DAVITA RISE PCT STUDY GUIDE
QUESTIONS WITH ALL CORRECT
ANSWERS
What is the preferred location for taking an accurate blood pressure? - Answer-Upper,
non-vascular access arm
What BP reading error can be caused by a cuff that's too small - Answer-Reading may
be higher than actual BP
What BP reading error can be caused by a cuff that's too big - Answer-Reading may be
lower than actual BP
What is a normal pre-treatment blood pressure? - Answer-Systolic equal to or less than
180 mm/Hg or equal to or greater than 90 mm/Hg and diastolic less than 100 mm/Hg
What is the normal heart rate range? - Answer-60-100 bpm
What is the normal respiratory range? - Answer-12-16 breaths/minute
What is a normal temperature? - Answer-Less than 100˚ Fahrenheit or 37.8˚ Celsius or
less than 2˚F (1˚C) of baseline (pre-treatment temperature reading)
The three words DaVita uses in order to easily recall the pre-treatment AVF/AVG
access evaluation are: - Answer-'Look, Listen, Feel'
When is post-treatment assessment by the licensed nurse required? - Answer-• If
required by state law
• If there were abnormal findings
What are the 6 "W"s to be used when completing a REM? - Answer-• What
• When
• Where
• Why
• Witness
• Who
What are the 3 things you should not include in a REM? - Answer-• Personal opinions
• Speculation
,• Vendettas - Remember include only the facts!!!
What is the target weight - Answer-TW is the physician prescribed weight post-dialysis
that the patient can safely and reasonably achieve TW should be modified by the
physician based on patient's tolerance, ongoing signs of fluid overload, and changes in
fluid status
What is target weight determined by? - Answer-Physician order
How must the target weight be adjusted? - Answer-Must be adjusted in a timely manner
so that the physician's most recent order is taken into account for each treatment. You
may not adjust the TW retroactively.
Interdialytic Weight Gain (IDWG)Calculation: - Answer-Pre-weight - Last post weight
UF Goal Calculation: - Answer-Pre-weight
- Target weight
+ NS prime & rinseback
+ Oral intake, infusions
= UF Goal
UFR Calculation: - Answer-UF Goal / Tx hours=UFR
The maximum ultra-filtration (UF) rate should not exceed (unless ordered by the
physician)? - Answer-13 mL/kg/hr
What are the four consequences of sodium loading during dialysis? - Answer-•
Increased thirst
• Large fluid gains
• More hypotension
• and ischemic events during treatment
State 3 ways we can contribute to sodium loading during dialysis - Answer-• Give broth
• Normal saline, hypertonic saline
• Increased sodium in dialysate (high setting in machine or sodium modeling)
What are the consequences if a patient is consistently fluid overloaded (hypervolemia)?
- Answer-LVH, increased CVP, hypertension, increased mortality, pulmonary edema,
increased hospitalization rate
What are the consequences and risks of hypovolemia/hypotension during the
treatment? - Answer-Attempting to remove large amounts of fluid can lead to
hypovolemia during tx which increases mortality, ischemia and damage to vital organs
(organ stunning) - loss of residual kidney function
, What is the difference between an AVF and an AVG? - Answer-• AVF - connection of
the patient's native artery to native vein
• AVG - uses artificial or biological material & requires 2 connections
What is the connection point called of the artery and vein for the creation of an AVF? -
Answer-Anastomosis
Describe the four AVF evaluations for maturation based on the KDOQI Rule of 6's. -
Answer-• 600 ml flow through access (on Doppler)
• 0.6 cm in depth under the skin
• 0.6 cm diameter (width of pencil eraser)
• 6-8 weeks post op maturation (some AVF will take longer- however notifying vascular
surgeon is
essential if access in not maturing)
Describe the teammate's cannulation level: beginner - Answer-Less than 6 months
experience or less than 10 successful cannulations.
Describe the teammate's cannulation level: intermediate - Answer-6 months experience
cannulation of AVF & 10 successful cannulations
Describe the teammate's cannulation level: advanced - Answer-Has completed all the
competencies for NFACT training, expert cannulation skills documented and can
determine if rule of 6's have been met
What is the difference between a tunneled and a non-tunneled CVC? - Answer-•
Tunneled CVC has a cuff that the skin grows to for anchoring to the patient - it is kept in
place longer. Sutures used at placement- but can be removed after site healed.
• Non-tunneled CVC (often referred to as temporary) are held in place by only sutures-
no cuff present
List the four transport mechanisms that play a role in hemodialysis - Answer-
Ultrafiltration
Convection
Diffusion
Osmosis
Explain ultrafiltration in hemodialysis - Answer-Fluid is pushed through the
semipermeable membrane (SPM). Think: wringing out a wet rag.
