Davita Theory Week

Front 1

What is DaVita's mission statement?

Back 1

To be the Provider, Partner, and Employer of choice

Front 2

What are DaVita's seven core values?

Back 2

a. Service Excellence
b. Integrity
c. Team
d. Continuous Improvement
e. Accountability
f. Fulfillment
g. Fun

Front 3

Diffusion is the movement of _________ from an area of __________ to __________ __________ concentration

Back 3

solutes
higher
lower
solute

Front 4

What is the principle by which fluid is removed during a Hemodialysis treatment?

Back 4

Ultrafiltration

Front 5

Hyperkalemia can lead to
a. Constipation
b. Cardiac arrest
c. Excessive thirst
d. Abdominal cramping

Back 5

b. Cardiac arrest

Front 6

Which of the following is NOT a symptom of uremia?
a. Itching
b. Lack of appetite
c. Elevated hematocrit
d. Decreased ability to concentrate

Back 6

c. Elevated hematocrit

Front 7

Urea in the blood is called?

Back 7

Uremia

Front 8

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

Back 8

a. Edema and shortness of breath

Front 9

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

Back 9

c. Draw a single line through, write "erroneous entry" and your signature, date and credentials.

Front 10

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

Back 10

d. Transplant

Front 11

PO med given to help lower PTH level

Back 11

Sensipar

Front 12

Primary anticoagulant used prior to and during treatnent

Back 12

Heparin

Front 13

Lipitor and Zocor are two examples - used to lower cholesterol

Back 13

Statins

Front 14

Taken with meals, binds phosphorus and expels it in the stool

Back 14

Renvela

Front 15

A form of Vitamin D that is used to treat secondary hyperparathyroidism

Back 15

Zemplar

Front 16

Hepatitis B vaccination schedule - given 0, 1, 2, and 6 months

Back 16

Energix B

Front 17

Taken for constipation

Back 17

Colace

Front 18

Cardiotonic - not removed by dialysis

Back 18

Digoxin

Front 19

Helps correct anemia by providing iron needed to make RBCs

Back 19

Venofer

Front 20

Hepatitis B vaccination schedule - given at 0, 1 and 6 months

Back 20

Recombivax HB

Front 21

Used as a CVC locking solution instead of heparin

Back 21

Sodium citrate 4%

Front 22

Enzyme that breaks down clots - may be instilled in CVC lumens

Back 22

Activase

Front 23

Supplement taken because dialysis removes water-soluble portions of it

Back 23

Nephro-Vite

Front 24

Given to increase blood pressure during treatment

Back 24

Normal saline

Front 25

Corrects anemia by stimulating the bone marrow to produce RBCs

Back 25

Epoetin alfa

Front 26

Activates Vitamin D - known as doxercalceferol - given IV or PO

Back 26

Hectorol

Front 27

Glucose
acceptable level

Back 27

80 - 100 mg/dl

Front 28

Potassium
acceptable level

Back 28

3.5 - 5.5 mEq/L
helps regulate the rhythm of the heart

Front 29

Corrected calcium
acceptable level

Back 29

8.4 - 10.2 mg/dl

Front 30

Phosphorus
acceptable level

Back 30

3.0 - 5.5 mg/dl

Front 31

PTH (intact)
acceptable level

Back 31

150 - 600

Front 32

Creatinine
acceptable level

Back 32

10 to 18 mg/dl, dependent of muscle mass

Front 33

BUN
acceptable level

Back 33

60 - 80 mg/dl

Front 34

URR
acceptable level

Back 34

65% or greater

Front 35

Albumin
acceptable level

Back 35

> or = 3.5 g/dl
a nutritional marker

Front 36

Hemoglobin
acceptable level

Back 36

10-12 mg/dl

Front 37

Hepatitis B antigen

Back 37

Negative or must isolate

Front 38

KT/V

Back 38

> or = 1.2 for adequate dialysis

Front 39

Along with calcium, is important for bone formation

Back 39

Phosphorus

Front 40

A waste product given off by muscles

Back 40

Creatinine

Front 41

Lifespan of normal RBC

Back 41

120 days

Front 42

If low, indicates metabolic acidosis (low pH)

