Renal Exam 2 – RRT Questions with 100%
Correct Answers Verified
3 types of vascular access for hemodialysis
Arteriovenous fistula, arteriovenous graft, venous catheters
Arteriovenous fistula
Surgical connection between artery and vein, ideal, heals quickly
Arteriovenous graft
Synthetic connection between artery and vein
Venous cathters
Inserted into veins, temporary, emergency situations
What risk do all types of vascular access have
Infection
When should you plan for dialysis
GFR below 30 (stage 4)
When is dialysis usually initiated
GFR below 15 (Stage 5)
HD diffusion
Passive movement of solute across semipermeable membrane, removes small electrolytes and can
add solutes to blood
HD ultrafiltration
Movement of solvent across a membrane with a pressure gradient, removes water and large solutes
(urea, drugs)
Hypotension definition
Sudden drop in SBP over 30 or SBP under 90
What causes hypotension in HD
Fluid removal from bloodstream, taking HTN meds before HF
Hypotension treatment
NS bolus, tilt head below feet
Hypotension prevention
Midrodrine 30 minutes before HD, hold HTN meds until after HD
, What causes muscle cramps in HD
Removal of too much fluid, decreased perfusion of muscles
Muscle cramps treatment
NS, hypertonic saline, dextrose 50%
Muscle cramps prevention (non-pharm)
Decrease rate, stretching
Muscle cramps prevention (pharm)
Vitamin E 400 units QHS, 2nd line quinine 324mg QD
What type of access is thrombosis most common with
Venous catheters
Thrombosis treatment
1st line: NS flush
2nd line: thrombolytic
Thrombosis prevention
Heparin locks
Which access is most likely to get infected
Venous catheters
Which bacteria likely infect HD access
Staph aureus (including MRSA) and staphepidermidis
HD - who is empiric G+ therapy indicated for
Everyone with infection
HD - who is empiric G- therapy indicated for
DM, HIV, prosthetic heart valves, receiving immunosuppression
Tunneled venous catheters without drainage treatment
Topical mupirocin
Tunneled venous catheters with drainage treatment
Cefazolin or IV vancomycin
Tunneled venous catheter asymptomatic bacteremia treatment
Cefazolin or vancomycin (MRSA) for 6 weeks
Correct Answers Verified
3 types of vascular access for hemodialysis
Arteriovenous fistula, arteriovenous graft, venous catheters
Arteriovenous fistula
Surgical connection between artery and vein, ideal, heals quickly
Arteriovenous graft
Synthetic connection between artery and vein
Venous cathters
Inserted into veins, temporary, emergency situations
What risk do all types of vascular access have
Infection
When should you plan for dialysis
GFR below 30 (stage 4)
When is dialysis usually initiated
GFR below 15 (Stage 5)
HD diffusion
Passive movement of solute across semipermeable membrane, removes small electrolytes and can
add solutes to blood
HD ultrafiltration
Movement of solvent across a membrane with a pressure gradient, removes water and large solutes
(urea, drugs)
Hypotension definition
Sudden drop in SBP over 30 or SBP under 90
What causes hypotension in HD
Fluid removal from bloodstream, taking HTN meds before HF
Hypotension treatment
NS bolus, tilt head below feet
Hypotension prevention
Midrodrine 30 minutes before HD, hold HTN meds until after HD
, What causes muscle cramps in HD
Removal of too much fluid, decreased perfusion of muscles
Muscle cramps treatment
NS, hypertonic saline, dextrose 50%
Muscle cramps prevention (non-pharm)
Decrease rate, stretching
Muscle cramps prevention (pharm)
Vitamin E 400 units QHS, 2nd line quinine 324mg QD
What type of access is thrombosis most common with
Venous catheters
Thrombosis treatment
1st line: NS flush
2nd line: thrombolytic
Thrombosis prevention
Heparin locks
Which access is most likely to get infected
Venous catheters
Which bacteria likely infect HD access
Staph aureus (including MRSA) and staphepidermidis
HD - who is empiric G+ therapy indicated for
Everyone with infection
HD - who is empiric G- therapy indicated for
DM, HIV, prosthetic heart valves, receiving immunosuppression
Tunneled venous catheters without drainage treatment
Topical mupirocin
Tunneled venous catheters with drainage treatment
Cefazolin or IV vancomycin
Tunneled venous catheter asymptomatic bacteremia treatment
Cefazolin or vancomycin (MRSA) for 6 weeks
