Fresenius Nurse Final Exam Part 2 – Q&A
What must be evaluated and documented pre-tx? Correct Ans -
Ambulation status, mental status, pre-weight, bp sitting and standing if patient
is able, temperature, heart rate and rhythm, respirations, edema, GI status,
skin color, access evaluation, hospitalizations since last tx, any new
complaints or life changes
What must be evaluated and documented during tx? Correct Ans -
Current time of evaluation, bp, BFR, DFR, safety checks, arterial/venous
pressures, fluid removed/administered, access check-hemosafe device
attached, patient's overall status, interventions, changes in dialysis
presecription
What must be evaluated and documented post-tx? Correct Ans -
Ambulation status, mental status, changes in condition, post weight, bp sitting
and standing, temperature, heart rate and rhythm, respirations, edema, new
complaints, evaluation of access including presence of thrill, condition of
dressing
Recommended body temperature range Correct Ans - 96.4-98.9
What is the recommended interdialytic weight gain? Correct Ans -
1.5-2.0 kg/day
Signs and symptoms that EDW is too low (Too much fluid is being removed):
Correct Ans - Dizziness, nausea, vomiting, hypotension, cramps, fatigue
that sometimes persist until the next tx
Signs and symptoms that EDW is too high (Not enough fluid is being
removed): Correct Ans - Htn, headaches, SOB, edema, distended neck
veins
What is AW and how is it calculated? Correct Ans - In the weight loss
plan, AW means "available weight", this is calculated by subtracting the EDW
from the patient's pre-tx weight
, What makes up the goal for fluid removal? Correct Ans - The AW
(available weight), priming and rinseback saline, and any other fluid the
patient will receive during the tx (oral fluids, saline rinses, packed cells, IDPN,
IVPB medications etc. )
____________ is the measurement of how well we are cleaning wastes from our
patients' blood Correct Ans - Adequacy of Dialysis
How can we measure how well we clean our patients' blood? Correct Ans
- By measuring the amount of wastes in the patient's blood before and after
dialysis, we can calculate the amount of clearance we achieve.
The following interventions improve the clearance of urea during
hemodialysis:
1.Well functioning ___________
2.Proper ____ of the circuit
3.Optimal _________ (autoflow <1.5 or 2 as ordered> and ________ flow
4.Larger _______ and _______
5.Ensuring needle tips are at _______ inches aprt
6. longer _______ Correct Ans - 1. access
2. priming
3. dialysate & blood
4. dialyzer membrane and needle gauges
5. 1.5 to 2 inches
6. tx times
What are 2 consequences of improperly primed dialyzer? Correct Ans -
1. When the # of fibers available to affect clearance is greatly reduced, the
result is a less effective tx for the patient.
2. Clotted fibers/ dialyzer will also result in a certain amount of blood loss for
the patient, resulting in a potential for reduced hgb level.
What is considered the best method currently available for determining tx
effectiveness and is mandatory in all FMC clinics? Correct Ans - UKM
(Urea Kinetic Modeling)
In addition to UKM, these are two other methods of determining adequacy.
Correct Ans - kt/V and URR
What must be evaluated and documented pre-tx? Correct Ans -
Ambulation status, mental status, pre-weight, bp sitting and standing if patient
is able, temperature, heart rate and rhythm, respirations, edema, GI status,
skin color, access evaluation, hospitalizations since last tx, any new
complaints or life changes
What must be evaluated and documented during tx? Correct Ans -
Current time of evaluation, bp, BFR, DFR, safety checks, arterial/venous
pressures, fluid removed/administered, access check-hemosafe device
attached, patient's overall status, interventions, changes in dialysis
presecription
What must be evaluated and documented post-tx? Correct Ans -
Ambulation status, mental status, changes in condition, post weight, bp sitting
and standing, temperature, heart rate and rhythm, respirations, edema, new
complaints, evaluation of access including presence of thrill, condition of
dressing
Recommended body temperature range Correct Ans - 96.4-98.9
What is the recommended interdialytic weight gain? Correct Ans -
1.5-2.0 kg/day
Signs and symptoms that EDW is too low (Too much fluid is being removed):
Correct Ans - Dizziness, nausea, vomiting, hypotension, cramps, fatigue
that sometimes persist until the next tx
Signs and symptoms that EDW is too high (Not enough fluid is being
removed): Correct Ans - Htn, headaches, SOB, edema, distended neck
veins
What is AW and how is it calculated? Correct Ans - In the weight loss
plan, AW means "available weight", this is calculated by subtracting the EDW
from the patient's pre-tx weight
, What makes up the goal for fluid removal? Correct Ans - The AW
(available weight), priming and rinseback saline, and any other fluid the
patient will receive during the tx (oral fluids, saline rinses, packed cells, IDPN,
IVPB medications etc. )
____________ is the measurement of how well we are cleaning wastes from our
patients' blood Correct Ans - Adequacy of Dialysis
How can we measure how well we clean our patients' blood? Correct Ans
- By measuring the amount of wastes in the patient's blood before and after
dialysis, we can calculate the amount of clearance we achieve.
The following interventions improve the clearance of urea during
hemodialysis:
1.Well functioning ___________
2.Proper ____ of the circuit
3.Optimal _________ (autoflow <1.5 or 2 as ordered> and ________ flow
4.Larger _______ and _______
5.Ensuring needle tips are at _______ inches aprt
6. longer _______ Correct Ans - 1. access
2. priming
3. dialysate & blood
4. dialyzer membrane and needle gauges
5. 1.5 to 2 inches
6. tx times
What are 2 consequences of improperly primed dialyzer? Correct Ans -
1. When the # of fibers available to affect clearance is greatly reduced, the
result is a less effective tx for the patient.
2. Clotted fibers/ dialyzer will also result in a certain amount of blood loss for
the patient, resulting in a potential for reduced hgb level.
What is considered the best method currently available for determining tx
effectiveness and is mandatory in all FMC clinics? Correct Ans - UKM
(Urea Kinetic Modeling)
In addition to UKM, these are two other methods of determining adequacy.
Correct Ans - kt/V and URR
