Bonent UPDATED Exam Questions and
CORRECT Answers
In center hemo must be done - CORRECT ANSWER- 3x a week for about 4 hours
Cons of in center HD - CORRECT ANSWER- Most limitation on Diet, fluid than other
modalities
Requires the most medication
Most symptoms
Patients who run 4 hour tx - ...
Bonent UPDATED Exam Questions and
CORRECT Answers
In center hemo must be done - CORRECT ANSWER- 3x a week for about 4 hours
Cons of in center HD - CORRECT ANSWER- Most limitation on Diet, fluid than other
modalities
Requires the most medication
Most symptoms
Patients who run 4 hour tx - CORRECT ANSWER- Are 30% less likely to die than pts who
run shorter times
Each 30 mins extra of tx increase life by 7%
Patients are 50% more likely to die after - CORRECT ANSWER- 2 day no treatment
weekend, the last 12 hours of the 2 days the risk of death triples
diastolic blood pressure - CORRECT ANSWER- When the heart is at rest.
Benefits of nocturnal in center - CORRECT ANSWER- You get 2x as many txs as standard
because it is longer and more gentle with fluid removal
Rarely cramp
Easy on heart
Fewer limitations on food and drink
Free days
72% better survival rate than standard in center
You check blood pressure with - CORRECT ANSWER- Stethoscope and
sphygmomanometer
Nocturnal in center hemo must be done - CORRECT ANSWER- 3x a weeks about 8 hours
per tx
,If BP site is below the heart.... - CORRECT ANSWER- The reading will be to high
Benefits of nocturnal home hemo - CORRECT ANSWER- Better protein level
Don't need binders
No fluid limits
Fewer symptoms
Less heart damage
Live as long as people who get a deceased kidney transplant
If BP site is above the heart.... - CORRECT ANSWER- The reading will be to low
Home hemo must be done - CORRECT ANSWER- 3x a week 4-6 hours per tx
Benefits of PD - CORRECT ANSWER- Can do alone at home or work
Only need 1-2weeks of training
Allows for a more normal diet
Allows pt to feel more normal
peritonitis - CORRECT ANSWER- inflammation of the peritoneum, this can scar the
peritoneum and make PD no longer possible, can be avoided by doing a sterile exchange
2 types of PD - CORRECT ANSWER- Continuous ambulatory peritoneal dialysis (CAPD)
Automated peritoneal dialysis (APD)- uses cycled at night done 8-10 hours during sleep
During in center HD how much blood is outside of body at a time - CORRECT ANSWER-
1/2 cup
Short Daily Home Hemodialysis must be done - CORRECT ANSWER- 5-6days a week for
the 2.5-4 hour per tx
a bp cuff that is too small or to loose will cause a - CORRECT ANSWER- Higher reading
,Nocturnal home hemomust be done - CORRECT ANSWER- At home 3-7 nights a week 8
hours per tx
A no cuff that is to big for a patients arm ... - CORRECT ANSWER- Lower reading
Why would someone want to do more HD than standard? - CORRECT ANSWER- Longer or
more frequent HD is gentle and cause fewer symptoms and may help Pt live longer, home
puts pt in charge
peritoneal dialysis - CORRECT ANSWER- the lining of the peritoneal cavity acts as the filter
to remove waste from the blood through tiny blood vessels.
Placed in abdomen and sometimes chest wall
Dialysate sits in catheter for a few hours and excess water and waste flows from BV to the
dialysate. The dialysate is then drained and replaced. (Exchange)
Pt can use a cycle mahjne while they sleep
Can also be done by hand 4xa day and can be done anywhere.
In dialysis patients the reason BP drops during or close to the end of tx is because -
CORRECT ANSWER- The total blood volume drops, from the water removal
regular respiration rate - CORRECT ANSWER- 12-16 breaths per minute
In dialysis patients water may enter the lungs due to water weight gains this can cause -
CORRECT ANSWER- Sob or trouble breathing
Payment for dialysis - CORRECT ANSWER- Medicare pays for 80% of dialysis
Medicare makes rules a clinic must follow to provide coverage of tax.
Pt who don't have Medicare before CKD a pt must wait 3 months for it to cover in center but
it will cover home-hemo right away.
2011 change how they pay for dialysis and created a "bundle" (composite rate, labs,drugs and
home training)
, Quality Incentive Program - CORRECT ANSWER- Pay for performance, Cuts pay by 2% if
measures aren't met. (Kt/v and hemoglobin)
ESRD networks - CORRECT ANSWER- Oversees quality of care, 18 mostly nonprofit
organizations.
Renal physicians association(RPA) - CORRECT ANSWER- 1993 nephrologist made first
clinical practice guidelines, including minimum dose of HD , when to start and stop HD and
care for kidney disease for pt not on HD
National Kidney Foundation (NKF) - CORRECT ANSWER- 1995, experts set guidelines for
anemia, adequacy, and vascular access
KDOQI - CORRECT ANSWER- Kidney Disease Outcomes Quality Initiative, improves care
and outcomes of all people with kidney disease
Dialysis Outcomes and Practice Pattern Study - DOPPS - CORRECT ANSWER- Help pts
love longer by finding patterns incenter that can be changed to improve outcome
state survey - CORRECT ANSWER- An inspection of the facility by state surveyors for
compliance with rules and regulations of Medicare. If clinics don't follow they must make a
plan of correction.
Continuous Quality Improvement (CQI) - CORRECT ANSWER- Finding problems and
fixing them. 4 step process
4 steps of continuous quality improvement - CORRECT ANSWER- 1.identify the problem-
collect data and figure out how to fix
2.analyze problem-see if there is a standard or guideline to fix it, look at patterns or trends
3.cause of problem?
4.Plan,do,check,act- make a plan to fix, try plan, check results and make changes if needed
Professionalism - CORRECT ANSWER- The quality of performing at a high level and
conducting oneself with purpose and pride
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