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which of the following terms indicates a solution that has the same concentration of solutes as blood? - correct answers isotonic a patient's potassium levels has been running high between dialysis treatment, so the patient has been working with the renal dietician to restrict potassium in the diet. which of the following fruits should the patient avoid? - correct answers bananas during osmosis, which of the following movements takes place? - correct answers fluid moves from an area of lower concentration to higher. a patient's granddaughter calls the dialysis center and asks for a progress report on her father, who is a patient in the center. the technician should. - correct answers state that patient information cannot be divulged if a hematoma forms at the access site where a needle infiltrated, the usual intervention is to apply - correct answers cold compresses which of the following actions by a patient increases the risk of blood clots in a venous access? - correct answers wearing a top with very tight- fitting long sleeves a patient is very anxious during an initial hemodialysis treatment and requires extra attention. when the treatment is completed, the patient offers a $20 tip. the technician should - correct answers politely decline the tip which of the following statements by a hemodialysis patient suggests that the patient needs more education? - correct answers i should stay on a low protein diet.
the inner part of the kidney is the - correct answers medulla a nephron is comprised of a glomerulus and a - correct answers tubule how much urine does a patient with healthy kidneys usually excrete in 24 hours? - correct answers 1000 to 2000mL when removing soiled gloves, the first glove removed should be. - correct answers grasped in the opposite gloved hand which of the following hormones is produced by the kidneys? - correct answers erythropoietin at which stages of chronic kidney disease should a patient being dialysis? - correct answers 5 which of the following is a genetic disorder that can lead to kidney failure? - correct answers polycystic kidney disease which of the following complains by a patient may be an indication of uremia? - correct answers itching
a patient is scheduled for serum creatinine test and asks the technician about preparation the day before the test. the patient should be advised to. - correct answers avoid excessive exercise which of the following ethnic group is most at risk for development of kidney failure? - correct answers african american a patient has buttonhole tracts for access. after the access is cleaned and prepped for treatment, what is the next step? - correct answers use a crab picker/ aseptic tweezer to remove the scabs with buttonhole tracts, the technician should apply pressure as the needle are removed and then for - correct answers 5 to 10 minutes if a buttonhole access frequently has long clots that are very difficult to remove, the most likely reason is - correct answers failure to use 2-finger hold for needle removal a patient who had an AV fistula in the forearm developed an aneurysm and has had to have a new AV fistula created in the upper arm. the patient has a temporary catheter in place for dialysis until the fistula has matured. which of the following exercise may help strengthen the AV fistula? - correct answers bicep curl with buttonhole access sites, what should the technician do to prevent '' hubbing "? - correct answers leave 1/16 th to 1/8 inch of the needle exposed
if a patient has a dialyzer clearance rate of 250 mL/ min with 4- hour treatment, the total volume of blood cleared is - correct answers 60 L. what is the most important factor in preventing exsanguination from dialysis line separation? - correct answers access site visible if a patient states that she has been skipping lunch because she is too tired to eat after dialysis, the best solution is to. - correct answers report to the nurse and renal dietician if a patient exhibits signs and symptoms of hemolysis during dialysis, the immediate action should be to - correct answers stops the blood pump and clamp the blood lines the amount of dialysis that a hemodialysis patient is prescribed is based on the removal of - correct answers urea maturation of a prosthetic arteriovenous graft usually takes - correct answers 3 to 6 weeks the purpose of the negative germicide test is to ensure that - correct answers the reprocessed dialyzer is free of germicides if a patient develops angina (chest pain) radiating to the neck, jaw, and left arm and the patient's blood pressure drops during treatment, the technician should notify the nurse and - correct answers decreased blood flow rate and ultrafiltration
if a high-pressure alarm for arterial pressure (pre-pum ) sounds during hemodialysis, this could indicate. - correct answers drop in speed of blood pump if a low- pressure alarm for venous sounds during hemodialysis, this could indicate. - correct answers clotting in the access according to KDOQI guidelines, when administering hemodialysis to a patient a, facemark should be worn - correct answers for all access connection the most common complication associated with poor needle site rotation in a graft is - correct answers pseudoaneurysm in hemodialysis, ultrafiltration refers to extraction of - correct answers fluid the patient has develop a small aneurysm and asks the technician to cannulate the aneurysm for the hemodialysis treatment because another patient told this patient that it would be less painful that cannulation of the fistula. the best response is to - correct answers advise the patient that cannulating an aneurysm may result i rupture. a patient experience a cardiac arrest with no pulse or respiration during hemodialysis. after the technician calls for help, the next action should be to - correct answers stop dialysis, return blood, and flush access lines with normal saline. when auscultating a patient's AV fistula to listen for the bruit, if the technician notes that the bruit is very high pitched, this may indicate - correct answers stenosis
