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WorksheetsHemodialysis
Total questions: 20
Worksheet time: 20mins
The standard proportioning of dialysis solution are
1:1.83:34 which are one parts of bicarbonate concentrate is mixed with 1.83 parts of acid concentrate and 34 parts of RO.
1:1.83:34 which are one parts of acid concentrate is mixed with 1.83 parts of bicarbonate concentrate and 34 parts of RO.
1:1.83:34 which are one parts of acid concentrate is mixed with 1.83 parts of RO and 34 parts of bicarbonate concentrate.
1:1.83:34 which are one parts of RO is mixed with 1.83 parts of acid concentrate and 34 parts of bicarbonate concentrate.
The purpose to removes calcium and magnesium in the dialysis water treatment is
to maintain deionization process
to support regeneration process
to prevent scaling on RO membrane
to confirm conductivity of the membrane
What is the advantages of arteriorvenous fistula compared to synthetic graft?
Easy to cannulate
Lower rates of infection
Variety of shapes and configuration
Good option for patient with poor vein
The management of heparin free dialysis are
using heparin saline during priming
minimum UF volume to remove extra saline
setting the blood flow rate as lower as possible
100-250ml normal saline flush into the arterial line every 15-30 minutes
Before commencing hemodialysis treatment, the nurse should check all the details in the patient note except;
arterial pressure
vascular access
dialysate regimen
duration of treatment
The following is specific preparation for a hemodialysis patient going for surgery
Infuse normal saline for hydration
prepare patient with Vitamin K injection.
no padding should be placed around the limb with the access.
a label with the words ‘NO BP TAKING OR NEEDLING’ should be placed on the AV fistula arm.
The correct technique for DFO test procedure on hemodialysis patient are
a baseline serum Al level is obtained before a HD session.
DFO will infused into the venous line during first hour of HD
withhold Al containing medication for at least 24 hours before test.
second serum Al level is obtained during last hour of HD session.
Patient at risk of disseminating viral infection include all the above except
patient with unknown viral status
patient with HBsAb is more than 100Miu/ML
Patient with history of recent transfusion of blood
Patients with negative viral status returning from another hemodialysis facility
The causes of high venous pressure alarm during hemodialysis treatment is
poor arterial flows.
patient having hypovolemia
dislodgement of venous fistula needle
incorrect positioning of venous fistula needle
MR X come to Hemodialysis unit with complained of pain, swelling and bruising on the arteriorvenous fistula site.
What is the proper management to prevent the complication as above occur?
Cleanse the skin using 50% alcohol.
Only use blunt needle for cannulation.
Using rope ladder technique of cannulation.
Applying pressure before removing AV fistula needle.
Mr M had done laparotomy and need urgent dialysis. The suitable anticoagulation that can be used for him are
Heparin Free
Tight Heparin
Normal Heparin
Regional Heparin
Miss A undergo hemodialysis treatment using heparin free. The warning sign that the nurse should be alert
venous blood appear darker.
blood plasma change to pink colour
black streak appear in dialyzer
blood in extracorporeal circuit appear transparent
After stopping an accidental air infusion in a patient undergoing hemodialysis, the nurse should immediately
turn the patient on his back and initiate CPR.
position the patient on his right side in semi Fowler’s position.
call for bedside X-ray to determine the presence of air in the patient heart.
place the patient on his left side in Trendelenburg position and
administer oxygen.
The Management of patient who is allergic with heparin during hemodialysis are
convert to CAPD
use tight heparin
Protamine infusion
re assess heparin dose
The following is preparation for the patient with first time hemodialysis using intrajugular catheter
Treatment time is 4 hours
Dialysate flow rate 800mls/min
Heparin free during hemodialysis
Blood flow rate is above 250 ml/min
MR X experienced hypotension during hemodialysis and doctor order to increase sodium profiling. The side effects of this action will be
enhances sweating.
decrease blood sugar
increase intradialytic thirst
patient will experience fatigue
MR T prescribed with lanthanum during his visit to nephrology clinic. The patient education should emphasize on
take the medication after meals.
crush the tablet and take with meals.
the medication should be swallow intact.
tahe the lanthanum togetehr with ferrous fumerate
Nurse A accidentally prick herself while removing the fistula needle from Hepatitis patient. The first step she should take is
report to the sister in charged.
wash hand with soap and water.
summit report to Infection Control Unit.
take blood investigation such as viral status.
A low alarm (more negative) in the pre pump arterial pressure monitor maybe the consequence of
decrease in blood pump speed.
hypotension or vasoconstriction
obstruction in the circuit after the dialyzer.
line separation between patient and the blood pump.
Mr L will be discharged with the IJC in situ, the following are patient education care for IJC
change the plaster every day.
wash catheter with bath soap.
do not mobilize the catheter.
put ointment around the exit site