Back 42

CO2

Front 43

Indicates the adequacy of the treatment

Back 43

URR, KT/V

Front 44

The amount of stored iron

Back 44

Ferritin

Front 45

The amount of iron available for use

Back 45

Iron saturation

Front 46

Electrolyte that exhibits control of heart rhythms

Back 46

Potassium

Front 47

It's level in the dialysate is 100 - 200 mg/dl

Back 47

Glucose

Front 48

A waste product of protein metabolism

Back 48

BUN

Front 49

Elevations indicate calcium is being removed from bone

Back 49

PTH

Front 50

Electrolyte that influences fluid movement

Back 50

Sodium

Front 51

Givin Hectorol will increase the absorption of this electrolyte from the GI tract

Back 51

Calcium

Front 52

Give Epoetin alfa (EPO) to increase

Back 52

Hemoglobin

Front 53

To check for patency of an access, you should

Back 53

Listen for bruit, palpate thrill

Front 54

It is important to rotate cannulation sites to

Back 54

Prevent aneurysms/pseudoaneurysms

Front 55

When cannulating, the TIPS of the needles should be:

Back 55

at least 2 inches apart

Front 56

Describe the proper technique for site preparation of an internal access.

Back 56

Clean the access with alcohol and betadine using concentric circles from inside to outside

Front 57

The venous needle in an AV fistula should point

Back 57

In the direction of the blood flow

Front 58

How do you assess a graft or fistula for direction of flow?

Back 58

Compress at midpoint; stronger bruit is arterial limb.

Front 59

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?

Back 59

2 kg

Front 60

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 .

Back 60

3 kg

Front 61

May cause the patient to faint upon standing post dialysis.

Back 61

Orthostatis hypotension

Front 62

Difficulty breathing; commonly caused by fluid overload called

Back 62

Dyspnea

Front 63

A heart rate of 40 beats per minute

Back 63

Bradycardia

Front 64

What is the normal respiratory rate?

Back 64

12-20 per minute

Front 65

What is a deep depression left on the skin after pressing firmly with the thumb classified

Back 65

3+ edema

Front 66

Pulse rate of 100 or more

Back 66

Tachycardia

Front 67

A diastolic pressure of >90

Back 67

Hypertension

Front 68

The pressure inside an artery during a heart beat

Back 68

Systolic blood pressure

Front 69

Symptoms include dizziness, nausea, vomiting and clammy skin

Back 69

Hypotension

Front 70

When no edema is present and the blood pressure is normal

Back 70

Dry weight

Front 71

Common obstacles to learning with adults on dialysis

Back 71

* Attention span is often shortened
* Cognitive abilities are decreased
* Denial is often present
* Sensory deprivation due to loss of vision or hearing

Front 72

Purpose of the Water Softener

Back 72

* Primarily for RO protection
* Removes "hardness" ions (calcium & magnesium

Front 73

Primary purpose of Carbon Tanks/Filters

Back 73

Essential for the removal of total chlorine and chloramines

Front 74

What does the RO remove?

Back 74

* Organic and inorganic contaminants
* Bacteria and endotoxin

Front 75

Indirect Feed Design Loop velocity

Back 75

>= 3 feet/second

Front 76

Direct Feed Design Loop velocity

Back 76

>=1.5 feet /second

Front 77

What are acceptable results for total chlorine?

Back 77

0.1 or <

Front 78

Minimum blood requirement for blood culture bottles

Back 78

8-10 cc per bottle.

Front 79

Post Dialysis Blood Sampling machine settings

Back 79

* UFR to 300
* DFR to Bypass or Minimum
* BFR to 100 for 15 seconds
* Draw from arterial bloodline

Front 80

What should be the average weight gain be between treatments?

Back 80

3-5% of dry weight

Front 81

What is the problem with the dry weight if the patient complains of hypotension and cramping?

Back 81

Dry weight is too hight.

Front 82

S/S of Fluid Excess

Back 82

* Weight gain >5% of dry weight
* Hypertension
* Edema or facial puffiness
* Shortness of breath
* Crackles
* Jugular vein distension
* Bounding pulse

Front 83

CDQI guidelines for pre and post blood pressures

Back 83

Pre 140/90
Post 130/80

Front 84

Pre-Dialysis Hypertension common causes

Back 84

* Fluid overload
* Blood pressure medication needs to be regulated
* Non-adherence to prescribed medication(s) schedule
* Street drug usage
* OTC cold/asthma remedies

Front 85

1 kg = how many pounds

Back 85

2.2 lbs

Front 86

How many kilograms is 1 liter

Back 86

1 kg = 1,000 ml

Front 87

What does heparin do?

Back 87

Helps prevent clotting

Front 88

When a patient receives a kidney transplant where does the surgeon usually place the donor kidney

Back 88

Pelvic area.