Davita RISE PCT Study Guide 2025
Latest Questions and simplified correct
Answers
List the four transport mechanisms that play a role in hemodialysis - correct answer-Ultrafiltration
Convection
Diffusion
Osmosis
Explain ultrafiltration in hemodialysis - correct answer-Fluid is pushed through the semipermeable
membrane (SPM). Think: wringing out a wet rag.
Explain convection in hemodialysis - correct answer-Solutes DRAG across the semipermeable membrane
with fluid
Explain diffusion in hemodialysis - correct answer-PARTICLES move from HIGH concentration to LOW
concentration
Explain osmosis in hemodialysis - correct answer-FLUID moves LOW concentration to HIGH concentration
What are the kidneys' excretory functions? - correct answer-To normalize electrolytes, remove wastes,
provide fluid and nutrient balance
How do we replace normal excretory kidney functions? - correct answer-By using acid concentrate to
help normalize electrolytes and ultrafiltration to provide fluid balance
What is the function of acid concentrate - correct answer-Provides the concentration gradient for
diffusion and helps normalize electrolytes
What is the function of bicarbonate in the dialysate solution? - correct answer-It buffers the acid
concentrate
What is the function of bicarbonate when it diffuses into the patient's blood? - correct answer-It
normalizes body pH
What are some S/Sx of hyperkalemia? - correct answer-K+ > 6.5 mEq
extreme muscle weakness, dysrhythmias, and possible cardiac arrest
What are some S/Sx of hypokalemia? - correct answer-K+ < 3.5 mEq
fatigue, muscle weakness, paralysis, resp. failure, cardiac instability, arrhythmias, cardiac arrest
What is the normal blood pH range? - correct answer-7.35 - 7.45
What are the kidneys' endocrine functions? - correct answer-Renin secretion
Erythropoietin secretion
Vitamin d activation
How do we replace normal endocrine kidney functions? - correct answer-By providing medications
How much of normal kidney function is replaced by HD? - correct answer-15%
What is uremia? - correct answer-Uremia is a buildup of wastes in the blood due to kidney failure
What does uremia affect? - correct answer-Uremia affects all body systems
What are the most common causes of CKD in the US? - correct answer-diabetes, HTN and polycystic
kidney disease
List the treatment goals for a pt. w/ CKD - correct answer--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? - correct answer-So the RN and PCT can ask
about possible problems during data collection and assessment
List some S/Sx of fluid imbalance - correct answer-HTN, edema, and SOB
Why is sodium balance important? - correct answer-Leads to volume expansion,
increased cardiac output,
increased peripheral vascular resistance
and increased BP
List some systemic effects of CKD - correct answer--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? - correct answer--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? - correct answer--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
What would you advise for a pt. with GI problems? - correct answer--inform RN and MD of any bleeding
problems, constipation, diarrhea
- inform RN and MD of ER visits
-Take meds as ordered (stool softeners, immodium, etc.)
What would you advise for a pt. with psychological problems? - correct answer-Verbalize struggles to IDT
(core team), especially the social worker
A common cause of HTN in dialysis patients is: - correct answer-Fluid overload
What does HTN lead to? - correct answer-Left ventricular hypertrophy
Left ventricular hypertrophy leads to: - correct answer-Ischemic heart disease, arrhythmia, myocardial
infarction, and sudden death.
Define pericarditis - correct answer-An inflammation of the membrane (pericardial sac) that surrounds
the heart due to fluid an waste build up
What is the Tx for pericarditis? - correct answer-Decrease or stop heparin and give more frequent dialysis
Why are dialysis patients anemic? - correct answer-The lifespan of their red blood cell is 60 days, 1/2 of
the normal 120 days.
What is the primary cause of anemia in dialysis patients? - correct answer-Lack of the hormone
erythropoietin (EPO)
What are secondary causes of anemia in dialysis patients? - correct answer--Inadequate iron stores,
-inadequate dialysis,
-malnutrition,
-blood loss during Tx
How can you prevent contributing to lower hemoglobin and blood loss in dialysis patients? - correct
answer--Verify epogen dose is correct and administered
-Rinse back until venous line is pink tinged
-Avoid repeat lab draws
What are the four key elements contributing to CKD-Mineral Bone Disorder (MBD) - correct answer--
Calcium
-Phosphorus
-PTH
Latest Questions and simplified correct
Answers
List the four transport mechanisms that play a role in hemodialysis - correct answer-Ultrafiltration
Convection
Diffusion
Osmosis
Explain ultrafiltration in hemodialysis - correct answer-Fluid is pushed through the semipermeable
membrane (SPM). Think: wringing out a wet rag.
