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WorksheetsHemodialysis Midterm/Final
Total questions: 75
Worksheet time: 1hrs 18mins
Diffusion is movement of particles?
By filtration through a biocompatible membrane.
From an area of higher concentration to an area of lower concentration through a semipermeable membrane until they are equal.
Into a vacuam created when fluids are forced through a membrane.
Into a space created by solutions moving into countercurrent flow.
Osmosis is the movement of:
Solutes from an area of high concentration to an area of low concentration
Fluid from an area of high concentration to an area of low concentration
Solutes from an area of low concentration to an area of high concentration
Fluid from an area of low concentration to an area of high concentration that allows some solutes to pass of certain size.
What is the main function of the kidney?
Remove urine from the body
To add salt to blood
Maintain water balance of the body
To break down proteins
The kidneys produce urine by filtration of the blood and selective re-absorption of useful substances such as glucose, some ions and water.
True
False
Not sure
Kidney failure can be treated by...
Dialysis
Removing all kidneys
Kidney transplant
Radiotherapy
The kidney produces what hormone?
estrogen
progesterone
Erythroprotein
Thyroxine
What is TMP
A mixture of a fluid and a solvent
Difference between positive pressure in blood and negative pressure in dialysate
Positive pressure occurs when blood is pumped through the dialyzer
a dissolved subtance
What is an Anastomosis?
A surgical union of a vein and artery
A graft that ties a vein and artery
A bowel fusion
An infection inside the graft
How many stages of renal failure are there?
2
6
5
4
What is the leading cause of ESRD?
Hypotension
COPD
Diabetes
Hypertension
Which stage is considered ESRD?
5
4
2
1
What stage do we start dialysis and what is the GFR?
2/15
4/25
5/15
3/30
afebrile
absence of fever
absence of seizure
fever
fever causing
What is the second leading cause of ESRD?
Cardiac disease
Hypotension
Glomerulonephritis
Hypertension
Define AIDS
Access infection dialysis syndrome
Acute infectious disease syndrome
Acquired immune dialysis syndrome
Acquired immunodeficiency syndrome
Define Afferent
away from an organ
toward an organ.
Inside the organ
outside an organ
_______ pressure or pushing occurs when blood is pumped through dialyzer.
negative
tmp
positive
osmotic
What is dry weight?
The weight when all fluid is removed
A weight when someone is dehydrated.
When all fluid is removed and blood pressure is normal.
Amount of weight to be removed during treatment.
What is HIPPA?
A law about how to treat patients
A law to protect patients private health information.
A law protecting health care workers.
A law about how to properly document in medical records.
What best describes an intravascular fluid compartment.
Fluid between cells
Fluid inside and between the cells
Fluid inside the cells
Blood inside the blood vessels
Name the two compartments of the dialyzer.
Hollow fiber and flat plate
Fiber and blood
Blood and dialysate
Dialysate and adsorption
What does K+ represent?
Calcium
Potassium
Magnesium
Chloride
What does na+ stand for?
Potassium
Magnesium
Sodium
Calcium
What does Ca++ stand for?
Calcium
Carbon
Bicarbonate
Magnesium
What does Mg++?
calcium
Zinc
potassium
Magnesium
What are solutes?
Substances dissolved in water.
A mixture of a solvent and a solute.
A mixture of acid and bicarbonate.
Substances that move from a higher concentration to a lower concentration.
What is ultrafiltration?
A mixture of a solvent and solute.
Substances that dissolve in water
Excess fluid removed from blood through a semipermeable membrane.
Excess waste removed from blood through a semipermeable membrane.
What is the most common health problem in ESRD?
Thyroid
Cardiac
Hepatic
Hormones
At the top of the kidney it is an endocrine gland that releases adrenaline?
Cortex
Adrenal gland
Nephron
Medulla
The outer portion of the kidney?
Cortex
Adrenal gland
Nephron
Medulla
This part of the kidney is split up into a number of sections called the renal pyramids?
Cortex
Adrenal gland
Nephron
Medulla
These carry deoxygenated blood to the from the kidney:
Cortex
Renal Artery
Renal Vein
Medulla
These carry oxygenated blood to the kidney:
Cortex
Renal Artery
Renal Vein
Medulla
This carries urine from the kidney to the bladder:
Cortex
Renal Artery
Renal Vein
Ureter
Brings blood to the nephron:
renal artery
renal vein
proximal tubule
distal tubule
Beginning of the nephron holds the glomerulus:
renal artery
Bowmen's Capsule
proximal tubule
distal tubule
A cluster of capillaries around the end of a kidney tubule, where waste products are filtered from the blood.
Glomerulus
Bowmen's Capsule
proximal tubule
distal tubule
Is a portion of kidney nephron between the loop of Henle and the collecting tubule.
Glomerulus
Bowmen's Capsule
proximal tubule
distal tubule
Collects urine:
Glomerulus
Bowmen's Capsule
proximal tubule
Collecting Duct
A loop at the bottom of the nephron where water and salt is absorbed from blood.
Glomerulus
Loop of Henle
proximal tubule
Collecting Duct
Portion of the nephron that lies between Bowman's capsule and the loop of Henle and functions especially in the resorption of sugar, sodium and chloride ions, and water from the glomerular filtrate.
Glomerulus
Loop of Henle
proximal convoluted tubule
Collecting Duct
What condition occurs due to dialysate that is too hot?
Hypersensitivity reaction
pyrogenic reaction
hemolysis
septicemia
The purpose of priming and recirculating the system before setup is?
To be certain fibers are thoroughly filled with germicide.
To access ultrafiltration capacity of dialyzers.
To remove air and germicide before initiating treatment.
