PCT DaVita (RN)Final Exam from 3 latest versions Questions and Answers (Verified Answers), Exams of Nursing

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PCT DaVita (RN)Final Exam from 3 latest versions

Questions and Answers (Verified Answers)

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? - correct answer ✅hypovolemia and hypotensive episodes can cause renal ischemia and can further damage the kidneys. CKD can have its origin pre-renal , intra-renalm or post renal. Which of the following conditions is an intra-renal cause of CKD - correct answer ✅HTN. Knowing what caused your patient's CKD - correct answer ✅is important because the underlying disease could cause health complications that can impact the dialysis treatment. When a PCT documents the extent of a patient's edema, for example as +3 - correct answer ✅the PCT is preforming an assessment which is not allowed legally. When a patient has an irregular heartbeat, - correct answer ✅the automatic BP reading may not be accurate. Which of the following is a data collection - correct answer ✅HR 72. at what time should the post treatment data collection be completed - correct answer ✅after the treatment has been completed. 2 the A in smart communication stands for - correct answer ✅actual- just report the facts. which of the following events is defined as a near miss - correct answer ✅the wrong dialyzer was set up and primed for a patient, but it was caught before dialysis was

initiated and the dialyzer was replaced. 2 using the approach is one way to fill out an REM - correct answer ✅SBAR. What is your main priority when returning a patient's blood with the hand crank during a power outage? - correct answer ✅you must be vigilant in watching for air in the blood lines. what problem will cause an increase in the patient's VP - correct answer ✅a clot in the venous drip chamber. Which blood test must be performed at regular intervals on patients susceptible to HPB - correct answer ✅HBsAg. who is accountable for appropriate patient and teammate scheduling in the acute setting - correct answer ✅ 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? - correct answer ✅the machine must be heat disinfected at the end of each day.

What is the most common factor contributing to bacteremia in dialysis patients? - correct answer ✅use of catheters for HD. which infectious disease requires frequent hand washing instead of using alcohol-based hand gels - correct answer ✅active clostridioides difficile infection. What precautions must be used when handling lab specimens? - correct answer ✅universal precautions. waiting only five seconds between lowering the blood pump speed and drawing the post treatment blood sample could - correct answer ✅cause the post treatment BUN reading to be falsely low (wait 15 seconds) which may cause a decrease in the hemoglobin of a patient with ESRD - correct answer ✅infection/inflammation. fluid overload and HTN lead to LVH, this means - correct answer ✅hypotensive episodes are more likely to occur during the dialysis treatment. your role in CKD-MBD management includes - correct answer ✅reminding the patient who is eating a snack during dialysis to take his phosphate binder.

your role in anemia management includes - correct answer ✅rinsing back as much of the patient's blood as you can at the termination of each treatment 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? - correct answer ✅no, a task delegated by the licensed nurse to a non-licenced teammate cannot be re-delegated by this teammate 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? - correct answer ✅Nicole is to inform the nurse that she performed the task only infrequently what is the nurse's responsibility in the delegation supervision process? - correct answer ✅to determine the level of supervision needed and to monitor the NAP's performance of the task accordingly the transport mechanism when particles move from an area of higher solute concentration to an area of lower solute concentration is called - correct answer ✅diffusion during dialysis, the movement of bicarb from the dialysate into the blood - correct answer ✅helps normalize body pH

the kidneys excretory functions include - correct answer ✅normalizing electrolytes what distance should be observed between needle tips and away from each other when cannulating an internal vascular access? - correct answer ✅1.5 inches the nephrologist has ordered 16 gauge needles and a 400 BFR for your patient. You - correct answer ✅ask the nephrologist to order a 15 gauge needles for the ordered BFR 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 - correct answer ✅inserting the needles into the same small area can over time damage your graft what is the appropriate intervals for total chlorine testing? - correct answer ✅prior to the first patient shift and within every 4 hours what is acceptable limit for total chlorine in the water leaving the carbon filter - correct answer ✅0.1 or less which is the primary device for purifying the water used in dialysis - correct answer ✅the RO

ICEBOAT? - correct answer ✅2 Identifiers Consent valid Equipment is functioning Hep B status Orders are complete Access is patent Documentation is timely ? any questions/concerns Your patient complains of ringing in the ears, being nauseated and having cold clammy skin. The most likely causes is - correct answer ✅Hypotension What is a likely cause for dysrhythmias? - correct answer ✅Hypotension, heart disease, or rapid changes in K In what position should you place a patient who experiences intradialytic hypotension? - correct answer ✅Supine What do you do for a patient with an air emblolism? - correct answer ✅Clamp 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

