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DaVita Exam Module 1 Exam Questions And Answers
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Ultrafiltration definition - correct answer ✅(Fluid movement) Controlled fluid removal by manipulation of hydrostatic pressure Convection definition - correct answer ✅(Particle/solute movement) Solutes are dragged across the semipermeable membrane along with fluid Diffusion definition - correct answer ✅(Particle/solute movement) Particles move from an area of higher solute concentration to lower solute concentration Osmosis definition - correct answer ✅(Fluid movement) fluid moves from lower solute concentration to higher solute concentration What are the kidney's excretory functions? - correct answer ✅Water removal, electrolyte balance, toxin removal and acid base balance
How do we replace normal excretory kidney functions? - correct answer ✅By normalizing the electrolytes and providing fluid balance through ultrafiltration What is the function of the acid concentrate? - correct answer ✅It provides the concentration gradient for diffusion What is the function of bicarbonate in the dialysate solution? - correct answer ✅It buffers the acid concentrate What is the function of bicarbonate when it diffuses into the patient's blood? - correct answer ✅It normalizes the patients body temp pH in the blood stream (7.35-7.45) Signs and symptoms of Hyperkalemia - correct answer ✅Greater than 6.5 EXTREME muscles weakness and abnormal heart rhythm
Outline the treatment goals for a patient with CKD - correct answer ✅Acid base balance, fluid removal, electrolyte balance and toxin removal Why is it important to know what caused your patients CKD - correct answer ✅So the nurse and pct can inquire about possible problems during data collection and assessment Signs and symptoms of fluid balance - correct answer ✅Hypertension (high BP), swelling or edema, and shortness of breathe Why is sodium balance important? - correct answer ✅Sodium creates thirst which leads to volume expansion, increases the bp, LVH, leads to higher mortality rate Advice for a pt that complains of dry, itchy skin - correct answer ✅Hyper fatty soaps and lotion, emotional support
Peripheral neuropathy (nerve pain in the extremities) - correct answer ✅Advise not to walk barefoot, bath water temp GI problems (nausea/vomiting) - correct answer ✅Get nurse involved Psychological problems (anxiety/depression) - correct answer ✅Get it up to the social worker What does hypertension lead to? - correct answer ✅Left ventricular hypertrophy (LVH) What is pericarditis? - correct answer ✅Inflammation of the membrane (pericardiosack) What is included in pericarditis treatment? - correct answer ✅Decrease or stop heparin or give more dialysis Why are dialysis patients anemic? (Primary cause) - correct answer ✅Lack of Erythropoietin
Define the term AKI - correct answer ✅encompasses wide spectrum of kidney issues, including kidney failure and kidney function changes 3 examples of pre-renal causes of AKI - correct answer ✅Volume depletion (hemorrhage, burns), decrease in cardiac output, renal vascular obstruction
How do you help in restoring kidney function with AKI pts? - correct answer ✅Find the cause of AKI and try to get rid of it What do you need to consider in regards to AKI pts vascular access - correct answer ✅Make sure to follow policy and procedures to prepare the access sites so they don't get septic (infection) How do you protect kidneys from further injury? - correct answer ✅Avoid substances that may be toxic to the kidneys What is important when monitoring weight and BP? - correct answer ✅Always want to keep a little bit of fluid on so the kidneys stay perfused AKI pts are at increased risk for which complications? - correct answer ✅hypovolemia (loss of fluid volume in blood) which leads to hypotension
What germ causes the most common infections in hemodialysis patients? - correct answer ✅MRSA - can remain on surfaces for days with plastic and vinyl Why is wearing gloves so important? - correct answer ✅reduces the risk of hand contamination Why do you need to perform hand hygiene before and after wearing gloves? - correct answer ✅Hands can become contaminated despite gloves through microscopic holes or contamination from the outside comes in contact with skin What is the difference between OSHA and CMS infection control requirements? - correct answer ✅OSHA requires employees to provide workers with a safe workplace while CMS is concerned with patient care and patient safety What are V-tags and why are they important? - correct answer ✅They state specific regulations to be met within a
condition providing interpretive guidance for each regulation and siting deficiency by tag number Is a cleaned dialysis machine considered a "clean area"? - correct answer ✅No, they are always considered dirty When should sharps containers be removed from the treatment floor? - correct answer ✅They are removed when they are 3/4 full State 3 strategies recommended by KDOQI to decrease the risk of infection when working with a CVC (central vinus catheter) - correct answer ✅1) Make sure you're using face masks when Lumans or exit sites are exposed
How long can a dial user and blood lines be set up for once recirculation is complete? - correct answer ✅No longer than 2 hours Why can't the recirculation remain set up longer? - correct answer ✅Due to bacterial proliferation The manual conductivity value must match +/- what on the fresenius (FMC) dialysis delivery system displayed conductivity? - correct answer ✅+- .4 mS What is a safe dialysate pH range? - correct answer ✅6.9-7. What is "strikethrough" of an external pressure transducer and why is it of concern? - correct answer ✅When fluid could have entered the machine and contaminated the internal pressure transducer protector, providing a reservoir of microorganisms to the next pt getting on
Why is it important for patient care teammates to know when the water treatment system disinfection was performed? - correct answer ✅The end to end disinfection process could also introduce the disinfection into deliver system, then the pt The reasonable & prudent" standard of care for nephrology nursing key concepts - correct answer ✅Care, actions, nephrology nursing, following standard of care, & license nurse ensuring teammates also meet the standard of care What role does DaVita P&P play? - correct answer ✅Provides evidenced based guidance, meets medicare conditions for coverage and complies with state and federal law What are the risks of performing activities your way? - correct answer ✅not providing safe evidence based care and can lead to civil liability
What is the difference between the role of a Nurse and a PCT? - correct answer ✅Nurse - Assessment ( the depth of edema) PCT - Data collection ( the present of edema) What is the role of the licensed nurse prior to treatment initiation?
correct answer ✅Assessment of the abnormal findings from data collections When is a pre-treatment assessment by the nurse required for a CKD hemodialysis pt? - correct answer ✅Based on state law or abnormal findings during data collection When is a pre-treatment assessment by the nurse required for a AKI hemodialysis pt? - correct answer ✅Pre-treatment assessment
What is the role of the PCT prior to treatment initiation? - correct answer ✅complete pre-treatment data collection and let RN know if they're any abnormal findings What are the appropriate times for documentation? - correct answer ✅Pre tx, intradialyte, post treatment and every 30 minutes Appropriate times for pre-treatment safety checks - correct answer ✅Prior to treatment Appropriate times for pre-treatment patient data collection - correct answer ✅prior to treatment Appropriate times for observations during treatment - correct answer ✅statistic line (e line) that you're getting in every 30 min. Appropriate times for post-treatment data collection/assessment - correct answer ✅after treatment
What is a normal pre-treatment blood pressure? - correct answer ✅140/90 (abormal: +/- 20mm/Hg) What is the normal heart rate range? - correct answer ✅60-100 beats a min. What is the normal respiratory range? - correct answer ✅16-20 breaths a min. What is the normal temperature? - correct answer ✅98.6 F (abnormal: greater than 100 F or 2 degrees rise over baseline) 3 words for access evaluation - correct answer ✅Look, Listen, Feel When is post-treatment assessment by the licensed nurse required? - correct answer ✅After treatment, state law determined, and ALWAYS when there is an abnormal findings
What are the 5 W's to be used when completing a REM? (Risk event management) - correct answer ✅1) What happened?
correct answer ✅1) increase thirst