Davita pct final exam QUESTIONS WITH COMPLETE VERIFIED SOLUTIONS 2024/2025, Exams of Health sciences

Download Davita pct final exam QUESTIONS WITH COMPLETE VERIFIED SOLUTIONS 2024/2025 and more Exams Health sciences in PDF only on Docsity! Davita pct final exam QUESTIONS WITH COMPLETE VERIFIED SOLUTIONS 2024/2025 Water and dialysate cultures are drawn every month in the dialysis unit to monitor bacteria and endotoxins what problems will cause a more positive (less negative) pre-pump arterial pressure. blockage of arterial blood flow from the vascular access. what is the most likely reason for a blood leak detector alarm during recirculation -air bubbles in the dialysate, dirty sensor -check dialysate connections, bleach machine what is an appropriate interventions with an air/foam detector alarm? look at circuit for blood in the system. DO NOT return blood with air in the system. what will cause a more negative pre-pump arterial pressure? Kinking of the arterial blood line between the vascular access and arterial monitor if clotting occurs in a high flux dialyzer, the transmembrane pressure (TMP) will decrease what could be the reasons for a conductivity alarm on the dialysis machine when the dialysate is mixed incorrectly or there is no water acid or bicarb. the person responsible for implementation, adherence, and training of the facility specific emergency management plan (EMP) and applicable policy and procedures is Fa or designee Teammates MUST be able to readily identify patients who may require additional assistance in the event of an emergency evacuation. This will include patients who need help with or are unable to both b and c what is an important action prior to returning a patients blood using the hand crank in the event of a power failure ? remove the venous line for the line clamp Per physician order and based on individual patient needs, Chronic Kidney Disease Mineral and Bone Disorder (MBD) is treated with phosphate binders, Vit D (Hectorol), and Cinacalcet Poor wound healing is directly related to low protein intake Phosphate binders are prescribed to prevent phosphorus in meals from being absorbed. When is the best time to take them ? with meal The definition of Health Literacy is ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment If you notice that a patient's caretaker is struggling to meet the demands of the patients treatment regime you should contact social worker The Psychosocial Assessment completed by the social worker an evaluation of a person's mental health, social status, and functional capacity within the communityCompeted initially and annually The Clinical Pyramid includes : • 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 DaVita Quality Index (DQI) success is achieved encourage continuous improvement across aboard range of disease management processes (all of the above ) What can be the most likely result if the surveyor sees a patient with a covered vascular access immediate jeopardy A surveyor asks you a question. Which of the following statements would be a good answer ? I do not know the answer but I will find out. Intra-renal causes of AKI Ischemic ATN, Sepsis, SIRS, Septic Shock, Anaphylaxis Drugs, Goodpasture Syndrome, Acute Glomerulonephritis, Trauma, Open Heart Surgery Knowing what caused your patients kidney failure can cause complications to treatment 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? The excretory function of the kidneys include remove access water, urea, and metabolic wastes from the blood. Acid concentrate replaces the excretory function of normal kidney function by When supervising pt care technicians an other non-licensed personnel, it is the resposibility of the licensed nurse to ensure these teammates 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 b the maximum ultrafiltration rate should not exceed ___ because it may lead to hypotensive episodes which increase the risk of organ stunning or mortality. An UFR >13 ml/hr/Kg what amount of fluid weight is considered excessive 5% of target weight is considered excessive The patients target weight is Both a and B prescribed and determined by physicians order what are the three steps included in the vascular access assessment look, listen and feel Scrubbing of each hub as part of CVC care is done for: 15 seconds the nephrologist has prescribed a 400 bfr for your patient. you would expect the physician order to also include 15 gauge needle for the prescribed BFR You listen to your patient's AV graft and hear a whistling sound 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 b to prevent the formation of aneurisms and pseudo aneurysms the following should be practiced Good needlesites rotation and complete needle site clotting techniques the neuprologist has ordered the use of hemostatic sponges, sureseal, for your patient. what is the correct procedure when using these sponges ? Remove the hemostatic sponge after hemostasis has been achieved and dress the needle site with sterile gauge or band-aid. flipping the artireal vascular access needle s not necessary since all arterial needles now have a back eye the sign that numbing has taken affect and it is time to stop spraying topical anastetic on the vascular access canulation sites is when Blanching of skin when a patient is prescribed topical anastatic spray, the appropriate time to clean the canulation site is is prior to applying spray 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 15 the urea reduction ratio calculates The amount of urea removed during the dialysis treatment which of the following factors would influence the; t of the kt/v formula Shortened treatment time which of the following factors would decrease the; k of the kt/v formula Inadequate anticoagulation When the lab receives a laboratory test tube with double labeling: The double labed specimen will be rejected at the laboratory for pt safety the blood flow rate is reduced to 100 ml-min for ___________ before obtaining post dialysis blood specimen for kt/v 15 seconds what steps are performed during the recirculation of blood in the extracorporeal circuit when there has been a treatment interruption (restroom?) return patients blood and recirculate the extracorporeal circuit with normal saline intredialytic treatment monitoring the data collection is performed every 30 minutes The waiting time after administration of the initial heparin loading dose prior to initiation of hemodialysis is 3-5 minutes which statement is true regarding the administration of normal saline the teammate must remain with the patient to monitor their progress until administration is complete and lines are securely clamp. Prior to use, how should the medication preparation surface area be disinfected ? with 1:100 bleach solution and disposible wipes what must be completed prior to medication preparation ? All of the above water treatment is needed in the dialysis setting to Meet renal networks standards what is the acceptable mg/L or parts per million (ppm) limit for total chlorine in the water leaving the carbon filter less than or equal to 0.1 which is the primary device for purifying the water used in dialysis reverse osmosis what complication would you expect to see if a patient is exposed to chlorine/chloramines Hemodialysis what time do you perform water harness testing? at the end of each treatment day left ventricular hypertrophy leads to Hypertension 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? Hyperkalymia The dialysis team prevents additional blood loss by providing appropiate heparin dose per physician order using good cannulation and proper rinseback after tx. fever caused by a pyrogenic reaction will most likely occur at what time during the treatment Within 45 to 75 minutes Per DaVita Policy, fever and chills is defined as: any temperature greater than 100 or increase over baseline of 2° with symptoms a recommended intervention for muscle cramps is Turning the UFR off which of the following may be, but doesn't have to be a sign of hemolysis Cherry red colored blood in the venous line in the event of a patient experiencing a seizure, the dialysis treatment should be Discontinued if the seizure is severe or the patient does not respond to treatment the patient position used for a suspected air embolism is Trendelenburg, on the left side Your immediate intervention for a patient experiencing an anaphylactic reaction is Stop the blood pump, discontinue tx, and do not return blood interventions for a patient complaining of chest pain include Placed patient in a flat supine position place machine into bypass