Why is thirst control and limiting interdialytic weight gains a shared responsibilyt between the healthcare team and the patient? - correct answer ✅Caregivers can contribute to Na loading during dialysis causing an increased thirst and fluid intake between treatments Preventing hypotensive episodes during dialysis treatment is important because they are associated with - correct answer ✅a higher mortality rate The mortality risk for patient who experience two or more episodes of intradialytic hypotension per week increases to - correct answer ✅70% which condition may impair a patient's increase in pulse rate as a response to hypovoilemia - correct answer ✅autonomic neuropathy 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? - correct answer ✅prevent HAIs Calciphylaxis (soft tissue calcification) is a consequence of which out or range labs? - correct answer ✅Ca, PTH, Phosphorus How do phosphate binders work? - correct answer ✅they prevent the phosphorus in food from being absorbed when taken with meals

The method to protect against infection by pathogenic microorganisms when preparing and administering medications is called - correct answer ✅aseptic technique Why must you wait 3-5 minutes after administering the initial heparin bolus before initiating treatment? - correct answer ✅takes 3-5 minutes for heparin to become systemic When do you take PO4 binders? - correct answer ✅with meals and snacks #1 thing we do - correct answer ✅patient safety Conductivity acceptable rrange - correct answer ✅13-15.5 and +/- 0.4 of the machine pH of dialysate - correct answer ✅6.9-7.6 blood pH - correct answer ✅7.35-7. When is the RO checked? - correct answer ✅before the first patient and every 4 hours afterwards Bicarb lasts for how long once opened? - correct answer ✅ 24 hours

Acid lasts for how long when opened? - correct answer ✅ 30 days if additives discard after treatment lifespan of a RBC for dialysis patient - correct answer ✅60 days Ultrafiltration - correct answer ✅fluid passing thru a membrane Convetion - correct answer ✅solute being dragged across the semipermeable membrane Diffusion - correct answer ✅particles from high to low concentrations Osmosis - correct answer ✅fluid from lower to higher concentration How much air can cause a patient harm? - correct answer ✅10mL What is the solution of bleach to clean up a spill? - correct answer ✅1: 2 independent nursing functions - correct answer ✅patient care and technical skills

2 common routes for CVC infection - correct answer ✅into cath via contact of the insertion site and via cath lumen- scrub the hub for 60 seconds each limb Most common cause for CKD in USA - correct answer ✅DM What is the percent of kidney function lost before going on dialysis - correct answer ✅75% HD replaces what percent of kidney function - correct answer ✅15% What is the direct result of intravascular fluid overload - correct answer ✅HTN Patient with cardiac disease are 10x more likely to develop intra HTN - correct answer ✅LVH Offer a patient of this is an example of oral sodium loading - correct answer ✅broth this electrolyte is often elevated with patients with severe itching - correct answer ✅phosphorus kidneys regulate BO by realeasing - correct answer ✅renin

hormone stimulated in bone marrow production - correct answer ✅erythropoeitin Excess of this electrolyte causes slowing of the hearts electrical system - correct answer ✅k mucosal alteration in the stomach of patients with AKI can lead to this - correct answer ✅anorexia what is the inflammation aroudn the heart called - correct answer ✅pericarditis restless leg syndrome is a complication of - correct answer ✅peripheral neropathy measures the RBC by weight - correct answer ✅HgB what is the diminished quality and quality of RBC - correct answer ✅anemia what is classified as bone disease associated with renal failure - correct answer ✅CKD-MBD

the vitamin converts vit d into which hormone - correct answer ✅Calictrol these procedures can causes significant blood loss in our patients - correct answer ✅access procedures maintaining a normal serum Ca levels are the primary function of this hormone - correct answer ✅PTH this disease is the leading cause of death at all stages in CKD - correct answer ✅cardiac this skin color is associated with the decrease circulation of RBC from secondary anemia - correct answer ✅pale it is important to use this team approach when dealing with psychological patients - correct answer ✅multidisplinary What is the reason for a meerCAT audit - correct answer ✅to prepare for survey readiness one thing to improve CAT audit scores - correct answer ✅practice good hand hygiene

one thing to improve meerCAT score - correct answer ✅store look-a-like, sound-a-like products appropriately Why is the order of lab draw important - correct answer ✅samples in subsequent tubes are not contaminated with additives from the previous what do you want the level of albumin to be - correct answer ✅> if drawing labs during dialysis how do you label them? - correct answer ✅DRAWING DURING DIALYSIS BUN lab draws post dialysis - correct answer ✅turn 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 Why is drawing the correct amount for blood cultures improtant - correct answer ✅too much blood may create a false positive When do we test Hep B - correct answer ✅need to have it every 28 days drawn for negative and susceptible, if negative and immune every 365 days. if unknown draw patient

