Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
88 Cards in this Set
- Front
- Back
What is DaVita's mission statement?
|
To be the Provider, Partner, and Employer of choice
|
|
What are DaVita's seven core values?
|
a. Service Excellence
b. Integrity c. Team d. Continuous Improvement e. Accountability f. Fulfillment g. Fun |
|
Diffusion is the movement of _________ from an area of __________ to __________ __________ concentration
|
solutes
higher lower solute |
|
What is the principle by which fluid is removed during a Hemodialysis treatment?
|
Ultrafiltration
|
|
Hyperkalemia can lead to
a. Constipation b. Cardiac arrest c. Excessive thirst d. Abdominal cramping |
b. Cardiac arrest
|
|
Which of the following is NOT a symptom of uremia?
a. Itching b. Lack of appetite c. Elevated hematocrit d. Decreased ability to concentrate |
c. Elevated hematocrit
|
|
Urea in the blood is called?
|
Uremia
|
|
What are the typical signs of fluid overload?
a. Edema and shortness of breath b. Hypotension and cramping c. Nausea and vomiting d. Numbness and tingling |
a. Edema and shortness of breath
|
|
The acceptable way to crrect charting errors is to
a. Use white-out, then write the correct entry over it. b. Draw a single line through and write intials. c. Draw a single line through, write "erroneous entry" and your signature, date and credentials. d. Draw multiple lines through so that what you wrote is not visible |
c. Draw a single line through, write "erroneous entry" and your signature, date and credentials.
|
|
Which of the following treatment modalities allows the patient to have the most "normal" life?
a. In-center hemodialysis b. Home hemodialysis c. Peritoneal dialysis d. Transplant |
d. Transplant
|
|
PO med given to help lower PTH level
|
Sensipar
|
|
Primary anticoagulant used prior to and during treatnent
|
Heparin
|
|
Lipitor and Zocor are two examples - used to lower cholesterol
|
Statins
|
|
Taken with meals, binds phosphorus and expels it in the stool
|
Renvela
|
|
A form of Vitamin D that is used to treat secondary hyperparathyroidism
|
Zemplar
|
|
Hepatitis B vaccination schedule - given 0, 1, 2, and 6 months
|
Energix B
|
|
Taken for constipation
|
Colace
|
|
Cardiotonic - not removed by dialysis
|
Digoxin
|
|
Helps correct anemia by providing iron needed to make RBCs
|
Venofer
|
|
Hepatitis B vaccination schedule - given at 0, 1 and 6 months
|
Recombivax HB
|
|
Used as a CVC locking solution instead of heparin
|
Sodium citrate 4%
|
|
Enzyme that breaks down clots - may be instilled in CVC lumens
|
Activase
|
|
Supplement taken because dialysis removes water-soluble portions of it
|
Nephro-Vite
|
|
Given to increase blood pressure during treatment
|
Normal saline
|
|
Corrects anemia by stimulating the bone marrow to produce RBCs
|
Epoetin alfa
|
|
Activates Vitamin D - known as doxercalceferol - given IV or PO
|
Hectorol
|
|
Glucose
acceptable level |
80 - 100 mg/dl
|
|
Potassium
acceptable level |
3.5 - 5.5 mEq/L
helps regulate the rhythm of the heart |
|
Corrected calcium
acceptable level |
8.4 - 10.2 mg/dl
|
|
Phosphorus
acceptable level |
3.0 - 5.5 mg/dl
|
|
PTH (intact)
acceptable level |
150 - 600
|
|
Creatinine
acceptable level |
10 to 18 mg/dl, dependent of muscle mass
|
|
BUN
acceptable level |
60 - 80 mg/dl
|
|
URR
acceptable level |
65% or greater
|
|
Albumin
acceptable level |
> or = 3.5 g/dl
a nutritional marker |
|
Hemoglobin
acceptable level |
10-12 mg/dl
|
|
Hepatitis B antigen
|
Negative or must isolate
|
|
KT/V
|
> or = 1.2 for adequate dialysis
|
|
Along with calcium, is important for bone formation
|
Phosphorus
|
|
A waste product given off by muscles
|
Creatinine
|
|
Lifespan of normal RBC
|
120 days
|
|
If low, indicates metabolic acidosis (low pH)
|
CO2
|
|
Indicates the adequacy of the treatment
|
URR, KT/V
|
|
The amount of stored iron
|
Ferritin
|
|
The amount of iron available for use
|
Iron saturation
|
|
Electrolyte that exhibits control of heart rhythms
|
Potassium
|
|
It's level in the dialysate is 100 - 200 mg/dl
|
Glucose
|
|
A waste product of protein metabolism
|
BUN
|
|
Elevations indicate calcium is being removed from bone
|
PTH
|
|
Electrolyte that influences fluid movement
|
Sodium
|
|
Givin Hectorol will increase the absorption of this electrolyte from the GI tract
|
Calcium
|
|
Give Epoetin alfa (EPO) to increase
|
Hemoglobin
|
|
To check for patency of an access, you should
|
Listen for bruit, palpate thrill
|
|
It is important to rotate cannulation sites to
|
Prevent aneurysms/pseudoaneurysms
|
|
When cannulating, the TIPS of the needles should be:
|
at least 2 inches apart
|
|
Describe the proper technique for site preparation of an internal access.
