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A comprehensive set of questions and answers related to the davita pct final exam. It covers various aspects of dialysis, including patient care, treatment procedures, complications, and quality management. A valuable resource for students preparing for the davita pct exam.
Typology: Exams
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A patient with acute kidney injury dialyzes in the out-patient facility. With regards to the patients target weight, why is being "wet" better that being too dry? - ANS a PCT greets a patient and the patient reports feeling short of breath. The PCT notices that the patients lips have a blue hue. The PCT would: - ANS Complete data collection and PCT must notify the RN if there are any abnormal findings prior to initiation of tx a recommended intervention for muscle cramps is – ANS Turning the UFR off A standing post- treatment blood pressure reading of __is considered an abnormal finding and should be reported to a licensed nurse - ANS A surveyor asks you a question. Which of the following statements would be a good answer? - ANSI do not know the answer but I will find out. Acid concentrate replaces the excretory function of normal kidney function by – ANS Hemodialysis removes urea, salts, and excess water from the blood normalizing electrolytes, removes metabolic acidosis, all documentation on machine set up and pretreatment patient information - ANSMust be entered into the computer before the treatment is initiated
Can you document patient vital signs under another teammate already signed into the computer? - ANSno Cynthia missed her treatment on Saturday and returns the following Tuesday for her next scheduled treatment. She complains of feeling weakness in her legs. David, a PCT, gets a wheelchair for her, helps her weigh in, and brings her back for the nurse to assess prior to starting her treatment. Which patient complication would the PCT and RN suspect Cynthia is most likely suffering from? - ANSHyperkalymia DaVita Quality Index (DQI) success is achieved - ANSencourage continuous improvement across aboard range of disease management processes (all of the above ) Dialysis replaces only ___ percent of normal kidney function. - ANS15% documentation in the medical record - ANSIs a permanent legal record of the care provided fever caused by a pyrogenic reaction will most likely occur at what time during the treatment - ANSWithin 45 to 75 minutes flipping the artireal vascular access needle - ANSs not necessary since all arterial needles now have a back eye For patients with Acute Kidney Injury (AKI)which statement is correct? - ANSA nursing assesment prior to tx initiation is always required
How do you verify that the patient is stable and safe for discharge after the dialysis treatment? - ANSEvaluate the effectiveness of the treatment by comparing data to pre-dialysis findings PCT's notify the nurse if there are any unusual findings if clotting occurs in a high flux dialyzer, the transmembrane pressure (TMP) will - ANSdecrease If you notice that a patient's caretaker is struggling to meet the demands of the patients treatment regime you should - ANScontact social worker If your facility dialyzes Hepatitis B positive patients, which assignment would NOT be appropriate patient care assignment. - ANScaring for HBsAG positive and hepatitis B susceptible patients at the same time in the event of a patient experiencing a seizure, the dialysis treatment should be - ANSDiscontinued if the seizure is severe or the patient does not respond to treatment In those states that do not require a nursing assessment to be completed prior to treatment initiation, the PCT would be required to report abnormal patient data collection findings. - ANSyes interventions for a patient complaining of chest pain include - ANSPlaced patient in a flat supine position place machine into bypass Intra-renal causes of AKI - ANSIschemic ATN, Sepsis, SIRS, Septic Shock, Anaphylaxis Drugs, Goodpasture Syndrome, Acute Glomerulonephritis, Trauma, Open Heart Surgery
intredialytic treatment monitoring the data collection is performed every - ANS minutes Knowing what caused your patients kidney failure - ANScan cause complications to treatment left ventricular hypertrophy leads to - ANSHypertension Per DaVita Policy, fever and chills is defined as: - ANSany temperature greater than 100 or increase over baseline of 2° with symptoms Per physician order and based on individual patient needs, Chronic Kidney Disease Mineral and Bone Disorder (MBD) is treated with - ANSphosphate binders, Vit D (Hectorol), and Cinacalcet Per the Centers for Disease Control and Prevention (CDC), which is the most important route by which pathogens are transmitted in health care setting including dialysis centers. - ANScontact transmission Per The centers for disease control prevention, which is the most common factor contributing to bacterial infections in dialysis patients? - ANSthe use of catheters for hemodialysis Performing a procedure "your way" rather than following DaVita's P&Ps a. Carriers no risk of being considered outside the Ordinary Standard of Care as long as "your way" achieves the same results
b. Can lead to civil liability in the event of an adverse patient outcome c. May be defended in court by demonstrating that your way is as good as DaVita's P&Ps d. Is accepted practice since there is no one right way to performing most procedures - ANSb Phosphate binders are prescribed to prevent phosphorus in meals from being absorbed. When is the best time to take them? - ANSwith meal Poor wound healing is directly related to - ANSlow protein intake post treatment data collection and assessment is performed - ANSAfter the tx was terminated Prior to use, how should the medication preparation surface area be disinfected?
