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And Answers
If a patient with acute kidney injury (AKI) dialyzes in the outpatient facility, one task of the patient care teammates is to monitor blood pressure (BP) and weight closely. Why is this important? - correct answer ✅Hypovolemia and hypotensive episodes can cause renal ischemia and can further damage the kidneys Chronic kidney disease can have it's origin pre-renal(Before), intra- renal(During), or post renal(after). Which of the following conditions is an intra-renal cause of CKD? - correct answer ✅Hypotension Knowing what caused your patients CKD... - correct answer ✅Is important because the underlying disease could cause health complications that can impact the dialysis treatment Which of the following factors would influence the K of the Kt/V Formula? - correct answer ✅Blood Volume processed (BVP) It is important that patients stay for their entire treatment time because adequate dialysis replaces... - correct answer ✅Less than 15% of normal kidney function
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Waiting only five seconds between lowering the blood pump speed and drawing the post treatment blood sample could... - correct answer ✅Cause the Kt/V reading to be falsely high When a PCT documents the extent of a patients edema, for example as +3... - correct answer ✅The PCT is performing an assessment, which is not legally allowed When a patient has an irregular heartbeat... - correct answer ✅The automated oscillometric BP reading may not be accurate A patient presents with an elevated temperature after the initiation of dialysis. This is most likely due to... - correct answer ✅A Pyrogenic reaction When is a pre-treatment assessment by the licensed nurse required? Check all that apply! - correct answer ✅A) When it is mandated by the state
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What does the term "Wet Crash" mean? - correct answer ✅Fluid overload overstretches the heart muscle tissue (left ventricular hypertrophy) resulting in decreased cardiac output and low BP What is your main priority when returning a patients blood with the hand crank during a power outage? - correct answer ✅You must be vigilant in watching for air in the blood lines Your patient dialyzes for four hours with a blood pump speed(BFR) of 400 ml/min. What is his calculated Blood Volume Processed(BVP) at the end of treatment? - correct answer ✅96,000 ml or 96 liters What problem will cause an increase in the patients venous pressure? - correct answer ✅A clot in the drip chamber
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What is the most frequent infections complication in dialysis patients? - correct answer ✅Bacterial vascular access infections Which infections requires frequent handwashing instead of using alcohol based hand gels - correct answer ✅Active Clostridioides difficile(C. Diff) infection Contact transmission is the most important route through which infections are spread. Contact transmission is defined as... - correct answer ✅Transmission of microorganisms through healthcare workers hands What precautions must be used when handling and packaging lab specimens? - correct answer ✅Universal Precautions Lavender tubes must be... - correct answer ✅Inverted a minimum of 8 to 10 times to properly mix and avoid clotting
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When a healthcare practitioner automatically intervenes when observing a patient doing something detrimental to their health... - correct answer ✅The healthcare practitioner gave in to the right reflex. Behavior change is best elicited through... - correct answer ✅Understanding the patient's motivations and providing support. 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 bicarbonate from the dialysate into the blood... - correct answer ✅Helps normalize body pH The kidneys excretory functions include... - correct answer ✅Secreting Renin
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A Patient's protein status is affected by nutritional and non- nutritional factors. What can you do to prevent a drop in your patients albumin? - correct answer ✅Prevent healthcare-associated infections (HAIs) Foods high in phosphorus include (Mark all that apply)... - correct answer ✅Chocolate, Dark pop/Soda, Milk Products, Legumes How do phosphate binders work? - correct answer ✅They prevent the phosphorus in food from being absorbed when taken with meals Your patient complains of ringing in the ears, being nauseated and having cold clammy skin. The most likely cause is... - correct answer ✅Hypotension What is a likely cause for dysrhythmias (irregular heartbeat)? - correct answer ✅Hypotension, Heart disease, or rapid changes in serum potassium
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Your patient asks whether it is ok to take an over-the counter cold remedy. What is your response? - correct answer ✅Lets ask your nephrologist what she recommends will be a safe medication for you. What are the conditions for coverage? - correct answer ✅CMS regulations that dialysis providers must meet to become and stay certified What can be the most likely result if the surveyor sees a patient with a covered vascular access? - correct answer ✅An immediate Jeopardy To assist in survey readiness, you should... - correct answer ✅A) know the following policy and procedure B) Be accountable and take initiative C) Live out our mission and core values (ALL OF THE ABOVE)
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The nephrologist has written orders to begin cannulating a patients new AVF. Per NFACT, only advanced cannulators are to insert needles into a new AVF. Who is the correct teammate to cannulate the AVF? - correct answer ✅Lilly has completed all compentencies listed on NFACT Skills Checklist and also has expert cannulation skill documented. The nephrologist has ordered 16 gauge needles and a 400 BFR for your patient. You... - correct answer ✅Ask the nephrologist to order 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. Why is carbon filter offline monitoring so important? - correct answer ✅There are no lights or alarms to indicate they are exhausted
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What is the first thing to do when manually returning blood? - correct answer ✅Remove venous line from air detector What problem will cause a more positive arterial pressure? - correct answer ✅Separation of the blood tubing from arterial access What problem will cause a more negative arterial pressure? - correct answer ✅Clotted arterial needle What problem will cause a decrease in venous pressure? - correct answer ✅A severely clotted dialyzer How long must you wait before starting treatment after heparin Administration? - correct answer ✅3-5 minutes What is the immediate action to do with a water alarm? - correct answer ✅Places machines into bypass
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What to do if you see that a patient is eating a banana during treatment - correct answer ✅1) Refer to dietitian
- tell patient that the banana will not be dialyzed during this treatment. How do you know if a numbing spray is working? - correct answer ✅Blanching of the skin How long can medications containing preservatives be kept for? - correct answer ✅28 days for Heparin 21 days for epogen What are 3 medications that a PCT can administer? - correct answer ✅Heparin, Lidocaine, Saline What are some possible consequences of fluid loading? - correct answer ✅Excessive thirst and fluid gain Pulling off too much fluid can cause... - correct answer ✅Hypotension associated with higher mortality
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- Focusing on problem solving, patient confidence and decision- making.
- Placing patient and care providers in partnership each with their own specific responsibilities a tool that may help Auditory learners is: - correct answer ✅Words associated with mnemonics 3 things that may help a tactile learner is: - correct answer ✅1) Background music
- Keeping notes with short lectures and hands on activities
- Frequent short breaks A chlorine/Chloramines check that comes back incorrect: - correct answer ✅is subject to immediate jeopardy What to say to a surveyor if an answer to a question is unknown... - correct answer ✅I'm not sure but I can find out.
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Water tested 10 minutes prior can - correct answer ✅present as a false negative KDOQI's Rule of 6's - correct answer ✅6 week post op greater than 600ml/min BFR diamiter of vessel greater than 0.6cm depth below skin less than 0.6cm Bleeding of access site during dialysis could be because of... - correct answer ✅Flipping / manipulation of needle How long does it take for an access site to heal? - correct answer ✅14 days How long does it take for iodine to air-dry? - correct answer ✅30 seconds to 1 minute Alcohol prep time - correct answer ✅1 minute to apply, 15 seconds dry time
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the BFR for a 17 gauge needle is - correct answer ✅200- the BFR for a 16 gauge needle is - correct answer ✅250- the BFR for a 15 gauge needle is - correct answer ✅350- the BFR for a 14 gauge needle is - correct answer ✅Greater than 450+ Dialysis staff should not care for... - correct answer ✅Both HBsAg positive and seronegative patients at the same time. Doing it "your way" - correct answer ✅can lead to civil liability