Rule of 6 is good for? - correct answer ✅new AVF to guide what is LOOK LISTEN AND FEEL? - correct answer ✅assessment without needles inflow stenosis is - correct answer ✅with AVF, venous stenosis, water hammer pulse outflow stenosis - correct answer ✅with AVG, whistling sound How do you identify disinfectant infusion is happening - correct answer ✅burning or pain at that access site What do you do for disinfectant infusion? - correct answer ✅stop pump, clamp lines, DO NOT RETURN blood, O2, NS via A Line and collect blood specimens what is hemolysis - correct answer ✅destruction of RBC what is S/S of hemolysis - correct answer ✅anxiety, restlessness, n/v, dyspenea, chest tightness, hyperkalemia, blood will look cranberry

what do we do for hemolysis - correct answer ✅stop treatment, clamp lines, DO NOT RETURN BLOOD, assess patient, draw labs, obtain samples for hypotonic dialysate, check dialysate temp, give o what are s/s of air embolism - correct answer ✅dyspnea, coughing, chest tightness/pain, cyanosis, confusion, visual disturbances hypotension - correct answer ✅a drop in BP by 20 decrease in MAP by 10 if pre SBP less than 90 drop of 10 with symptoms Intervention for hypotension - correct answer ✅take BP, minimum UFR, give NS, elevate feet, supine position what is a fever - correct answer ✅temp >100 or increase in 2 degrees from baseline what will hyperkalemic patients have - correct answer ✅peaked T waves what do we do for pericarditis patients - correct answer ✅more frequent dialysis what do we avoid with pericarditis patients - correct answer ✅heparin

what is the K bath we give for digoxin patients - correct answer ✅2k heparin is considered what - correct answer ✅systemic vitamins should be given when? - correct answer ✅post treatment so they dont dialyze out what is the half life of heparin - correct answer ✅30-90 minutes How long should Vanc be administered? - correct answer ✅over 60 minutes UF profiling - correct answer ✅MD must order Linear profile - correct answer ✅fluid gainers, fluid overload, patients have hypotension toward the end of treatment Stepped profile - correct answer ✅hypotension happens midway may start at 800 then reduce down intermittent - correct answer ✅up and down approach

Weight gain over 5% of patient's target weight is - correct answer ✅fluid excess what medication must be given on an IV pump - correct answer ✅IV Fe What happens with mannitol? - correct answer ✅It dialyzes off how long do you scrub the hub of a CVC? - correct answer ✅ 60 seconds each limb Platelets should be adminstered how - correct answer ✅thru venous med lock on the venous drip chamber using an IV pump how often do you rotate sites? - correct answer ✅every 14 days How often do you draw Hepatitis B - correct answer ✅draw every 28 days they are good for 30 days Final Exam davita_With Questions and Answers/davita Final Exam what is the difference between data collection and assessment? who does what? (Correct)- ✅data collection:yes or no assessment: the extend. what is the role of pct prior to treatment initiation? (Correct)- ✅data collection notify nurse of any abnormalities what is the role of the licensed nurse prior to treatment initiation?(Correct)- ✅nurse assessment

when us a pre-treatment assessment by the licensed nurse required? (Correct)- ✅if vitals were abnormal when is post treatment assessment by the licensed nurse required? (Correct)- ✅up normalities during treatment. note about bp (Correct)- ✅squeezing the auto blood pressure cuff to speed deflation can damage machine internal bp module. why do we document in the medical record? 4 reasons (Correct)- ✅1.proof that care was rendered 2.provide data continuity 3.permnent legal record 4.communication tool list 6 occurrences when to chart? (Correct)- ✅1.change from baseline assessment 2.change in patient condition 3.procedure for treatment 4.medication given

5. patient teaching
6. care plan review and intervention pre-treatment data collection/ assessment (Correct)- ✅before treatment intuition assessment within one hour if pt is stable for nurse

post treatment data collection/assessment (Correct)- ✅post treatment only what are possible consequence of proof or incomplete documentation? (Correct)- ✅poor or incomplete documentation can open an attack on your care what are the 6 items included in charting administered (Correct)- ✅1.medication dosage

