Davita PCT Exam Study Guide Questions (100 Terms) with Correct Answers 2024., Exams of Nursing

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Davita PCT Exam Study Guide Questions

(100 Terms) with Correct Answers 2024.

What is important when monitoring weight and BP for acute patients? - Answer:

keep patients wet to avoid hypotensive episodes What do you need to consider in regards to acute patents vascular access? -

Answer: Usually have a CVC

• follow policy and procedure to prevent infections

Why is it important to know what caused your patient's CKD? - Answer: to

inquire about possible problems during data collection and assessments

Kt/V: What is K? - Answer: clearance of urea

What treatment factors decrease K? - Answer: not waiting 3-5 minutes after

giving heparin with treatment initiation to prevent clotting

What factors influence V (volume)? - Answer: sex, age, weight, height,

amputations

Needle gauge and suggested BFR - Answer: 17: 200-

16: 250-

15: 350-

14: >

What do you do if a patient wants to get off early? - Answer: educate and

document, still draw lab on habitual patients, MUST NOTIFY NURSE

Lab draw mistakes that would falsely increase Kt/V - Answer: not waiting the full

15 seconds to draw the BUN

What is the role of the PCT prior to treatment initiation? - Answer: DATA

COLLECTION

Squeezing the BP cuff can damage the machine: T/F - Answer: True

4 reasons we document in the medical record - Answer: 1. proof that care was

rendered

2. provides data continuity and planning of patient care
3. permanent legal record
4. communication tool

Pre-treatment patient data collection/assessment - Answer: Data collection:

before initiation Assessment: 30 minutes into treatment

Post treatment data collection/assessments - Answer: after treatment

-NOT DURING RINSEBACK

What are possible consequences of poor or incomplete documentation -

Answer: attack on your care

What are the six items included in charting administered medications? - Answer:

REASON FOR ADMINISTERING

What are the 5 W's to be used when completing an AOR - Answer: who should

report an AOR what type of incident when should it be reported where should they be reported why

What are the four consequences of sodium loading during dialysis? - Answer:

Thirsty Increase Fluid Intake Increased intradialytic weight gain Increased ultrafiltration rate

What is the purpose of UF profiling? - Answer: fit to the patient to prevent

crashing and allow for vascular refill

Why do we measure the pH in the dialysate - Answer: to verify acid-base balance

is within an acceptable range

Conductivity and pH alarm causes - Answer: no concentrate

improper bicarb calcium or magnesium precipitate line of filter occlusion from debris improper calibration

Temperature alarm causes - Answer: lower temperature, increases BP

hemolysis occurs at 42 degrees calcium which releases potassium

Power - Answer: the appropriate intervention is to remove venous line from air

detector clamp before starting hand crank

Arterial Pressure High alarm causes - Answer: separation of tubing

Venous pressure high alarm causes - Answer: kink in tubing

infiltration clotting in the venous drip chamber

Davita Quality Index - Answer: the purpose of selecting the component measure

for DQI is to encourage continuous improvement across a broad range of disease management processes

DQI success is achieved by - Answer: -managing individual patients first and

allowing scores to follow -knowing each team members role and improving DQI scores -using the CQI (continuous quality improvement) process to help identify trends and make improvements (answer all of the above)

Importance of P&P - Answer: when supervising non-licensed, assistive

personnel, it is the responsibility of the licensed nurse to ensure these teammates also meet the standard of care

What are the risks of doing it your way - Answer: it can lead to civil liability

What makes dialysis patients more susceptible to HAIs? - Answer: they have

weakened immune systems and prolonged access to blood Why are dialysis patients at increased risk for acquiring a HAI at the facility? -

Answer: CONTACT TRANSMISSION

what is the most common transmission route for HAIs? - Answer: contact

transmission

What is the most important intervention you can do to prevent HAIs? - Answer:

Hand washing

What is the most common infectious complication in hemodialysis patients? -

Answer: Per the CDC, the most common factor contributing to bacteremia is CVC

What germ causes the most common infections in hemodialysis patients? -

Answer: MRSA

Why is wearing gloves so important? - Answer: Decreases risk of hand

contamination

Who can use sinks designated for hand washing? - Answer: clean sinks must be

dedicated for hand washing only What is the correct procedure in regards to your hands when you have casual

contact with a patient? - Answer: don't need to have gloves but must perform

hand hygiene before caring for patients

Successful Lab draws - Answer: know the 20 tips

-follow the order of the lan draws to prevent specimens from being contaminated with other tube additives -double labeling tubes prohibits processing

rules for spinning samples - Answer: only spin tubes of same kind, size, and fill

level and should be placed opposite of each other

hyperkalemia - Answer: potassium above 6.

extreme muscle weakness cardiac arrest

What is the primary cause patients are anemic? - Answer: decreased production

of Erythropoietin

How can you print contributing to blood loss? - Answer: adequate heparinization

What is pericarditis? - Answer: inflammation of sac around the heart

What is included in pericarditis treatment? - Answer: RESTRICTION OF HEPARIN

more/adequate dialysis

What to use for Dry, itchy skin - Answer: hyper fatted soaps and lotions

Peripheral neuropathy - Answer: educate patient about good shoes, look at feet,

don't go barefoot -can't feel sores

What are the four key elements affected in CKD-MBD? - Answer: calcium

phosphorus parathyroid hormone

calcitriol (vitamin D)

What are symptoms of CKD-MBD in addition to bone disease? - Answer: severe

itching, muscle weakness CALCIFICATION OF SOFT TISSUE

What is your role in CKD-MBD management? - Answer: encourage patients to

take binders with their food! talks to patients and listen to them!

