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Davita Final Exam 1

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Davita Final Exam 1 What complication would you expect to see if a patient is exposed to chlorine/chloramines? - answer Hemolysis You are performing the first chlorine/chloramine testing of the day after the RO has been running for 10 minutes. Performing thetest at this time - answer Could result in a false negative test At what time do you perform water hardness testing? - answer At the end of each treatment day What is your immediate response to a final water quality alarm on the treatment floor? - answer Place all machines into bypass Benifits of peritoneal dialysis and home hemodialysis? - answer Home based Flexible schedule Fewer diatary restrictions The two types of peritoneal dialysis are - answer CAPD and CCPD Procedure when useing hemostatic sponges such as SureSeal? - answer Remove the hemostatic sponge after hemostasis has been acheived and dress needle site w bandaid or gauze - answer Two weeks Why should a pt be in a comfortable supine position when performing Pre dialysis CVC care? - answer The supine position increases pressure with in central veins and diminishes the risk of an air embolism Flipping the arterial vascular access needle - answer Is not necessary since all arterial needles now have a back eye A new AVF has received his post op exam and meets KDOQIs rule of 6s which NFACT cannulator would the AVF - answer Advanced cannulater AV graft and hear whistling sound could be indicative of - answer An outflow stenosis KDOQI rule of 6s - answer Provides guidelines for use of new AV fistula To prevent the formation of aneurysms in pseudo aneurysm the following should be practice - answer Good needle site rotation in complete needle site clotting techniques During cannulation of all AV fistula's - answer A tourniquet is to be applied to increase vein engorgement and stabilize vessel What is an important action prior to returning a patient's blood using the hand crank in the event of a power failure - answer Remove the venous line from the line clamp What problems will cause a more negative (high-pressure alarm) pre-pump arterial pressure - answer Kinking of the arterial blood line between the vascular access in the arterial monitor What problems will cause an increase in venous pressure - answer Clotting of the Venus drip chamber Which statement is true regarding the "reason of prudent" standard of care - answer When supervising patient care technicians and other non-licensed personnel it is the responsibility of the license nurse to ensure these teammates also meet the standard of care Performing a procedure "your way" rather than following to daVitas policy and procedures - answer Can lead to civil liability in the event of an adverse patient outcome A surveyor ask you a question which of the following statements would be a good answer? - answer I do not know the answer but I will find out A surveyor discovers that the chlorine checks have not been done correctly what kind of deficiency would the surveyor give the facility? - answer Immediate jeopardy When comparing the dialysis machines conductivity reading to your manual reading policy states that the difference between these two readings is to be - answer No greater than +/- 0.4 Why do we measure the pH of the dialysis solution? - answer To verify it's acid base balance is within the acceptable range What complication occurs if blood is exposed to dialysate that is too hot? - answer Hemolysis The waiting time after administration of the initial heparin loading dose prior to initiation of hemodialysis is - answer 3-5 mins In optimal nutrition status is evidenced by - answer A stable desirable target weight ,adequate fat stores and muscle mass ,appropriate appetite and intake, and a serum albumin of equal to or greater than 4gm/dl Phosphate binders are prescribed to prevent phosphorus and meals from being absorbed. when is the best time to take them? - answer With a meal Your patient pulls out her snack during dialysis as she savers the first bite of her banana she smiles and tells you she always wants to eat foods high in potassium during dialysis so it won't harm her what is your appropriate response? - answer Explain to the patient that the potassium and food eaten during dialysis is not dialyzed off Definition of health literacy - answer The degree to which individuals understand basic health information Educational tips for auditory learners - answer Using word associations and mnemonic Educational tips for kinesthetic learner's include - answer Taking short breaks and allowing your patient to get up and walk around Educational tips for visual learners include - answer Selecting quiet surroundings The sign that Numbing has taken effect and it is time to stop spraying topical anesthetic onto a vascular access cannulation sites is - answer Blanching on the skin Unless otherwise directed by the manufacture or state specific pharmacy regulations when must medications containing a preservative be discarded - answer 28days after opening Diffusion is defined as - answer Particles move from an area of higher solute concentration to an area of lower solute concentration Osmosis is defined as - answer Fluid moves from an area of lower solute concentration to an area of higher solute concentration Hemodialysis helps normalize body pH through - answer Diffusion of bio carbonate from the dialysate into the blood The endocrine function of the kidney are - answer Renin and erythropoietin secretion ,activation of vitamin D The excretory function of the kidney is - answer To normalize electrolytes

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Davita Final Exam 1


What complication would you expect to see if a patient is exposed to chlorine/chloramines? - answer
Hemolysis

You are performing the first chlorine/chloramine testing of the day after the RO has been running for 10
minutes. Performing thetest at this time - answer Could result in a false negative test

At what time do you perform water hardness testing? - answer At the end of each treatment day

What is your immediate response to a final water quality alarm on the treatment floor? - answer Place all
machines into bypass

Benifits of peritoneal dialysis and home hemodialysis? - answer Home based

Flexible schedule

Fewer diatary restrictions

The two types of peritoneal dialysis are - answer CAPD and CCPD

Procedure when useing hemostatic sponges such as SureSeal? - answer Remove the hemostatic sponge
after hemostasis has been acheived and dress needle site w bandaid or gauze

- answer Two weeks

Why should a pt be in a comfortable supine position when performing Pre dialysis CVC care? - answer The
supine position increases pressure with in central veins and diminishes the risk of an air embolism