2. data and time
3. route for administeration 4.pt response
4. signiture of teammate adminsteration
5. allergies always check the allergy screen in screen in falcon for a list of your pt. how do you document charting errors (Correct)- ✅single line sign and date what does SMART communication stand for (Correct)- ✅Simple and clear Meaningful Actual Read Teach what are the 5 w's to be used when completing an AOR (Correct)- ✅what where who when why what are the four consequence of sodium loading during dialysis (Correct)- ✅.thirst
6. fuid intalle
7. idwg;headaches +hypertenstion

4.ufr

what treatment factors decreases K? (Correct)- ✅not waiting 3- 5 minutes after giving Heprin what factors influence V? (Correct)- ✅on average a persons body composed of 50-55 % water. a person height weight sex,age and amputation are included in calculating V lab draw mistakes that would falsely increase kt/v? (Correct)- ✅not waiting 15 second when is post treatment blood sample draw too high? (Correct)- ✅waiting only 5 seconds between lowering the blood pump speed and drawing post treatment blood sample would cause the kt/v reading to be too high is it okay for pt to come off early on lab day? (Correct)- ✅If pt wants to get off early educate pt risk involved.and still draw lab and re-draw on full treatment (every time) what is important when monitoring weight and bp? (Correct)- ✅acute patient only-keep pt wet and avoid hypotensive episodes. what do you need to consider in regards to their vascular access? (Correct)- ✅follow p and p to prevent infection why is it important to know what caused your patients CRF? (Correct)- ✅its important to know to help inquire about possible problem during data collection and assessment. what is the purpose of uf profilling? (Correct)- ✅purpose of uf profiling the way fluid removed during treatment allow time for vascular refilling what are consequence if patient is consistently fluid overloaded(hypervolemia)? (Correct)- ✅hypertension, left ventricular hypertrophy, cardiovascular disease what can cause hypovolemia? (Correct)- ✅attempting to remove large amount of fluid weight for patient can lead to hypovolemia what are conductivity and ph alarm causes? (Correct)- ✅machine conductivity ad manual reading can be no greater or less then 0.4 difference. after test use phenix meter to: (Correct)- ✅measure ph in dialysate to verify acid base balance with acceptable range

what are temperature alarm causes? (Correct)-^ ✅hemolysis

occurs at 42 Celsius or higher. power appropriate intervention (Correct)- ✅1.remove venous line from air detector clamp before starting Hand cracked. 2.be delight watching for air venous pressure high alar causes (Correct)- ✅more positive cinck in tubing/clamp,infilteration,venous stenosis. clotting in venous drip chamber the reasonable and prudent standard of care for nephrology nursing: key concept (Correct)- ✅when supervising non license personal.it is the responsibility of the license nurse to ensure also teammate meet standard of care. what role does Davita p&P play? (Correct)- ✅policy is guide lines principle "the why" what are the risk of doing it your way? (Correct)- ✅civil liability what makes dialysis patient more susceptible to HAIs? (Correct)- ✅weakened immune system prolong accès to pt blood why are dialysis pt at increased risk for acquiring a HAI at the facility? (Correct)- ✅contact transmition wha tis the most common transmition route for HAIs? (Correct)- ✅contact transition what is the most important intervention you can do to prevent HAIs? (Correct)- ✅hand hygiene wha tis the most common infectious complication in hemodialysis pt? (Correct)- ✅1.vascular access infection

2. per cdc the most common factor contributing to bacteriumia is use of cvc. what germ causes the most common infections in hemodialysis pt? (Correct)- ✅MRSA MRSA can remain on service for days. being most favorable to survival

why is wearing gloves important? (Correct)-^ ✅function^ of

gloves decrease the risk of hand contamination. successful lab draws know the 20 tips (Correct)- ✅follow the order of draw to prevent specimens from being contaminated with other tube additive double labeling tubes prohibits processing what is rule of spinning samples? (Correct)- ✅balance, spin tubes of same kind size fill level and should be placed opposite of each other. what are signs and symptoms of hyperkalemia (Correct)- ✅high potassuim-muscle weakness, abnormal heart rate what are signs and symptoms of hypokalemia (Correct)- ✅low potassium-muscle cramp abnormal heart rate cold how can you prevent contributing to blood loss? (Correct)- ✅1.adequte heparinzation giving heprin why are patients anemic? (Correct)- ✅lack of (ego)erythropoietin what is pericarditis? what is included in its treatment? (Correct)- ✅no heparin hold or decrease heparin peripheral neuropathy (Correct)- ✅check temperature of bathwater don't walk bare feet frequent foot check what are the 4 key elements affected in CKD-MBD? (Correct)- ✅1.calcium 2.phosphorous 3.parathyroid hormone 4.vitment D what does the acronym DARN stand for? (Correct)- ✅desire