What does the acronym DARN stand for? - Answer: Desire to change

Ability to understand Reason to change Need

What's the best way to help patients successfully change behaviors? - Answer:

Inspire behavioral change through support, compassion and empathy

When should the communication style "Directing" be used? - Answer: when

training to perform procedures What are the three core communication skills to be used within the

communication styles? - Answer: Asking Listening Informing

Righting Reflex - Answer: Intervention of a healthcare practitioner who observes

a patient doing something detrimental to their health

Summarizing - Answer: includes the main aspects of what was said during the

conversation

The 5 stages of grief - Answer: Denial

Anger Bargaining Depression Acceptance

Is there an order to work through the five stages of grief? - Answer: No

what is KDQOL 36 - Answer: an assessment tool for the social worker to identify

barriers -the social worker compiles the results and develops goals with the patient

Who is the social worker available for? - Answer: Caretakers struggling to meet

demands of the patient's treatment regime

Ultrafiltration - Answer: (only fluid)

controlled fluid removal by manipulation of hydrostatic pressure

Convection - Answer: (solutes and fluid)

solutes are dragged across the semipermeable membrane along with fluid

Diffusion - Answer: (solutes)

particles move from an area of high concentration to an area of low concentration

Osmosis - Answer: (fluid only)

fluid moves from lower solute concentration to higher solute concentration

What are the kidney's endocrine functions? - Answer: blood pressure control

(Renin) anemia (erythropoiesis) activation of vitamin D3 and Ca Regulation (calcitriol)

What is the function of bicarbonate? - Answer: acts as a buffer

-diffusion of the bicarb from the dialysate to the blood helps normalize body pH

The 4 indicators of optimal nutrition status - Answer: 1. protein (albumin) 4.0 or

higher

2. stable/desirable target weight
3. appropriate appetite
4. adequate fat stores/muscle mass

importance of limiting phosphorous/when to take binders - Answer: tingling

bone damage take with meal

Consequences of organ stunning - Answer: hypotension can have many adverse

affects including impaired tissue profusion of vital organs and organ injury

Muscles cramps - Answer: caused by rapid fluid removal and electrolyte shifts

intervention for muscle cramps - Answer: DON'T MASSAGE in case of blood clot

-stretch the affected muscle and turn off UF

Fever and chills - Answer: any temp greater than 100 degrees or over 2 degrees

of baseline WITH symptoms

pyrogen reaction - Answer: endotoxins in the water

seizures intervention - Answer: discontinue treatment if seizure is severe or

patient does not respond to treatment

Dialysis disequilibrium syndrome prevention - Answer: don't skip treatments

-have to go to hospital to get dialyzed if missed more than two treatments in a row

Symptoms of disinfectant infusion - Answer: PAIN AT THE VENOUS NEEDLE

-respiratory distress tingling around the lips

intervention for chest pain/angina - Answer: mild: stop pulling fluid: turn UF off

turn down BFR to 200 so we don't clot

Air embolism intervention - Answer: STOP PUMP

lay patient on left side trendelenburg

what are the three basic principles of self-management - Answer: Dealing with

the consequences of illness rather than just the disease itself

what is the definition of health literacy? - 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

What are the educational tips for visual learners? - Answer: select quiet

surroundings

What are the educational tips for auditory learners? - Answer: word associations

or mnemonics

what are the educational tips for tactile learners? - Answer: short lectures with

hands on activities and frequent short breaks

at what time are medications containing a preservative discarded? - Answer: 28

days how long do we wait after administering the heparin bolus prior to treatment

initiation? - Answer: 3-5 minutes

Explain a reason for Immediate jeopardy (IJ) - Answer: insufficient or inaccurate

chlorine checks how to talk to a surveyor or what to do when a surveyor observes you or asks

questions - Answer: I don't know the answer, but I will find out

Examples of what not to say to a surveyor - Answer: I was never told that

nobody ever told me explain the four AVF evaluations for maturation based on the KDOQI rule of 6's -

Answer: rules of 6's proved guidelines for a FISTULA

• 6-8 weeks post op -blood flow of 600 -diameter of 0.6 cm -can't be deeper than 0.6 cm below the skin

Water hammer pulse, whistling sound - Answer: outflow stenosis = whistling

inflow stenosis = hammer sound

BESTIPS Complications and Prevention: Thrombosis - Answer: if using hemostatic

sponges, we must remove before sending patient home and cover with sterile gauze

Cannulation site prep - Answer: use a tourniquet during cannulation on ALL AV

fistula unless documentation for otherwise

Site rotation/ healing time - Answer: 14 days/2 weeks

chlorine in water used for hemodialysis causes - Answer: hemolysis which

releases potassium

Chlorine/chloramine testing - Answer: can't be more than 4 hours apart

What is removed in hardness testing? - Answer: calcium and magnesium

When do we test for hardness? - Answer: at the end of each day

response to final water quality alarm - Answer: 1. put all machines in bypass

mode

2. notify charge nurse, FA, boomed, Medical director
3. if water quality cannot be restored terminate all treatments

How do you know numbing has taken effect? - Answer: blanching of skin