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When dialyzing a patient with acute kidney injury, one task of the patient care teammates is to monitor blood pressure and weight closely. Why is it important? - correct answer ✅hypovolemia and hypotensive episodes can cause renal ischemia and can further damage the kidneys CKD can have its orgin pre-renal , intra-renalm or post renal. Which of the following conditions is an intra-renal cause of CKD - correct answer ✅HTN Knowing what caused your patient's CKD - correct answer ✅is important because the underlying disease could cause health complications that can impact the dialysis treatment When a PCT documents the extent of a patient's edema, for example as +3 - correct answer ✅the PCT is preforming an assessment which is not allowed legally When a patient has an irregular heartbeat, - correct answer ✅the automatic BP reading may not be accurate
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Which of the following is a data collection - correct answer ✅HR 72 at what time should the post treatment data collection be completed - correct answer ✅after the treatment has been completed the A in smart communication stands for - correct answer ✅actual- just report the facts which of the following events is defined as a near miss - correct answer ✅the wrong dialyzer was set up and primed for a patient, but it was caught before dialysis was initiated and the dialyzer was replaced using the __________ approach is one way to fill out an REM - correct answer ✅SBAR What is your main priority when returning a patient's blood with the hand crank during a power outage? -
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What is the most common factor contributing to bacteremia in dialysis patients? - correct answer ✅use of catheters for HD which infectious disease requires frequent hand washing instead of using alcohol based hand gels - correct answer ✅active clostridioides difficile infection What precautions must be used when handling lab specimens? - correct answer ✅universal precautions waiting only five seconds between lowering the blood pump speed and drawing the post treatment blood sample could - correct answer ✅cause the post treatment BUN reading to be falsely low (wait 15 seconds) which may cause a decrease in the hemoglobin of a patient with ESRD - correct answer ✅infection/inflammation
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fluid overload and HTN lead to LVH, this means - correct answer ✅hypotensive episodes are more likely to occur during the dialysis treatment your role in CKD-MBD management includes - correct answer ✅reminding the patient who is eating a snack during dialysis to take his phosphate binder your role in anemia management includes - correct answer ✅rinsing back as much of the patient's blood as you can at the termination of each treatment the licensed nurse has delegated a specific task to a PCT, but the PCT gets called away before performing this task. Can the PCT asek another PCT to take over? - correct answer ✅no, a task delegated by the licensed nurse to a non-licenced teammate cannot be re-delegated by this teammate the licensed nurse delegated a task to the PCT, Nicole, but Nicole has not performed this task during the last 2.5 months. What is Nicole's responsibility in the delegation communication process? -
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what distance should be observed between needle tips and away from each other when cannulating an internal vascular access? - correct answer ✅1.5 inches the nephrologist has ordered 16 gauge needles and a 400 BFR for your patient. You - correct answer ✅ask the nephrologist to order a 15 gauge needles for the ordered BFR your patient prefers two places on her AVG to insert the needles because they hurt a lot less than when you cannulate different sites. You tell the patient - correct answer ✅inserting the needles into the same small area can over time damage your graft what is the appropriate intervals for total chlorine testing? - correct answer ✅prior to the first patient shift and within every 4 hours what is acceptable limit for total chlorine in the water leaving the carbon filter - correct answer ✅0.1 or less
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which is the primary device for purifying the water used in dialysis - correct answer ✅the RO ICEBOAT? - correct answer ✅2 Identifiers Consent valid Equipment is functioning Hep B status Orders are complete Access is patent Documentation is timely ? any questions/concerns Your patient complains of ringing in the ears, being nauseated and having cold clammy skin. The most likely causes is - correct answer ✅Hypotension What is a likely cause for dysrhythmias? - correct answer ✅Hypotension, heart disease, or rapid changes in K
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The mortality risk for patient who experience two or more episodes of intradialytic hypotension per week increases to - correct answer ✅70% which condition may impair a patient's increase in pulse rate as a response to hypovoilemia - correct answer ✅autonomic neuropathy a patient's protein status is affected by nutritional and non- nutritional factors. what can you do to prevent a drop in your patient's albumin? - correct answer ✅prevent HAIs Calciphylaxis (soft tissue calcification) is a consequence of which out or range labs? - correct answer ✅Ca, PTH, Phosphorus How do phosphate binders work? - correct answer ✅they prevent the phosphorus in food from being absorbed when taken with meals
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The method to protect against infection by pathogenic microorganisms when preparing and administering medications is called - correct answer ✅aseptic technique Why must you wait 3-5 minutes after administering the initial heparin bolus before initiating treatment? - correct answer ✅takes 3-5 minutes for heparin to become systemic When do you take PO4 binders? - correct answer ✅with meals and snacks #1 thing we do - correct answer ✅patient safety Conductivity acceptable rrange - correct answer ✅13-15.5 and +/- 0.4 of the machine pH of dialysate - correct answer ✅6.9-7.