The Clinical Pyramid includes : - ANS• The Fundamentals: Immunizations, Iron, Dialysis Access, Calcium, Phosphorus, Hb, Kt/V, Target Weight, Access,PTH, etc.• Complex Programs: Fluid Management, Infection Management, Diabetes Management, Med Management, CVCManagement, Palliative / EOL Care, Infection Surveillance, Transition of Care, CKDEducation, Depression, Missed Treatments, etc.• Measures of Effectiveness • Mortality, Hospitalization /Re- hospitalization, Patient Experience of Care• What Matters Most • Our patient's health-related Quality of Life The definition of Health Literacy is - ANSability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment The dialysis team prevents additional blood loss by - ANSproviding appropiate heparin dose per physician order using good cannulation and proper rinseback after tx. The endocrine functions of the kidneys are - ANSRenin and erythropoietin secretion ,activation of vitamin D The excretory function of the kidneys include - ANSremove access water, urea, and metabolic wastes from the blood. the maximum ultrafiltration rate should not exceed ___ because it may lead to hypotensive episodes which increase the risk of organ stunning or mortality. - ANSAn UFR >13 ml/hr/Kg The most common infectious complication for hemodialysis patients is - ANScentenal line infections
the nephrologist has prescribed a 400 bfr for your patient. you would expect the physician order to also include - ANS15 gauge needle for the prescribed BFR the nephrologist orders a blood flow rate of 450 ml/min for a patient with established AV fistula. what needle gage would be appropriate for this BFR - ANS the neuprologist has ordered the use of hemostatic sponges, sureseal, for your patient. what is the correct procedure when using these sponges? - ANSRemove the hemostatic sponge after hemostasis has been achieved and dress the needle site with sterile gauge or band-aid. The patient is using a central venous catheter for dialysis and has a new arteriovenous fistula (AVF) present in his lower arm, What observation/assessment should the PCT perform the AVF? - ANSchecking for the bruitand thrill every time treatment day the patient position used for a suspected air embolism is - ANSTrendelenburg, on the left side The patients target weight is - ANSBoth a and B prescribed and determined by physicians order the pct notes that a patient still has considerable in edma in her legs when performing the post treatment data collection, in addition to informing the nurse, what should the pct document? - ANSDocument the swelling and that RN was informed.
the person responsible for implementation, adherence, and training of the facility specific emergency management plan (EMP) and applicable policy and procedures is - ANSFa or designee The Psychosocial Assessment completed by the social worker - ANSan evaluation of a person's mental health, social status, and functional capacity within the communityCompeted initially and annually the sign that numbing has taken affect and it is time to stop spraying topical anastetic on the vascular access canulation sites is when - ANSBlanching of skin the urea reduction ratio calculates - ANSThe amount of urea removed during the dialysis treatment The waiting time after administration of the initial heparin loading dose prior to initiation of hemodialysis is - ANS3-5 minutes to prevent the formation of aneurisms and pseudo aneurysms the following should be practiced - ANSGood needlesites rotation and complete needle site clotting techniques Ultrafiltration is defined as - ANScontrolled fluid removed by manipulation of hydrostatic pressure upon completing machine set up and before treatment initiation it is important to verify the prescription and machine settings: - ANSboth b and c
V-tags cite deficiencies, provide interpretive guidance, and provide a condition that must be met for each regulation. How can knowledge of V-tags affect the practice of patient care providers? - ANSall of the above Water and dialysate cultures are drawn every month in the dialysis unit to monitor
what is an appropriate interventions with an air/foam detector alarm? - ANSlook at circuit for blood in the system. DO NOT return blood with air in the system. what is an important action prior to returning a patients blood using the hand crank in the event of a power failure? - ANSremove the venous line for the line clamp What is one method surveyors used to verify infection control training and education? - ANSpatient interview what is the acceptable mg/L or parts per million (ppm) limit for total chlorine in the water leaving the carbon filter - ANSless than or equal to 0. what is the most likely reason for a blood leak detector alarm during recirculation
what steps are performed during the recirculation of blood in the extracorporeal circuit when there has been a treatment interruption (restroom?) - ANSreturn patients blood and recirculate the extracorporeal circuit with normal saline what time do you perform water harness testing? - ANSat the end of each treatment day what type of blood/dialysate flow within the dialyzer increases the rate of diffusion providing optimal dialysis for patients? - ANSconcurrent flow what will cause a more negative pre-pump arterial pressure? - ANSKinking of the arterial blood line between the vascular access and arterial monitor when a patient is prescribed topical anastatic spray, the appropriate time to clean the canulation site is - ANSis prior to applying spray When is a pre-treatment assessment by the licensed nurse required? - ANS⁃ when it is mandated by state. ⁃ when the pct performing a data collection notices abnormal findings ⁃ when the patient reports unusual symptoms to the nurse prior to treatment initiation. ⁃ when nurse observes initial behavior When the lab receives a laboratory test tube with double labeling: - ANSThe double labed specimen will be rejected at the laboratory for pt safety
Which infectious disease requires frequent handwashing instead of using alcohol based hand gels? - ANSActive Clostridioides difficile infection C.diff which is the primary device for purifying the water used in dialysis - ANSreverse osmosis which of the following factors would decrease the; k of the kt/v formula - ANSInadequate anticoagulation which of the following factors would influence the; t of the kt/v formula - ANSShortened treatment time which of the following may be, but doesn't have to be a sign of hemolysis - ANSCherry red colored blood in the venous line which statement is true regarding the "Reasonable and Prudent" Standard of care
a. This could be inactive of an inflow stenosis b. This could be indicative of an outflow stenosis c. This could be indicative of advanced access thrombosis d. This is a normal sounding bruit - ANSb Your immediate intervention for a patient experiencing an anaphylactic reaction is