Fresenius PREP Review For PCT Exam
Questions And Verified Solutions
What is the order of the urinary tract and what does each part do? Correct
Ans - Kidney - filters blood & forms urine
Ureter - transports urine to the bladder
Bladder - stores urine
Urethra - excretes urine
Why are dialysis pt's anemic? Correct Ans - Due to lack of
erythropoietin secondary to decreased kidney function.
Kidneys convert ________ to active form. Correct Ans - Vitamin D
Dialyzer Correct Ans - Semipermeable membrane (artificial kidney)
What sort of molecules are too large to pass through the dialyzer? Correct
Ans - RBC's, WBC's, protein...
Blood and dialysate go in opposite directions of each other in the dialyzer.
What type of flow is this? Correct Ans - Countercurrent flow
What process moves waste across the dialyzer? Correct Ans -
Diffusion
What 3 things is dialysate made of? Correct Ans - Acid + Bicarbonate +
RO water
What happens to RBC's in hypotonic solution? Correct Ans - RBC's
swell & burst due to fluid moving into the RBC. This process causes hemolysis.
What happens to RBC's in a hypertonic solution? Correct Ans - RBC's
dehydrate & shrink due to fluid being pulled out of the RBC. This process
causes crenation.
What is the key sign of hemolysis? Correct Ans - Bright red, cherry-
pop colored blood.
, What is the key sign of crenation? Correct Ans - Dark opaque blood.
What is adequacy? Correct Ans - How well dialysis is working to clear
waste from the blood. This is checked by drawing a BUN lab (pre & post, must
be done on the same day).
What is clearance? Correct Ans - Amount of blood completely cleared
of a solute in one minute at a given BFR & DFR. This is checked by the OLC &
KECN.
What is OLC? Correct Ans - Online clearance test. Measures sodium
across the dialyzer d/t sodium being closest in size to urea. There are two
parts to the OLC test, it tests first by raising conductivity and then second by
decreasing conductivity.
What is KECN? Correct Ans - Clearance effective by conductivity of
sodium. It's measured in ml. It's the amount of blood cleaned in 1 minute.
Higher than 40 degrees celsius of machine temperature may cause ________.
Correct Ans - Hemolysis
What should be considered when a pt's machine temperature is lower?
Correct Ans - The pt may need to run longer to maintain adequate dialysis.
What are the elements that affect dialysis clearance? Correct Ans - -
Typer of dialyzer
- Tx time
- Needle size
- BFR & DFR
- ACO
- Temperature
Needle sizes based on flow rate. Correct Ans - 17 gauge (Orange) -
250 ml to 300 ml BFR
16 gauge (Green) - 300 ml to 350 ml BFR
15 gauge (Blue) - 350 ml to 450 ml BFR
14 gauge (White) - over 450 ml BFR
Questions And Verified Solutions
What is the order of the urinary tract and what does each part do? Correct
Ans - Kidney - filters blood & forms urine
Ureter - transports urine to the bladder
Bladder - stores urine
Urethra - excretes urine
Why are dialysis pt's anemic? Correct Ans - Due to lack of
erythropoietin secondary to decreased kidney function.
Kidneys convert ________ to active form. Correct Ans - Vitamin D
Dialyzer Correct Ans - Semipermeable membrane (artificial kidney)
What sort of molecules are too large to pass through the dialyzer? Correct
Ans - RBC's, WBC's, protein...
Blood and dialysate go in opposite directions of each other in the dialyzer.
What type of flow is this? Correct Ans - Countercurrent flow
What process moves waste across the dialyzer? Correct Ans -
Diffusion
What 3 things is dialysate made of? Correct Ans - Acid + Bicarbonate +
RO water
What happens to RBC's in hypotonic solution? Correct Ans - RBC's
swell & burst due to fluid moving into the RBC. This process causes hemolysis.
What happens to RBC's in a hypertonic solution? Correct Ans - RBC's
dehydrate & shrink due to fluid being pulled out of the RBC. This process
causes crenation.
What is the key sign of hemolysis? Correct Ans - Bright red, cherry-
pop colored blood.
, What is the key sign of crenation? Correct Ans - Dark opaque blood.
What is adequacy? Correct Ans - How well dialysis is working to clear
waste from the blood. This is checked by drawing a BUN lab (pre & post, must
be done on the same day).
What is clearance? Correct Ans - Amount of blood completely cleared
of a solute in one minute at a given BFR & DFR. This is checked by the OLC &
KECN.
What is OLC? Correct Ans - Online clearance test. Measures sodium
across the dialyzer d/t sodium being closest in size to urea. There are two
parts to the OLC test, it tests first by raising conductivity and then second by
decreasing conductivity.
What is KECN? Correct Ans - Clearance effective by conductivity of
sodium. It's measured in ml. It's the amount of blood cleaned in 1 minute.
Higher than 40 degrees celsius of machine temperature may cause ________.
Correct Ans - Hemolysis
What should be considered when a pt's machine temperature is lower?
Correct Ans - The pt may need to run longer to maintain adequate dialysis.
What are the elements that affect dialysis clearance? Correct Ans - -
Typer of dialyzer
- Tx time
- Needle size
- BFR & DFR
- ACO
- Temperature
Needle sizes based on flow rate. Correct Ans - 17 gauge (Orange) -
250 ml to 300 ml BFR
16 gauge (Green) - 300 ml to 350 ml BFR
15 gauge (Blue) - 350 ml to 450 ml BFR
14 gauge (White) - over 450 ml BFR
