Annual Competency Exam-with 100% verified solutions.docx, Exams of Advanced Education

Download Annual Competency Exam-with 100% verified solutions.docx and more Exams Advanced Education in PDF only on Docsity! Annual Competency Exam-with 100% verified solutions List three blood borne pathogens HIV Hepatitis B Hepatitis C What is hepatitis? Inflammation of the liver How is hep a transmitted? Contaminated food and oral-fecal route How is hep B and C transmitted? Exposure to blood and body fluids of an infected person How long can hep b live on surfaces for? Seven days When caring for HBV patients staff should NOT Take care of hepatitis susceptible patients on the same shift at the same time Why do we dialyze hep c in the clinical area and not in isolation? Not as contagious as hep B What blood test indicates infection with Hep B? HbsAg Indicates viral presence Tests for the antigen What blood test indicates immunity against hep b? HbsAb Indicates presence of immunity What vaccine provides long term immunity to hep b? Recombivax Engerix S/S of TB Night sweats Productive, persistent cought Unexplained weight loss Chills Fever Blood tinged sputum How is TB spread? Droplet What can live outside of the body for seven days? How are they spread? MRSA VRE Spread through contaminated hands of health care workers What assures that MRSA patients are no longer actively infected? Three consecutive cultures come back negative Precautions to take when caring for MRSA/VRE? Contact Severely reduced kidney function 15-29 Very severely reduced kidney function less than 15 Why are renal patients acidotic? Kidneys control acid/base balance Hydrogen builds up due to lack of bicarb What needs to be considered when giving meds? Decrease elimination due to loss of kidney function Potential toxicity Increased potency/duration Increased frequency Phosphate binders Tums Amphojel Alucaps Renagel Renvela Phoslo What is hectoral, calcijex, and zemplar? Help absorb calcium Reduce PTH What is the desired hemoglobin level for hemodialysis patients 10-11 What med is seen to slow progression of kidney disease? Lisinopril beta blocker How do you check blood sugar levels? From the arterial port What controls the bodies homeostasis? Electrolytes What are the most important electrolytes to consider in uremic patients? Sodium Potassium Calcium Phosphate Magnesium Bicarb What is normal blood pH? 7.35 to 7.45 What is added to dialysate to maintain a patients ph? Bicarb Hypertonic Contains more particles Hypotonic Contains less particles When does diffusion cease to occur? Until the concentration of each electrolyte found in the patients blood is equal to the electrolyte concentration in the dialysate Why is dextrose added to the dialysate? To prevent hypoglycemia What is the purpose of checking the dialysate? That it is compatible with human pH Conductivity and temp to prevent hemolysis and crenation Name four ways dialysate is checked pH conductivity What happens if you prime the machine higher than 150 ml/min Gas vapor lock Not all the fibers open How long can a dialyzer recirculate with saline before it is considered unsafe to use? Four hours What three processes occur in the dialyzer simultaneously? Osmosis Diffusion Ultrafiltration What is ultrafiltration in dialysis? The use of more than one type of pressure, positive and negative, to remove fluid How do blood and dialysate flow travel through the dialyzer Countercurrent flow Blood flows down (arterial to venous) Dialysate flows up (venous to arterial) How to tell if your dialyzer is clotting Rising TMP Rising venous pressure Dark blood in dialyzer Air detector alarms Heparin Heparin does not dissolve clots Anticoagulant effect 5-10 minutes after injection 90 minute half life After heparin is given, how long must you wait before starting the treatment? 3-5 minutes When might the heparin dose be decreased? Treatment time and dialzyer size is reduced When might the heparin dose be increased? When a patients KECN is decreasing Signs of clotting Infection or fever What circumstances would contraindicate the use of heparin? Actively bleeding Post-surgery or dental procedure Allergy/sensitivity Scheduled for surgery How long can a patients blood be recirculated during treatment interuption? May lose oxygen after 15 minutes Why do transducers have to be blood and fluid free? To get accurate arterial and venous pressure readings What does pre pump arterial blood flow measure? The amount of pressure and the quality of blood flow from the access to the blood pump What must be removed when hand cranking? The venous tubing Renal patient temperature 96.4-98.9 Many patients have below normal body temp Elevated pre temp could mean infection 1 kg = 1000 cc 2.2 lbs 1 oz = 30cc I liter = 1000 cc Disadvantage of an AV fistula? Takes longer to mature 1-4 months Disadvantages of a graft Bleed more More prone to infection Why is it better to conduct access flow testing at the start of treatment? Patients are more hemodynamically stable Not affected by ultrafiltration What can cause an access to clot? Hypotension post treatment What to look for in an internal access pre and post treatment? Bleeding Swelling Bruising Redness Drainage Thrill and bruit What direction should needles be placed for optimal flow? Venous in the direction of blood flow Arterial can go either way What is steal syndrome? Arterial blood being shunted into the venous circulation through the anastomosis Reduction of blood flow (ischemia) to the extremity Distal to the access pain, tingling, numbness, cold, cyanotic hands or nails Where do catheters sit? In the right atrium of the heart How can you manage poor catheter flow during treatment? Lower the patients head Have the patient cough When is cramping seen? Middle to end of treatment What do you NOT do for cramping? MASSAGE