FRESENIUS NEW HIRE, EXAM QUESTIONS AND
ANSWERS 100% CORRECT. Buy Quality Materials!
Role of RN
-oversee and assess the patient and the patient's treatment
-develop and implement the patient's plan of care
-direct interventions
-provide initial patient education
Role of LPN/LVN
-evaluate and monitor patients
-complete interventions as delegated by the RN
-reinforce education provided by the RN
Role of PCT
-evaluate patients, prepare for, initiate, monitor, and terminate treatments
-reinforce nursing education
Role of Physician
-direct all patient care
-prescribe changes to the dialysis treatment orders: dialysate bath, dialyzer size,
treatment time, BFR/DFR based on patient laboratory values, vital signs, physical
assessment, and patient complaints
Flow of Urine Anatomy and Physiology
kidneys --> ureters --> bladder (stored) --> urethra
Functions of the Kidney "A WET BED"
A - acid/base balance
W - water or fluid balance
E - electrolyte balance
T - toxin or waste product removal
B - blood pressure regulation
E - erythropoietin production
D - vitamin D metabolism
Acute Renal Failure
-sudden onset
-severe
-usually reversible
-examples of causes: drug toxicity, trauma, dehydration, infection
Chronic Renal Failure
-slow onset
-progressive
-permanent
-examples of causes: diabetes (most common), hypertension (second most common),
glomerulonephritis, congenital diseases
Symptoms of Renal Failure or Uremia
,-Lethargy
-Weakness
-Fatigue
-Headache
-Itching
-Nausea
-Loss of Appetite
-Restlessness
-Mental status changes
Uremia
A set of symptoms associated with the build up of urea in the blood
Signs of Renal Failure
-Yellow-gray appearance of Skin
-Nerve Damage
-Fluid Overload
Signs of Fluid Volume Overload
-Shortness of Breath
-Edema (Swelling)
-Hypertension
Elevated Serum Levels Associated with Renal Failure
-BUN/Creatinine
-Phosphorus
-Potassium
-Proteinuria (protein in the urine)
Which electrolyte imbalance may result in cardiac complications?
Potassium (K)
Decreased Serum Levels Associated with Renal Failure
-Anemia: low hemoglobin
Treatment Options for Renal Failure
-hemodialysis
-peritoneal dialysis
-kidney transplant
Hemodialysis
Uses vascular access to withdraw blood from the patient, which is sent to the dialyzer
for waste removal via diffusion through the semipermeable membrane and fluid removal
via ultrafiltration
Peritoneal Dialysis
-Uses a permanently placed catheter in the peritoneal cavity within the abdomen
-The peritoneal membrane, which surrounds the organs in the abdomen acts as a
semipermeable membrane
-Through osmosis and diffusion, excess fluid and waste products are removed
Continuous Cycling Peritoneal Dialysis (CCPD)
Uses a machine to assist with the infusion and drainage of dialysate
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Dialysate is infused into the peritoneal space, allowed to dwell for the time ordered by
the physician, and then drained
, Transplant
A working kidney from a living or cadaveric donor is surgically implanted
Diffusion
-Movement of solutes or particles across a semipermeable membrane from an area of
higher concentration to an area of lower concentration
What is the semipermeable membrane is hemodialysis vs peritoneal dialysis
across which particles travel during dialysis?
-Hemodialysis uses a dialyzer
-Peritoneal dialysis uses the peritoneal membrane
What are the solutes/particles that diffuse during dialysis?
-Urea
-Electrolytes
-Creatine
-Drugs
Osmosis
Movement of fluid from an area of lower concentration of solutes or particles to an area
of higher concentration
Ultrafilatration
Uses both negative and positive pressure to remove excess fluid
What are the four categories where fluid can be in the body?
-Intracellular: in the cell
-Extracellular: outside the cells (in excess appears as edema)
-Interstitial: between cells
-Intravascular: inside the blood vessels
Where is the fluid removed from during hemodialysis?
Intravascular space (blood)
Vascular Refill
During and after the dialysis treatment, fluid shifts from other compartments back into
the intravascular space.
What can occur if fluid is removed faster than vascular refill can occur or if too
much fluid is removed?
-hypotension
-muscle cramps
Signs and symptoms that the EDW is too high (not enough fluid removed)
-hypertension
-headaches
-shortness of breath
-crackles in lung bases
-edema
-distended neck veins
Signs and symptoms that the EDW is too low (too much fluid being removed)
-dizziness
-nausea
-vomiting
-hypotension
ANSWERS 100% CORRECT. Buy Quality Materials!
