Fresenius Final Exam 2023 with complete solution

hand washing What is the number 1 infection control practice? HBsAG+ patients Who is dialyzed in an isolation room? true True or False: Hep B is bloodborne MRSA, VRE, or VRSA patients Who is dialyzed in a separation room? in the hospital in a negative pressure room Where are active TB patient's dialyzed in? within 2 hours If potential exposed to HIV, in how much time should you receive prophylaxis treatment? 2 kidneys, 2 ureters, bladder, and a urethra What is the urinary system made up of? Through the renal artery Where does blood enter the kidney? antidiuretic hormone What is ADH? It affects the healthy kidney by reducing the excretion of urine What does ADH do? excretory, endocrine, regulatory, and filtration What are the kidneys four functions? renin, erythropoietin, and calcitrol What hormones do the kidneys produce? It constricts blood vessels (vasoconstriction) which increases blood pressure What does renin do? It signals bone marrow to produce RBC's What does erythropoietin do? #1 is DM and #2 in HTN What is the #1 and #2 cause of chronic renal failure? The build up of waste products in the blood What is uremia? purified water, acid, and bicarbonate What is dialysate made up of? calcium and potassium What electrolytes are in the acid solution portion of the dialysate? False. it is biocompatible and CLEAN. True or False: Dialysate is sterile It ultra purifies the dialysate before it goes into the dialyzer which prevents endotoxins from entering the dialyzer/dialysate What is the purpose of the diasafe filter? The movement of solutes across a semipermeable membrane from higher concentration to lower. What is diffusion? It is affected by concentration gradient, temperature, and countercurrent flow. What is the diffusion rate affected by? It is the movement of water from lower concentration of solutes to a higher concentration What is osmosis? It is the use of negative and positive pressures to pull excess fluid from patient What is ultrafiltration? It is how much weight is needed to be removed to get the pt down to their EDW What is the pt's "available weight"? Intravascular, intercellular, and interstitial What are the 3 bod compartments? Place pt in reclining position with feet elevated. Turn UF down or off. Give bolus if needed. Notify RN. What are the interventions for hypotension? Shifting of electrolytes, attempting to pull large amount of fluid in short time, or going below EDW What causes cramping? Turn down BFR, and turn off UF. RN give O2, and MAYBE nitro if needed. What do you do if a pt is complaining of chest pain? If pt's BUN is extremely high or if it is pt's first treatment When does disequilibrium syndrome possibly occur? potassium What does hemolyzed blood have excess amounts of? hemolysis What can occur if the arterial pressure is greater than -250? urea kinetic modeling (UKM) What is adequacy measured in? glomelular filtration rate (GFR) What is used for measuring the level of kidney function in CRF patients? 1.4 What is Fresenius's goal for spktd/v? blood and dialysate What are the two types of alarms on the dialysis machine? Fibers inside the dialyzer are broken causing blood and dialysate to mix together. What does the blood leak alarm indicate? That air is detected in the machine which causes the clamp to secure completely below venous chamber. What does an air detector alarm indicate? Venous pressure too high. Caused by kinks in lines, infiltration, clots, etc. What does the VP alarm indicate? Arterial pressure is too high. Caused by blockage, clots, etc What does the AP alarm indicate? There is a pressure difference across the membrane fibers inside the dialyzer What does the TMP pressure alarm indicate? Means it is a hypotonic solution and can cause hemolysis What occurs if conductivity is too low? Means it is a hypertonic solution which causes crenation What occurs if conductivity is too high? 1. Turn UF and DFR off. 2. Decrease BFR to 100 for 15 seconds then stop pump. 3. Clamp line. 4. Collect sample from arterial port How do you draw post BUN labs? 4-6 weeks How long does it take a fistula to mature? 1-2 weeks after placement How long after can you cannulate a graft? It is when blood escapes from the blood vessels into tissue. What is an infiltration? 1-2 inches How far apart should the venous and arterial needles be? 10-15% By the time kidney function reaches stage 5, how much percent function is left? N/V/D, and loss of appetite What does uremia cause? There is decreased absorption of calcium from the gut as well as a rise in PHT What happens when there is a decrease in production of calcitrol? Continuous cycling peritoneal dialysis (CCPD) and continuous ambulatory peritoneal dialysis (CAPD) What are the two types of peritoneal dialysis? PD fluid placed in peritoneal cavity for period of time (dwell time) then drained, and refilled again. What is "exchange"?