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DAVITA DIALYSIS THEORY EXAMLATEST UPDATE GRADED A+
define the term AKIranging from kidney failure to functional loss ✔✔acute kidney injury that incorporates a wide variety of kidney issues
Pre-renal causes of AKIdecreased cardiac output (dysrhythmias, HF, MI), decreased peripheral vascular resistance ✔✔hypovolemia (hemorrhage, dehydration, diarrhea, vomiting), (anaphylaxis, septic shock), decreased renovascular blood flow (embolism, renal arterythrombosis)
Intra-renal causes of AKI ✔✔direct damage to kidneys due to
Ischemic ATNare highly sensitive and susceptible to, due to their very high metabolism ✔✔occurs when the tubular cells do not get enough oxygen, a condition that they
Post-renal causes of AKIneuromuscular disorders, prostate cancer, spinal cord disease, strictures, trauma ✔✔benign prostatic hyperplasia, bladder cancer, calculi formation,
pre, intra and post renal AKI ✔✔
AKI patients are at an increased risk for which complication? ✔✔infection
Why is it important to monitor BP and weight for dialysis patientsthe body. ✔✔To prevent excess fluid in Blood pressure measurements taken after dialysis are a good indicator of whether we areremoving enough fluid and whether your dry weight target is correct.
Difference between AKI and CKD ✔✔acute kidney failure vs chronic kidney AKI is the sudden onset of functional kidney loss and a decrease in GFR. CKD is loss ordecreased GFR for at least 3 months or more.
communication BP reading if cuff is too small ✔✔False high reading
BP reading if cuff is too big ✔✔falsely low reading
BP reading if clothing is too thick ✔✔falsely high reading
BP reading if patient has peripheral vascular disease ✔✔high BP
BP reading if patient has bradycardia ✔✔high arterial BP
BP reading if patient has arrhythmias ✔✔Low BP
what does SMART communication stand for ✔✔Simple MeaningfulActual
ReadTeach
What are the five "W's" when completing an REM ✔✔who what when where why
what are the three things you should not include in an REM ✔✔opinions, vendettas, speculation When dialyzing a patient with AKI, monitoring weight and BP is important because ✔✔hypovolemia and hypotensive episodes can cause renal ischemia and further damage
What are the four consequences of sodium loading a patienthypertension ✔✔edema, thirst, weight gain and
3 ways we can contribute to sodium loading during dialysisdialysate, normal saline ✔✔broth, too much sodium in
HAI'S ✔✔healthcare associated infections
hemoglobin for patients on EPO limit ✔✔no greater than 12 gm/dL
renal reference range for phosphorous ✔✔3.0-5.5 mg/dL
renal reference range for calcium ✔✔8.4-10.2 mg/dL
renal reference range ✔✔60-80 mg/dL
bicarbonate reference range ✔✔22-28 mEq/L
Albumin reference range ✔✔less than 4.0 gm/dL
why is drawing the correct amount of blood for a blood culture so importantcan create a false positive due to a "high blood background" from increased cell count ✔✔too much blood
how much of normal kidney function is replaced by hemodialysis? ✔✔15%
signs and symptoms of fluid imbalancemuscular spasticity, tetany, respiratory depression, muscular weakness and/or muscular ✔✔dehydration, hyponatremia, nausea, vomiting, twitching, diaphoresis and a high temperature hypokalemia ✔✔deficient potassium in the blood less than 3. primary cause why patients are anemia ✔✔lack of erythropoietin
what are the four key elements affected in CKD-MBD ✔✔calcium phosphorousPTH calcitriol what does hypertension lead to ✔✔left ventricular hypertrophy
list two examples of independent nursing functions ✔✔patient care technical skills
acid base balance what are the kidneys endocrine functions ✔✔renin, erythropoiesis, and vitamin D
what is the function of bicarbonateprevent metabolic acidosis ✔✔helps maintain the acid-base balance in patients and
how do we replace normal excretory kidney functions ✔✔remove excess fluid normalize electrolytesreduce metabolic acidosis
How do we replace normal endocrine functions of the kidney? ✔✔reduce hypertension Epo and iron for anemiaphosphate binders Ca+ replacements goal for albumin ✔✔greater than 4
recommended daily intake of sodium ✔✔2000 mg or 2 g /day
potassium goal ✔✔3.5-5.
Reasons for hyperkalemia ✔✔metabolic acidosis
why is PTH secreted ✔✔high phosphorous low calciumlow calcitrol
how long do we wait after administering the heparin bolus to treatment initiation ✔✔3-5 minutes
What does TRAMP stand for ✔✔time, reason, amount, med, person
apheresis ✔✔collection or removal of blood components for therapeutic effect "sick blood" BFR: of 40-150 ml/minslow
needle gauge and suggested BFR rate ✔✔17-200- 16-250-35015-350-
angle to insert AVF needle ✔✔30-45 degree
what are the two reasons for water treatment ✔✔Patient safety and to prevent equipment damage
what is removed during water testing ✔✔calcium, chloride, magnesium, and sodium
why is water testing important ✔✔prevents build up and scaling of calcium on the membrane
albumin in water used for dialysis is used for ✔✔helps with fluid removal during the treatment when dialyzing a patient with acute kidney injury, one task of the team is to monitor BP andweight closely why? ✔✔hypovolemia and hypotensive episodes can cause ren ischemia that can further damage the kidneys
chronic kidney disease can have its origin pre renal intra or post. which are the followingconditions of intra renal causes of CKD ✔✔hypertension
knowning what causes your patients CKDcause health complications which could impact the treatment ✔✔is important because the underlying disease could
why must you wait 3-5 min after adminstering the initial hepatin bolus before initiating thetreatment ✔✔it takes 3-5 minutes for systemic heparinization to occur
preventing hypotensive episodes during the treatment is important because they are associatedwith ✔✔a higher mortality rate
which condition may impair a patients increase in pulse rate as a response to hypovolemia ✔✔autonomic neuropathy
what is your main priority when returning a patient blood with the hand crank during a poweroutage ✔✔you must be vigilant in watching for ain the blood lines
which may cause a decrease in the hemoglobin with ES KD ✔✔infection
which is an indication of the physician to order an aphaeresis treatmentharmful antibodies in the blood plamsa ✔✔accumulation of
what is on benefit of CRRThemodynamically unstable patients ✔✔the therapy is slow, gentle, and well tolerated by
which condition may impair a patients increase in pulse rate as a response to hypovolemia ✔✔autonomic neuropathy
what problem will cause an increase in the patients venous pressurechamber ✔✔a clot in the venous drip
