Davita RISE PCT Study Guide Exam
Questions & Answers 2024/2025
List the four transport mechanisms that play a role in hemodialysis - ANSWERSUltrafiltration
Convection
Diffusion
Osmosis
Explain ultrafiltration in hemodialysis - ANSWERSFluid is pushed through the semipermeable membrane
(SPM). Think: wringing out a wet rag.
Explain convection in hemodialysis - ANSWERSSolutes DRAG across the semipermeable membrane with
fluid
Explain diffusion in hemodialysis - ANSWERSPARTICLES move from HIGH concentration to LOW
concentration
Explain osmosis in hemodialysis - ANSWERSFLUID moves LOW concentration to HIGH concentration
What are the kidneys' excretory functions? - ANSWERSTo normalize electrolytes, remove wastes, provide
fluid and nutrient balance
How do we replace normal excretory kidney functions? - ANSWERSBy using acid concentrate to help
normalize electrolytes and ultrafiltration to provide fluid balance
What is the function of acid concentrate - ANSWERSProvides the concentration gradient for diffusion and
helps normalize electrolytes
What is the function of bicarbonate in the dialysate solution? - ANSWERSIt buffers the acid concentrate
,What is the function of bicarbonate when it diffuses into the patient's blood? - ANSWERSIt normalizes
body pH
What are some S/Sx of hyperkalemia? - ANSWERSK+ > 6.5 mEq
extreme muscle weakness, dysrhythmias, and possible cardiac arrest
What are some S/Sx of hypokalemia? - ANSWERSK+ < 3.5 mEq
fatigue, muscle weakness, paralysis, resp. failure, cardiac instability, arrhythmias, cardiac arrest
What is the normal blood pH range? - ANSWERS7.35 - 7.45
What are the kidneys' endocrine functions? - ANSWERSRenin secretion
Erythropoietin secretion
Vitamin d activation
How do we replace normal endocrine kidney functions? - ANSWERSBy providing medications
How much of normal kidney function is replaced by HD? - ANSWERS15%
What is uremia? - ANSWERSUremia is a buildup of wastes in the blood due to kidney failure
What does uremia affect? - ANSWERSUremia affects all body systems
What are the most common causes of CKD in the US? - ANSWERSdiabetes, HTN and polycystic kidney
disease
List the treatment goals for a pt. w/ CKD - ANSWERS-slowing the progression of CKD
-managing comorbidities and complications
, -controlling symptoms
-minimizing the effects if CKD on pt. lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Why is it so important to know what caused your pt.'s CKD? - ANSWERSSo the RN and PCT can ask about
possible problems during data collection and assessment
List some S/Sx of fluid imbalance - ANSWERSHTN, edema, and SOB
Why is sodium balance important? - ANSWERSLeads to volume expansion,
increased cardiac output,
increased peripheral vascular resistance
and increased BP
List some systemic effects of CKD - ANSWERS-Dry, itchy skin
-Peripheral neuropathy in the extremities
-GI problems (N/V)
-Psychological problems (anxiety, depression)
What would you advise for a pt. with dry, itchy skin? - ANSWERS-use hyper-fatted soaps and lotions
-assess for safety at home
-provide emotional support
-control diabetes and phosphorus
What would you advise for a pt. with peripheral neuropathy? - ANSWERS-Monitor pt. for changes in
motor function, decreased strength in legs, C/O restless legs, and burning feet.
-Advise not to walk barefoot
-Practice good foot care
Questions & Answers 2024/2025
List the four transport mechanisms that play a role in hemodialysis - ANSWERSUltrafiltration
Convection
Diffusion
Osmosis
Explain ultrafiltration in hemodialysis - ANSWERSFluid is pushed through the semipermeable membrane
(SPM). Think: wringing out a wet rag.
Explain convection in hemodialysis - ANSWERSSolutes DRAG across the semipermeable membrane with
fluid
Explain diffusion in hemodialysis - ANSWERSPARTICLES move from HIGH concentration to LOW
concentration
Explain osmosis in hemodialysis - ANSWERSFLUID moves LOW concentration to HIGH concentration
What are the kidneys' excretory functions? - ANSWERSTo normalize electrolytes, remove wastes, provide
fluid and nutrient balance
How do we replace normal excretory kidney functions? - ANSWERSBy using acid concentrate to help
normalize electrolytes and ultrafiltration to provide fluid balance
What is the function of acid concentrate - ANSWERSProvides the concentration gradient for diffusion and
helps normalize electrolytes
What is the function of bicarbonate in the dialysate solution? - ANSWERSIt buffers the acid concentrate
,What is the function of bicarbonate when it diffuses into the patient's blood? - ANSWERSIt normalizes
body pH
What are some S/Sx of hyperkalemia? - ANSWERSK+ > 6.5 mEq
extreme muscle weakness, dysrhythmias, and possible cardiac arrest
What are some S/Sx of hypokalemia? - ANSWERSK+ < 3.5 mEq
fatigue, muscle weakness, paralysis, resp. failure, cardiac instability, arrhythmias, cardiac arrest
What is the normal blood pH range? - ANSWERS7.35 - 7.45
What are the kidneys' endocrine functions? - ANSWERSRenin secretion
Erythropoietin secretion
Vitamin d activation
How do we replace normal endocrine kidney functions? - ANSWERSBy providing medications
How much of normal kidney function is replaced by HD? - ANSWERS15%
What is uremia? - ANSWERSUremia is a buildup of wastes in the blood due to kidney failure
What does uremia affect? - ANSWERSUremia affects all body systems
What are the most common causes of CKD in the US? - ANSWERSdiabetes, HTN and polycystic kidney
disease
List the treatment goals for a pt. w/ CKD - ANSWERS-slowing the progression of CKD
-managing comorbidities and complications
, -controlling symptoms
-minimizing the effects if CKD on pt. lifestyles
-kidney replacement therapy modality education
-encouraging patients to actively participate in their healthcare
Why is it so important to know what caused your pt.'s CKD? - ANSWERSSo the RN and PCT can ask about
possible problems during data collection and assessment
List some S/Sx of fluid imbalance - ANSWERSHTN, edema, and SOB
Why is sodium balance important? - ANSWERSLeads to volume expansion,
increased cardiac output,
increased peripheral vascular resistance
and increased BP
List some systemic effects of CKD - ANSWERS-Dry, itchy skin
-Peripheral neuropathy in the extremities
-GI problems (N/V)
-Psychological problems (anxiety, depression)
What would you advise for a pt. with dry, itchy skin? - ANSWERS-use hyper-fatted soaps and lotions
-assess for safety at home
-provide emotional support
-control diabetes and phosphorus
What would you advise for a pt. with peripheral neuropathy? - ANSWERS-Monitor pt. for changes in
motor function, decreased strength in legs, C/O restless legs, and burning feet.
-Advise not to walk barefoot
-Practice good foot care
