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When dialyzing a patient with acute kidney injury, one task of the patient care teammates is tomonitor blood pressure and weight closely. Why is it important? ✔✔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 conditionsis an intra-renal cause of CKD ✔✔HTN
Knowing what caused your patient's CKDcause health complications that can impact the dialysis treatment ✔✔is important because the underlying disease could
When a PCT documents the extent of a patient's edema, for example as +3preforming an assessment which is not allowed legally ✔✔the PCT is
When a patient has an irregular heartbeat, ✔✔the automatic BP reading may not be accurate Which of the following is a data collection ✔✔HR 72
at what time should the post treatment data collection be completedbeen completed ✔✔after the treatment has
the A in smart communication stands for ✔✔actual- just report the facts which of the following events is defined as a near missprimed for a patient, but it was caught before dialysis was initiated and the dialyzer was replaced ✔✔the wrong dialyzer was set up and
using the __________ approach is one way to fill out an REM ✔✔SBAR What is your main priority when returning a patient's blood with the hand crank during a poweroutage? ✔✔you must be vigilant in watching for air in the blood lines
what problem will cause an increase in the patient's VP ✔✔a clot in the venous drip chamber Which blood test must be performed at regular intervals on patients susceptible to HPB ✔✔HBsAg
which may cause a decrease in the hemoglobin of a patient with ESRD ✔✔infection/inflammation
fluid overload and HTN lead to LVH, this meansoccur during the dialysis treatment ✔✔hypotensive episodes are more likely to
your role in CKD-MBD management includesduring dialysis to take his phosphate binder ✔✔reminding the patient who is eating a snack
your role in anemia management includescan at the termination of each treatment ✔✔rinsing back as much of the patient's blood as you
the licensed nurse has delegated a specific task to a PCT, but the PCT gets called away beforeperforming this task. Can the PCT asek another PCT to take over? ✔✔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 taskduring the last 2.5 months. What is Nicole's responsibility in the delegation communication process? ✔✔Nicole is to inform the nurse that she performed the task only infrequently
what is the nurse's responsibility in the delegation supervision process?level of supervision needed and to monitor the NAP's performance of the task accordingly ✔✔to determine the
the transport mechanism when particles move from an area of higher solute concentration to anarea of lower solute concentration is called ✔✔diffusion
during dialysis, the movement of bicarb from the dialysate into the bloodbody pH ✔✔helps normalize
the kidneys excretory functions include ✔✔normalizing electrolytes what distance should be observed between needle tips and away from each other whencannulating an internal vascular access? ✔✔1.5 inches
the nephrologist has ordered 16 gauge needles and a 400 BFR for your patient. Younephrologist to order a 15 gauge needles for the ordered BFR ✔✔ask the
? any questions/concerns Your patient complains of ringing in the ears, being nauseated and having cold clammy skin. Themost likely causes is ✔✔Hypotension
What is a likely cause for dysrhythmias? ✔✔Hypotension, heart disease, or rapid changes in K In what position should you place a patient who experiences intradialytic hypotension? ✔✔Supine
What do you do for a patient with an air emblolism?Trendelenburg, attempt to aspirate the air, administer O2 per MD, monitor VS closely, initiate ✔✔Clamp lines, put patient on left side, CPR if needed, notify code team Why is thirst control and limiting interdialytic weight gains a shared responsibilyt between thehealthcare team and the patient? ✔✔Caregivers can contribute to Na loading during dialysis causing an increased thirst and fluid intake between treatments
Preventing hypotensive episodes during dialysis treatment is important because they areassociated with ✔✔a higher mortality rate
The mortality risk for patient who experience two or more episodes of intradialytic hypotensionper week increases to ✔✔70%
