if a hemodialysis patient's temperature per tympanic membrane thermometer is 37C in order to reduce incidendence of intradialytic ( during dialysis ) hypotension, the temperature of the dialysate solution should ideally be set at 36.5 C foam in the venous bloodline of a dialyzer may indicate air embolism prior to initiating hemodialysis, the ph of the dialyste usually ranges from 7.0 to 7. the number one cause of kidney failure in the US is diabetes mellitus, type 2
if a patient is to undergo heparin-free dialysis, the optimal blood flow rate is 300 to 400 ml/min before cannulating An AV fistula for a hemodialysis treatment, the technician examines the patient's access arm and finds that the access arm appears slightly edamatous, and the skin is pale. on further examination, the technician notes that there are small purple veins evident on the chest wall near where the arm meets the body. the technician should suspect stenosis in order to increase survival rates. the ultrafiltration rate for hemodialysis patients should be maintained at least than 12 ml/kg/m as part of fistula assessment before cannulation, the technician evaluates the thrill and then applies acclusion by placing a finger across the body of the fistula. while the fistula is acceded, the technician palpates and feels both a thrill and a pulse. this probably signifies a (n) accessory pathway ( collateral circulation ) how much additional proteins should a patient on hemodialysis ingest every day in comparison to a health person 50%
weight gain between hemodialysis treatments should not exceed 5% of dry weight the technician has calculate the target weight loss for a patent's hemodialysis session, but the patient insists that the technician has made an error and the target is 1 kg too high. the technician should recalculate the target weight loss. the most important reason for placing hemodialysis needles in antegrade position ( in direction of blood flow) is because it causes less scarring when preparing dialysate with a 45x concentrate, if the proportioning ratio contains 1. part acid and 1.72 parts bicarbonate, how many parts of water are needed?
if conductivity monitoring stops dialysate from flowing to the dialyzer but instead sends it to the drain (bypass), this means that the conductivity monitor is malfunctioning
