DaVita - PCT Study Guide questions with
actual answers.
Chlorine/Chloramine testing: ANS - When: R/O runs 15 mins before patient shift every 4 hours
Where: After Primary carbon tank sample port
Acceptable result: Less than or equal to 0.1 mg/L
Action if results are too high post primary tank: Repeat the test
Define the term AKI ANS - - Term incorporates a wide spectrum of kidney issues
- Includes acute kidney failure as well as less catastrophic kidney function changes
- May dialyze in an out-patient facility until kidney function recovers
Give examples of pre-renal causes of AKI ANS - - Obstruction
- Volume Depletion
- Impaired Cardiac Function
Give examples of intra-renal causes of AKI ANS - - Ischemic ATN
- Sepsis
- SIRS
- Septic Shock
- Anaphylaxis Drugs
- Goodpasture Syndrome
- Acute Glomerulonephritis
- Trauma
- Open Heart Surgery
Give examples of post-renal causes of AKI ANS - - Obstruction
,- Oliguric
- Bladder Rupture
- Pregnancy
How do you help in restoring kidney function? ANS - Find the cause of the AKI
How do you protect kidneys from further injury? ANS - Avoid substances to the kidney which may be
toxic (radiographic contrast, amphotericin B, low dose aspirin, NSAIDS)
What is important when monitoring weight and BP? ANS - Keep a little extra fluid on them so it is
available to the kidneys when they start filtering/ultrafiltrating on their own
AKI patients are at increased risk for which complications? ANS - - Hypovolemia
- Hypotension
What do you need to consider in regards to their (AKI patients') vascular access? ANS - Patients will
typically have a dialysis catheter, so be careful to avoid catheter related infections
Explain the difference between AKI and CKD ANS - Eliminating the cause of the AKI can often lead to
the return of kidney function. You cannot eliminate the cause of CKD which is HTN, Diabetes, and
genetic disorders (PKD)
Outline the treatment goals for a patient with CKD ANS - - Slowing the progression of CKD
- Managing comorbidities and complications
- Controlling symptoms
- Minimizing the effects of CKD on patients' lifestyles
- Kidney replacement therapy modality education
- Encouraging patients to actively participate in their healthcare
What are the most common causes for CKD in the USA? ANS - - DM
,- HTN
- PKD
Why it is important to know what caused your patient's CKD? ANS - So the nurse and PCT can inquire
about possible problems during data collection and assessment
In Kt/V, what is 'K'? ANS - Clearance of urea
What treatment factors decrease 'K'? ANS - - Inadequate coagulation
- Decreased BFR
- Poor priming
- Not following eP&P
- Patient not staying on TX as prescribed
What treatment factors increase 'K'? ANS - - Increased BFR
- Correct DFR
- Correct dialyzer
- Correct target weight-amputation factor
In Kt/V, what is 't'? ANS - Time of dialysis session
What factors influence 't'? ANS - Running prescribed TX time
- Follow physician orders
- Encourage pt. to run entire TX [Getting off early will impact time (missing tx also impact tx time)]
In Kt/V, what is 'V'? ANS - - Volume of urea distribution
- Volume of patient's body water in which urea is distributed
What factors influence 'V'? ANS - - Amputation
, - Height
- Sex
- Age
- Type of access (less efficient access reduces the volume process of a patient's blood)
Suggested BFR for 17 gauge needles ANS - 200-250
Suggested BFR for 16 gauge needles ANS - 250-350
Suggested BFR for 15 gauge needles ANS - 350-450
Suggested BFR for 14 gauge needles ANS - 450+
Procedure for Post BUN lab draw ANS - 1. Turn off UFR or decrease it to 50
2. Decrease DFR to 300 or put in bypass
3. Decrease BFR to 100
4. Wait 15 secs for all access types and draw post
Lab draws mistakes that would falsely increase Kt/V ANS - - BFRs not reduced
- Waiting only 5 seconds
- Drawing post BUN from venous line
Lab draws mistakes that would falsely decrease Kt/V ANS - - Accidently diluting pre tx Arterial BUN
blood sample with saline
- Waiting longer than 15 seconds to draw blood sample
What is the difference between data collection and assessment? ANS - Assessment - Nurse
− Determining depth of edema
− Rate, rhythm, quality of heart sounds
actual answers.
