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DaVita

Terms in this set (49)

During osmosis, water moves toward the solution with the _________ solute concentration.
greater
Which of the following terms indicates a solution that has the same concentration of solutes as blood?
Atonic
Isotonic
Hypotonic
Hypertonic
Isotonic
The inner part of the kidney is called the...
Medulla
Calyx
Pelvis
Glomerulus
Medulla
A nephron is comprised of a glomerulus and a
Pyramid
Calyx
Papilla
Tubule
Tubule
How much urine does a patient with healthy kidneys usually excrete in 24hrs?
1000 to 2000mL
Which of the following hormones is produced by the kidneys?
Erythropoietin
Cortisol
Aldosterone
Parathyroid hormone
Erythropoietin- it stimulates bone marrow to produce RBCs. If kidney function is impaired, epo decreases and fewer RBCs are produced which results in anemia
Kidneys also produce calciferol, the active form of Vit D which allows the GI Trace to absorb Calcium from food
What are the sx of uremia?
Itching, edema, difficulty breathing, increased urination at night, foamy bubbly urine, metallic taste, ammonia breath, nausea, anorexia, pericarditis, platelet dysfunction, encephalopathy with asterixis, and deposition of urea crystals in skin, blurred vision, numbness hands and feet
A solution is a mixture of
Solute and solvent
Solute and chemical
Water and electrolytes
Fluid and particles
Solute and solvent
When reinforcing education about weight gain, a patient should be advised that the usual goal for interdialytic weight gain is less than
1.0kg/day
If a high pressure alarm for arterial pressure (pre pump) sounds, this could indicate
Drop in the speed of blood pump
If a low pressure alarm for venous pressure sounds during hemodialysis, this could indicate
Clotted Dialyzer
With the formula for urea kinetic modeling, the K in Kt/V stands for
Urea clearance (mL/min) plus residual urinary output
When inserting needles into a graft for hemodialysis, needle tips should be at least how far apart?
2 inches
0.5" away from previous needle sites and at least 1.5" away from the anastomoses or any sign of stenosis
In hemodialysis, ultrafiltration refers to extraction of

Electrolytes
Proteins
Fluid
Waste/toxins
Fluid
A patient experiences a cardiac arrest with no pulse or respirations during hemodialysis. After calling for help, the tech should

Stop dialysis, return blood, flush access lines with NS
Stop dialysis, clamp lines without returning blood
Continue dialysis without change during resuscitation
Stop dialysis, return blood, remove access needles
Stop dialysis, return blood, flush access lines with NS
When auscultation a patient's AV fistula to listen for bruit, if the bruit is very high pitched this may indicate
Stenosis
During HD, expect the patients temp to rise by about
0.5*C
Approximately what % of total blood volume circulates in veins
65-80%
Which intervention will decrease hypotension that occurs during Hd?

Using a different dialyzer
Increasing sodium intake
Increasing UFR
decreasing UFR
Decreasing UFR
If outflow stenosis of an AV fistula occurs, the thrill usually

Is absent
Remains continuous
Is lower pitched and discontinuous
Is loud and higher pitched and then discontinuous
Is loud and higher pitched and then discontinuous
Which vitamins may be removed by HD?
Vitamin B & C
The primary purification process of the dialysis water system is
Reverse osmosis
If a pt develops painful muscle cramps in the hands, feet, and abdomen shortly after HD begins, the most likely intervention is
Saline bonus and/or decreased UFR
Foam in the venous bloodline of a dialyzer May indicate
Air embolism
Patients access arm is slightly edematous, and pale. There are small purple veins evident on the chest wall where the arm meets the body. What do you suspect?
Stenosis
In order to increase survival rates, the UFR for HD patients should be maintained at less than
12mL/kg/min
While fistula is occluded, the pct palpates and feels both a thrill and a pulse. This signifies a
Accessory pathway (collateral circulation)
How much additional protein should a pt on HD ingest every day
50%
Wt gain between HD tx should not exceed
5% of dry weight. (1kg/d)
How long can hep b live on surfaces
7 days
First week of tx with new AVF, initial needle size and blood flow should be
17G, BFR 200-250
AVF cannulation should be done at an angle of
25-35*
Five mins after beginning Hd, pt has difficulty breathing and rapidly develops generalized hives, itching, and swelling around the eyes. After asking the nurse for help, the next action should be
Stop dialysis and clamp all lines
Following formation of an AVF, and beginning of HD, the tech notes that the pts nail bed and skin on hand below fistula are cyanotic and pt is complaining of pain in hand. This is
Steal syndrome.
Pain, paresthesia, and coldness
17G needle

Suggested BFR
200-250
250-350
350-450
>450
200-250
16G needle

Suggested BFR
200-250
250-350
350-450
>450
250-350
15G needle

Suggested BFR
200-250
250-350
350-450
>450
350-450
14G needle

Suggested BFR
200-250
250-350
350-450
>450
>450
When is post tx assessment by RN required regarding temperature?
>100 or 2* above baseline with Sx
A patient presents with an elevated temp after initiation of dialysis. This is most likely due to
A pyrogenic reaction
DQI stands for
Davita quality index
SMART communication
Simple
Meaningful
Actual
Rea
Teach
Preventing hypotensive episodes during dialysis is important because they are associated with
A higher mortality rate
Wet Crash means
Fluid overload overstretches the heart muscle tissue resulting in decreased cardiac output and low BP
What will cause an increase in patients venous pressure?
A clot in the drip chamber (most common)
What causes an increase in arterial pressure? (More negative #)
Clotted or infiltrated needle, kink in arterial line, low BP, poor functioning CVC
Conductivity
13-15.5
pH
6.9-7.6
TMP alarm
measure the transmembrane or total membrane pressure, the pressure difference across the membrane fibers inside the dialyzer. as fibers clot off in the dialyzer, TMP alarms.
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