DaVita's PCT Final Exam Module 1, Module 2, Module 3, and Module 4 Quizzes.

Ultrafiltration is defined as: - Fluid pushed through the semipermeable membrane If a patient with acute kidney injury (AKI) dialyzes in the outpatient facility, one task of the patient care teammates is to monitor blood pressure and weight closely. Why is this important? - Hypovolemia and hypotensive episodes can cause renal ischemia and can further damage the kidneys. ***The underlying cause of prerenal kidney failure is hypovolemia or poor perfusion. Care must be taken to understand patients who are at high risk. Your role in anemia management includes: - Rinsing back as much of the patient's blood as you can at the termination of each treatment. During dialysis, the movement of bicarbonate from the dialysate into the blood: - The diffusion of bicarbonate helps the patient to achieve acid-base balance by buffering the hydrogen ions. The transport mechanism when particles move from an area of higher solute concentration to an area of lower solute concentration is called: - Diffusion Convection: solutes dragged across SPM Osmosis: low to high TRUE OR FALSE: Hemodialysis patients are at increased risk of contracting Hepatitis B. - True, the virus can be transmitted from the use of multidose drug vials and contamination of medical equipment. Dialysis patients are immuno-suppressed. A common reason how Hepatitis B is transmitted from a patient to a healthcare worker is: - 1. Penetration of the skin by sharps 2. Contact of blood with broken skin or mucous membranes If your facility dialyzes Hepatitis B positive patients, which assignment would NOT be an appropriate patient care assignment? - Caring for HBsAg and Hepatitis B susceptible patients at the same time Appropriate personal protective equipment (PPE) should be worn whenever there is potential for contact with blood or bodily fluids, hazardous chemicals, contaminated equipment, and environmental surfaces. PPE includes: - Gloves, gowns, mask and eye protection (full face shield or goggles). Handwashing at a designated clean sink should be performed for a minimum of: - 20 seconds Contact transmission is the most important route through which infections are spread. Contact transmission is defined as: - Transmission of microorganisms through healthcare workers hands. Per the CDC, which is the most common factor contributing to bacteremias in dialysis patients? - The use of catheters for hemodialysis. Teammates caring for a patient with active Clostridioides difficile (C-diff) infection are required to: - Perform frequent hand washing with antimicrobial soap, as alcohol-based hand gels may not be effective to eliminate C. Diff. To prepare a 1:100 bleach solution, you would - Add 1 part bleach, 99 parts water. A 1:10 bleach solution is used to - Clean up visible blood or gross blood spills According to Policy and Procedure, gowns: - Must be fully snapped up (or tied at the neck and waist) and wrists covered. Why is a "strikethrough" of an external pressure transducer protector of concern? - Fluid could have entered the machine and contaminated the internal pressure transducer protector providing a reservoir for microorganisms and causing subsequent patient blood infections. What is the safe range for dialysate pH? - The desired pH range is 6.9-7.6. What is the correct procedure for residual bleach testing after chemical disinfection of distribution loops and equipment fluid pathways? - Residual bleach testing is performed after bleach disinfectant and prior to use. Which is a true statement regarding the monitoring, testing, and verification of conductivity prior to each patient treatment for all Fresenius machine models and the B Braun system? - B Braun Conductivity: ENDLF, N/A->13.0-15.5 range Fresenius Conductivity: ? To avoid bacterial proliferation (rapid reproduction) within the extracorporeal circuit, once primed the recirculation of saline within the dialyzer and blood lines should not exceed______ prior to initiating the hemodialysis treatment. - 2 hours Machine alarm tests are performed: - Before the initiation of each patient treatment. TRUE OR FALSE? Procedures provide a step-by-step series of actions, processes, or measures to be taken to implement or address a particular activity, system, or problem. - True When using an automatic blood pressure cuff on a patient with an irregular heartbeat - The recorded blood pressure may be inaccurate. This electrolyte plays a major role in muscle contraction and high or low levels can lead to weakness or cardiac arrest. - Potassium Post-treatment, a patient complains of a headache and there was a noted temperature increase to 98.8°F from the pre-treatment baseline of 96.6°F. What follow up is required before patient discharge? - This is considered a fever which should be investigated A post treatment patient assessment - -Is completed to verify that the patient is stable, to determine the patient's discharge status, and to evaluate the effectiveness of the treatment plan. -Is compared to the patient's pre treatment assessment findings -Requires the licensed nurse to notify the physician as needed of changes in patient status For a patient who can stand, a post-treatment blood pressure reading of _______ is considered an abnormal finding and should be reported to a licensed nurse, per DaVita Policy - Normal range: 120/80 mm Hg or less Orthostatic hypotension: drops by at least 20 mmHg during transition from lying down to standing up, or when diastolic blood pressure (the bottom reading) drops by at least 10mmHg within three minutes after standing.