Flipping the arterial vascular access needle - answer Is not necessary since all arterial needles now have a
back eye

A new AVF has received his post op exam and meets KDOQIs rule of 6s which NFACT cannulator would the
AVF - answer Advanced cannulater

AV graft and hear whistling sound could be indicative of - answer An outflow stenosis

KDOQI rule of 6s - answer Provides guidelines for use of new AV fistula

To prevent the formation of aneurysms in pseudo aneurysm the following should be practice - answer Good
needle site rotation in complete needle site clotting techniques

During cannulation of all AV fistula's - answer A tourniquet is to be applied to increase vein engorgement
and stabilize vessel

What is an important action prior to returning a patient's blood using the hand crank in the event of a power
failure - answer Remove the venous line from the line clamp

What problems will cause a more negative (high-pressure alarm) pre-pump arterial pressure - answer
Kinking of the arterial blood line between the vascular access in the arterial monitor

What problems will cause an increase in venous pressure - answer Clotting of the Venus drip chamber

Which statement is true regarding the "reason of prudent" standard of care - answer When supervising
patient care technicians and other non-licensed personnel it is the responsibility of the license nurse to
ensure these teammates also meet the standard of care

,Performing a procedure "your way" rather than following to daVitas policy and procedures - answer Can
lead to civil liability in the event of an adverse patient outcome

A surveyor ask you a question which of the following statements would be a good answer? - answer I do not
know the answer but I will find out

A surveyor discovers that the chlorine checks have not been done correctly what kind of deficiency would
the surveyor give the facility? - answer Immediate jeopardy

When comparing the dialysis machines conductivity reading to your manual reading policy states that the
difference between these two readings is to be - answer No greater than +/- 0.4

Why do we measure the pH of the dialysis solution? - answer To verify it's acid base balance is within the
acceptable range

What complication occurs if blood is exposed to dialysate that is too hot? - answer Hemolysis

The waiting time after administration of the initial heparin loading dose prior to initiation of hemodialysis is -
answer 3-5 mins

In optimal nutrition status is evidenced by - answer A stable desirable target weight ,adequate fat stores and
muscle mass ,appropriate appetite and intake, and a serum albumin of equal to or greater than 4gm/dl

Phosphate binders are prescribed to prevent phosphorus and meals from being absorbed.

when is the best time to take them? - answer With a meal

Your patient pulls out her snack during dialysis as she savers the first bite of her banana she smiles and tells
you she always wants to eat foods high in potassium during dialysis so it won't harm her what is your
appropriate response? - answer Explain to the patient that the potassium and food eaten during dialysis is
not dialyzed off

Definition of health literacy - answer The degree to which individuals understand basic health information

Educational tips for auditory learners - answer Using word associations and mnemonic

Educational tips for kinesthetic learner's include - answer Taking short breaks and allowing your patient to
get up and walk around

Educational tips for visual learners include - answer Selecting quiet surroundings

The sign that Numbing has taken effect and it is time to stop spraying topical anesthetic onto a vascular
access cannulation sites is - answer Blanching on the skin

Unless otherwise directed by the manufacture or state specific pharmacy regulations when must medications
containing a preservative be discarded - answer 28days after opening

Diffusion is defined as - answer Particles move from an area of higher solute concentration to an area of
lower solute concentration

Osmosis is defined as - answer Fluid moves from an area of lower solute concentration to an area of higher
solute concentration

Hemodialysis helps normalize body pH through - answer Diffusion of bio carbonate from the dialysate into
the blood

The endocrine function of the kidney are - answer Renin and erythropoietin secretion ,activation of vitamin
D

, The excretory function of the kidney is - answer To normalize electrolytes

Which of the following is a basic principle of patient self management - answer Dealing with the
consequences of illness rather than just the physical disease

Which statement is true regarding the stages of grief - answer Sometimes people can get stuck in one stage

If you notice that a patient caretaker is struggling to meet the Demands of the patient's treatment regime you
should - answer Notify the social worker because he or she is there for patients and their families

The psychosocial assessment completed by the social worker - answer Is completed initially and annually

Ultra filtration is defined as - answer Controlled fluid removal by manipulation of hydrostatic pressure

Convection is defined as - answer Solutes are dragged across the semi permeable membrane along with
fluid

The acronym DARN stand for - answer Desire, ability, reason, need

The three core communication skills used in motivation interviewing are - answer Asking, listening,
informing

Summarizing during reflective listening - answer Includes the main aspects of what the patient said during
the entire communication



The best way to help patient successfully change behaviors is to - answer Inspire behavior change to
support, compassion, and empathy



Left ventricular hypertrophy (LVH) is caused by - answer Hypertension



Hemodialysis replaces what % of normal kidney function - answer 15%



What does CKD-MBD lead to? - answer Abnormalities in Ca, PO4,PTH and vit D Metabolism with soft tissue
calcification and bone disease



Your patient complains of dry itchy skin you would advise her to - answer Use hyper fatted soaps and
lotions



Peripheral neuropathy is a complication and chronic renal failure which affects sensory and motor nerve
fibers. If you're patient complains of a burning sensation in the feet, you should advise him - answer Not to
walk barefoot, be careful with foot care, and check the bathwater temperature with a thermometer



Some lab tubes contain additives to assess blood to clot or prevent it from clotting. To prevent specimens
from being contaminated with another tubes additives you should - answer Follow the order of the draw

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