DAVITA DIALYSIS THEORY EXAM 2024

define the term AKI - acute kidney injury that incorporates a wide variety of kidney issues ranging from kidney failure to functional loss Pre-renal causes of AKI - hypovolemia (hemorrhage, dehydration, diarrhea, vomiting), decreased cardiac output (dysrhythmias, HF, MI), decreased peripheral vascular resistance (anaphylaxis, septic shock), decreased renovascular blood flow (embolism, renal artery thrombosis) Intra-renal causes of AKI - direct damage to kidneys due to Ischemic ATN - occurs when the tubular cells do not get enough oxygen, a condition that they are highly sensitive and susceptible to, due to their very high metabolism Post-renal causes of AKI - benign prostatic hyperplasia, bladder cancer, calculi formation, neuromuscular disorders, prostate cancer, spinal cord disease, strictures, trauma pre, intra and post renal AKI - AKI patients are at an increased risk for which complication? - infection Why is it important to monitor BP and weight for dialysis patients - To prevent excess fluid in the body. Blood pressure measurements taken after dialysis are a good indicator of whether we are removing enough fluid and whether your dry weight target is correct. Difference between AKI and CKD - acute kidney failure vs chronic kidney AKI is the sudden onset of functional kidney loss and a decrease in GFR. CKD is loss or decreased GFR for at least 3 months or more. Most common causes of chronic kidney disease - diabetes and hypertension CAT audit - 3rd party validation of clinical operations performance ACT scores - the tracking of risk factors in the healthcare setting over a 6 month period MeerCAT audit - self reported review of clinical operations performance What is the difference between data collection and assessment--and who does what - Nurse performs any assessments and data collection while the technicians are allowed to only data collect-- Data collection: numerical values from monitors Assessment: making a judgement based on findings Why do we document in the medical record - proof of care data continuity permanent legal record communication BP reading if cuff is too small - False high reading BP reading if cuff is too big - falsely low reading BP reading if clothing is too thick - falsely high reading BP reading if patient has peripheral vascular disease - high BP BP reading if patient has bradycardia - high arterial BP BP reading if patient has arrhythmias - Low BP what does SMART communication stand for - Simple Meaningful Actual Read Teach What are the five "W's" when completing an REM - who what when where why what are the three things you should not include in an REM - opinions, vendettas, speculation When dialyzing a patient with AKI, monitoring weight and BP is important because - hypovolemia and hypotensive episodes can cause renal ischemia and further damage What are the four consequences of sodium loading a patient - edema, thirst, weight gain and hypertension 3 ways we can contribute to sodium loading during dialysis - broth, too much sodium in dialysate, normal saline HAI'S - healthcare associated infections The innate system - white blood cells which recognize and digest harmful bacteria and virus the adaptive system - antibodies working against harmful bacteria making them immune to future attacks