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This study guide provides a comprehensive overview of key concepts and procedures related to davita dialysis treatments. It covers topics such as patient care, infection control, dialysis machine operation, and patient assessment. The guide includes multiple-choice questions and answers, providing a valuable resource for healthcare professionals seeking to enhance their knowledge and understanding of davita dialysis practices.
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what is One for All ✔✔is a program to help you understand the DaVita way
What is HIPAA? ✔✔a law requiring us to keep protected health information confidential
Discussing personal problems with your patients is: ✔✔considered unprofessional behavior
What is the purpose of professional boundaries? ✔✔They keep the relationship between you and your patient appropriate and safe
The transport mechanism when particles move from an area of higher solute concentration to an area of lower solute concentration is called ✔✔diffusion
during dialysis, the movement of bicarbonate from the dialysate into the blood... ✔✔helps normalize body pH
fluid overload and hypertension lead to left ventricular hypertrophy. This means ✔✔hypotensive episodes are more likely to occur during the dialysis treatment
Your role in CKD-MBD management includes ✔✔reminding the patient who is eating a snack during dialysis to take his phosphate binder
Your role in anemia management includes ✔✔Rinsing back as much of the patient's blood as you can at the termination of each treatment
If a patient with acute kidney injury dialyses in the outpatient facility, one task of the patient care teammates is to monitor blood pressure and weight closely. Why is this important? ✔✔Hypovolemia and hypotensive episodes can cause renal ischemia and can further damage the kidneys
Chronic kidney disease can have its origin -re-renal, intra-renal or post renal. Which of the following conditions is an intra-renal cause of CKD? ✔✔Hypertension
Knowing what caused your patients' CKD ✔✔is important because the underlying disease could cause health complications that can impact the dialysis treatment
True or false: adequate nutrition is essential to promote both the recovery of the injured nephrons and the healing of the illness that caused the AKI ✔✔true
What did Janelle tell you about spores in our Hand Hygiene video? ✔✔some spores have been revived after laying dormant for 250 million years
the hand hygiene video states: ✔✔supplies needed to wash your hands are liquid antiseptic soap, paper towels and a clean sink with running water
The PPE Training video lists the order in which the don PPE. Which item is first? ✔✔gown
according to the policy and procedure, gowns: ✔✔must be fully snapped up (or tied at the neck and waist) and wrists covered
A 1:10 bleach solution is used to ✔✔clean up visible blood or gross blood spills
to prepare a 1:100 bleach solution, you would ✔✔add 1 part of bleach to 99 parts of water
what happens if bleach and per-acetic acid are mixed? ✔✔a chemical reaction occurs, producing toxic chlorine gas
a clean object or area is defined as: ✔✔not sterile, but is disinfected.
a dirty object or area is defined as: ✔✔neither sterile nor clean, may or may not be visibly contaminated, and requires PPE for safe interaction
Treatment supplies such as tape, gauze, and alcohol prep pads must be kept in a clean area in the clinic. An example of a clean area would include: ✔✔NOT:
computer desk area
chair-side snappy cart (*if attached to machine)
on the windowsill behind the patients dialysis chairs
What is the most frequent infectious complication in dialysis patients ✔✔bacterial vascular access infections
What is the correct procedure for residual bleach testing after chemical disinfection of distribution loops and equipment fluid pathways? ✔✔Residual bleach testing is performed after bleach disinfection and prior to use
What is the safe range for dialysate pH? ✔✔6.9 to 7.
Why is a "strikethrough" of an external pressure transducer protector of concern? ✔✔fluid could have entered the machine and contaminated the internal pressure transducer protector providing a reservoir for microorganisms and causing subsequent patient blood infections
Why is it important for patient care teammates to know when the water treatment system is disinfected using an end-to-end disinfection process? ✔✔the end-to-end disinfection process will also introduce the disinfectant solution to the dialysis delivery systems through their water inlet lines
Which of the following statements is correct when documenting in the patient's medical record? ✔✔chart what you do, others need to chart what they do
what three symptoms would alert you that a patient's target weight may have to be increased? ✔✔excessive cramping
hypotension
dizziness
what symptoms would alert you that a patient's target weight may have to be decreased? ✔✔hypertension
peripheral edema
congestion in lungs
when a PCT documents the extent of a patient's edema, for example as +3, what is happening? ✔✔the PCT is performing an assessment which is not allowed legally
when a patient has an irregular heartbeat ✔✔the automated oscillometric blood pressure reading may not be accurate
True or False: all pre-treatment data and machine set up parameters are required to be entered into Snappy before the tx starts ✔✔true
when is a pre-treatment assessment by the licensed nurse required? Check all that apply ✔✔when it is mandated by the state
which is considered a normal pre-treatment blood pressure? ✔✔140/
A post treatment patient assessment: ✔✔All of the ABOVE
Is completed to verify that the patient is stable, to determine the patient's discharge status, and to evaluate the effectiveness of the treatment plan
is compared to the patient's pre-treatment assessment findings
requires the licensed nurse to notify the physician as needed of changes in patient status