|
Clean the access with alcohol and betadine using concentric circles from inside to outside
|
|
The venous needle in an AV fistula should point
|
In the direction of the blood flow
|
|
How do you assess a graft or fistula for direction of flow?
|
Compress at midpoint; stronger bruit is arterial limb.
|
|
Your patient's dry weight is 56 kg. The post weight from last treatment was 57. Today they arrive at 59 kg. What is the weight gain?
|
2 kg
|
|
Dry weight 56 kg.
Post weight from last treatment was 57 Arrive today at 59 kg. If the dry weight is correct, what is the fluid goal (without rinseback) for today's treatment for the patient . |
3 kg
|
|
May cause the patient to faint upon standing post dialysis.
|
Orthostatis hypotension
|
|
Difficulty breathing; commonly caused by fluid overload called
|
Dyspnea
|
|
A heart rate of 40 beats per minute
|
Bradycardia
|
|
What is the normal respiratory rate?
|
12-20 per minute
|
|
What is a deep depression left on the skin after pressing firmly with the thumb classified
|
3+ edema
|
|
Pulse rate of 100 or more
|
Tachycardia
|
|
A diastolic pressure of >90
|
Hypertension
|
|
The pressure inside an artery during a heart beat
|
Systolic blood pressure
|
|
Symptoms include dizziness, nausea, vomiting and clammy skin
|
Hypotension
|
|
When no edema is present and the blood pressure is normal
|
Dry weight
|
|
Common obstacles to learning with adults on dialysis
|
* Attention span is often shortened
* Cognitive abilities are decreased * Denial is often present * Sensory deprivation due to loss of vision or hearing |
|
Purpose of the Water Softener
|
* Primarily for RO protection
* Removes "hardness" ions (calcium & magnesium |
|
Primary purpose of Carbon Tanks/Filters
|
Essential for the removal of total chlorine and chloramines
|
|
What does the RO remove?
|
* Organic and inorganic contaminants
* Bacteria and endotoxin |
|
Indirect Feed Design Loop velocity
|
>= 3 feet/second
|
|
Direct Feed Design Loop velocity
|
>=1.5 feet /second
|
|
What are acceptable results for total chlorine?
|
0.1 or <
|
|
Minimum blood requirement for blood culture bottles
|
8-10 cc per bottle.
|
|
Post Dialysis Blood Sampling machine settings
|
* UFR to 300
* DFR to Bypass or Minimum * BFR to 100 for 15 seconds * Draw from arterial bloodline |
|
What should be the average weight gain be between treatments?
|
3-5% of dry weight
|
|
What is the problem with the dry weight if the patient complains of hypotension and cramping?
|
Dry weight is too hight.
|
|
S/S of Fluid Excess
|
* Weight gain >5% of dry weight
* Hypertension * Edema or facial puffiness * Shortness of breath * Crackles * Jugular vein distension * Bounding pulse |
|
CDQI guidelines for pre and post blood pressures
|
Pre 140/90
Post 130/80 |
|
Pre-Dialysis Hypertension common causes
|
* Fluid overload
* Blood pressure medication needs to be regulated * Non-adherence to prescribed medication(s) schedule * Street drug usage * OTC cold/asthma remedies |
|
1 kg = how many pounds
|
2.2 lbs
|
|
How many kilograms is 1 liter
|
1 kg = 1,000 ml
|
|
What does heparin do?
|
Helps prevent clotting
|
|
When a patient receives a kidney transplant where does the surgeon usually place the donor kidney
|
Pelvic area.
|