Final Exam DaVita (RN) 2024-2025. Questions and Correct, Verified Answers. Graded A+, Exams of Nursing

Download Final Exam DaVita (RN) 2024-2025. Questions and Correct, Verified Answers. Graded A+ and more Exams Nursing in PDF only on Docsity! Final Exam DaVita (RN) 2024-2025. Questions and Correct, Verified Answers. Graded A+ #1 thing we do - ANSpatient safety 2 common routes for CVC infection - ANSinto cath via contact of the insertion site and via cath lumen- scrub the hub for 60 seconds each limb 2 independent nursing functions - ANSpatient care and technical skills a patient's protein status is affected by nutritional and non-nutritional factors. what can you do to prevent a drop in your patient's albumin? - ANSprevent HAIs Acid lasts for how long when opened? - ANS30 days if additives discard after treatment at what time should the post treatment data collection be completed - ANSafter the treatment has been completed Bicarb lasts for how long once opened? - ANS24 hours blood pH - ANS7.35-7.45 BUN lab draws post dialysis - ANSturn off or decrease UR to 50 decrease DFR to 300 or place machine in bypass reduce BFR to 100 wait 15 seconds for AVG/AVF and CVC (WAIT 15 seconds!!) Obtain from A Line Calciphylaxis (soft tissue calcification) is a consequence of which out or range labs? - ANSCa, PTH, Phosphorus CKD can have its orgin pre-renal , intra-renalm or post renal. Which of the following conditions is an intra-renal cause of CKD - ANSHTN Conductivity acceptable rrange - ANS13-15.5 and +/- 0.4 of the machine Convetion - ANSsolute being dragged across the semipermeable membrane Diffusion - ANSparticles from high to low concentrations during dialysis, the movement of bicarb from the dialysate into the blood - ANShelps normalize body pH Excess of this electrolyte causes slowing of the hearts electrical system - ANSk fluid overload and HTN lead to LVH, this means - ANShypotensive episodes are more likely to occur during the dialysis treatment HD replaces what percent of kidney function - ANS15% heparin is considered what - ANSsystemic hormone stimulated in bone marrow production - ANSerythropoeitin How do phosphate binders work? - ANSthey prevent the phosphorus in food from being absorbed when taken with meals one thing to improve CAT audit scores - ANSpractice good hand hygiene one thing to improve meerCAT score - ANSstore look-a-like, sound-a-like products appropriately Osmosis - ANSfluid from lower to higher concentration outflow stenosis - ANSwith AVG, whistling sound Patient with cardiac disease are 10x more likely to develop intra HTN - ANSLVH pH of dialysate - ANS6.9-7.6 Platelets should be adminstered how - ANSthru venous med lock on the venous drip chamber using an IV pump Preventing hypotensive episodes during dialysis treatment is important because they are associated with - ANSa higher mortality rate restless leg syndrome is a complication of - ANSperipheral neropathy Rule of 6 is good for? - ANSnew AVF to guide Stepped profile - ANShypotension happens midway may start at 800 then reduce down the A in smart communication stands for - ANSactual- just report the facts the kidneys excretory functions include - ANSnormalizing electrolytes the licensed nurse delegated a task to the PCT, Nicole, but Nicole has not performed this task during the last 2.5 months. What is Nicole's responsibility in the delegation communication process? - ANSNicole is to inform the nurse that she performed the task only infrequently the licensed nurse has delegated a specific task to a PCT, but the PCT gets called away before performing this task. Can the PCT asek another PCT to take over? - ANSno, a task delegated by the licensed nurse to a non-licenced teammate cannot be re-delegated by this teammate The method to protect against infection by pathogenic microorganisms when preparing and administering medications is called - ANSaseptic technique The mortality risk for patient who experience two or more episodes of intradialytic hypotension per week increases to - ANS70% the nephrologist has ordered 16 gauge needles and a 400 BFR for your patient. You - ANSask the nephrologist to order a 15 gauge needles for the ordered BFR the transport mechanism when particles move from an area of higher solute concentration to an area of lower solute concentration is called - ANSdiffusion the vitamin converts vit d into which hormone - ANSCalictrol these procedures can causes significant blood loss in our patients - ANSaccess procedures this disease is the leading cause of death at all stages in CKD - ANScardiac