CCHT Dialysis Questions (with answers) 2023 (238 Qs)., Exams of Nursing

Download CCHT Dialysis Questions (with answers) 2023 (238 Qs). and more Exams Nursing in PDF only on Docsity!

Excretory functions of the kidney - correct answer ✅Fluid balance, electrolyte balance, waste removal, acid/base balance Excretory functions of dialyzer - correct answer ✅Removal of excess fluid based on the pt's TW, Normalizing electrolytes, waste removal, reduce metabolic acidosis Endocrine functions of the kidney - correct answer ✅Blood pressure regulation, anemia, CKD- MBD Endocrine functions of dialysis - correct answer ✅Antihypertensive medications, Epogen and IV iron, phosphate binders, vitamin D, calcimimetics 4 AVF evaluations- Rule of 6's - correct answer ✅<o.6 cm depth below skin 6-8 week post-op

0.6 cm diameter Access BFR 600 ml/min Immediate jeopardy - correct answer ✅Potential for actual harm to patient

Distance between Needles - correct answer ✅1 1/2 to 2 inches Chlorine testing - correct answer ✅Every morning prior to first treatment, every four hours health literacy - correct answer ✅The degree to which individuals have the capacity to obtain, process and understand basic information and services needed to make appropriate health decisions Standard deficiency - correct answer ✅Failure to meet the CMS requirements in one or more areas Hyperkalemia - correct answer ✅Arrhythmia, muscle weakness, possible cardiac arrest, hemolysis Four key elements affected in CKD-MBD - correct answer ✅Calcium, phosphorus, parathyroid hormone,vitamin D Intervention for anaphylaxis - correct answer ✅Left Trendelenburg position

Intervention for chest pain - correct answer ✅Notify charge nurse, decrease blood flow rate, turn UF off, nitroglycerin, oxygen, Saline, if hypotensive restore BP Mineral bone disorder - correct answer ✅MBD Venous port - correct answer ✅Returning the blood Observations during treatment - correct answer ✅Every 30 minutes UF goal calculator - correct answer ✅Pre weight -target weight +NS price and rinse back +oral intake, infusions To convert KG to LBS - correct answer ✅multiply by 2. convert pounds to kg - correct answer ✅divide by 2. Always chart - correct answer ✅Medication

Nurse assessment AKI patients - correct answer ✅Within one hour Why are patients anemic - correct answer ✅Diminished quantity of red blood cells For indicators of optimal nutrition status - correct answer ✅1. Albumin greater than or equal to four

2. Stable target weight
3. Adequate fat storage and muscle mass
4. Appropriate appetite and intake Interventions for seizures - correct answer ✅Notify RN, reduce UF rate, give oxygen, protect access, protect airway DDS intervention - correct answer ✅Slower BFR & DFR inCKD patients Cherry red blood, anxiety, restlessness, abdominal cramping, chest pain, back tightness, hyper/hypotension - correct answer ✅Hemolysis Can one experience more than one stage of grief at once - correct answer ✅Yes

Three core communication skills to be used within communication styles - correct answer ✅Asking, listening, informing Define three skills of reflective listening - correct answer ✅Restating, deducing, summarizing Is there a specific order to work through the five stages of grief - correct answer ✅No Skills to most likely change a patient's behavior - correct answer ✅Support, compassion, empathy The fundamentals and complex programs - correct answer ✅The clinical pyramid shows that you must do what for patient to achieve their highest quality of life Denial, depression, bargaining, anger, acceptance - correct answer ✅Five stages of grief

Benefits of PD - correct answer ✅Homebase, flexible schedules, preserved residual renal function, improved transplant outcomes, active lifestyle, less anemia, needle free, steady Benefits of home hemodialysis - correct answer ✅Homebase, flexible, if your dietary restrictions, improved clinical outcomes, may allow for easier travel, independent treatment Reasonable and prudent standard of care concepts - correct answer ✅Care where you give Sam Kerr under similar circumstances. Do you the actions a reasonable and prudent nurse what do you as well as being avoided. Follow standard care to avoid negligence. When supervising non-licensed people it is the RN job to make sure they are following the standard of care Beginner cannulation level - correct answer ✅Less than six months of practice less than 10 successful cannulations Intermediate cannulator - correct answer ✅Six months or more of practice more than 10 cannulations Advanced cannulator - correct answer ✅Complete our competencies on NFACT checklist, expert assessments, and cannulation skills documented

