Download Davita ICHD PCT Exam Questions And Answers and more Exams Nursing in PDF only on Docsity!
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4 Transport mechanisms that play a role in hemodialysis? - correct answer ✅ultrafiltration convection diffusion osmosis What are kidneys excretory functions? - correct answer ✅normalize electrolytes, remove waste, provide fluid, and nutrient balance What is ultrafiltration? - correct answer ✅fluid pushed through semipermeable membrane ( SPM) membrane What is diffusion? - correct answer ✅particles move from an area of high concentration to low What is osmosis? - correct answer ✅fluid moves from area of low to high concentration
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How do we replace normal excretory kidney functions? - correct answer ✅By normalizing electrolytes and providing fluid balance through ultrafiltration What is the function of acid concentrate? - correct answer ✅Provides the concentration gradient for diffusion What is the function of bicarbonate in dialysis solution? - correct answer ✅buffers the acid concentrate What is the function of bicarbonate when it diffuses into the patient's blood? - correct answer ✅Normalizes body PH Signs and symptoms of hyperkalemia - correct answer ✅>6.5 mEq symptoms: Extreme muscle weakness, Abnormal heart rhythm, and possible cardiac arrest What are the signs and symptoms of hypokalemia? - correct answer ✅<3.5 mEq symptoms: Fatigue, muscle weakness,
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Signs and symptoms of fluid imbalance - correct answer ✅Edema, hypertension, shortness of breath Why is sodium balance important? - correct answer ✅Leads to Volume Expansion--increased CO-- increased peripheral vascular resistance- -increased BP Systemic effects of CKD-send what would you advise for a patientt who complains of peripheral neuropathy( Nerve paint in the extremities) - correct answer ✅Monitor patient for changes in motor function, decrease strength in legs, C/O Restless legs, burning feet. Advise patients not to walk barefoot, have good foot care practices What does hypertension lead to? - correct answer ✅Left ventricular hypertrophy Treatment for pericarditis - correct answer ✅Decrease or stop heparin, give more frequent dialysis
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Why are dialysis patients anemic? - correct answer ✅The lifespan of the red blood cell is 60 days or probably half of the normal 120 days Primary cause of anemia - correct answer ✅Lack of hormone erythropoietin (EPO) Secondary cause of anemia - correct answer ✅Inadequate iron stores, and adequate dialysis, malnutrition coma blood loss during treatment What are the 4 key elements contributing to CKD- Mineral bone disorder (MBD)? - correct answer ✅CA, phos, vitamin D (calcitriol)- all lead to CKD- MBD when they are abnormal How do we prevent contributing to lower hemoglobin and blood loss in dialysis patients? - correct answer ✅verify epogindose is correct and administered, rinse back until venous line is pink and tingedand avoid repeated lab draws
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Examples of pre-renal cause of AKI - correct answer ✅Obstruction, volume depletion, impaired cardiac function Examples of intra-renal cause of AKI - correct answer ✅ischemic ATN and, sepsis, SIRS, septic shock, anaphylaxis drugs, good posture syndrome, trauma, open heart surgery Examples of post-renal cause of AKI - correct answer ✅obstruction, oliguric, bladder rupture, pregnancy How do you protect kidneys from further injury? - correct answer ✅Avoid substances to the kidney which may be toxic (radiographic contrast, amphotericin B, low dose aspirin, NSAIDS) What is important when monitoring weight and blood pressure? - correct answer ✅Keep the little extra fluid on them so it is available to the kidneys when they start filtering/ultra-filtering on their own
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AKI patients are at increased risk for which complications? - correct answer ✅hypovolemia and hypotension What makes dialysis patients more susceptible to HAIs? - correct answer ✅Immunosuppressed and more vulnerable to infection which leads to the 2nd most common cause of death in this population Why are dialysis patients at increased risk for acquiring a HAI at the facility? - correct answer ✅Requires prolonged access to the patient's blood especially those involving CVC vascular access is making them more at risk What is the most common complication in hemodialysis patience? - correct answer ✅Vascular access infection What are V-tags and why are they important? - correct answer ✅They state specific regulations to be met within a condition such as infection control, providing interpretive guidance for each regulation and citing deficiencies by tag