this electrolyte is often elevated with patients with severe itching - ANSphosphorus this skin color is associated with the decrease circulation of RBC from secondary anemia - ANSpale UF profiling - ANSMD must order Ultrafiltration - ANSfluid passing thru a membrane using the __________ approach is one way to fill out an REM - ANSSBAR vitamins should be given when? - ANSpost treatment so they dont dialyze out waiting only five seconds between lowering the blood pump speed and drawing the post treatment blood sample could - ANScause the post treatment BUN reading to be falsely low (wait 15 seconds) Weight gain over 5% of patient's target weight is - ANSfluid excess what are s/s of air embolism - ANSdyspnea, coughing, chest tightness/pain, cyanosis, confusion, visual disturbances what distance should be observed between needle tips and away from each other when cannulating an internal vascular access? - ANS1.5 inches what do we avoid with pericarditis patients - ANSheparin what do we do for hemolysis - ANSstop treatment, clamp lines, DO NOT RETURN BLOOD, assess patient, draw labs, obtain samples for hypotonic dialysate, check dialysate temp, give o2 what do we do for pericarditis patients - ANSmore frequent dialysis What do you do for a patient with an air emblolism? - ANSClamp lines, put patient on left side, Trendelenburg, attempt to aspirate the air, administer O2 per MD, monitor VS closely, initiate CPR if needed, notify code team What do you do for disinfectant infusion? - ANSstop pump, clamp lines, DO NOT RETURN blood, O2, NS via A Line and collect blood specimens When dialyzing a patient with acute kidney injury, one task of the patient care teammates is to monitor blood pressure and weight closely. Why is it important? - ANShypovolemia and hypotensive episodes can cause renal ischemia and can further damage the kidneys When do we test Hep B - ANSneed to have it every 28 days drawn for negative and susceptible, if negative and immune every 365 days. if unknown draw patient When do you take PO4 binders? - ANSwith meals and snacks When is the RO checked? - ANSbefore the first patient and every 4 hours afterwards Which blood test must be performed at regular intervals on patients susceptible to HPB - ANSHBsAg which condition may impair a patient's increase in pulse rate as a response to hypovoilemia - ANSautonomic neuropathy which infectious disease requires frequent hand washing instead of using alcohol based hand gels - ANSactive clostridioides difficile infection which is the primary device for purifying the water used in dialysis - ANSthe RO which may cause a decrease in the hemoglobin of a patient with ESRD - ANSinfection/inflammation which of the following events is defined as a near miss - ANSthe wrong dialyzer was set up and primed for a patient, but it was caught before dialysis was initiated and the dialyzer was replaced Which of the following is a data collection - ANSHR 72 who is accountable for appropriate patient and teammate scheduling in the acute setting - ANS Why is drawing the correct amount for blood cultures improtant - ANStoo much blood may create a false positive Why is the order of lab draw important - ANSsamples in subsequent tubes are not contaminated with additives from the previous Why is thirst control and limiting interdialytic weight gains a shared responsibilyt between the healthcare team and the patient? - ANSCaregivers can contribute to Na loading during dialysis causing an increased thirst and fluid intake between treatments Why must you wait 3-5 minutes after administering the initial heparin bolus before initiating treatment? - ANStakes 3-5 minutes for heparin to become systemic you are dialyzing a patient and the only available HPB surveillance test is a HBsAb of 8. What are the machine disinfection requirements after dialyzing this patient? - ANSthe machine must be heat disinfected at the end of each day Your patient complains of ringing in the ears, being nauseated and having cold clammy skin. The most likely causes is - ANSHypotension your patient prefers two places on her AVG to insert the needles because they hurt a lot less than when you cannulate different sites. You tell the patient - ANSinserting the needles into the same small area can over time damage your graft your role in anemia management includes - ANSrinsing back as much of the patient's blood as you can at the termination of each treatment your role in CKD-MBD management includes - ANSreminding the patient who is eating a snack during dialysis to take his phosphate binder