Difference between aneurysm and pseudo aneurysm - correct answer ✅AVF- aneurysm AVG- Pseudo aneurysm Putting all of the machines in bypass mode - correct answer ✅Response to water quality alarm Tactile learner - correct answer ✅Background music, highlight important information, short lectures, hands on, frequent breaks, role-playing Visual learners - correct answer ✅Notes, quiet surroundings, visual aids, short lectures, I contact Auditory learner - correct answer ✅Repeat info, read notes out loud, word associations, watch videos, discuss and explain Volume of water in patient's body - correct answer ✅V HBV nomenclature and which test is performed monthly on patients - correct answer ✅HBsAg- surface antigen. If positive isolation and monthly test

left ventricular hypertrophy - correct answer ✅Hypertension can lead to this pH of urine - correct answer ✅4.5- Normal heart rate - correct answer ✅60-100 bpm What is in acid concentrate - correct answer ✅Sodium, calcium, dextrose, potassium, magnesium, chloride Dialysate with a high pH - correct answer ✅Metabolic alkalosis Dialysate with a very low pH - correct answer ✅Metabolic acidosis What is in bicarb concentrate - correct answer ✅Bicarb sodium, act as a buffer, forms acetate ions in carbon dioxide Blood pH - correct answer ✅7.35-7.

Excretory functions of kidney - correct answer ✅Fluid balance, Electrolyte balance, waste removal, acid/base balance Excretory functions of the dialyzer - correct answer ✅Removal of excess fluid based on patient target weight, normalizing electrolytes, waste removal, reduce metabolic acidosis Endocrine functions of the kidney - correct answer ✅Blood pressure regulation, anemia What factors decrease K - correct answer ✅Incorrect pump speed, low BFR Factors that influence V - correct answer ✅Height, weight, age, amputation, sex BFR for 17G needle - correct answer ✅200- BFR for 16G needle - correct answer ✅250- BFR FOR 15G needle - correct answer ✅350-

BFR for 14g needle - correct answer ✅> Post BUN lab draw steps - correct answer ✅Turn off UF, bring down dialysate flow rate to 50, wait 15 seconds, obtain sample form arterial port False KT/v (increase) - correct answer ✅BFR not decreased, did not wait 15 seconds before drawing, drew from venous line Low KT/V causes - correct answer ✅Diluted sample(saline) Why is weight and BP important when monitoring AKI patients - correct answer ✅Keep them wet so they don't dry out! AKI hypotensionepisodes due to - correct answer ✅Less blood flow going to the kidneys causing ischemia Why is it important to know what caused PT chronic renal failure? - correct answer ✅So we can treat complications and zone in on things during data collection

When is a pre-treatment assessment by the licensed nurse required? - correct answer ✅AKI patients or state mandate DQI purpose - correct answer ✅A way for facilities to measure performance to improve our Pt quality of life When is it okay for a PT to be released from TX - correct answer ✅Evaluate effectiveness of the Tx, and compare pre Tx to post Tx 4 reasons why we document on a medical record - correct answer ✅1. Proof care was rendered

2. Provides data continuity
3. Permanent legal record
4. Communication tool When to chart - correct answer ✅Medication given, and Pt response Times for documentation - correct answer ✅Pre and post tx REM may be seen on the test as - correct answer ✅AOR

Consequence of sodium overloading - correct answer ✅Increased thirst, increased fluid weight gain, higher UF rate, more hypotension Foods high in phosphorus - correct answer ✅Chocolate, dairy products, legumes, dark pop Binders work by - correct answer ✅Prevention of absorption in the gut(remember magnet) Diffusion - correct answer ✅Higher to lower concentration (down) Osmosis - correct answer ✅Lower to higher, opposite of diffusion Movement of bicarb from dialysate to blood - correct answer ✅Helps normalize body's PH Bicarb in dialysate acts as a - correct answer ✅BUFFER