Explain convection in hemodialysis - Answer-Solutes DRAG across the semipermeable
membrane with fluid
Explain diffusion in hemodialysis - Answer-PARTICLES move from HIGH concentration
to LOW concentration
QUESTIONS WITH ALL CORRECT
ANSWERS
What is the preferred location for taking an accurate blood pressure? - Answer-Upper,
non-vascular access arm
What BP reading error can be caused by a cuff that's too small - Answer-Reading may
be higher than actual BP
What BP reading error can be caused by a cuff that's too big - Answer-Reading may be
lower than actual BP
What is a normal pre-treatment blood pressure? - Answer-Systolic equal to or less than
180 mm/Hg or equal to or greater than 90 mm/Hg and diastolic less than 100 mm/Hg
What is the normal heart rate range? - Answer-60-100 bpm
What is the normal respiratory range? - Answer-12-16 breaths/minute
What is a normal temperature? - Answer-Less than 100˚ Fahrenheit or 37.8˚ Celsius or
less than 2˚F (1˚C) of baseline (pre-treatment temperature reading)
The three words DaVita uses in order to easily recall the pre-treatment AVF/AVG
access evaluation are: - Answer-'Look, Listen, Feel'
When is post-treatment assessment by the licensed nurse required? - Answer-• If
required by state law
• If there were abnormal findings
What are the 6 "W"s to be used when completing a REM? - Answer-• What
• When
• Where
• Why
• Witness
• Who
What are the 3 things you should not include in a REM? - Answer-• Personal opinions
• Speculation
,• Vendettas - Remember include only the facts!!!
What is the target weight - Answer-TW is the physician prescribed weight post-dialysis
that the patient can safely and reasonably achieve TW should be modified by the
physician based on patient's tolerance, ongoing signs of fluid overload, and changes in
fluid status
What is target weight determined by? - Answer-Physician order
How must the target weight be adjusted? - Answer-Must be adjusted in a timely manner
so that the physician's most recent order is taken into account for each treatment. You
may not adjust the TW retroactively.
Interdialytic Weight Gain (IDWG)Calculation: - Answer-Pre-weight - Last post weight
UF Goal Calculation: - Answer-Pre-weight
- Target weight
+ NS prime & rinseback
+ Oral intake, infusions
= UF Goal
UFR Calculation: - Answer-UF Goal / Tx hours=UFR
The maximum ultra-filtration (UF) rate should not exceed (unless ordered by the
physician)? - Answer-13 mL/kg/hr
What are the four consequences of sodium loading during dialysis? - Answer-•
Increased thirst
• Large fluid gains
• More hypotension
• and ischemic events during treatment
State 3 ways we can contribute to sodium loading during dialysis - Answer-• Give broth
• Normal saline, hypertonic saline
• Increased sodium in dialysate (high setting in machine or sodium modeling)
What are the consequences if a patient is consistently fluid overloaded (hypervolemia)?
- Answer-LVH, increased CVP, hypertension, increased mortality, pulmonary edema,
increased hospitalization rate
What are the consequences and risks of hypovolemia/hypotension during the
treatment? - Answer-Attempting to remove large amounts of fluid can lead to
hypovolemia during tx which increases mortality, ischemia and damage to vital organs
(organ stunning) - loss of residual kidney function
, What is the difference between an AVF and an AVG? - Answer-• AVF - connection of
the patient's native artery to native vein
• AVG - uses artificial or biological material & requires 2 connections
What is the connection point called of the artery and vein for the creation of an AVF? -
Answer-Anastomosis
Describe the four AVF evaluations for maturation based on the KDOQI Rule of 6's. -
Answer-• 600 ml flow through access (on Doppler)
• 0.6 cm in depth under the skin
• 0.6 cm diameter (width of pencil eraser)
• 6-8 weeks post op maturation (some AVF will take longer- however notifying vascular
surgeon is
essential if access in not maturing)
Describe the teammate's cannulation level: beginner - Answer-Less than 6 months
experience or less than 10 successful cannulations.
Describe the teammate's cannulation level: intermediate - Answer-6 months experience
cannulation of AVF & 10 successful cannulations
Describe the teammate's cannulation level: advanced - Answer-Has completed all the
competencies for NFACT training, expert cannulation skills documented and can
determine if rule of 6's have been met
What is the difference between a tunneled and a non-tunneled CVC? - Answer-•
Tunneled CVC has a cuff that the skin grows to for anchoring to the patient - it is kept in
place longer. Sutures used at placement- but can be removed after site healed.
• Non-tunneled CVC (often referred to as temporary) are held in place by only sutures-
no cuff present
List the four transport mechanisms that play a role in hemodialysis - Answer-
Ultrafiltration
Convection
Diffusion
Osmosis
Explain ultrafiltration in hemodialysis - Answer-Fluid is pushed through the
semipermeable membrane (SPM). Think: wringing out a wet rag.
Explain convection in hemodialysis - Answer-Solutes DRAG across the semipermeable
membrane with fluid
Explain diffusion in hemodialysis - Answer-PARTICLES move from HIGH concentration
to LOW concentration
