peritonitis Correct Ans-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 Ans-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 Ans-1/2 cup
Short Daily Home Hemodialysis must be done Correct Ans-5-6days a week for the 2.5-4
hour per tx
a bp cuff that is too small will cause a Correct Ans-Higher reading
Nocturnal home hemomust be done Correct Ans-At home 3-7 nights a week 8 hours per tx
A no cuff that is to big for a patients arm ... Correct Ans-Lower reading
Why would someone want to do more HD than standard? Correct Ans-Longer or more
frequent HD is gentle and cause fewer symptoms and may help Pt live longer, home puts pt in
charge
, CHT Bonent Exam Test 1 with Complete Solutions
peritoneal dialysis Correct Ans-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
Ans-The total blood volume drops, from the water removal
regular respiration rate Correct Ans-12-16 breaths per minute
In dialysis patients water may enter the lungs due to water weight gains this can cause
Correct Ans-Sob or trouble breathing
Payment for dialysis Correct Ans-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)
, CHT Bonent Exam Test 1 with Complete Solutions
Quality Incentive Program Correct Ans-Pay for performance, Cuts pay by 2% if measures
aren't met. (Kt/v and hemoglobin)
ESRD networks Correct Ans-Oversees quality of care, 18 mostly nonprofit organizations.
Renal physicians association(RPA) Correct Ans-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 Ans-1995, experts set guidelines for anemia,
adequacy, and vascular access
KDOQI Correct Ans-Kidney Disease Outcomes Quality Initiative, improves care and
outcomes of all people with kidney disease
Dialysis Outcomes and Practice Pattern Study - DOPPS Correct Ans-Help pts love longer by
finding patterns incenter that can be changed to improve outcome
state survey Correct Ans-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.
, CHT Bonent Exam Test 1 with Complete Solutions
Continuous Quality Improvement (CQI) Correct Ans-Finding problems and fixing them. 4
step process
4 steps of continuous quality improvement Correct Ans-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 Ans-The quality of performing at a high level and conducting
oneself with purpose and pride
Boundaries Correct Ans-Never share personal life or concerns with patients, never date
pts, never borrow money, never invite to home or events, never except tips or money, do not
sexually harass
How big are the kidneys? Correct Ans-size of fist, 5oz a piece
What protect the kidneys Correct Ans-Pads of fat and the bones of the rib cage
What makes up the outside of the kidney Correct Ans-Tough fibrous capsule, inside the
capsule is the cortex which is made of layers of cells
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