which condition may impair a patient's increase in pulse rate as a response to hypovoilemia ✔✔autonomic neuropathy
a patient's protein status is affected by nutritional and non-nutritional factors. what can you do toprevent a drop in your patient's albumin? ✔✔prevent HAIs
Calciphylaxis (soft tissue calcification) is a consequence of which out or range labs?PTH, Phosphorus ✔✔Ca,
How do phosphate binders work?when taken with meals ✔✔they prevent the phosphorus in food from being absorbed
Bicarb lasts for how long once opened? ✔✔24 hours Acid lasts for how long when opened? ✔✔30 days if additives discard after treatment lifespan of a RBC for dialysis patient ✔✔60 days Ultrafiltration ✔✔fluid passing thru a membrane Convetion ✔✔solute being dragged across the semipermeable membrane Diffusion ✔✔particles from high to low concentrations Osmosis ✔✔fluid from lower to higher concentration How much air can cause a patient harm? ✔✔10mL
What is the solution of bleach to clean up a spill? ✔✔1: 2 independent nursing functions ✔✔patient care and technical skills 2 common routes for CVC infectionlumen- scrub the hub for 60 seconds each limb ✔✔into cath via contact of the insertion site and via cath
Most common cause for CKD in USA ✔✔DM What is the percent of kidney function lost before going on dialysis ✔✔75% HD replaces what percent of kidney function ✔✔15% What is the direct result of intravascular fluid overload ✔✔HTN Patient with cardiac disease are 10x more likely to develop intra HTN ✔✔LVH Offer a patient of this is an example of oral sodium loading ✔✔broth
what is the diminished quality and quality of RBC ✔✔anemia what is classified as bone disease associated with renal failure ✔✔CKD-MBD the vitamin converts vit d into which hormone ✔✔Calictrol these procedures can causes significant blood loss in our patients ✔✔access procedures maintaining a normal serum Ca levels are the primary function of this hormone ✔✔PTH this disease is the leading cause of death at all stages in CKD ✔✔cardiac this skin color is associated with the decrease circulation of RBC from secondary anemia ✔✔pale
it is important to use this team approach when dealing with psychological patients ✔✔multidisplinary
What is the reason for a meerCAT audit ✔✔to prepare for survey readiness one thing to improve CAT audit scores ✔✔practice good hand hygiene one thing to improve meerCAT score ✔✔store look-a-like, sound-a-like products appropriately Why is the order of lab draw importantwith additives from the previous ✔✔samples in subsequent tubes are not contaminated
what do you want the level of albumin to be ✔✔> if drawing labs during dialysis how do you label them? ✔✔DRAWING DURING DIALYSIS BUN lab draws post dialysis ✔✔turn off or decrease UR to 50 decrease DFR to 300 or place machine in bypassreduce BFR to 100 wait 15 seconds for AVG/AVF and CVC (WAIT 15 seconds!!)Obtain from A Line
What do you do for disinfectant infusion?blood, O2, NS via A Line and collect blood specimens ✔✔stop pump, clamp lines, DO NOT RETURN
what is hemolysis ✔✔destruction of RBC what is S/S of hemolysisblood will look cranberry ✔✔anxiety, restlessness, n/v, dyspenea, chest tightness, hyperkalemia,
what do we do for hemolysisassess patient, draw labs, obtain samples for hypotonic dialysate, check dialysate temp, give o2 ✔✔stop treatment, clamp lines, DO NOT RETURN BLOOD,
what are s/s of air embolismvisual disturbances ✔✔dyspnea, coughing, chest tightness/pain, cyanosis, confusion,
hypotension ✔✔a drop in BP by 20 decrease in MAP by 10if pre SBP less than 90 drop of 10 with symptoms
Intervention for hypotension ✔✔take BP, minimum UFR, give NS, elevate feet, supine position what is a fever ✔✔temp >100 or increase in 2 degrees from baseline what will hyperkalemic patients have ✔✔peaked T waves what do we do for pericarditis patients ✔✔more frequent dialysis what do we avoid with pericarditis patients ✔✔heparin what is the K bath we give for digoxin patients ✔✔2k heparin is considered what ✔✔systemic vitamins should be given when? ✔✔post treatment so they dont dialyze out
how long do you scrub the hub of a CVC? ✔✔60 seconds each limb Platelets should be adminstered howan IV pump ✔✔thru venous med lock on the venous drip chamber using
how often do you rotate sites? ✔✔every 14 days How often do you draw Hepatitis B ✔✔draw every 28 days they are good for 30 days
