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Davita PCT Final Exam (Davita RISE0505)
Ultrafiltration is defined as (Ans- controlled fluid removed by manipulation of hydrostatic pressure The endocrine functions of the kidneys are (Ans- Renin and erythropoietin secretion, activation of vitamin D Dialysis replaces only ___ percent of normal kidney function. (Ans- 15% The most common infectious complication for hemodialysis patients is (Ans- centenal line infections What is one method surveyors used to verify infection control training and education? (Ans- patient interview Which infectious disease requires frequent handwashing instead of using alcohol based hand gels? (Ans- Active Clostridioides difficile infection C.diff
Per the Centers for Disease Control and Prevention (CDC), which is the most important route by which pathogens are transmitted in health care setting including dialysis centers. (Ans- contact transmission V-tags cite deficiencies, provide interpretive guidance, and provide a condition that must be met for each regulation. How can knowledge of V-tags affect the practice of patient care providers? (Ans- all of the above Why is meticulous hand hygiene so important in healthcare? (Ans- its the single most important intervention in preventing HAI's If your facility dialyzes Hepatitis B positive patients, which assignment would NOT be appropriate patient care assignment. (Ans- caring for HBsAG positive and hepatitis B susceptible patients at the same time Per The centers for disease control prevention, which is the most common factor contributing to bacterial infections in dialysis patients? (Ans- the use of catheters for hemodialysis upon completing machine set up and before treatment initiation it is important to verify the prescription and machine settings: (Ans- both b and c
In those states that do not require a nursing assessment to be completed prior to treatment initiation, the PCT would be required to report abnormal patient data collection findings. (Ans- yes For patients with Acute Kidney Injury (AKI)which statement is correct? (Ans- A nursing assessment prior to tx initiation is always required How do you verify that the patient is stable and safe for discharge after the dialysis treatment? (Ans- Evaluate the effectiveness of the treatment by comparing data to pre-dialysis findings PCT's notify the nurse if there are any unusual findings The patient is using a central venous catheter for dialysis and has a new arteriovenous fistula (AVF) present in his lower arm, What observation/assessment should the PCT perform the AVF? (Ans- checking for the bruit and thrill every time treatment day Can you document patient vital signs under another teammate already signed into the computer? (Ans- no
what are the three things you should not include in a Risk Event Management (REM) report (Ans- personal opinions documentation in the medical record (Ans- Is a permanent legal record of the care provided all documentation on machine set up and pre treatment patient information (Ans- Must be entered into the computer before the treatment is initiated post treatment data collection and assessment is performed (Ans- After the tx was terminated the pct notes that a patient still has considerable in edma in her legs when performing the post treatment data collection, in addition to informing the nurse, what should the pct document? (Ans- Document the swelling and that RN was informed. which statement is true regarding the "Reasonable and Prudent" Standard of care (Ans- When supervising pt care technicians an other non-licensed personnel, it is the resposibility of the licensed nurse to ensure these teammates Performing a procedure "your way" rather than following DaVita's P&Ps
the nephrologist has prescribed a 400 bfr for your patient. you would expect the physician order to also include (Ans- 15 gauge needle for the prescribed BFR You listen to your patient's AV graft and hear a whistling sound a. This could be inactive of an inflow stenosis b. This could be indicative of an outflow stenosis c. This could be indicative of advanced access thrombosis d. This is a normal sounding bruit (Ans- b to prevent the formation of aneurisms and pseudo aneurysms the following should be practiced (Ans- Good needlesites rotation and complete needle site clotting techniques the neuprologist has ordered the use of hemostatic sponges, sureseal, for your patient. what is the correct procedure when using these sponges? (Ans- Remove the hemostatic sponge after hemostasis has been achieved and dress the needle site with sterile gauge or band-aid. flipping the artireal vascular access needle (Ans- s not necessary since all arterial needles now have a back eye the sign that numbing has taken affect and it is time to stop spraying topical anastetic on the vascular access canulation sites is when (Ans- Blanching of skin
