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Therapeutics Test 2 > dialysis2 > Flashcards

dialysis2 Flashcards

1
Q

what type of access is used in hemodialysis

A
  1. arrterial venous graft
  2. arterial venous fistula
  3. catheter
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2
Q

blood that leaves the patient in hemodialysis undergoes what

A
  1. pressure
  2. anticoagulant
  3. dialyzer (filter)
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3
Q

what is the urine looking leftovers from hemodialysis?

A

ultrafiltrate and dialysate

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4
Q

how often is hemodialysis for CKD? how long are each

A

3x’s a week

4 hours

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5
Q

what is the blood flow rate of hemodialysis

A

200-500 mL/min

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6
Q

what is the dialysate flow rate?

A

500-800 ml/min

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7
Q

a dialysis prescription contains what

A
  1. flow rates
  2. type of dialyzer
  3. type of solution
  4. time of dialysis
  5. anticoagulant regimen
  6. pt’s dry weight
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8
Q

what is the most common type of vascular access for dialysis

A

arteriovenous fistula

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9
Q

where are temproary access ports inserted

A

catheter into jugular, femoral or subclavian vein

usually only when have complications w fistula

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10
Q

what is one of the number one complications with pt’s with CKD on dialysis

A

vascular access complications

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11
Q

what are the most common type of vascular access complications

A
  1. stenosis
  2. thrombosis
  3. infection
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12
Q

how is thrombosis prevented in dialysis access?

A
  1. cathaters are locked with heparin
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13
Q

patients with an elevated bleeding risk (on warfarin) should not have what? what should be done instead

A

avoid systemic anticoagulation

flush with saline

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14
Q

what is regional citrate anticoagulation

A

anticoagulation by binding ionized calcium so clotting cascade is inhibited

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15
Q

what are nonpharm therapies for cathater related thrombosis

A

forced saline flush

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16
Q

what are pharm therapies for management of catheter related thrombosis

A

alteplase (clot breaker)

17
Q

what is the leading cause of mortality in dialysis patients (other than CV)

A

vascular access infection

18
Q

what is the difference in a local infection vs. extensive infection

A

local infection - catheter infection

extensive infection - kidney is infected

19
Q

what can happen from vascular access infection

A
  1. endocarditis (heart valve infection)
  2. osteomyelitis (bone infection)
  3. septic arthritis (joint infection)
  4. septic pulmonary emboli
  5. septic syndrome
20
Q

what should be done if a dialysis pt. has a fever during HD

A

immediately take blood culture

21
Q

what should be done for AV fistula infection

A

long term antibiotic treatment

22
Q

what is an infection localized to catheter site?

how should it be treated

A

tunneled cuffed cathater

use bactrim if no drainagewho

23
Q

who has a high risk for intradialytic hypotension

A
  1. Diabetes
  2. autonomic insufficiency
  3. heart disease
  4. elderly

Therapeutics Test 2 (31 decks)

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