Role of RN
-oversee and assess the patient and the patient's treatment
-develop and implement the patient's plan of care
-direct interventions
-provide initial patient education
Role of LPN/LVN
-evaluate and monitor patients
-complete interventions as delegated by the RN
-reinforce education provided by the RN
Role of PCT
-evaluate patients, prepare for, initiate, monitor, and terminate treatments
-reinforce nursing education
Role of Physician
-direct all patient care
-prescribe changes to the dialysis treatment orders: dialysate bath, dialyzer size,
treatment time, BFR/DFR based on patient laboratory values, vital signs, physical
assessment, and patient complaints
Flow of Urine Anatomy and Physiology
kidneys --> ureters --> bladder (stored) --> urethra
Functions of the Kidney "A WET BED"
A - acid/base balance
W - water or fluid balance
E - electrolyte balance
T - toxin or waste product removal
B - blood pressure regulation
E - erythropoietin production
D - vitamin D metabolism
Acute Renal Failure
-sudden onset
-severe
-usually reversible
-examples of causes: drug toxicity, trauma, dehydration, infection
Chronic Renal Failure
-slow onset
-progressive
-permanent
-examples of causes: diabetes (most common), hypertension (second most common),
glomerulonephritis, congenital diseases
Symptoms of Renal Failure or Uremia
,-Lethargy
-Weakness
-Fatigue
-Headache
-Itching
-Nausea
-Loss of Appetite
-Restlessness
-Mental status changes
Uremia
A set of symptoms associated with the build up of urea in the blood
Signs of Renal Failure
-Yellow-gray appearance of Skin
-Nerve Damage
-Fluid Overload
Signs of Fluid Volume Overload
-Shortness of Breath
-Edema (Swelling)
-Hypertension
Elevated Serum Levels Associated with Renal Failure
-BUN/Creatinine
-Phosphorus
-Potassium
-Proteinuria (protein in the urine)
Which electrolyte imbalance may result in cardiac complications?
Potassium (K)
Decreased Serum Levels Associated with Renal Failure
-Anemia: low hemoglobin
Treatment Options for Renal Failure
-hemodialysis
-peritoneal dialysis
-kidney transplant
Hemodialysis
Uses vascular access to withdraw blood from the patient, which is sent to the dialyzer
for waste removal via diffusion through the semipermeable membrane and fluid removal
via ultrafiltration
Peritoneal Dialysis
-Uses a permanently placed catheter in the peritoneal cavity within the abdomen
-The peritoneal membrane, which surrounds the organs in the abdomen acts as a
semipermeable membrane
-Through osmosis and diffusion, excess fluid and waste products are removed
Continuous Cycling Peritoneal Dialysis (CCPD)
Uses a machine to assist with the infusion and drainage of dialysate
Continuous Ambulatory Peritoneal Dialysis (CAPD)
Dialysate is infused into the peritoneal space, allowed to dwell for the time ordered by
the physician, and then drained
, Transplant
A working kidney from a living or cadaveric donor is surgically implanted
Diffusion
-Movement of solutes or particles across a semipermeable membrane from an area of
higher concentration to an area of lower concentration
What is the semipermeable membrane is hemodialysis vs peritoneal dialysis
across which particles travel during dialysis?
-Hemodialysis uses a dialyzer
-Peritoneal dialysis uses the peritoneal membrane
What are the solutes/particles that diffuse during dialysis?
-Urea
-Electrolytes
-Creatine
-Drugs
Osmosis
Movement of fluid from an area of lower concentration of solutes or particles to an area
of higher concentration
Ultrafilatration
Uses both negative and positive pressure to remove excess fluid
What are the four categories where fluid can be in the body?
-Intracellular: in the cell
-Extracellular: outside the cells (in excess appears as edema)
-Interstitial: between cells
-Intravascular: inside the blood vessels
Where is the fluid removed from during hemodialysis?
Intravascular space (blood)
Vascular Refill
During and after the dialysis treatment, fluid shifts from other compartments back into
the intravascular space.
What can occur if fluid is removed faster than vascular refill can occur or if too
much fluid is removed?
-hypotension
-muscle cramps
Signs and symptoms that the EDW is too high (not enough fluid removed)
-hypertension
-headaches
-shortness of breath
-crackles in lung bases
-edema
-distended neck veins
Signs and symptoms that the EDW is too low (too much fluid being removed)
-dizziness
-nausea
-vomiting
-hypotension
