Download Kidney Function and Dialysis Principles and more Exams Health sciences in PDF only on Docsity!
CCHT Exam Review Questions and
Answers (100% Correct)
The functional unit of the kidney, or the structure in the kidney that does the work, is the:
- ANSWER-Nephron A nephron is made up of: - ANSWER-A glomerulus and a tubule The endocrine functions of the kidney includes: - ANSWER-Making erythropoietin and the active form of vitamin D The leading cause of End-Stage Renal Disease for adult in the United States is: - ANSWER-Diabetes Patients with kidney failure often complain of itching, which is likely to be caused by: - ANSWER-Hyperphosphatemia Why do kidney patients often have bone disease? - ANSWER-Kidneys stop producing calcitriol Symptoms that a patient may need more dialysis time include: - ANSWER-Anorexia, fatigue, swelling A semipermeable membrane is a porous barrier that: - ANSWER-Allow for only certain sized particles to cross Diffusion is movement of particles: - ANSWER-From an area of higher concentration Negative pressure is pressure created when: - ANSWER-Fluid is pulled through a restriction During dialysis, ultrafiltration occurs when: - ANSWER-Water is removed from blood because there is a pressure gradient between blood and dialysate At which point in the extracorporeal circuit is the blood usually under negative pressure?
- ANSWER-The arterial line section before the blood pump Which of the following will increase the amount of solutes that will diffuse across the semipermeable membrane? - ANSWER-High concentration gradients The components of the dialysate treatment that affect clearance includes: - ANSWER- Dialysate flow, time of treatment, dialyzer size, blood flow rate
Two things that affect the dialyzer's ability to remove wastes from the body include: - ANSWER-Surface area and molecular weight cutoff Dialysate is the fluid that help remove waiste products from the body. It contains a number of substances. What are the substances that might be prescribed for a dialysate solution? - ANSWER-Bicarbonate, Sodium, Potassium What is the most important safety monitor during a dialysis treatment - ANSWER-The dialysis technician Dialysate conductivity measures: - ANSWER-The total electrical charge of a solution Dialysate that has too much sodium may cause patient injury. Too much sodium or hypernatremia can cause: - ANSWER-Headache, high BP, and shriveling of RBCs (crenation) Dialysate that has too much calcium can cause: - ANSWER-Vomiting, confusion, irritability Dialysate that has too little sodium can cause: - ANSWER-Low BP, cramping, and bursting of RBCs (hemolysis) Things that affect dialysis adequacy are: - ANSWER--Treatment time -BFR -DFR -Dialyzer clotting/inadequate heparinization Normal body temp. taken orally is: - ANSWER-98.6 degrees F _______ is the instrument use to measure blood pressure - ANSWER- Sphygmomanometer A rapid pulse of 104 beats/min would indicate that the patient has: - ANSWER- Tachycardia Seizures during dialysis maybe cause by all of the following EXCEPT: -Electrolyte imbalance -Hypotension -Sudden decrease in dialyzer clearance -Dialysate composition - ANSWER-Sudden decrease in dialyzer clearance ________ is the normal range for a resting pulse rate in an adult: - ANSWER-60- beats/min.
AAMI standards recommend quality control activities before a reprocessed dialyzer is used on a patient. How many people must check the dialyzer to verify quality control information? - ANSWER-Two people, one of whom should be the patient Which of the following is NOT a symptom of chemical reaction due to incomplete rinsing of germicide from a reprocessed dialyzer: -Burning in the access site -Numbness in the access arm -Blurred vision -Diarrhea - ANSWER-Diarrhea Dialyzer are processed before use to rinse out manufacturing residues and to: - ANSWER-Establish the original fiber bundle volume of the dialyzer and check for leaks Two criteria for rejecting a reprocessed dialyzer - ANSWER-1) Less than 80% of original fiber bundle volume
- aesthetic appearance The AAMI (Association for the Advancement of Medial Instrumentation) - ANSWER-The AAMI recommends voluntary standards for dialysis water treatment According to AAMI standards, bacteriologic testing for water and dislysate should take place: - ANSWER-Monthly According to AAMI standards, the total microbial count of water used to prepare dialysate shall not exceed: - ANSWER-200 CFU/mL Stenosis is a major cause of access failure, which unless corrected, can lead to thrombosis and other complications. What are the signs of stenosis? - ANSWER- Changes in the thrill and bruit Describe 4 types of anastomosis for an arteriovenous fistula - ANSWER-Artery-side to vein-side anastomosis Artery-end to vein-end anastomosis Artery-end to vein-side Artery-side to vein-end What is an infiltration? - ANSWER-A needle tip that punctures a vessel and goes out the other side, allowing blood to seep into the surrounding tissue What is the preferred insertion site for both temporary and long term catheters? - ANSWER-Internal jugular vein
