Davita RISE PCT Study Guide
. How do you document charting errors? - ANS - When documenting on paper draw a
single line through the entry, date/ signature/ teammate credentials, chart the correct
information. If documenting in an electronic health record system follow facility
procedure for that system.
A common cause of HTN in dialysis patients is: - ANS - Fluid overload
A sudden decrease in blood pressure can be an indication that the patient is losing
intravascular fluid too quickly, this can be seen with a change in blood pressure equal to
or greater than: - ANS - 20 mmHg
Acceptable result for chlorine/chloramine testing - ANS - 0.1 mg/L or less
Action if results are too high post primary tank for chlorine/chloramine testing - ANS -
Repeat the test- if still too high - move onto secondary port and test, remember to notify
biomed and FA
AKI patients are at increased risk for which complications? - ANS - Hypovolemia and
hypotension
Aluminum in water used for dialysis causes - ANS - • Anemia • Bone disease •
Nausea • Vomiting
At what time are medications containing a preservative discarded? - ANS - 28 days
(except when the manufacturer specifies differently such as Epogen MDV at 21 days)
BEST TIPS Complications and Prevention - ANS - B: Bleeding
E: Erosion
S: Stenosis
T: Thrombosis
I: Infection
P: Pseudoaneurysm/aneurysms
S: Steal syndrome
,Cardiac consequences of organ stunning - ANS - Acute stress on the cardiovascular
system, development of LV regional wall motion abnormalities (RWMAs), arrhythmias,
can lead to cardiac failure
Causes of dialysis disequilibrium syndrome - ANS - Missed treatment, rapid drop in
BUN
Causes of fever & chills - ANS - Systemic infections, access infections, contamination
of blood or dialysate compartments
Causes of muscle cramps - ANS - Rapid or excessive fluid removal, hypo-osmolality,
tissue hypoxemia/ischemia, electrolyte
disorders or imbalances: low sodium, calcium, potassium, magnesium, any local
irritating
factor or metabolic abnormality of a muscle (e.g., severe cold, lack of blood flow, over‐
exercise)
Causes of seziures - ANS - Some patients have seizures as a dialysis side effect
(severe hypotension, dialysis disequilibrium syndrome) or seizures may occur during
dialysis as an adverse reaction to a problem such as the use of improperly prepared
dialysate. Some patients may have a pre‐ existing seizure disorder.
Chlorine in water used for hemodialysis causes - ANS - Hemolysis
Clotting time - ANS - Follow requisition label
Define AKI - ANS - -Wide spectrum of kidney issues
-Includes acute renal failure & renal function changes
-May dialyze in an out-patient facility until kidney function recovers
Define dialysis disequilibrium syndrome - ANS - A condition in which rapid or drastic
changes in the patient's extracellular fluid affect the brain
Define fever & chills - ANS - Any temperature greater than 100°F (37.8°C) or increase
over baseline of 2°F (1°C) with symptoms
Define HTN - ANS - Pre-dialysis adult BP is > 140/90 Post is > 130/80
Define hypotension - ANS - Systolic BP <90 Diastolic BP < 50 or drop in systolic more
than 20 mm/hg
, Define muscle cramps - ANS - painful muscle contractions in extremities or abdomen
Define pericarditis - ANS - An inflammation of the membrane (pericardial sac) that
surrounds the heart due to fluid an waste build up
Define seizures - ANS - Involuntary muscle spasms and loss of consciousness
Definition of established AVF - ANS - Prescribed BFR and max needle size for 2
months
Definition of mature AVF - ANS - Intermediate teammate can cannulate, AVF is at
prescribed BFR matching needle gauge size
Definition of newly mature AVF - ANS - New fistula has post op surgical exam, meets
the rules of 6's, can be cannulated by NFACT trained teammates
Describe the four AVF evaluations for maturation based on the KDOQI Rule of 6's. -
ANS - • 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: advanced - ANS - Has completed all the
competencies for NFACT training, expert cannulation skills documented and can
determine if rule of 6's have been met
Describe the teammate's cannulation level: beginner - ANS - Less than 6 months
experience or less than 10 successful cannulations.
Describe the teammate's cannulation level: intermediate - ANS - 6 months experience
cannulation of AVF & 10 successful cannulations
Dialysate endotoxin testing results - ANS - • Acceptable level: <0.25 EU/ml
• Action level: 0.25 to < 0.50 EU/ml
• Unacceptable level: 0.50 EU/ml or >
Distance between needle tips: - ANS - 1.5 inches
. How do you document charting errors? - ANS - When documenting on paper draw a
single line through the entry, date/ signature/ teammate credentials, chart the correct
information. If documenting in an electronic health record system follow facility
procedure for that system.