To maintain fiber noncompliance until treatment begins.
What is the correct angle for cannulating a fistula?
10-15
15-25
25-30
45
What is the correct angle for cannulating a graft?
10-15
15-25
25-30
45
Which way must a venous needle be placed?
Antegrade
Retrograde
Techs discretion
None of the above
What is one physical sign of hyperphosphatemia?
gastric irritation
bone demineralization
increased serum phosphate
to prevent constipation
The water softener performs the following activity:
Removes chlorine and chloramines from water
Removes calcium and potassium from water
Adds calcium and magnesium to water
Removes calcium and magnesium from water
What is TPA?
For anemia
For Vitamin D replacement
For dissolving clots
For itching
The RO operating parameters should be checked?
Monthly
Every shift
Daily
Twice per month
Bacteriologic testing for water and dialysate should be checked?
Daily
Every shift
After each patient
Monthly
Carbon tanks should be checked for chlorine and chloramines?
Every shift
Daily
Monthly
After each patient
According to the AAMI standards the total microbial count of dialysate should not exceed:
200 CFU
400 CFU
800 CFU
1,000 CFU
According to the AAMI standards the total endotoxin level should be less than:
.1EU
.2EU
2.0EU
2.5EU
What are diuretics?
Removes excess water from the body
Removes excess potassium from the body
Removes excess calcium from the body
Removes excess phosphate
What is renin?
A fluid consisting of waste product
An adrenal hormone that controls urinary secretion
The first step in urine formation
A hormone released by the kidneys when blood pressure drops
Which of the following are two criteria for rejecting a reprocessed dialyzer?
HIV status
Less than 80% of original fiber bundle volume and aesthetic apperarance
patient preference and access is recirculating
label incomplete and dialyzer not heparinized
Which of the following would you do first if your patients blood pressure dropped?
Address need to decrease goal with nurse
Assess mental status and check bp after checking proper placement of bp cuff
Place patient in upright position
Give normal saline
Four main functions of the kidney:
Removes excess fluid, renin, toxins, and electrolytes.
Removes thyroxine, excess fluid, balances pH, removes RBC's.
Removes excess fluid, toxins, regulates BP, and balances hormones.
Removes excess fluid, toxins, and sends a message to the reproductive system to produce estrogen, and balances hormones.
Pre-Weight W/C is 125 and W/C weights 30 what is the pre weight?________ Dry weight is 88.5 what is the amount the patient is over? _______ The patient gets a rinseback of 200cc, meds 150cc, and brought a drink of 500cc with a max fluid removal of 5.0 what is the total amount of fluid we will input into the machine to be removed?
Pre-weight= 99.2 Fluid gained=7.5 Total fluid removal= 6.9
Pre-weight= 100.0 Fluid gained=6.0 Total fluid removal= 6.9
Pre-weight= 95.5 Fluid gained=6.0Total fluid removal= 8.0
Pre-weight= 95.0 Fluid gained=6.5 Total fluid removal= 5.850
Pre-Weight W/C is 100 and W/C weights 25 what is the pre weight?________ Dry weight is 70.5 what is the amount the patient is over? _______ The patient gets a rinseback of 200cc, meds 50cc, and brought a drink of 300cc with a max fluid removal of 3.0 what is the total amount of fluid we will input into the machine to be removed?
Pre-weight= 70.2 Fluid gained=3.5 Total fluid removal= 2.5
Pre-weight= 75.0 Fluid gained=4.5 Total fluid removal= 3.550
Pre-weight= 85.5 Fluid gained=4.0Total fluid removal= 6.0
Pre-weight= 65.0 Fluid gained=5.0 Total fluid removal= 4.550
Pt. receives a 4 hour TX there Pre-Weight W/C is 100 and W/C weights 25 what is the pre weight?________ Dry weight is 70.5 what is the amount the patient is over? _______ The patient gets a rinseback of 200cc, meds 50cc, and brought a drink of 325cc. Pt. also receives N/S flushes of 100cc per hr. And has a max fluid removal of 4.0 what is the total amount of fluid we will input into the machine to be removed?________
Pre-weight= 70.2 Fluid gained=3.5 Total fluid removal= 5.250
Pre-weight= 75.0 Fluid gained=4.5 Total fluid removal= 3.550
Pre-weight= 85.5 Fluid gained=4.0 Total fluid removal= 6.550
Pre-weight= 75.0 Fluid gained=4.5 Total fluid removal= 4.975
An indentation in the surface of the kidney:
Trigone
Hilus
Renal pelvis
Calyx
Triangular region between the openings of the ureters and urethra.
Hilus
Nephron
Trigone
Medulla
The organization that sets the standards for dialyzer reprocessing and water quality?
FDA
CDC
AAMI
CMS
The kidneys play a major role in the excretion of drugs from the body. Due to rebal failure, which of the following is true concerning medications?
They patient may need more than the regular dose.
The patient may be at increased toxicity.
Certain medications may only require a third of the usual dose.
If a patient has a functioning liver, it will compensate for renal failure.
What is one physical sign of hyperphosphatemia?
sleepiness
severe itching
nausea
irritability
Water used for dialysate must be treated because dialysis patients:
Have strict fluid intake
Drink large amounts of water
Are exposed to large amounts of water during dialysis
Are able to excrete waste in dialysate during dialysis
Which of the following would you do first if your patient's BP dropped during TX:
Address need to decrease goal with nurse.
Assess mental status and check bp after checking proper placement of bp cuff.
Place patient in an upright position.
Give normal saline bolus.
What is the number one way to spread infection?
Pre-open packages and leave supplies open to germs.
Handwashing
Dialysis
Patients