Why is artrivenous fistula preferable as the vascular access of choice whenever possible? - ANSWER-They have the lowest rate of primary failure of all known accesses Example of an indication of a break in the integrity of the extracorporeal circuit (ECC)? - ANSWER-Appreance of air or foam in any bloodline During dialysis, patients should be monitored for the following complications (list all that apply): a. Separation of bloodlines or rupture of an access b. The presence of air or foam in the lines c. Bleeding around needle or catheter exit sites d. Sudden change in blood flow, or venous pressure, or line collapse - ANSWER-All letters a. Separation of bloodlines or rupture of an access b. The presence of air or foam in the lines c. Bleeding around needle or catheter exit sites d. Sudden change in blood flow, or venous pressure, or line collapse Poor blood flow during dialysis in patient with catheters is often due to which of the following factors? (List all that apply) a. Blood clot b. An aneurysm c. Poor placement of the catheter within the blood vessel d. A fibrin sheath that has formed around the catheter - ANSWER-a. Blood clot c. Poor placement of the catheter within the blood vessel d. A fibrin sheath that has formed around the catheter A dialyzer with an ultrafiltration coefficient of 12, (Kuf of 12) and a TMP of 120 will remove how many mL of fluid per hour? - ANSWER-1440 mL of fluid/hr UF coefficient x TMP = mL of fluid/hr able to be removed 12 x 120 = 1440 If venous needle is infiltrated, what would you do? - ANSWER-Insert second needle above the venous infiltration Blood flow (QB) of 17 gauge needle - ANSWER-250-300 mL/min. Blood flow (QB) of 16 gauge needle - ANSWER- Blood flow (QB) of 15 gauge needle - ANSWER-
What term indicates a solution that has the same concentration of solutes as blood? - ANSWER-Isotonic For patients on hemodialysis, a 1 kg (2.2 lb) increase in weight in 24 hours is approximately equivalent to fluid retention of: - ANSWER-1.0 L (1 kg = 1 L) Which of the following is the most common cause of hypotension developing during hemodialysis? a. Eating/drinking during treatment b. Removing excessive volume of fluid c. Anemia d. Dialyzer reaction - ANSWER-b. Removing excessive volume of fluid When washing the hands, the hands should be wet and soap applied and then the hands rubbed together for at least - ANSWER-15 seconds With an AV fistula, cannulation should usually be done at an angle of - ANSWER-25° to 35° What percentage of water that is filtered out of the blood by the glomeruli is excreted as urine? - ANSWER-1% Which of the following needle sizes has the largest lumen (diameter)? a. 17 gauge b. 16 gauge c. 15 gauge d. 14 gauge - ANSWER-d. 14 gauge How frequently should patients and staff members of a dialysis center have tuberculosis skin tests? - ANSWER-Once a year How often should colony counts and limulus amebocyte lysate tests be conducted on the water feeding the bicarbonate mixer? - ANSWER-Monthly Which of the following is an extracorporeal alarm rather than a dialysate alarm? a. Conductivity b. Temperature c. Air detector d. pH - ANSWER-c. Air detector The primary functions of the kidney tubules are: - ANSWER-reabsorption and secretion
In dialysis patients, the Kt/V typically measures the removal of ______ - ANSWER-urea A female patient's predialysis weight is 149.6 lb (68 kg) and the prescribed target weight is 138.6 lb (63 kg). For her four-hour treatment, the priming saline amount is 240 ml and the rinse back amount is 200 ml. She is not allowed any oral fluids during her treatment. The patient's hourly ultrafiltration rate should be how many mL per hour? - ANSWER- UF rate should be 1360 mL/hour 5 kg weight difference from dry weight = 5 ml
- 440 ml (240 ml and 200 ml saline)
5440 ml 5440 ml / 4 hours = 1360 ml/hour A male patient who has diabetes and receives hemodialysis treatments sometimes drinks juice when his blood sugar is low. Which of the following types of juice would be the best for this patients, since it is lowest in potassium? a. Prune juice b. Grapefruit juice c. Vegetable juice cocktail (V-8) d. Cranberry juice cocktail - ANSWER-d. Cranberry juice cocktail On a Monday morning, a female patient arrives at the hemodialysis unit 8.8 lb (4 kg) above her target weight. Near the end of her treatment, the patient complains of severe muscle cramping in her lower extremities. Which of these actions should the technician take? a. Discontinue the dialysis treatment b. Elevate the patient's legs c. Administer a bolus of normal saline per protocol d. Increase the patient's ultrafiltration rate - ANSWER-c. Administer a bolus of normal saline per protocol What are some of the responsibilities and requirements of the medical director of a dialysis facility? - ANSWER-Being knowledgeable of and responsible for the integrity of the water treatment system in the facility Prior to beginning dialysis, what must the physician order include? - ANSWER-1. Specific Dialyzer
- Blood Flow Rate
- Duration of the dialysis
Kidney failure causes retention of hydrogen ions. What is the result? - ANSWER- Metabolic acidosis Which of these patient populations has the lowest proportion of body water? - ANSWER-Adult females Blood urea levels are influenced by many factors. Decreased levels may result from: - ANSWER-Low dietary protein intake Overhydration A shortage of oxygen-carrying red blood cells is called - ANSWER-anemia The technician would expect a patient's anemia to be monitored by what laboratory test? - ANSWER-Hemoglobin A patient's laboratory results reveal a significant drop inhemoglobin. Whichmedicationwouldthe technician expect the nurse to administer to the patient during dialysis treatments? - ANSWER-Erythropoietin (Epogen) What practice helps to build a patient's immunity to hepatitis B? - ANSWER-Vaccination