when using the buttonhole technique for vascular access for hemodialysis, the needles are placed in. - correct answers the same site in a fistula when inserting a needle for hemodialysis, which of the following increases the risk of infiltration? - correct answers rotating the needle 180 degrees the legal document that assigns a heal care proxy to make decisions in the event that a person is unable to do so is called - correct answers durable power of attorney carbon filters in the water system are necessary to remove - correct answers chlorine, chloramine, and organic material backwashing to free residue from sediment filters in the water system should be done at least - correct answers once daily with the formula for urea kinetic modeling (UKM), the K in the Kt/V formula stands for
- correct answers urea clearance (mL/ min) plus residual urinary output when inserting needles into a graft for hemodialysis, the needle tips be should be at least how far apart? - correct answers 2.0 inches if a patient is undergoing hemodialysis and the technician notes that a bloodlines has separated and blood has pooled beneath the access site, the first intervention should be to - correct answers stop the blood pump
which of the following is the most common cause of hypotension developing during hemodialysis? - correct answers removing excessive volume of fluid which of the following interventions is most likely to decrease hypotension that occurs during hemodialysis? - correct answers decreasing the ultrafiltration rate if an air sector alarm sounds during hemodialysis, the technician should initially - correct answers stop the blood pump and clamp the patients venous line if outflow stenosis of an AV fistula occurs, the thrill usually - correct answers is loud and higher pitched and then discontinuous when reviewing a patient's food dairy, the technician advise the patient that which of the following protein sources is of low biological value? - correct answers dried bean which of the following vitamins may be removed by hemodialysis - correct answers vitamin B the renal nutritionist has advised the patient to have a diet high in fiber, but the patient is unsure which foods to choose. which of the following foods per serving is highest in insulate fibers? - correct answers kidney beans the primary purification process of the dialysis water is - correct answers filtering with activated carbon
if the dialysis center uses hemoclips on dialysis tubing to prevent disconnection, what other precautions should be utilized? - correct answers visible access sites/line connections and documentation of integrity every 30 minutes if during hemodialysis, blood is evident in the used dialysate, this probably indicates - correct answers tear in the membrane if a patient asks a question to which the technician does not know the answer, an appropriate response is - correct answers I 'll find out for you '' during routine hemodialysis, a patient's blood pressure should monitored every - correct answers 30 to 60 minutes if a patient develops painful muscle cramps in the hands, feet, and abdomen shortly after hemodialysis begins, the most likely interventions is - correct answers saline bolus and/or decreased ultrafiltration rate. if a hemodialysis patient's temperature per tympanic membrane thermometer is 37C in order to reduce incidendence of intradialytic ( during dialysis ) hypotension, the temperature of the dialysate solution should ideally be set at - correct answers 36.5 C foam in the venous bloodline of a dialyzer may indicate - correct answers air embolism prior to initiating hemodialysis, the ph of the dialyste usually ranges from - correct answers 7.0 to 7.
before cannulating An AV fistula for a hemodialysis treatment, the technician examines the patient's access arm and finds that the access arm appears slightly edamatous, and the skin is pale. on further examination, the technician notes that there are small purple veins evident on the chest wall near where the arm meets the body. the technician should suspect - correct answers stenosis in order to increase survival rates. the ultrafiltration rate for hemodialysis patients should be maintained at least than - correct answers 12 ml/kg/m as part of fistula assessment before cannulation, the technician evaluates the thrill and then applies acclusion by placing a finger across the body of the fistula. while the fistula is acceded, the technician palpates and feels both a thrill and a pulse. this probably signifies a (n) - correct answers accessory pathway ( collateral circulation ) how much additional proteins should a patient on hemodialysis ingest every day in comparison to a health person - correct answers 50% weight gain between hemodialysis treatments should not exceed - correct answers 5% of dry weight the technician has calculate the target weight loss for a patent's hemodialysis session, but the patient insists that the technician has made an error and the target is 1 kg too high. the technician should - correct answers recalculate the target weight loss. the most important reason for placing hemodialysis needles in antegrade position ( in direction of blood flow) is because - correct answers it causes less scarring