Excretory Functions of Kidney(to get rid of) - correct answer ✅Normalizing electrolytes, removing waste and fluid Conditions for coverage - correct answer ✅A CMS regulation that the dialysis provider must meet A surveyor sees a covered vascular access, and this can result in a - correct answer ✅IJ(immediate jeopardy) What precautions do you take when handling lab specimens - correct answer ✅Universal precautions(everything is infectious) Lavender tubes - correct answer ✅Inverted, no clotting, no shaking What do you do if a tube breaks in the centrifuge? - correct answer ✅Take sleeve out, remove opposing sleeve Importance of V tags - correct answer ✅Infection control, CMS regulation Most frequent infectious complicaitons - correct answer ✅Vascular access infection

Most common germ we experience - correct answer ✅MRSA Why do we wear gloves? - correct answer ✅Reduces risk of hand contamination Why preform hand hygiene before and after gloves? - correct answer ✅Microscopic holes CVC KDOQI Strategy - correct answer ✅Masks, gloves, aseptic technique Rules for spinning samples - correct answer ✅Balance centrifuge, use dummy tubes if needed LVH is associated with - correct answer ✅Hypertension Hyperkalemia symptoms - correct answer ✅Arrhythmia, muscle weakness, possible cardiac arrest. Hyperkalemia causes - correct answer ✅usually treatment related, impaired renal function, hypoaldosteronism, tissue trauma, acidosis

Why are patients anemic - correct answer ✅Lack of Erythropoietin What is pericarditis - correct answer ✅Inflammation around the heart We would limit this patient's heparin if they have this - correct answer ✅Pericarditis Systemic effects of CKD - correct answer ✅Dry itchy skin, use hyper fat lotion Four key elements of MBD - correct answer ✅Calcium, phosphorus, parathyroid, vitamin D Who controls the target weight - correct answer ✅Physician only Hypervolemia risks and consequences during treatment - correct answer ✅Increased mortality rate due to hypotension Conductivity range PH - correct answer ✅No greater than.

Temperature is too hot - correct answer ✅Causes homolysis Temperature is too cold - correct answer ✅Hypothermia Intervention for power alarm - correct answer ✅Determine cause, remove Venous line clamps, returned with a hand crank High arterial pressure alarm - correct answer ✅Kink in the arterial tubing High Venus pressure alarm - correct answer ✅Clamped or kinked line A low Venus pressure alarm - correct answer ✅Severely clotted dialyzer, Incorrect blood flow rate, separation from tubing Clotting in the Venus trip - correct answer ✅High venous pressure Severely clotted dialyzer - correct answer ✅Low Venous alarm CMS relates to - correct answer ✅Patient care and patient safety

Why are patients more susceptible to HAI - correct answer ✅Immuno compromised Why is there an increased risk for HAI's at our facility - correct answer ✅Prolonged exposure to their blood What is the most common HAI route - correct answer ✅Contact transmission What percentage of normal kidney function is replaced with dialysis - correct answer ✅15% Define DARN - correct answer ✅Desire, Ability, Reason, Need Explain reflective listening - correct answer ✅Summarizing aspects of what the patient said fully restating what you discussed The best way to help change a patient's behavior - correct answer ✅Inspire change through support and compassion and empathy Five stages of grief - correct answer ✅denial, anger, bargaining, depression, acceptance

What is KDQOL 36? - correct answer ✅A 36 item questionnaire What is the role of the social worker and what kind a PCT a nurse do to assist - correct answer ✅Counselor, advocate, we have, behavioral change, notify a social worker of any changes you see Ultrafiltration - correct answer ✅The process by which fluid and small molecules are filtered out of the blood in the glomerulus. Diffusion - correct answer ✅Movement of molecules from an area of higher concentration to an area of lower concentration. Osmosis - correct answer ✅Diffusion of water through a semi permeable membrane Convection - correct answer ✅Solutes are dragged across the membrane along with fluid Kidney excretory functions - correct answer ✅