in states where a pre-treatment patient assessment is not required, select the best answer for nurse role: ✔✔it is the responsibility of the licensed nurse to be aware of data collection findings that may preclude treatment initiation, and assess the patient immediately and intervene as appropriate
Mrs. Thirsty's target weight is 73kg. Her pre-dialysis weight is 77.8 kg. Her last post weight was 74.2 kg. What is Mrs. Thirsty's UF goal today (not including prime and rinse-back)? ✔✔4.8 kg
patients presenting to dialysis below their target weight should ✔✔be re-weighed and evaluated for the cause of the weight loss
what is this pt condition considered: post treatment, a patient's temperature increased from 96.6 F to 98.8 F and the patient complains of a headache ✔✔this is considered a fever which should be investigated
the electrolyte that plays a major role in muscle contraction and high or low levels can lead to weakness or even cardiac arrest is ✔✔potassium
when taking a patient's blood pressure who also has an irregular heart beat with an automatic BP cuff ✔✔the recorded blood pressure may not be accurate
Who is considered the best source of a patient's current disposition? ✔✔the patient him/herself
use of an arm board to support an arterial venous access extremity requires ✔✔a physician's order
when cannulating an AVF/AVG, the needle tips should be ✔✔at least 1.5 inches apart
which of the following is NOT an acceptable way of dressing cannulation sites post treatment? ✔✔wrap and encircle the access extremity with tape or gauze
which statement is true about Povidone Iodine: ✔✔effective contact time is 30 seconds and air drying time is 2 minutes
which statement is true regarding the administration of topical anesthetic spray? ✔✔a can of topical anesthetic spray can be used on different patients
the venous needle is placed: ________________________ (antegrade or retrograde) ✔✔antegrade ie WITH the flow of blood
an arteriovenous fistula AVF ✔✔connects an artery to a vein most commonly in the upper extremity
why is it important that we draw lab tubes in the correct oder ✔✔some tubes have additives
what precautions must be used when handling and packaging lab specimen? ✔✔universal precautions
lavender tubes must be: ✔✔inverted a minimum of 8 to 10 times to properly mix and avoid clotting
if a tube breaks in the centrifuge you must ✔✔discard the sleeve and remove the opposing sleeve
at the completion of the dialysis treatment you should turn off or decrease UFR to: ✔✔50 ml/hr or the lowest recommended setting
when drawing the adequacy lab (Kv/t) you should do what to the dialysate flow rate DFR ✔✔one of any of these:
because the pre-pump arterial pressure that becomes too negative can cause hemolysis, DaVita policy states that the pressure must not exceed ✔✔negative -260 mmmHG
for severe hypotensive symptoms, dialysis technicians may give up to ____________ml normal saline and then inform the licensed nurse for further intervention ✔✔200 mL NSS
if clotting occurs in a high flux dialyzer, the TMP will ✔✔decrease
once rinseback is completed, what should be done prior to removing a patient's venous needle? ✔✔check their blood pressure
sudden BP drops of ________ or more can be an indication that the pt is losing intravascular fluid too quickly ✔✔20 mmHg
what needle size should be used for a BFR (pump speed) prescription of 400 ml/min ✔✔ 15 guage
when collecting a post BUN blood specimen, how long should you wait after decreasing the BFR to 100 mL/min before drawing the sample? ✔✔15 seconds
when terminating a treatment, the pump speed during rinse back should be: ✔✔200-250 mL/min
which of the following is not an approved treatment intervention for cramps ✔✔gloves filled with hot water
which statement is true regarding a recirculated dialyzer and blood line: ✔✔the dialyzer and blood lines should not be used 2 hours after the completion of recirculation due to the potential for bacterial growth
which statement is true when interrupting a hemodialysis treatment for a patient bathroom break? ✔✔return patient's blood and recirculate the extracorporeal circuit with normal saline
a sterile _________ needle and syringe should be used for all heparin does preparations when entering a vial ✔✔21g x 1"
which of the following actions does NOT require the use of a safety needle device? ✔✔adding a medication to a diluent for infusion
which statement is true regarding the administration of normal saline? ✔✔the teammate must remain with the patient to monitor the process until administration is complete and the lines are securely clamped
the three processes that make up the water treatment system are ✔✔pre treatment, water purification, distribution
pre-treatment water samples for chlorine testing are collected after the RO has operated for at least _____________ minutes ✔✔15 minutes
if a Total Chlorine sample is collected prior to the minimum time the RO should be operating, test results: ✔✔could be falsely negative
the first Total Chlorine testing of the primary carbon tank shows a result greater than 0.1ppm. If the result from the second Total Chlorine test of the primary carbon tank indicates a level of greater than 0.1 ppm: ✔✔testing is performed after the secondary carbon filter
if the result of the Total Chlorine testing from the primary carbon filter is too high, but results from the secondary carbon filter are within normal limits: ✔✔breakthrough total chlorine testing is done every 30 minutes
total water hardness is checked when: ✔✔at the end of the treatment day
what is the role of the licensed nurse in regards to the Daily Water Treatment Log? ✔✔the licensed nurse reviews the log for completeness, verifies all parameters are within specified limits, and initial sand signs the log
what is the purpose of testing the pH of the final dialysate ✔✔it verifies that the bicarbonate concentrate has been prepared correctly
if you have residual acid concentrate from a single gallon container, you should: ✔✔neutralize it with sodium bicarbonate powder prior to disposal