when preparing dialysate with a 45x concentrate, if the proportioning ratio contains 1. part acid and 1.72 parts bicarbonate, how many parts of water are needed? - correct answers 42. if conductivity monitoring stops dialysate from flowing to the dialyzer but instead sends it to the drain (bypass), this means that - correct answers the conductivity monitor is malfunctioning when using a portable digital dialysate meter, such as the D6 (myron L meter ) , to verify that inline meters are accurate regarding conductivity and ph, the technician must - correct answers obtain an unused dialysate sample the target ultrafiltration goal set for the patient is based on the patient's - correct answers dry weight a patient is to receive a bolus of ulfrationated heparin (25 IU/kg ) at the onset of dialysis and 800 U at one-hour intervals during treatment, which is scheduled from 1 to 5 PM. the first dose is given at 1 Pm and the last dose at - correct answers 4 pm when checking the pump occlusion for the blood pump, the technician nots, that the rollers appear to loose.this may result in - correct answers cracking of the blood pump segment of tubing in the hemodialysis machine, a separate air detector is usually placed - correct answers between the venous pressure gauge and the venous access
for documentation in the medical record, which of the following includes a correct - correct answers 0.5 kg for a hemodialysis cannulation with a blood flow rate of fewer than 300mL/ min, which of the following needle gauge sizes is usually recommended? - correct answers 17 if the nephrologist has ordered a pre-dialytic and post-dialytic BUN ( blood urea nitrogen) for a patient with an AV fistula, the pre-dialytic blood sample should be obtained from the. - correct answers arterial needle the primary focus of the life safety code is on - correct answers protection of people the dialysis prescription is for a 3- hour treatment with 1.5 kg to be removed. during treatment 250 mL is used as saline prime and 200 mL as saline rinseback. the patient ingested 150 mL of fluid that contains oral proteins supplement. the ultrafiltration rate to be removed per hour is - correct answers 700 ml if the ultrafiltration rate to be removed per hour is 600 ml and the dialyzer kuf is 40 what is the transmembrane pressure (TMP)? - correct answers 15 mm hg if using a combination chlorhexidine gluconate and alcohol skin prep (such as chloraprep before cannulation, how much skin contact time is required? - correct answers 30 seconds
which of the following preventive measures is usually the best approach for patients who routinely experience hypotension during dialysis because of volume-related problems associated with large weight gain between treatments? - correct answers increasing restrictions of sodium intake if a patient undergoing hemodialysis and in the care of the technician has a persistent cough, standards precautions require that the - correct answers patient wear a mask what color is arterial blood tubing for hemodialysis most often color-coded? - correct answers red during hemodialysis, how much blood is usually outside of a patient's body at one time?
- correct answers 100 to 250mL during the first week of treatment with a new AV fistula, the initial needle size and blood flow rate are usually ~ - correct answers 17 - gauge needle and blood flow of 200 to 250 mL/min. with an AV fistula, cannulation should usually be done at an angle of - correct answers 25 - 35 a hemodialysis system includes blood volume monitoring to assess changes in the patients democrat.if the hematocrit increases rapidly, this means - correct answers blood volume is decreased
thrombosis is newly-created access may be caused by - correct answers low blood pressure if a new patient has Hero (hemodialysis reliable outflow) graft, the cannulation site is generally in the - correct answers proximal upper arm (below the axilla). if effluent (used dialysate ) spills into the floor, the technician should - correct answers notify staff trained in hazardous waste removal a patient is recovering hemodialysis with 17-gauge needle, but his blood flow rate has been increased to 450ml/min. the patient complains of symptoms consisten with hemodialysis ( breakdown of red blood cells) sudden onset of chest tightness, back pain, dyspnea, reddening ok skin color, and blood in the venous line appearing port- wine in color. what is likely cause of this complication? - correct answers needle too small for blood flow rate when handing off a patient to another staff person, the technician should always - correct answers follow the hand-off protocol established by the institution the technician should ensure when exposing the opening of a central catheter to air (such as when removing the cap or a syringe) that the - correct answers clamp is closed the hemodialysis center has instituted a "zero lift" policy. the primary purpose of such a policy is to - correct answers prevent injuries
if the dialysis center has an extra hemodialysis machine that has not been used in the previous 2 weeks, how frequently does this machine need to be disinfected? - correct answers every 48 hours five minutes after a patient begins a hemodialysis treatment, the patient has difficulty breathing and rapidly develops generalized hives, itching and swelling about the eyes. after asking the nurse for help, the next action should be to. - correct answers stop the dialysis and clamps all the lines a patient routinely experiences hypotensive episodes near the end of a session and experiences malaise (tiredness), muscle cramps, and dizziness after dialysis. what is the most likely cause? - correct answers the dry weight is set too high an adolescent patient has required frequent hospitalization because of nonadherece to be the treatment plan. the best approach to take with the patient is to - correct answers ask the patient how the staff can help the patient manage better. when the first carbon tank ( the worker) in the water system is exhausted, the next step is to - correct answers remove the first tank, move the second tank to first position, and add a new tank in second position. following dialysis, the patient's blood pressure in semi-reclining position is 128/86. the technician takes a series of blood pressure over 3 minutes after the patient stands. at which blood pressure should the technician alert the nurse that the patient is exhibiting orthotic hypotension? - correct answers 108/ the technician is able to feel no pulse or thrill along the patient's outflow vein and can detect no bruit. the technician should suspect - correct answers thrombosis