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Convetion - correct answer ✅solute being dragged across the semipermeable membrane Diffusion - correct answer ✅particles from high to low concentrations Osmosis - correct answer ✅fluid from lower to higher concentration How much air can cause a patient harm? - correct answer ✅10mL What is the solution of bleach to clean up a spill? - correct answer ✅1: 2 independent nursing functions - correct answer ✅patient care and technical skills
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2 common routes for CVC infection - correct answer ✅into cath via contact of the insertion site and via cath lumen- scrub the hub for 60 seconds each limb Most common cause for CKD in USA - correct answer ✅DM What is the percent of kidney function lost before going on dialysis
correct answer ✅75% HD replaces what percent of kidney function - correct answer ✅15% What is the direct result of intravascular fluid overload - correct answer ✅HTN Patient with cardiac disease are 10x more likely to develop intra HTN - correct answer ✅LVH
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what is the inflammation aroudn the heart called - correct answer ✅pericarditis restless leg syndrome is a complication of - correct answer ✅peripheral neropathy measures the RBC by weight - correct answer ✅HgB what is the diminished quality and quality of RBC - correct answer ✅anemia what is classified as bone disease associated with renal failure - correct answer ✅CKD-MBD the vitamin converts vit d into which hormone - correct answer ✅Calictrol these procedures can causes significant blood loss in our patients - correct answer ✅access procedures
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maintaining a normal serum Ca levels are the primary function of this hormone - correct answer ✅PTH this disease is the leading cause of death at all stages in CKD - correct answer ✅cardiac this skin color is associated with the decrease circulation of RBC from secondary anemia - correct answer ✅pale it is important to use this team approach when dealing with psychological patients - correct answer ✅multidisplinary What is the reason for a meerCAT audit - correct answer ✅to prepare for survey readiness one thing to improve CAT audit scores - correct answer ✅practice good hand hygiene
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Obtain from A Line Why is drawing the correct amount for blood cultures improtant - correct answer ✅too much blood may create a false positive When do we test Hep B - correct answer ✅need to have it every 28 days drawn for negative and susceptible, if negative and immune every 365 days. if unknown draw patient Rule of 6 is good for? - correct answer ✅new AVF to guide what is LOOK LISTEN AND FEEL? - correct answer ✅assessment without needles inflow stenosis is - correct answer ✅with AVF, venous stenosis, water hammer pulse outflow stenosis - correct answer ✅with AVG, whistling sound
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How do you identify disinfectant infusion is happening - correct answer ✅burning or pain at that access site What do you do for disinfectant infusion? - correct answer ✅stop pump, clamp lines, DO NOT RETURN blood, O2, NS via A Line and collect blood specimens what is hemolysis - correct answer ✅destruction of RBC what is S/S of hemolysis - correct answer ✅anxiety, restlessness, n/v, dyspenea, chest tightness, hyperkalemia, blood will look cranberry what do we do for hemolysis - correct answer ✅stop treatment, clamp lines, DO NOT RETURN BLOOD, assess patient, draw labs, obtain samples for hypotonic dialysate, check dialysate temp, give o
