Dialysis Finals

Question 1

How long for soap/water and alcohol rub?

Answer 1

• 40-60 seconds for soap/water

- 20-30 seconds for alcohol rub

Question 2

PPE cannot be worn before leaving clinical area except?

Answer 2

-transporting medical waste

Question 3

Order of removal of access needle post treatment?

Answer 3

-preferably arterial first

Question 4

All PPE are disposed where?

Answer 4

-biohazard waste

Question 5

How do you deliver medications to each patients?

Answer 5

-separately

Question 6

Buffer zone of patients that are _____ are placed next to isolation room.

Answer 6

-antibody positive

Question 7

What is normal GFR?

Answer 7

-100-140 ml/min

Question 8

Acute renal failure

Answer 8

-urine output less than 400ml/day or less than 20 ml/hr

Question 9

The three most common causes of chronic renal failure in order?

Answer 9

-diabetes,hypertension, and glumerulonephritis

Question 10

Signs and symptoms of uremia?

Answer 10

-fatigue, n/v, high BUN and creatinine, HTN, edema, anorexia, and hematuria

Question 11

What is the dialyser of peritoneal dialysis?

Answer 11

-dextran(dextrose)

Question 12

What are the two test of HD devices?

Answer 12

-alarm and pressure holding tests

Question 13

What is steal syndrome?

Answer 13

-blood flow is rerouted to the internal vascular access and there is decreased blood flow to the distal capillaries of the access hand

Question 14

Desired number(flow of F or G) for baseline of AF?

Answer 14

-fistula is greater than 400 and graft is more than 600

Question 15

What is clearance?

Answer 15

-the amount of solutes completely removed from one ml of blood in one minute. It is influenced by flow rate of blood and dialysate, and permeability of semipermeable membrane.

Question 16

What is creatinine clearance?

Answer 16

-urine test that measures the kidney’s ability to remove waste products; elevated levels may indicate kidney failure. Creatinine is by-product of muscle breakdown.

Question 17

What is EDW and AW?

Answer 17

-EDW is estimated dry weight, is the amount a patient should weigh without excess body fluid. AW is available weight, is the pre-treatment weight minus the EDW.

Question 18

Signs and symptoms of fluid overload?

Answer 18

-edema, HTN, SOB, JVD, abnormal breath sounds(cough, crackles, rales, ronchi, or wheezing)pulmonary edema

Question 19

What does adjusting/challenging a patient’s dry weight means?

Answer 19

-dropping or increasing EDW by increments of 0.5 to 1 kg every dialysis treatment until the patient becomes stable and there is no evidence of edema(facial or extremities) or dryness

Question 20

What is the antidote for heparin?

Answer 20

protamine sulfate

Question 21

What is pH range?

Answer 21

-6.9 to 7.6

Question 22

What is AAMI?

Answer 22

-association for the advancement of medical instrumentation, oversee state, local and national water standards

Question 23

What is albumin?

Answer 23

-is a protein substance that helps maintain fluid balance in the vessel; low level indicate malnutrition, liver disease, chronic inflammation/infection, or albumin loss in peritoneal dialysis or urine. it has been linked to higher hospitalization and death. dialysis patient should be 4.0 and greater.

Question 24

What is BUN?

Answer 24

-blood urea nitrogen, Urea is an end product of protein metabolism. It is used to indicate levels of wastes in the blood and determine delivered doses of dialysis. Elevated levels usually indicates inadequate dialysis. Low BUN levels can indicate poor nutrition. Dialysis patient should be 60-80 mg/dl

Question 25

What is creatinine?

Answer 25

-is an end-product of muscle metabolism. Very muscular patient will normally have higher creatinine than small, non-muscular patient. Dialysis patient should be 10-18mg/dl.

Question 26

What is ferritin?

Answer 26

-is chief iron-storage in the body. iron may be stored as ferritin, which is readily available. serum ferritin is low in iron deficiency. excessive intake of iron intake or multiple blood transfusions can lead to hemochromatosis, massive amount of hemosiderin deposited in the cells of organs and can lead to organ failure. High ferritin levels may also be caused by chronic inflammation, certain anemias, or malignancies

Question 27

pyrogen reaction?

Answer 27

-fever, chills, and hypotension

Question 28

Sources of potassium?

Answer 28

-potato, banana, watermelon, cantaloupe, salt substitutes, orange juice

Question 29

Six rights of medication?

Answer 29

-right(patient, medication, dose, time, route, and documentation) Acronym: pmdtrd : pull my doctor to read document

Question 30

Hemolysis

Answer 30

-cranberry(cherry colored), translucent

Question 31

Air embolism

Answer 31

-cough, SOB, and chest pain. COLT(clamp blood lines, off blood pump, place on left side, and trendelenburg patient)

Question 32

Infiltration: where to cannulate?

Answer 32

-arterial is above or below and venous is above

Question 33

What is normal value of KECN?

Answer 33

200-300

Question 33

BFR of gauges 14,15,16, and 17 needles

Answer 33

14 is more than 450 ml/min, i15 is more than 350-450, 16 is 300-350, and 17 is less than 300