Explain convection in hemodialysis - correct answer-Solutes DRAG across the semipermeable membrane
with fluid
Explain diffusion in hemodialysis - correct answer-PARTICLES move from HIGH concentration to LOW
concentration
Explain osmosis in hemodialysis - correct answer-FLUID moves LOW concentration to HIGH concentration
What are the kidneys' excretory functions? - correct answer-To normalize electrolytes, remove wastes,
provide fluid and nutrient balance
How do we replace normal excretory kidney functions? - correct answer-By using acid concentrate to
help normalize electrolytes and ultrafiltration to provide fluid balance
What is the function of acid concentrate - correct answer-Provides the concentration gradient for
diffusion and helps normalize electrolytes
What is the function of bicarbonate in the dialysate solution? - correct answer-It buffers the acid
concentrate
What is the function of bicarbonate when it diffuses into the patient's blood? - correct answer-It
normalizes body pH
What are some S/Sx of hyperkalemia? - correct answer-K+ > 6.5 mEq
extreme muscle weakness, dysrhythmias, and possible cardiac arrest
What are some S/Sx of hypokalemia? - correct answer-K+ < 3.5 mEq
fatigue, muscle weakness, paralysis, resp. failure, cardiac instability, arrhythmias, cardiac arrest
What is the normal blood pH range? - correct answer-7.35 - 7.45
What are the kidneys' endocrine functions? - correct answer-Renin secretion
Erythropoietin secretion
Vitamin d activation
How do we replace normal endocrine kidney functions? - correct answer-By providing medications
How much of normal kidney function is replaced by HD? - correct answer-15%
What is uremia? - correct answer-Uremia is a buildup of wastes in the blood due to kidney failure
What does uremia affect? - correct answer-Uremia affects all body systems
What are the most common causes of CKD in the US? - correct answer-diabetes, HTN and polycystic
kidney disease
List the treatment goals for a pt. w/ CKD - correct answer--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? - correct answer-So the RN and PCT can ask
about possible problems during data collection and assessment
List some S/Sx of fluid imbalance - correct answer-HTN, edema, and SOB
Why is sodium balance important? - correct answer-Leads to volume expansion,
increased cardiac output,
increased peripheral vascular resistance
and increased BP
List some systemic effects of CKD - correct answer--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? - correct answer--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? - correct answer--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
What would you advise for a pt. with GI problems? - correct answer--inform RN and MD of any bleeding
problems, constipation, diarrhea
- inform RN and MD of ER visits
-Take meds as ordered (stool softeners, immodium, etc.)
What would you advise for a pt. with psychological problems? - correct answer-Verbalize struggles to IDT
(core team), especially the social worker
A common cause of HTN in dialysis patients is: - correct answer-Fluid overload
What does HTN lead to? - correct answer-Left ventricular hypertrophy
Left ventricular hypertrophy leads to: - correct answer-Ischemic heart disease, arrhythmia, myocardial
infarction, and sudden death.
Define pericarditis - correct answer-An inflammation of the membrane (pericardial sac) that surrounds
the heart due to fluid an waste build up
What is the Tx for pericarditis? - correct answer-Decrease or stop heparin and give more frequent dialysis
Why are dialysis patients anemic? - correct answer-The lifespan of their red blood cell is 60 days, 1/2 of
the normal 120 days.
What is the primary cause of anemia in dialysis patients? - correct answer-Lack of the hormone
erythropoietin (EPO)
What are secondary causes of anemia in dialysis patients? - correct answer--Inadequate iron stores,
-inadequate dialysis,
-malnutrition,
-blood loss during Tx
How can you prevent contributing to lower hemoglobin and blood loss in dialysis patients? - correct
answer--Verify epogen dose is correct and administered
-Rinse back until venous line is pink tinged
-Avoid repeat lab draws
What are the four key elements contributing to CKD-Mineral Bone Disorder (MBD) - correct answer--
Calcium
-Phosphorus
-PTH
