Davita Final Quiz Questions with 100% Correct Solutions| Graded A+

What's AAMI? - Association for Advancement of Medical Instrumentation Whats happens if chlorine checks are done to early? - You may get a false negative What is the role of Bicarbonate? - It acts as a buffer. It can diffuse into the patient's blood and replenish the bodies buffer stores What is diffusion? - The movement of dissolved particles across a semipermeable membrane from an area of high concentration to an area of lower concentration. example: spraying perfume What is osmosis? - movement of water across a semi permeable membrane from the side with the lower solute concentration to the side with the higher solute concentration. example: raisin soaked in water swells up What is a semi-permeable membrane? - A thin sheet of natural or synthetic membrane that allows some molecules to pass through but not others What is convection? - convection or solute drag means that solutes move with the water across the semi-permeable membrane What is ultrafiltration? - controlled fluid removal by manipulation of hydrostatic pressure Manual conductivity should be within what range? - + or - 0.4 of the range 13-15.5 Ms/cm (millisiemens per centimeter What can cause arterial pressure to become more negative? - a kink in the line What can cause higher venous pressure? - clotting in the venous drip chamber What test is done at the end of the day? - water hardness What happens if chlorine/chloramines aren't removed? - red blood cells burst allowing the escape of K+ What is done if chlorine test is greater than 0.1? - recheck and check at secondary tank What are 3 steps of water treatment? - pre-treatment, purification, distribution What do you do if the final quality water monitor alarm goes off? - put patients in by-pass mode Why is it important to follow correct order when drawing labs? - to stop cross contamination What should be done to tube once lab is drawn? - invert gently 8-10 times How should you spin blood? - spin like tubes with the same fill levels at the same time What % of kidney function does hemodialysis replace? - 15% What is Renin? - a vasoconstrictor that will cause the BP to increase A vasoconstrictor that will increase the BP is? - Renin What is LVH (Left ventricular hypertrophy) caused by? - Hypertension What is the stronges predictor of sudden death in dialysis patients? - LVH (left ventricular hypertroply) What is LVH (left ventricular hypertrophy)? - enlargement and thickening of the walls of the heart's main pumping chamber If patient has pericarditis what do we do? - hold or decrease heperin to prevent tamponaid. that patient may require more frequent dialysis What is hypokalemia? - low potassium What is hyperkalemia? - high potassium What are sighs/symptoms of hyperkalemia (high K+)? - extreme muscle weakness, cardiac arrhythmias (irregular HB), cardiac arrest What should a dialysis patient use for dry itchy skin? - hyper-fatted soaps and lotions example: goat milk soaps/lotions What is Perifial neuropathy? - decreased sensation in hands and feet What do we tell dialysis patients with perifial neuropathy? - dont go barefoot, check bathwater temp, perform good foot care Whats the primary cause of anemia in our patients? - lack of Erythopoientin What do we give our patients to help with anemia? - hemoglobin (iron) What is CKD-MBD? - Chronic kidney disease—mineral and bone disorder What can CKD-MBD lead to? - abdormalities in Ca, PO4, PTH and vitamin D metabolism as well as soft tissue calcification and bone disease Why must we document? - it's a permanent legal record of the care provided How do i access thrill and bruit? - palpate (feel the thrill) and stethescope (hear the bruit) Regarding near miss question on the test, the answer is - dialyzer What will I document - Who, What, When, Where and Witness's. not personal opinion Dynamic venus pressure(DVP) should not be greater than? - 1/2 the blood flow rate(BFR). What is an REM? - Risk Event Management report Where are REM's (risk event management) found? - chair side snappy-left side Whats an abnormal temperature? - greater than 100 or 2 above baseline temp WITH SYMPTOMS How do I verify patient is stable and safe for discharge? - 1. eval effectiveness of treatment plan through pre and post data collection, 2. Notify the nurse of unusual or abnormal findings before discharge, 3. RN post-assessment If the UF goal exceeds the max perscribed UF goal per hour what do I do? - decrease the goal and document why What does water softener do? - protects the RO water by attracting calcium and magnesium What do carbon tanks remove? - Chlorine and chloramine What is hemolysis and what can cause it? - Breakdown of red blood cells. can be caused by copper, chloromines and nitrates How long does RO water need to run before testing and what can happen if it doesnt? - 15 minutes or you may get a false negative What do i do when the final water quality alarms from bad water? - submit REM (risk event management) report What are the 2 main waste removed during dialysis? - BUN(blood-urea-nitrogen)waste from protein and CREATININE- waste from muscle metabolism What are the 3 functions of kidneys? - renin secretion, erythropoietin secretion and activation of vitamin D What is erythropoietin (EPO)? - The hormone that stimulates the production of red blood cells in our bone marrow Normal pH of blood is? - 7.35-7.45 What's an expiratory function of the kidneys? - to normalize electrolytes When must medication in multi-use vials with preservative be discarded? - 28 days unless its EPO which expires in 21 days Once open how long is EPO(Erythropoietin) good for? - 21 days