A common cause of HTN in dialysis patients is: - ANS - Fluid overload
A sudden decrease in blood pressure can be an indication that the patient is losing
intravascular fluid too quickly, this can be seen with a change in blood pressure equal to
or greater than: - ANS - 20 mmHg
Acceptable result for chlorine/chloramine testing - ANS - 0.1 mg/L or less
Action if results are too high post primary tank for chlorine/chloramine testing - ANS -
Repeat the test- if still too high - move onto secondary port and test, remember to notify
biomed and FA
AKI patients are at increased risk for which complications? - ANS - Hypovolemia and
hypotension
Aluminum in water used for dialysis causes - ANS - • Anemia • Bone disease •
Nausea • Vomiting
At what time are medications containing a preservative discarded? - ANS - 28 days
(except when the manufacturer specifies differently such as Epogen MDV at 21 days)
BEST TIPS Complications and Prevention - ANS - B: Bleeding
E: Erosion
S: Stenosis
T: Thrombosis
I: Infection
P: Pseudoaneurysm/aneurysms
S: Steal syndrome
,Cardiac consequences of organ stunning - ANS - Acute stress on the cardiovascular
system, development of LV regional wall motion abnormalities (RWMAs), arrhythmias,
can lead to cardiac failure
Causes of dialysis disequilibrium syndrome - ANS - Missed treatment, rapid drop in
BUN
Causes of fever & chills - ANS - Systemic infections, access infections, contamination
of blood or dialysate compartments
Causes of muscle cramps - ANS - Rapid or excessive fluid removal, hypo-osmolality,
tissue hypoxemia/ischemia, electrolyte
disorders or imbalances: low sodium, calcium, potassium, magnesium, any local
irritating
factor or metabolic abnormality of a muscle (e.g., severe cold, lack of blood flow, over‐
exercise)
Causes of seziures - ANS - Some patients have seizures as a dialysis side effect
(severe hypotension, dialysis disequilibrium syndrome) or seizures may occur during
dialysis as an adverse reaction to a problem such as the use of improperly prepared
dialysate. Some patients may have a pre‐ existing seizure disorder.
Chlorine in water used for hemodialysis causes - ANS - Hemolysis
Clotting time - ANS - Follow requisition label
Define AKI - ANS - -Wide spectrum of kidney issues
-Includes acute renal failure & renal function changes
-May dialyze in an out-patient facility until kidney function recovers
Define dialysis disequilibrium syndrome - ANS - A condition in which rapid or drastic
changes in the patient's extracellular fluid affect the brain
Define fever & chills - ANS - Any temperature greater than 100°F (37.8°C) or increase
over baseline of 2°F (1°C) with symptoms
Define HTN - ANS - Pre-dialysis adult BP is > 140/90 Post is > 130/80
Define hypotension - ANS - Systolic BP <90 Diastolic BP < 50 or drop in systolic more
than 20 mm/hg
, Define muscle cramps - ANS - painful muscle contractions in extremities or abdomen
Define pericarditis - ANS - An inflammation of the membrane (pericardial sac) that
surrounds the heart due to fluid an waste build up
Define seizures - ANS - Involuntary muscle spasms and loss of consciousness
Definition of established AVF - ANS - Prescribed BFR and max needle size for 2
months
Definition of mature AVF - ANS - Intermediate teammate can cannulate, AVF is at
prescribed BFR matching needle gauge size
Definition of newly mature AVF - ANS - New fistula has post op surgical exam, meets
the rules of 6's, can be cannulated by NFACT trained teammates
Describe the four AVF evaluations for maturation based on the KDOQI Rule of 6's. -
ANS - • 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: advanced - ANS - Has completed all the
competencies for NFACT training, expert cannulation skills documented and can
determine if rule of 6's have been met
Describe the teammate's cannulation level: beginner - ANS - Less than 6 months
experience or less than 10 successful cannulations.
Describe the teammate's cannulation level: intermediate - ANS - 6 months experience
cannulation of AVF & 10 successful cannulations
Dialysate endotoxin testing results - ANS - • Acceptable level: <0.25 EU/ml
• Action level: 0.25 to < 0.50 EU/ml
• Unacceptable level: 0.50 EU/ml or >
Distance between needle tips: - ANS - 1.5 inches
