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PCT Fresenius Exam - Questions And Answers
PCT Fresenius Exam - Questions And Answers
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PCT Fresenius Exam - Questions And AnswersWhat are the functions of a healthy kidney? Correct Ans - REGULATE,
SYNTHESIS, ENDOCRINE:
Regulate fluid balance, blood volume, electrolytes, acid-base balance,
synthesize calcitrol (active vitamin D), secrete erythropoietin and release
renin
what is the glomerular filtration rate in the five stages of kidney disease?
Correct Ans - flow rate of filtered fluid through the kidney
stage 1: 90+
stage 2:60-89
stage 3: 30-59
stage 4: 15-29
stage 5: <15
what are the types and stages of kidney failure? Correct Ans - acute
renal failure: sudden onset, severe, usually reversible. can be caused by drug
toxicity, dehydration, or motor vehicle accident
Chronic renal failure: slow onset, progressive, permanent. can be caused by
diabetes, hypertension, or genetic disease such as glomerulonephritis or
nephrosclerosis
what are the signs and symptoms of renal failure or uremia? Correct Ans
- elevated serum levels of BUN/Creatinine, phosphorus, potassium. anemia,
nerve damage, yellow-gray appearance of skin, fluid overload, dyspnea,
edema, hypertension, proteinuria, uremia, lethargy, weakness, headache,
itching, fatigue, nausea restlessness, mental change, loss of appetite.
what is anemia and how is it treated? Correct Ans - lack of RBC
(decreased or lack of erythropoietin production). iron binds with hemoglobin
in RBC and transports oxygen. it is treated using erythropoieting stimulating
agents and usually administered IV.
,which of the functions of healthy kidneys are replaced by dialysis? Correct
Ans - removal of waste products and regulation of fluid balance. dialysis
does not regulate endocrine production
list briefly and describe three modalities of treatment for end stage renal
disease Correct Ans - Hemodialysis: uses vascular access to draw
blood from patient and send to dialyzer and into semipermeable membrane
where diffusion removes waste products and ultrafiltration removes fluid.
provides approximately 15% of the normal function of the kidney.
peritoneal dialysis: continuous cycling peritoneal dialysis and continuous
ambulatory peritoneal dialysis. both types use permanent catheter in highly
vascularized peritoneal cavity. dialysate is infused into peritoneal space and
allowed to dwell and then drained. excess fluid and waste is removed through
osmosis and diffusion
what is the difference between hemodialysis and peritoneal dialyisis?
Correct Ans - Hemo: outpatient, dialyzer is used to remove waste from
blood via diffusion and fluid is removed through ultra filtration.
peritoneal: home setting, peritoneal membrane is the semipermeable
membrane that filters waste and fluid removal occurs via osmotic pressure
and concentration gradients caused by the dextrose solution and dwell times.
when is it known that a patient has developed sensitivity to a dialyzer?
Correct Ans - seen within the first half hour of treatment. sneezing,
itching, pain at access site, chest pain, rashing, hives, fever are symptoms.
alarm conditions Correct Ans - Blood: blood leak, air detector,
venous/arterial pressure, TMP. stops the blood pump therefor blood is not
cleaned and no ultrafiltration. potential for clotting due to stagnant blood
Dialysate: conductivity high/low, temperature. dialysate goes into bypass so
no cleaning of blood. uf continues.
what are the body fluid compartments? Correct Ans - 50-70% of body
is water. intracellular, extracellular, intravascular, interstitial.
what is diffusion Correct Ans - movement of solutes across
semipermeable membrane from high concentration to low concentration.
solutes include urea, electrolytes, creatinine, drugs
, what is osmosis? Correct Ans - movement of fluid from lower
concentration of solutes to a higher concentration.
what is ultrafiltration? Correct Ans - use of both negative and positive
pressure to pull excess fluid from the patient
why is water used for dialysis treated? Correct Ans - water contains
contaminants, electrolytes, and impurities. these must be removed bc the
patients are exposed to large volumes of water during tx
what is chloramine and how is it different from chlorine Correct Ans -
combination of chlorine and ammonia
what is the diasafe filter? Correct Ans - found on back of hemodialysis
machine that allows for the delivery of ultrapure dialysate.
what factors impact the rate of diffusion? Correct Ans - concentration
gradient, temperature, molecular weight of solutes, nature of solution,
membrane permeability, surface area, flow geometry convection (solute drag-
irrespective of molecular size, solutes are dragged along with water across
dialyzer membrane as long as solute can fit through pore "magnetic
attraction")
what happens to diffusion when dialyzer fibers clot? Correct Ans -
diffusion is decreased. clotted fibers cause permeability of the fiber to be
reduced or eliminated.
at what point point during the hemodialysis tx will diffusion cease to occur?
Correct Ans - once the concentration of each electrolyte found in the
patients blood is equal to the electrolyte concentration in the dialysate.
what is the largest factor that impacts ultrafiltration Correct Ans -
pressure
what happens when the dialysate flow is turned off during treatment?
Correct Ans - pt blood is not cleaned and adequacy will decrease
what are the compartments of the dialyzer and what separates them?
Correct Ans - blood compartment and dialysate compartment is seperated
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