Chlorine/Chloramine testing: ANS - When: R/O runs 15 mins before patient shift every 4 hours
Where: After Primary carbon tank sample port
Acceptable result: Less than or equal to 0.1 mg/L
Action if results are too high post primary tank: Repeat the test
Define the term AKI ANS - - Term incorporates a wide spectrum of kidney issues
- Includes acute kidney failure as well as less catastrophic kidney function changes
- May dialyze in an out-patient facility until kidney function recovers
Give examples of pre-renal causes of AKI ANS - - Obstruction
- Volume Depletion
- Impaired Cardiac Function
Give examples of intra-renal causes of AKI ANS - - Ischemic ATN
- Sepsis
- SIRS
- Septic Shock
- Anaphylaxis Drugs
- Goodpasture Syndrome
- Acute Glomerulonephritis
- Trauma
- Open Heart Surgery
Give examples of post-renal causes of AKI ANS - - Obstruction
,- Oliguric
- Bladder Rupture
- Pregnancy
How do you help in restoring kidney function? ANS - Find the cause of the AKI
How do you protect kidneys from further injury? ANS - Avoid substances to the kidney which may be
toxic (radiographic contrast, amphotericin B, low dose aspirin, NSAIDS)
What is important when monitoring weight and BP? ANS - Keep a little extra fluid on them so it is
available to the kidneys when they start filtering/ultrafiltrating on their own
AKI patients are at increased risk for which complications? ANS - - Hypovolemia
- Hypotension
What do you need to consider in regards to their (AKI patients') vascular access? ANS - Patients will
typically have a dialysis catheter, so be careful to avoid catheter related infections
Explain the difference between AKI and CKD ANS - Eliminating the cause of the AKI can often lead to
the return of kidney function. You cannot eliminate the cause of CKD which is HTN, Diabetes, and
genetic disorders (PKD)
Outline the treatment goals for a patient with CKD ANS - - Slowing the progression of CKD
- Managing comorbidities and complications
- Controlling symptoms
- Minimizing the effects of CKD on patients' lifestyles
- Kidney replacement therapy modality education
- Encouraging patients to actively participate in their healthcare
What are the most common causes for CKD in the USA? ANS - - DM
,- HTN
- PKD
Why it is important to know what caused your patient's CKD? ANS - So the nurse and PCT can inquire
about possible problems during data collection and assessment
In Kt/V, what is 'K'? ANS - Clearance of urea
What treatment factors decrease 'K'? ANS - - Inadequate coagulation
- Decreased BFR
- Poor priming
- Not following eP&P
- Patient not staying on TX as prescribed
What treatment factors increase 'K'? ANS - - Increased BFR
- Correct DFR
- Correct dialyzer
- Correct target weight-amputation factor
In Kt/V, what is 't'? ANS - Time of dialysis session
What factors influence 't'? ANS - Running prescribed TX time
- Follow physician orders
- Encourage pt. to run entire TX [Getting off early will impact time (missing tx also impact tx time)]
In Kt/V, what is 'V'? ANS - - Volume of urea distribution
- Volume of patient's body water in which urea is distributed
What factors influence 'V'? ANS - - Amputation
, - Height
- Sex
- Age
- Type of access (less efficient access reduces the volume process of a patient's blood)
Suggested BFR for 17 gauge needles ANS - 200-250
Suggested BFR for 16 gauge needles ANS - 250-350
Suggested BFR for 15 gauge needles ANS - 350-450
Suggested BFR for 14 gauge needles ANS - 450+
Procedure for Post BUN lab draw ANS - 1. Turn off UFR or decrease it to 50
2. Decrease DFR to 300 or put in bypass
3. Decrease BFR to 100
4. Wait 15 secs for all access types and draw post
Lab draws mistakes that would falsely increase Kt/V ANS - - BFRs not reduced
- Waiting only 5 seconds
- Drawing post BUN from venous line
Lab draws mistakes that would falsely decrease Kt/V ANS - - Accidently diluting pre tx Arterial BUN
blood sample with saline
- Waiting longer than 15 seconds to draw blood sample
What is the difference between data collection and assessment? ANS - Assessment - Nurse
− Determining depth of edema
− Rate, rhythm, quality of heart sounds
