Davita Final Exam .

Davita Final Exam 2022 Per The centers for disease control prevention, which is the most common factor contributing to bacterial infections in dialysis patients - ANS-The use of catheters in hemolysis You are assisting a patient to step on the scale by holding the patients hand such as casual contact - ANS-Does not require to wear gloves but must preform hand hygiene Per the centers for disease control prevention, which is the most important route by pathogens are transmitted in health care setting including dialysis - ANS-Contact transmission The signs that numbing has taken effect and it is time to stop spraying topical anesthetic on the vascular access cannulation sites is when - ANS-You observe blanching of the skin which is the primary device for purifying the water used in dialysis ANS-reverse osmosis what complications would you expect to see if a patient is exposed to chlorine/chloramines - ANS-hemolysis cynthia missed treatment on saturday and returns the following tuesday for her next scheduled treatment. She complains of feeling weakness in her legs. David, a PCT gets a wheelchair for her, helps her weigh in, and brings her back for the nurse to assess prior to starting her treatment. Which patient complication would you the PCT and Rn suspect Cynthia is most likely suffering from - ANS-Hyperkalemia In the event of patient experiencing a siezure, the dialysis treatment should be ANS-Discontinue if the seizure is severe or the patient does not respond to treatment Per Davita Policy, fever is defined as - ANS-Any temperature greater than 100° F or increase over baseline of 2°F with symptoms Interventions for a patient complaining of chest pain - ANS-Decrease blood flow rate, decrease ultrafiltration rate, administer H2O, take vital signs What problem will cause a more positive (less negative) pre pump arterial pressure - ANS-Separation of blood tubing from arterial access What is an important action prior to returning patients blood using the hand crank in the event of a power failure - ANS-Remove the venous line from the clamp line Knowing what caused your patients renal failure ANS-is important to identify possible problems during data collection and assessment a patient with acute kidney injury (AKI) dialysis in the out-patient facility. IN regards to the patients target weight, why is being "wet" better than being too dry? - ANS-Being wet helps avoids hypovolemia and hypotensive episodes Ultrafiltration is defined as - ANS-controlled fluid removed by manipulation of hydrostatic pressure Why is meticulous hand hygiene so important in healthcare? - ANS-its the single most important intervention in preventing HAI's What should be done to the heparin infusion line if a patient does not have maintenance heparin prescribed? - ANS-Clamp & Knot the heparin line When is a pre treatment assessment by the licensed nurse required? check all that apply - ANS-When it is mandated by state law ( pre-treatement vs within 1 hour after start of tx) , when What are three things you should NOT include in a Risk Event Management (REM) report? - ANS- Personal Opinons, speculation, vendettasw The nephrologist has prescribed a 400 blood flow rate (BFR) for your patient. You would expect the physician order to also include - ANS-15 gauge needle for this prescribed BFR You listen to you patients arteriovenous graft (AVF) and hear a whistling sound - ANS-This could be an indication of outflow stenosis To prevent the formation of aneurysms and pseudoaneurysms the following should be practiced - ANS-Good needle site rotation and complete needles site clotting techniques The nephrologist has ordered the use of hemostatic sponges, such as SureSeal, for your patient. What is the correct procedure when using these sponges? - ANS-Remove the hemostatic sponge after hemostatis has been achieved and dress the needle sites with sterile gauze or band aid The Urea Reduction Ratio calculates - ANS-The amount of urea removed during the dialysis treatment Which of the following factors would decrease the K of the Kt/V formula ? - ANS-Inadequate anticoagulation What steps are preformed to replace fluid removed and prevent clotting during the re circulation of blood in the extra corporeal circuit when there has been treatment interruption (i.e. patient using the restroom? - ANS-The saline infusion line is opened and if the patient is receiving an intradialytic heparin infusion via the dialysis machine: the heparin pump remains on The waiting time after administration of the initial heparin loading does prior to initiation of hemodialysis is - ANS-3-5 minutes What must be completed prior to medication preparation ? - ANS-Put on PPE and perform hand hygiene, visually inspect ampules and vials for cracks, leaks, discoloration, or particulate matter including checking the expiration date Water and dialysate cultures are drawn every month in the dialysis unit to monitor - ANS-bacteria & endotoxins Intra-renal causes of Acute Kidney Injury - ANS-Sepsis, trauma, anaphylaxis, drugs, acute glomerulonephritis The excretory functions of the kidneys include - ANS-fluid balance,electrolyte balance, waste removal and acid base balance Acid concentrate replaces the excretory function of normal kidney function by - ANS-normalizing electrolytes The endocrine functions of the kidneys are - ANS-Renin and erythropoietin secretion, activation of vitamin D The dialysis prescription, nursing assessments, interventions and follow ups help us to provide the highest quality treatment for every patient, every time. Despite our efforts, dialysis replaces only ___ percent of normal kidney function - ANS-15% Which statement is true about sinks used for hand washing? - ANS-handwashing sinks must be dedicated for handwashing purposes only and should remain clean The most common infectious complication for hemodialysis patients is - ANS-vascular access infection What is one method surveyors use to verify infection control training and education ? - ANS- Documentation of infection control training in teammates file or transcript Which infectious disease requires frequent hand washing instead of using alcohol based hand gels? - ANS-active clostridioides difficile infection (c-diff) Per the centers for disease contorl and prevention (CDC), which is the most important route by which pathogens are transmitted in health-care settings including dialysis centers? - ANS-contact transmisson