when a patient is prescribed topical anastatic spray, the appropriate time to clean the canulation site is (Ans- is prior to applying spray the nephrologist orders a blood flow rate of 450 ml/min for a patient with established AV fistula. what needle gage would be appropriate for this BFR (Ans- 15 the urea reduction ratio calculates (Ans- The amount of urea removed during the dialysis treatment which of the following factors would influence the; t of the kt/v formula (Ans- Shortened treatment time which of the following factors would decrease the; k of the kt/v formula (Ans- Inadequate anticoagulation When the lab receives a laboratory test tube with double labeling: (Ans- The double labed specimen will be rejected at the laboratory for pt safety the blood flow rate is reduced to 100 ml-min for ___________ before obtaining post dialysis blood specimen for kt/v (Ans- 15 seconds
what will cause a more negative pre-pump arterial pressure? (Ans- Kinking of the arterial blood line between the vascular access and arterial monitor if clotting occurs in a high flux dialyzer, the transmembrane pressure (TMP) will (Ans- decrease what could be the reasons for a conductivity alarm on the dialysis machine (Ans- when the dialysate is mixed incorrectly or there is no water acid or bicarb. the person responsible for implementation, adherence, and training of the facility specific emergency management plan (EMP) and applicable policy and procedures is (Ans- Fa or designee Teammates MUST be able to readily identify patients who may require additional assistance in the event of an emergency evacuation. This will include patients who need help with or are unable to (Ans- both b and c what is an important action prior to returning a patients blood using the hand crank in the event of a power failure? (Ans- remove the venous line for the line clamp
Per physician order and based on individual patient needs, Chronic Kidney Disease Mineral and Bone Disorder (MBD) is treated with (Ans- phosphate binders, Vit D (Hectorol), and Cinacalcet Poor wound healing is directly related to (Ans- low protein intake Phosphate binders are prescribed to prevent phosphorus in meals from being absorbed. When is the best time to take them? (Ans- with meal The definition of Health Literacy is (Ans- ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment If you notice that a patient's caretaker is struggling to meet the demands of the patient’s treatment regime you should (Ans- contact social worker The Psychosocial Assessment completed by the social worker (Ans- an evaluation of a person's mental health, social status, and functional capacity within the community Competed initially and annually The Clinical Pyramid includes : (Ans- • The Fundamentals: Immunizations, Iron, Dialysis Access, Calcium, Phosphorus, Hb, Kt/V, Target Weight, Access,PTH, etc.• Complex Programs: Fluid Management, Infection Management, Diabetes Management, Med Management, CVCManagement, Palliative / EOL Care, Infection
The excretory function of the kidneys include (Ans- remove access water, urea, and metabolic wastes from the blood. Acid concentrate replaces the excretory function of normal kidney function by (Ans- Hemodialysis removes urea, salts, and excess water from the blood normalizing electrolytes, removes metabolic acidosis, which statement is true regarding the administration of normal saline (Ans- the teammate must remain with the patient to monitor their progress until administration is complete and lines are securely clamp. Prior to use, how should the medication preparation surface area be disinfected? (Ans- with 1:100 bleach solution and disposible wipes what must be completed prior to medication preparation? (Ans- All of the above water treatment is needed in the dialysis setting to (Ans- Meet renal networks standards what is the acceptable mg/L or parts per million (ppm) limit for total chlorine in the water leaving the carbon filter (Ans- less than or equal to
which is the primary device for purifying the water used in dialysis (Ans- reverse osmosis what complication would you expect to see if a patient is exposed to chlorine/chloramines (Ans- Hemodialysis what time do you perform water harness testing? (Ans- at the end of each treatment day left ventricular hypertrophy leads to (Ans- Hypertension Cynthia missed her treatment on Saturday and returns the following Tuesday for her next scheduled treatment. She complains of feeling weakness in her legs. David, a PCT, gets a wheelchair for her, helps her weigh in, and brings her back for the nurse to assess prior to starting her treatment. Which patient complication would the PCT and RN suspect Cynthia is most likely suffering from? (Ans- Hyperkalymia The dialysis team prevents additional blood loss by (Ans- providing appropiate heparin dose per physician order using good cannulation and proper rinseback after tx. fever caused by a pyrogenic reaction will most likely occur at what time during the treatment (Ans- Within 45 to 75 minutes
