Davita Final Exam Questions with Correct
Answers
Explain the four transport mechanisms that play a role in hemodialysis - Answer--●
Ultrafiltration: Fluid is pushed through a semipermeable membrane.
● Convection: Or solute drag means that solutes move with the water across the
semipermeable membrane. In this way, convection adds to the clearance achieved
through diffusion as solutes are dragged along with the ultrafiltrate.
● Diffusion: Is the movement of dissolved particles across a semipermeable membrane
from the side with the higher concentration to the side with the lower concentration. This
difference in solute concentration on each side of the membrane is called concentration
gradient. The higher the concentration gradient, the faster diffusion occurs. Once the
concentration of a dissolved particle is the same on both sides of the semipermeable
membrane, diffusion stops.
● Osmosis: Is a chemical process by which dissolved chemicals will migrate from an
area of high concentration to one of low
concentration. Essentially if you dissolve something in a liquid, the dissolved
compounds (called solutes) will spread out until there is
an equal concentration of solute everywhere.
What are the kidneys excretory functions - Answer--To normalize electrolytes, remove
wastes, provide fluid and nutrient balance
What is the function of the acid concentration - Answer--Provides the concentration
gradient for diffusion and helps normalize electrolytes
,What is the function of bicarbonate - Answer--Buffers the acid concentrate
Signs and symptoms of hyperkalemia - Answer--> 5.5 mEq: extreme muscle weakness,
abnormal heart rhythm, possible cardiac arrest
Signs and symptoms of hypokalemia - Answer--< 3.5 mEq: fatigue, muscle weakness,
paralysis, respiratory failure, cardiac instability, arrhythmias, cardiac arrest
What are the kidneys endocrine functions - Answer--Renin secretion, Erythropoeitin
secretion, Vit D Activation
How do we replace normal endocrine kidney functions - Answer--Provide medications
How much of normal kidney function is replaced by hemodialysis - Answer--15%
What is uremia and how does it affect the body? - Answer--Uremia is a buildup of
wastes in the blood due to kidney failure and affects all body systems.
What are the most common causes of CKD in the usa? - Answer--Diabetes
Hypertension
Polycystic Kidney Disease
Outline the treatment goals for a patient with CKD - Answer---slowing the progression of
ckd
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects of ckd on patients' lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Why is it important to know what caused your patients CKD - Answer--So the nurse and
PCT can inquire about possible problems during data collection and assessment
Why is sodium balance important? - Answer--Leads to volume expansion, increased
cardiac output, increased peripheral vascular resistance, and increased blood pressure
Signs and symptoms of fluid imbalance - Answer--Edema, hypertension, shortness of
breath
, Systemic effects of CKD what would you advise for a patient who complains of: dry itchy
skin, peripheral neuropathy(nerve pain in extremities) and gi problems - Answer--Use
hyper-fatted soaps and lotions, monitor patient for changes in motor function and inform
RN and physician of any bleeding problems/constipation/diarrhea
What is the consequences of prolonged fluid overload and hypertension - Answer--Left
ventricular hypertrophy
What is Percarditis? - Answer--Inflammation of the membrane (pericardial sac) around
the heart
What is a common cause of hypertension in dialysis patients - Answer--fluid overload
Left ventricular hypertrophy leads to - Answer--Ischemic heart disease, arrhythmia,
myocardial infarction, and sudden death
Why are dialysis patients anemic? - Answer--1. the lifespan of their red blood cell is 60
days 1/2 of the normal 120 days.
What can you do to avoid contributing to lower hemoglobin and blood loss in dialysis
patients - Answer--Verify correct Erythropoietin Stimulating Agent (ESA) dose is
administered, rinse back until venous line is pink tinged, and avoid repeat lab draws
What are the 4 key elements contributing to CKD-mineral bone disorder(MBD) -
Answer--1. Calcium
2. Phosphorus
3. PTH
4. Vitamin D (Calcitriol)
What are the symptoms of CKD-MBD in addition to bone disease - Answer--Soft tissue
calcification, itching, muscle weakness, pathological fractures, tendon ruptures,
compression of vertebrae, atherosclerosis, heart disease
What is your role in CKD-MBD management - Answer--*report symptoms * urge
patients to take meds (home & treatment)
*report noncompliance problems related to nonadherence
Define the term AKI - Answer--- Term incorporates a wide spectrum of kidney issues
- Includes acute kidney failure as well as less catastrophic kidney function changes
Answers
Explain the four transport mechanisms that play a role in hemodialysis - Answer--●
Ultrafiltration: Fluid is pushed through a semipermeable membrane.
