DaVita PCT Study Guide Verified Answers 2023

DaVita PCT Study Guide Verified Answers 2023 Ultrafiltration Ans- Fluid pushed through the semipermeable membrane Convection Ans- Solutes dragged across semipermeable membrane along with fluid Diffusion Ans- Particles move from area of high concentration to low Osmosis Ans- Fluid moves from area of low to high concentration What are the kidneys' excretory functions? Ans- To normalize electrolytes, remove wastes, provide fluid and nutrient balance What are the kidneys' endocrine functions? Ans- Renin secretion, erythropoietin secretion, vitamin D activation What is the function of the acid concentrate? Ans- Provides the concentration gradient for diffusion What is the function of bicarbonate the dialysate solution? Ans- Buffer the acid concentrate What is the function of bicarbonate when it diffuses into the patient's blood? Ans- Normalizes body pH How do we replace normal excretory kidney functions? Ans- Normalizes electrolytes, provide fluid balance through ultrafiltration How do we replace normal endocrine kidney functions? Ans- Provide medications Outline the treatment goals for a patient with chronic kidney disease (CKD) Ans- -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 What are the most common causes for CKD in the USA? Ans- Diabetes Hypotension Polycystic Kidney Disease Why is it important to know what caused your patient's CKD? Ans- So the nurse and PCT can inquire about possible problems during data collection and assessment Signs and Symptoms of fluid imbalance Ans- Hypertension Edema Shortness of breath What does hypertension lead to? Ans- Left Ventricular Hypertrophy Why is sodium balance important? Ans- Leads to volume expansion- increased CO- increased peripheral vascular resistance- increased BP Signs and symptoms of Hyperkalemia Ans- 6.5 mEq symptoms: extreme muscle weakness, abnormal heart rhythm, and possible cardiac arrest Signs and symptoms of Hypokalemia Ans- 3.5 mEq symptoms: fatigue, muscle weakness, paralysis, and respiratory failure, cardiac instability, arrhythmias, cardiac arrest Why are dialysis patients anemic? The lifespan of their RBC is 60 days or approx 1/2 of normal 120 days Ans- Primary cause: lack of the hormone erythropoietin (epo) Secondary cause: inadequate iron stores, inadequate dialysis, malnutrition, blood loss during treatment How can you prevent contributing to lower hemoglobin levels and blood loss in dialysis patients? AnsEnsure Epogen dose is correct and administered, rinse back blood completely, avoid repeat lab draws What is pericarditis? Ans- Inflammation of the membrane (pericardial sac) around the heart What is included in its treatment? Ans- decrease or stop heparin give more frequent dialysis Systemic effects of CKD Dry, itchy skin - what do you do? Ans- use hyper-fatty soaps and lotions caution patient re; safety at home, provide emotional support, control diabetes and phosphorus Systemic effects of CKD Peripheral Neuropathy (nerve pain in extremities) - what do you do? Ans- monitor patient for changes in motor function, decreased strength in legs, C/O restless legs, burning feet. advise patient not to walk barefoot, have good foot care practices Systemic effects of CKD GI problems - what do you do? Ans- inform rn and md of any bleeding problems/ constipation/ diarrhea/ er visits, take meds as ordered ex: stool softness/ Imodium Systemic effects of CKD Psychological problems - what do you do? Ans- anxiety or depression verbalize struggles to IDT ex: the social worker What are the 4 key elements affected in CKD-Mineral Bone Disorder (MBD)? Ans- Calcium Phosphorous PTH Vitamin D (Calcitrol) All lead to CKD-MBD when they are abnormal What are the symptoms of CKD-MBD in addition to bone disease? Ans- Soft tissue calcification, itching, muscle weakness, pathological fractures, tendon ruptures, compression of vertebrae, atherosclerosis, heart disease What is your role in CKD-MBD management? Ans- report symptoms, urge patients to take meds at home and at treatment report noncompliance problems related to non adherence How much of normal kidney function is replaced by HD? Ans- 15% Define Acute Kidney Injury (AKI) Ans- term incorporates a wide spectrum of kidney issues includes acute kidney failure as well as less catastrophic kidney function changes may dialyze in an out-patient facility until kidney function recovers Pre-renal causes of AKI Ans- obstruction, volume depletion, impaired cardiac function Intra-renal causes of AKI Ans- ischemic ATN, sepsis, SIRS, septic shock, anaphylaxis drugs, good pasture syndrome, acute glomerulonephritis, trauma, open heart surgery Post-renal causes of AKI Ans- obstruction, oliguric, bladder rupture, pregnancy Treatment goals for a patient with AKI: How do you help in restoring kidney function? Ans- find the cause of AKI Treatment goals for a patient with AKI: How do you protect kidneys from further injury? Ans- avoid substances to the kidney which may be toxic (radiographic contrast, amphotericin B, low dose aspirin, NSAIDS) Treatment goals for a patient with AKI: What is important when monitoring weight and BP? Ans- keep a little extra fluid on them so it is available to the kidneys when they start filtering/ ultra-filtrating on their own Treatment goals for a patient with AKI: AKI patients are at increased risk for which complications? Ans- hypovolemia and hypotension Treatment goals for a patient with AKI: What do you need to consider in regards to their vascular access? Ans- patients will typically have a dialysis catheter, be careful to avoid catheter related infections Explain the difference between AKI and CKD Ans- eliminating the cause of the AKI can often lead to the return of kidney function you cannot eliminate the cause of CKD which is HTN, diabetes, genetic disorders (PKD) What makes dialysis patients more susceptible to HAIS? Ans- immunosuppressed and more vulnerable to infection which leads to the 2nd most common cause of death in this pop