Davita PCT Exam Complete

Davita PCT Exam Complete What is important when monitoring weight and BP for acute patients? Ans- keep patients wet to avoid hypotensive episodes What do you need to consider in regards to acute patents vascular access? Ans- Usually have a CVC - follow policy and procedure to prevent infections Why is it important to know what caused your patient's CKD? Ans- to inquire about possible problems during data collection and assessments Kt/V: What is K? Ans- clearance of urea What treatment factors decrease K? Ans- not waiting 3-5 minutes after giving heparin with treatment initiation to prevent clotting What factors influence V (volume)? Ans- sex, age, weight, height, amputations Needle gauge and suggested BFR Ans- 17: 200-250 16: 250-350 15: 350-450 14: >450 What do you do if a patient wants to get off early? Ans- educate and document, still draw lab on habitual patients, MUST NOTIFY NURSE Lab draw mistakes that would falsely increase Kt/V Ans- not waiting the full 15 seconds to draw the BUN What is the role of the PCT prior to treatment initiation? Ans- DATA COLLECTION Squeezing the BP cuff can damage the machine: T/F Ans- True 4 reasons we document in the medical record Ans- 1. proof that care was rendered 2. provides data continuity and planning of patient care 3. permanent legal record 4. communication tool Pre-treatment patient data collection/assessment Ans- Data collection: before initiation Assessment: 30 minutes into treatment Post treatment data collection/assessments Ans- after treatment -NOT DURING RINSEBACK What are possible consequences of poor or incomplete documentation Ans- attack on your care What are the six items included in charting administered medications? Ans- REASON FOR ADMINISTERING What are the 5 W's to be used when completing an AOR Ans- who should report an AOR what type of incident when should it be reported where should they be reported why What are the four consequences of sodium loading during dialysis? Ans- Thirsty Increase Fluid Intake Increased intradialytic weight gain Increased ultrafiltration rate What is the purpose of UF profiling? Ans- fit to the patient to prevent crashing and allow for vascular refill Why do we measure the pH in the dialysate Ans- to verify acid-base balance is within an acceptable range Conductivity and pH alarm causes Ans- no concentrate improper bicarb calcium or magnesium precipitate line of filter occlusion from debris improper calibration Temperature alarm causes Ans- lower temperature, increases BP hemolysis occurs at 42 degrees calcium which releases potassium Power Ans- the appropriate intervention is to remove venous line from air detector clamp before starting hand crank Arterial Pressure High alarm causes Ans- separation of tubing Venous pressure high alarm causes Ans- kink in tubing infiltration clotting in the venous drip chamber Davita Quality Index Ans- the purpose of selecting the component measure for DQI is to encourage continuous improvement across a broad range of disease management processes DQI success is achieved by Ans- -managing individual patients first and allowing scores to follow -knowing each team members role and improving DQI scores -using the CQI (continuous quality improvement) process to help identify trends and make improvements (answer all of the above) Importance of P&P Ans- when supervising non-licensed, assistive personnel, it is the responsibility of the licensed nurse to ensure these teammates also meet the standard of care What are the risks of doing it your way Ans- it can lead to civil liability What makes dialysis patients more susceptible to HAIs? Ans- they have weakened immune systems and prolonged access to blood Why are dialysis patients at increased risk for acquiring a HAI at the facility? Ans- CONTACT TRANSMISSION what is the most common transmission route for HAIs? Ans- contact transmission What is the most important intervention you can do to prevent HAIs? Ans- Hand washing What is the most common infectious complication in hemodialysis patients? Ans- Per the CDC, the most common factor contributing to bacteremia is CVC What germ causes the most common infections in hemodialysis patients? Ans- MRSA Why is wearing gloves so important? Ans- Decreases risk of hand contamination Who can use sinks designated for hand washing? Ans- clean sinks must be dedicated for hand washing only What is the correct procedure in regards to your hands when you have casual contact with a patient? Ans- don't need to have gloves but must perform hand hygiene before caring for patients Successful Lab draws Ans- know the 20 tips -follow the order of the lan draws to prevent specimens from being contaminated with other tube additives -double labeling tubes prohibits processing rules for spinning samples Ans- only spin tubes of same kind, size, and fill level and should be placed opposite of each other hyperkalemia Ans- potassium above 6.5 extreme muscle weakness cardiac arrest What is the primary cause patients are anemic? Ans- decreased production of Erythropoietin How can you print contributing to blood loss? Ans- adequate heparinization What is pericarditis? Ans- inflammation of sac around the heart What is included in pericarditis treatment? Ans- RESTRICTION OF HEPARIN more/adequate dialysis What to use for Dry, itchy skin Ans- hyper fatted soaps and lotions Peripheral neuropathy Ans- educate patient about good shoes, look at feet, don't go barefoot -can't feel sores What are the four key elements affected in CKD-MBD? Ans- calcium phosphorus parathyroid hormone calcitriol (vitamin D) What are symptoms of CKD-MBD in addition to bone disease? Ans- severe itching, muscle weakness CALCIFICATION OF SOFT TISSUE What is your role in CKD-MBD management? Ans- encourage patients to take binders with their food! talks to patients and listen to them! What does the acronym DARN stand for? Ans- Desire to change Ability to understand Reason to change Need What's the best way to help patients successfully change behaviors? Ans- Inspire behavioral change through support, compassion and empathy When should the communication style "Directing" be used? Ans- when training to perform procedures What are the three core communication skills to be used within the communication styles? Ans- Asking Listening Informing Righting Reflex Ans- Intervention of a healthcare practitioner who observes a patient doing something detrimental to their health Summarizing Ans- includes the main aspects of what was said during the conversation The 5 stages of grief Ans- Denial Anger Bargaining Depression Acceptance Is there an order to work through the five stages of grief? Ans- No what is KDQOL 36 Ans- an assessment tool for the social worker to identify barriers -the social worker compiles the results and develops goals with the patient Who is the social worker available for? Ans- Caretakers struggling to meet demands of the patient's treatment regime Ultrafiltration Ans- (only fluid) controlled fluid removal by manipulation of hydrostatic pressure Convection Ans- (solutes and fluid) solutes are dragged across the semipermeable membrane along with fluid Diffusion Ans- (solutes) particles move from an area of high concentration to an area of low concentration Osmosis Ans- (fluid only) fluid moves from lower solute concentration to higher solute concentration What are the kidney's endocrine functions? Ans- blood pressu