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DAVITA EXAM MODULE 1
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DAVITA EXAM MODULE 1
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DAVITA EXAMMODULE 1
Ultrafiltration definition - Answers-(Fluid movement) Controlled fluid removal by
manipulation of hydrostatic pressure
Convection definition - Answers-(Particle/solute movement) Solutes are dragged across
the semipermeable membrane along with fluid
Diffusion definition - Answers-(Particle/solute movement) Particles move from an area of
higher solute concentration to lower solute concentration
Osmosis definition - Answers-(Fluid movement) fluid moves from lower solute
concentration to higher solute concentration
Signs and symptoms of Hypokalemia - Answers-Less than 3.5; fatigue, muscle
weakness, irregular heart rhythm and cardiac instability
What are the kidneys' endocrine functions? - Answers-Blood pressure regulation
(Renin), Erythropoiesis (helps prevent anemia), and vitamin D activation
(calcium/phosphorus)
How do we replace normal endocrine kidney functions? - Answers-Give them their
meds
How much of normal kidney function is replaced by hemodialysis? - Answers-15%
What is uremia and what does it affect? - Answers-It's the build up of waste products in
the blood due to kidney failure and it affects all body symptoms
,What are the most common causes for CKD in the USA? - Answers-Diabetes and
hypertension
Outline the treatment goals for a patient with CKD - Answers-Acid base balance, fluid
removal, electrolyte balance and toxin removal
Why is it important to know what caused your patients CKD - Answers-So the nurse and
pct can inquire about possible problems during data collection and assessment
Signs and symptoms of fluid balance - Answers-Hypertension (high BP), swelling or
edema, and shortness of breathe
Why is sodium balance important? - Answers-Sodium creates thirst which leads to
volume expansion, increases the bp, LVH, leads to higher mortality rate
What are the kidney's excretory functions? - Answers-Water removal, electrolyte
balance, toxin removal and acid base balance
How do we replace normal excretory kidney functions? - Answers-By normalizing the
electrolytes and providing fluid balance through ultrafiltration
What is the function of the acid concentrate? - Answers-It provides the concentration
gradient for diffusion
What is the function of bicarbonate in the dialysate solution? - Answers-It buffers the
acid concentrate
What is the function of bicarbonate when it diffuses into the patient's blood? - Answers-It
normalizes the patients body temp pH in the blood stream (7.35-7.45)
Signs and symptoms of Hyperkalemia - Answers-Greater than 6.5 EXTREME muscles
weakness and abnormal heart rhythm
Advice for a pt that complains of dry, itchy skin - Answers-Hyper fatty soaps and lotion,
emotional support
Peripheral neuropathy (nerve pain in the extremities) - Answers-Advise not to walk
barefoot, bath water temp
GI problems (nausea/vomiting) - Answers-Get nurse involved
Psychological problems (anxiety/depression) - Answers-Get it up to the social worker
What does hypertension lead to? - Answers-Left ventricular hypertrophy (LVH)
What is pericarditis? - Answers-Inflammation of the membrane (pericardiosack)
, What is included in pericarditis treatment? - Answers-Decrease or stop heparin or give
more dialysis
Why are dialysis patients anemic? (Primary cause) - Answers-Lack of Erythropoietin
Secondary causes of anemic pts - Answers-Inadequate dialysis and blood loss during
treatment
How can you prevent contributing to lower hemoglobin levels and blood loss in dialysis
patients? - Answers-Get the heparin into them, give good rinse back, and avoid
repeated lab draws
What are the four key elements affected in CKD-Mineral Bone Disorder (MBD)? -
Answers-Calcium, phosphorus, calcitriol (Vitamin D) and parathyroid hormone (PTH)
What are symptoms of CKD-MBD in addition to bone disease? - Answers-Soft tissue
calcification
What is your role in CKD-MBD Management? - Answers-Get meds in, take binders, get
dietitian in and encourage them to be compliant
Define the term AKI - Answers-encompasses wide spectrum of kidney issues, including
kidney failure and kidney function changes
3 examples of pre-renal causes of AKI - Answers-Volume depletion (hemorrhage,
burns), decrease in cardiac output, renal vascular obstruction
3. examples of Intra-renal causes of AKI - Answers-Acute interstitial nephritis, acute
tubular necrosis, chemotherapy
3 examples of post-renal causes of AKI - Answers-Bladder or ureteral malignancy,
kidney stones, benign prostatic hyperplasia
Explain the difference between AKI and CKD - Answers-AKI- happens suddenly, hoping
to eliminate the cause and hope of recovery
CKD- slowly progressing and irreversible
How do you help in restoring kidney function with AKI pts? - Answers-Find the cause of
AKI and try to get rid of it
What do you need to consider in regards to AKI pts vascular access - Answers-Make
sure to follow policy and procedures to prepare the access sites so they don't get septic
(infection)
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