Acute Kidney Injury: Patient Care and Prevention - Prof. Waithaka, Exams of Computer Science

Download Acute Kidney Injury: Patient Care and Prevention - Prof. Waithaka and more Exams Computer Science in PDF only on Docsity! Davita Exam with Complete questions and Answers Graded A+ Only advanced cannulators should be - Correct Answer-cannulating on a newly established fistula the reason why you have to draw in order is because - Correct Answer-some tubes have additives and it can contaminate results if not drawn in the correct order. Exposure to blood and potentially contaminated items can be routinely anticipated during hemodialysis. you should wear - Correct Answer-gloves to reduce the risk of hand contamination. The 2 things to avoid for acute kidney injury patients - Correct Answer-Hypovolemia and hypotension Know what caused the chronic kidney disease in order to... - Correct Answer-Inquire about possible problems during data assessment and collection. A factor that influences "K" - Correct Answer-Adequate anticoagulation Needle Sizes/Gauges, suggested BFR, and anticipated pre-pump Ap pressure limit (4) - Correct Answer-17 gauge, 200-250 ml/min, no more negative than -150mm/Hg 16 gauge, 250-350 ml/min, no more negative than -200mm/Hg 15 gauge, 350-450 ml/min, no more negative than -220mm/Hg 14 gauge, greater than 450 ml/min, no more negative than -260 mm/Hg Adequate dialysis replaces less than.... - Correct Answer-15% of normal kidney function waiting only 5 Seconds between lowering the blood pump speed and drawing the post- treatment blood sample could cause the Kt/V reading to be falsely... - Correct Answer- Too high K stands for - Correct Answer-clearance of urea Main factor that affects clearance - Correct Answer-heparin (inadequate anticoagulation) The purpose of post data collection and assessment is to... - Correct Answer-Verify the patient is stable post treatment and can safely be discharged from the facility. Patient with AKI require.. - Correct Answer-An RN assessment before every treatment If the patient has any abnormal findings you must - Correct Answer-Report it to the RN If no abnormal findings - Correct Answer-the PCT may start treatment and the RN can asses within the 1st hour. Squeezing the cuff to speed up deflation may - Correct Answer-Damage the internal working of the blood pressure monitor. Post dialysis data collection and assessment helps - Correct Answer-Verify that the patient is stable and safe for discharge Evaluate the effectiveness of the treatment plan Notify the nurse if there are any unusual or abnormal finding before discharging the patient RN post assessment before discharge Document provides - Correct Answer-permanent legal record to protect the patient, team, and DaVita. Can post treatment data collection be done five minutes before the patient comes off the machine? - Correct Answer-no, it has to be done after blood is returned/treatment is complete. How do you draw a post lab? - Correct Answer-lower the blood pump to 100 and then wait 15 seconds before drawing the blood sample. What do you document for a decrease In blood pressure - Correct Answer-document blood pressure and amount of saline given, and document blood pressure after saline bolus is given T.R.A.M.P stands for - Correct Answer-time, route, amount, medication, patient Can a PCT document "edema" - Correct Answer-no, they can report swelling Failure to use SMART communications - Correct Answer-exposes you and DVA to liability Makes you a "star"... at a deposition or trail repetitional injury jeopardizes the recipient treatment for pericarditis is - Correct Answer-more frequent treatment with restricted heparin. Symptoms of hyperkalemia - Correct Answer-muscle weakness, abnormal heart rhythm and possible cardiac arrest teach patient not to walk _______ and to take care of their feet, and be careful w/ ____ ____ trims and _____ ________ for patients w/ neuropathy - Correct Answer-barefoot, toe nail, bath water The primary cause of Anemia is - Correct Answer-the lack of erythropoietein what are some ways we can prevent contributing to blood loss in the hemodialysis patient? - Correct Answer-return their blood continuously monitor the effectiveness of heparin (too much or too little) watch for blood loss. transport mechanism: convection - Correct Answer-solutes are dragged across the semipermeable membrane along with fluid. Transport Mechanism: diffusion - Correct Answer-particles (solutes) move from an area of higher solute concentration to an area of lower solute concentration. transport mechanism: osmosis - Correct Answer-fluid moves from lower solute concentration to higher solute concentration. function of the dialysate - Correct Answer-it facilitates normal serum electrolyte levels (homeostasis) hemodialysis helps normalize body ___ through _______ of ____________from the dialysate into the blood - Correct Answer-pH, diffusion, bicarbonate what is the definition of optimal nutrition status: - Correct Answer-albumin less than or equal to 4.0, stable desirable target weight, adequate fat stores and muscle mass, appropriate appetite and intake. Your patient comes in with a banana and tells you they will eat it on treatment. What should you explain to them? - Correct Answer-explain to them that because you are eating it during treatment. The potassium will not be dialyzed off. It will hit them after the treatment. Hypo-tension during treatment can lead to - Correct Answer-organ stunning A recommended intervention for cramping is - Correct Answer-turning off the UFR. Fever is defined as - Correct Answer-any temperature greater than 100 degrees or an increase over baseline of 2 degrees Fahrenheit w/ symptoms. Pyrogen reaction occurs within - Correct Answer-the first 45-75 minutes of a treatment starting. Do you have to stop treatment if a patient has a seizure - Correct Answer-no, if normal just keep them safe. discontinue if not normal patients that are most prone to DDS (Dialysis Disequilibrium Syndrome) are - Correct Answer-patients that are missing treatment. If you suspect hemolysis immediately - Correct Answer-stop treatment and do not return blood. If hemolysis is occuring it can look like - Correct Answer-cherry Kool aid Disinfectant infusion symptoms - Correct Answer-pain at the venous needle site, tingling around lips and difficulty breathing If Angina (described as chest pain) is occurring - Correct Answer-decrease the BFR and UFR and administer oxygen if air embolism is suspected put patient in - Correct Answer-left side-trendenberg What do you do if a patient is experiencing anaphylaxis - Correct Answer-stop blood pump, discontinue treatment and do not return the blood. air embolism - Correct Answer-Air bubbles in the blood vessels. anaphylaxis - Correct Answer-a severe immune response to an allergen Medications containing a preservative must be discarded at what time after opening - Correct Answer-28 days; this is in general and for medications w/ multidose vials what is the waiting time after administration of initial heparin loading dose prior to initiation of hemodialysis - Correct Answer-3-5 minutes what is the sign that numbing has taken effect and it is time to stop spraying topical anesthetic onto Vascular access cannulation sites - Correct Answer-when there is blanching of the skin what needs to be taken with meals? - Correct Answer-phosphorus binders An outflow stenosis may be present and indicated by a - Correct Answer-whistling sound Do not go into the same needle site for at least - Correct Answer-2 weeks When cannulating, flip the needle for - Correct Answer-a cause and not just because. A cannulation rule is to always rotate the - Correct Answer-puncture sites allowing 14 days for healing if you use a hemostatic sponge - Correct Answer-it must be removed before the patient leaves the treatment area. hemolysis is the rupture of - Correct Answer-RBC Water Softener monitoring occurs - Correct Answer-off line hardness testing at the end of each operating day post water softener how do you respond to bad quality water - Correct Answer-put all machines into bypass and notify biomed and FA. If water quality cannot be restored you - Correct Answer-terminate treatment. What does the clinical pyramid include? - Correct Answer-The Fundamentals, Complex programs and Quality of Life The purpose of ICHD DQI is - Correct Answer-the component measures for DQI are selected to encourage continuous improvement across a broad range of disease management processes. How do you achieve DQI - Correct Answer-it takes teamwork, success is achieved by managing individual patients first-DQI scores will follow, and the focus is on great patient outcomes! Can a patient get stuck in a stage of grief? - Correct Answer-yes KDQOL happens - Correct Answer-initially first when we get a new patient and then annually after that. D.A.R.N stands for - Correct Answer-Desire, Ability, Reason, Need What are the 3 communication styles - Correct Answer-asking, listening, and informing What is the righting reflex? - Correct Answer-automatic intervention of a health care practitioner who observes a patient doing something detrimental to their health. active listening - Correct Answer-reflecting back what you heard to ensure you understood correctly while simultaneously encouraging the patient to go on. For auditory learners use - Correct Answer-word associations/ mnemonics