Kidney endocrine functions - correct answer ✅Renin: regulation of blood pressure and kidney function Erythropoietin: regulation of RBC production What is the function of the bicarb in dialysate - correct answer ✅To buffer What is the function of bicarb in blood - correct answer ✅To correct a patient's PH Importance of limiting phosphorus and went to take binders - correct answer ✅Bone damage, itching, mineral vital to energy production MBD - correct answer ✅Remember binders and phosphates Hypotension causes - correct answer ✅blood loss, dehydration, anemia Organ stunning impaired tissue perfusion Intervention for muscle cramps - correct answer ✅Turn the UF off, stretch the muscle

Definition of fever - correct answer ✅Temperature over 100°, or a rise of 2° of baseline temperature pyrogenic reaction - correct answer ✅Sudden onset of fever, chills, backache, headache, nausea, and vomiting as a result of being exposed to foreign proteins, such as those found in bacteria or fungi. Typically happens between 45 and 75 minutes of the treatment seizures and interventions - correct answer ✅Discontinue dialysis only if patient has no response Dialysis Disequilibrium Syndrome - correct answer ✅Discontinue treatment for severe symptoms. Patient please don't miss treatments Do not return the blood if - correct answer ✅Hemolysis Disinfectant Infusion - correct answer ✅Pain at the Venus Needle site, tingling around lips

You would place a patient and left side Trendelenburg position if - correct answer ✅There is an air embolism The threePrinciples of patient self management - correct answer ✅Dealing with the consequences of the illness and not just the physical disease What is health literacy? - correct answer ✅the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions Auditory learner tips - correct answer ✅Word associations are mnemonics The three medications a PCT can administer - correct answer ✅Heparin, saline, lidocaine Preservative medications need to be discarded after - correct answer ✅28 days The wait time for Heprain bolus - correct answer ✅3 to 5 minutes And outflow stenosis a.k.a. narrowing - correct answer ✅Water hammer, whistling sound

Use of tourniquet - correct answer ✅AVF only Pseudo aneurysm and aneurysms are caused by - correct answer ✅Poor site rotation Site rotation and healing time - correct answer ✅Two weeks Flipping needles tips - correct answer ✅Only for a cause not just because. Not typically on an arterial needle Hemostat sponges rules - correct answer ✅PD order only. Do not allow to leave the clinic with a surseal dressing on The patient will be in a supine position for - correct answer ✅CVC care Chlorine in water causes - correct answer ✅Hemolysis and anemia When is hardness testing done - correct answer ✅At the end of each day

two types of peritoneal dialysis - correct answer ✅CAPD and CCPD Clinical pyramid - correct answer ✅Fundamentals, complex programs, effectiveness What is the risk of performing R/O chlorine/chloramine test prior to 15 minutes - correct answer ✅False negative 15 minutes - correct answer ✅The time R/O must be running prior to performing chlorine/ chloramine test Pain at the Venus needle site/tingling around the lips and difficulty breathing - correct answer ✅Disinfectant infusion Can remain on surfaces for days with plastic and vinyl being most favorable to their survival - correct answer ✅MRSA This works only with a sufficient amount of salt pellets - correct answer ✅Water softener/brine

Dealing with the consequences of the illness rather than just the physical disease - correct answer ✅Basic principle of self management Flipping or over manipulation - correct answer ✅Bleeding from the needle site during dialysis A complication win a patient's blood is exposed to Chlorine - correct answer ✅Hemolysis This produces highly dangerous water when exhausted - correct answer ✅DIY tank The test to be performed monthly on patient susceptible for hepatitis B - correct answer ✅HBSAG (Antigen) Intermediate cannulator - correct answer ✅Six months of AV access cannulation experience at least 10 cannulations Desire, ability, reason, need - correct answer ✅What does DARN stand for? Using word associations and Mnemonics - correct answer ✅Auditory learner

Patients who are skipping treatments are at risk for - correct answer ✅Dialysis disequilibrium syndrome Overindulgence causes extreme muscle weakness and abnormal heart rhythm - correct answer ✅Potassium Essential for growth maintenance, infection and anemia - correct answer ✅Albumin A reused dialyzer must be replaced when it has reached - correct answer ✅80% Of function BUN, waste product of metabolism - correct answer ✅Protein Hyperkalemia can lead to - correct answer ✅Cardiac arrest What are the possible consequences of poor or incomplete documentation - correct answer ✅1. personal and business liability

2. career threatening