● Convection: Or solute drag means that solutes move with the water across the
semipermeable membrane. In this way, convection adds to the clearance achieved
through diffusion as solutes are dragged along with the ultrafiltrate.
● Diffusion: Is the movement of dissolved particles across a semipermeable membrane
from the side with the higher concentration to the side with the lower concentration. This
difference in solute concentration on each side of the membrane is called concentration
gradient. The higher the concentration gradient, the faster diffusion occurs. Once the
concentration of a dissolved particle is the same on both sides of the semipermeable
membrane, diffusion stops.
● Osmosis: Is a chemical process by which dissolved chemicals will migrate from an
area of high concentration to one of low
concentration. Essentially if you dissolve something in a liquid, the dissolved
compounds (called solutes) will spread out until there is
an equal concentration of solute everywhere.
What are the kidneys excretory functions - Answer--To normalize electrolytes, remove
wastes, provide fluid and nutrient balance
What is the function of the acid concentration - Answer--Provides the concentration
gradient for diffusion and helps normalize electrolytes
,What is the function of bicarbonate - Answer--Buffers the acid concentrate
Signs and symptoms of hyperkalemia - Answer--> 5.5 mEq: extreme muscle weakness,
abnormal heart rhythm, possible cardiac arrest
Signs and symptoms of hypokalemia - Answer--< 3.5 mEq: fatigue, muscle weakness,
paralysis, respiratory failure, cardiac instability, arrhythmias, cardiac arrest
What are the kidneys endocrine functions - Answer--Renin secretion, Erythropoeitin
secretion, Vit D Activation
How do we replace normal endocrine kidney functions - Answer--Provide medications
How much of normal kidney function is replaced by hemodialysis - Answer--15%
What is uremia and how does it affect the body? - Answer--Uremia is a buildup of
wastes in the blood due to kidney failure and affects all body systems.
What are the most common causes of CKD in the usa? - Answer--Diabetes
Hypertension
Polycystic Kidney Disease
Outline the treatment goals for a patient with CKD - Answer---slowing the progression of
ckd
-managing comorbidities and complications
-controlling symptoms
-minimizing the effects of ckd on patients' lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Why is it important to know what caused your patients CKD - Answer--So the nurse and
PCT can inquire about possible problems during data collection and assessment
Why is sodium balance important? - Answer--Leads to volume expansion, increased
cardiac output, increased peripheral vascular resistance, and increased blood pressure
Signs and symptoms of fluid imbalance - Answer--Edema, hypertension, shortness of
breath
, Systemic effects of CKD what would you advise for a patient who complains of: dry itchy
skin, peripheral neuropathy(nerve pain in extremities) and gi problems - Answer--Use
hyper-fatted soaps and lotions, monitor patient for changes in motor function and inform
RN and physician of any bleeding problems/constipation/diarrhea
What is the consequences of prolonged fluid overload and hypertension - Answer--Left
ventricular hypertrophy
What is Percarditis? - Answer--Inflammation of the membrane (pericardial sac) around
the heart
What is a common cause of hypertension in dialysis patients - Answer--fluid overload
Left ventricular hypertrophy leads to - Answer--Ischemic heart disease, arrhythmia,
myocardial infarction, and sudden death
Why are dialysis patients anemic? - Answer--1. the lifespan of their red blood cell is 60
days 1/2 of the normal 120 days.
What can you do to avoid contributing to lower hemoglobin and blood loss in dialysis
patients - Answer--Verify correct Erythropoietin Stimulating Agent (ESA) dose is
administered, rinse back until venous line is pink tinged, and avoid repeat lab draws
What are the 4 key elements contributing to CKD-mineral bone disorder(MBD) -
Answer--1. Calcium
2. Phosphorus
3. PTH
4. Vitamin D (Calcitriol)
What are the symptoms of CKD-MBD in addition to bone disease - Answer--Soft tissue
calcification, itching, muscle weakness, pathological fractures, tendon ruptures,
compression of vertebrae, atherosclerosis, heart disease
What is your role in CKD-MBD management - Answer--*report symptoms * urge
patients to take meds (home & treatment)
*report noncompliance problems related to nonadherence
Define the term AKI - Answer--- Term incorporates a wide spectrum of kidney issues
- Includes acute kidney failure as well as less catastrophic kidney function changes
