DaVita Final Exam
3 strategies to decrease risk of infection in CVC patients - correct answer-wearing
facemasks when lumens are exposed
wearing gloves when touching anything exposed
minimize lumen/exit sites from being exposed
3 ways we can contribute to sodium loading during dialysis - correct answer-broth
normal saline
Na in dialysate
5 Ws when completing a REM - correct answer-what happened
who was involved
when did it happen
what was the result
any witnesses?
6 occurences to document - correct answer-change from baseline
change in pt condition
procedure/treatment
medication given and pt response
patient teaching
care plan review and interventions
advanced cannulator - correct answer-completed all competencies of NFACT skills checklist
AKI - correct answer-acute kidney injury, encompasses wide range of kidney issues
Aluminum in water used for dialysis causes - correct answer-Anemia, bone disease, nausea
and vomiting
BEST TIPS (complications and prevention) - correct answer-bleeding
erosion
stenosis
thrombosis
infection
pseudoaneurysm/ aneurysms
steal syndrome
BFR for 14G needle - correct answer->450
BFR for 15G needle - correct answer-350-450
, BFR for 16G needle - correct answer-250-350
BFR for 17G needle - correct answer-200-250
causes of intra-renal AKI - correct answer-acute glomerulonephritis, acute tubular necrosis,
acute interstitial nephritis, rhabdomyolysis, hemolysis, myeloma, medications/toxins
causes of post renal AKI - correct answer-bladder/ureteral malignancy, kidney stones,
enlarged prostate
Causes of pre-renal AKI - correct answer-volume depletion, decreased cardiac output,
severe hypotension, renal vascular obstruction
chlorine in water used for hemodialysis causes - correct answer-hemolysis
Chlorine/chloramine testing - correct answer-after RO has been on 15 mins, before first shift,
every 4 hours via primary carbon sample port
Concerns with using DI tanks - correct answer-exhaust quickly
when exhausted will dump previously removed ions back into water
Consequences if pt is consistently overloaded - correct answer-LVH, increased
cardiovascular pressure, hypertension, pulmonary edema, increased risk of hospitalization
and death
consequences of hypovolemia during tx - correct answer-organ stunning, loss of residual
kidney function, increased mortality
consequences of organ stunning - correct answer-heart: acute stress, development of
LVRWA, arrythmias
GI: releases endotoxins, inflammation
kidneys: fibrosis, loss of residual kidney function
brain: white matter injury
considerations for AKI patients - correct answer-typical pt will have CVC
do not dry pt out
avoid renal toxic substances
ask pt to track urine output and to report changes during nursing assessment
pts are at increased risk for hypovolemia, infection and CKD
Convection - correct answer-Fluid and solutes being moved through spm during ultrafiltration
Dialysate endotoxin testing results - correct answer-acceptable level: <0.25 EU
action level: 0.25 to <0.50 EU
unacceptable level: </= 0.50 EU
dialysis machines, even when cleaned, are always considered - correct answer-a dirty area
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