ability

This study source was downloaded by 100000838530596 from CourseHero.com on 08-28-2023 14:40:26 GMT -05:00 https://www.coursehero.com/file/204323759/Final-Exam-davitadocx/ reason need when should the communication style directing be used? (Correct)- ✅when training to perform procedure what are the 3 core communication skills to be used within the communication styles (Correct)- ✅asking, lisening,involving what is the best way to help pt successful change behavior? (Correct)- ✅the best way to help pt successfully change behavior is to inspire behavioral change through support, compassion and empathy. summarizing skill (Correct)- ✅includes main aspect of what the pt said during the entire communication writing reflex (Correct)- ✅in automatic intervention of health care practitioner who absorbs a pt doing something detrimental reflex. is there an order to work through the 5 stages of grief? (Correct)- ✅NO what is KDQOL 36? (Correct)- ✅kidney disease quality of care of life it is an assessment tool used for social workers to identify barriers what is KDQOL used for? (Correct)- ✅social worker complies result and develops goals with the pt are social workers available to caregiver? (Correct)- ✅social worker available for caregivers strangling to meet demands of pt treatment regiment 4 transport machisms that play role in hemodialysis (Correct)- ✅1.ultrafilteration 2.convection 3.diffustion 4.osmosis what is ultrafilteration? (Correct)- ✅controlled fluid removed by manipulation.removes fluid only

what is convection? (Correct)-^ ✅salutes^ are^ dragged^ with

water. saluts and water what is diffusion? (Correct)- ✅particles move from high concentration to low construction.only particles what is osmosis? (Correct)- ✅fluid from lower to high.zuccni what are the kidney endocrine function? (Correct)- ✅1.produce renin.regulate 2.erythropoetin

3. activiation of fitment d which convert (calibrated bone disease what is the function of bicarbonate? (Correct)- ✅diffusion of bicarb from dialysate to blood helps normalize body ph consequence of organ stunning? (Correct)- ✅hypotension can have many adverse affects includes impaired tissue prevention of vital organs. muscle cramps intervention (Correct)- ✅decrease or turn off uf offer to stretch we don't want to dialoged clot. fever and chills defention (Correct)- ✅any temperature greater then 100 fahernhit or increase over baseline of 2 fahrnihit with symptoms. pyrogen reaction definition (Correct)- ✅react are caused by pyrogen such as endotoxin in water treatment occurs with in 45-75 min of treatment. pyrogen reaction causes (Correct)- ✅break of water treatment, toxins inside bacteria seizures intervention (Correct)- ✅discontinue treatment if seizures is sever or pt doesn't not respond to treatment dialysis disequiblrium syndrome prevention (Correct)- ✅encourage pt not to skip treatment blood loss definition (Correct)- ✅tmp clotting of dialyzer,needle disloging blood loss causes (Correct)- ✅blood leak(fiber break loss) high pressure blood loss symptoms (Correct)- ✅blood on floor, chair or clothing, tmp alarm

disinfectant infusion symptoms (Correct)-^ ✅pain^ at^ venous

needle side, respiratory distress tingling around the mouth chest pain/angina intervention (Correct)- ✅if mild turn uf decrease blood flow rate give oxygen air embolism intervention (Correct)- ✅stop pump clamp lines left side trenvelenburg air taped int right atrium and venticular when pt is place into trendlengburg postion what are the 3 basic principle of self-managment? (Correct)- ✅1.dealing of consequence of illness rather than physical disease alone what is the definition of health literacy? (Correct)- ✅the degree to which individuals have the capacity to obtain process and understand basic health information what are the educational tips for visual learners? (Correct)- ✅select quit surrounding what are the educational tips for auditory learners? (Correct)- ✅word association and numonics what are the educational tips for tactile learners (Correct)- ✅short lectures frequent breaks what are the meds PCTs can administer per DaVita P&p? (Correct)- ✅1.heprin 2.lidocaine 3.saline at what time are medications contain a preservative discarded? (Correct)- ✅ 28 days how long do we wait after administering heparin bolus prior to treatment intuition (Correct)- ✅3-5 minutes how do you administer pain ease spray? (Correct)- ✅blanching of the skin describe 4 AVF evaluations for maturation based on the KDOQI rules of 6s? (Correct)- ✅6-8 weeks post op