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why is it important for patient care teammates know when the water treatment system disinfection was performed? - correct answer ✅because the end-to-end disinfection process will also introduce the disinfection solution to the dialysis delivery systems through their water inlet lines Key concepts related to Reasonable and prudent care. - correct answer ✅Standard of care is care which a reasonable and prudent nefrology nurse would give under the same or similar circumstances Actions are reasonable and prudent nefrology nurse would do as well as actions the nurse would avoid doing Skills and knowledge expected that the nefrology nurse is key to the specialty of nephrology nursing What is the purpose of standards of care? - correct answer ✅Serve as a basis for many areas including policy procedures, protocols, educational offerings, regulatory systems, and more
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What world does devita's P&P play? - correct answer ✅Provide evidence based guidance Meet CMS conditions for coverage Complies with state and federal laws What are the risks of performing activities your way? - correct answer ✅Not providing safe evidence based care can lead to civil liability 6 occurrences when to document - correct answer ✅baseline assessment change from baseline assessment change in patients condition procedure or treatment medication given and patient response patient teaching What does smart communication stand for? - correct answer ✅Simple: Keep message clear and simple
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The late entry must be timed and dated at the time it is rendered What is a normal Pre-treatment blood pressure - correct answer ✅systolic equal to or less than 180mm/Hg or equal to or greater than 90mm/Hg and diastolic less than 100mm/Hg What is the normal respiratory range? - correct answer ✅12-16 breath/minute What is a normal temperature? - correct answer ✅Less than 100 ﾟ F or 37.8 ﾟ C or less than 2 ﾟ F 1 ﾟ C of baseline Let's 3 words to DaVita uses in order to easily recall the pre treatment AVF/AVG access valuation - correct answer ✅look, listen. feel What are the 5 Ws to be used when completing an REM? - correct answer ✅what when where
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why witness Interdialytic weight gain (IDWG) calculation - correct answer ✅Pre weight - (minus) Last post weight How do you calculate UF goal? - correct answer ✅target weight+NS prime & rinseback+oral intake infusions= UF goal UFR calculation - correct answer ✅UF goal / tx hours 4 consequences of sodium loading during dialysis? - correct answer ✅increased thirst LG fluid gain hypotension ischemic events
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What is the connection point called up the artery and vein for the creation of NAVF - correct answer ✅anastomosis Describe the 4AVF evaluations for maturation based on the KDOQI rule of sixes - correct answer ✅600 ml flow through access O.6 cm in depth under the skin 0.6 diameter( width of pencil ereaser) 6-8 weekspost op maturation Describe the teammates cannulation level based on NFACT - correct answer ✅beginner, intermediate, advanced Beginner cannulater - correct answer ✅less than 6 months experience or less than 10 successful cannulations
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Intermediate cannulator - correct answer ✅6 months experience of AVF & 10 successful cannulations Advanced cannulator - correct answer ✅completed all competencies of NFACT skills checklist and expert assessment and cannulation skills documented What is a tunneled CVC - correct answer ✅CVC hass a cuff that the skin grows too for anchoring to the patient, is kept in place longer searchers used for at placement can be removed after site healed What is a non- tunneled CVC - correct answer ✅CVC are held in place only by suture no cough present Definition of a newly mature AVF - correct answer ✅New fiscilla has post op surgical exam, meets the rules of the 6s, can be calculated by an NFACT trained teammates
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Definition of established AVF - correct answer ✅Prescribe BFR and Max needle size for 2 months Recommended needle gauge and Max BFR for new AVF initial canulation - correct answer ✅17 gauge and BFR not to exceed 250 ml/min Needle gauge and suggested BFR - correct answer ✅17g 200-250ml/min, 16g 250-350, 15g 350-450, 14g greater than 450 Site prep cannulation rules - correct answer ✅Evaluation of blood flow: Thrill/bruit look listen feel Site rotation/healing time: 14 days Wrote latter method rotation of sites needed to promote healing Need to insertion: AVF 25 degrees AVG 45 degree Flipping the needle/ Complications: Is not necessary arterial needle has a back eye
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Vascular access complications "BEST TIPS" - correct answer ✅B: bleeding E: erosion S: stenosis T: thrombosis I: infection P: pseudoaneurysm/aneurysms S: steal syndrome What is the goal for single pool (spKt/V) for 3x a wk frequency of dialysis treatments? - correct answer ✅greater than or equal to 1. Kt/V: What is K? - correct answer ✅Clearance of urea Kt/V what treatment factors decrease K? - correct answer ✅inadequate coagulation, decreased BFR, poor priming, not following P&P, patient not staying on TX as prescribed
