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WorksheetsNNRT 1 (Set 2)
Total questions: 25
Worksheet time: 13mins
The statement below is correct about principle of peritoneal dialysis
Size of solute determine the rate of removal
water removed via diffusion and convection only
Amount of vascular supply in peritoneum determine protein removal
Cooler dialysate helps the diffusion of glucose through the membrane
Below is the advantage of icodextrin dialysates
cheaper in term of price
Easily absorbed and doesn’t cause peritoneal fibrosis
Require lower concentration of dextrose for better solute removal
can be stored at any temperature and doesn’t cause degradation
What is contraindication to donor of kidney transplantation?
eGFR lesser than 60ml/min
extensive vascular disease
BMI lesser than 45kg/m2/1.73
commercial non-living related transplantation
Clinical manifestation for acute kidney transplant rejection is
haematuria and pyuria
increased urine output and hypotension
fever, weight gain and diminished urine output
pain in the incision, general malaise and depression
Madam K on intermittent peritoneal dialysis, complained of abdominal pain during treatment. The cause may be due to
rapid inflow
long dwell time
hypotonic solution
kinking of dialysis catheter
Patient on intermittent peritoneal dialysis (IPD) notice poor outflow second cycle of treatment. What is the immediate action by attending nurse?
Ask the patient to cough
check for kinks in the outflow tubing
place the patient in a reverse Trendelenburg position
Raise the drainage bag above the level of the abdomen
Nurses should be alert while reviewing patient’s laboratory result who is on intermittent peritoneal dialysis (IPD). This includes
hematocrit level > 35 %
glucose level <8.0mmol/l
potassium level < 5.0 mmol/l
white cell count (WBC) > 10000mm
The health education that should be given to newly trained patient include
Take laxative to prevent constipation
Apply thick oinment around the exit site
Heat up the dialysate solution prior to exchange
Take calcium-based phosphate binder after meal
A client with chronic kidney disease (CKD) has asked to be evaluate for a home continuous ambulatory peritoneal dialysis (CAPD) program. The nurse should provide following advice to improve clearance
Do PD exchange every 4-6 hours every day
perform hand rub once during every exchange
Switch on the fan to provide better ventilation during the exchange
Use glove to cover the hand if unable to remove the ring from the finger before starting the procedure
The nurse is preparing to care for a client receiving continuous ambulatory peritoneal dialysis
(CAPD). The following should be included in the nursing care plan to prevent complication associated
with peritoneal dialysis
Maintain strict aseptic technique
Add heparin to the dialysate solution
Change the catheter site dressing daily
Monitor the client’s level consciousness
The client with chronic kidney disease (CKD) has an indwelling tenchkoff catheter for peritoneal
dialysis. The client accidentally wet the catheter dressing while having shower. What is the
immediate action need to be done?
scrud the catheter with povidone-iodine
Flush the peritoneal dialysis catheter
reinforce the dressing
change the dressing
Mr S undergone continuous ambulatory peritoneal dialysis (CAPD) training for 7 days at CAPD
unit before discharge. The following statement shows the correct understanding of client regarding
CAPD training.
The procedure last for 1 hour
I have to go hospital to do procedure
I am expected to perform the procedure at home
I have to sit and raise my leg during procedure
Before selecting patient for peritoneal dialysis the nurse must consider
gender of the patient
hand dexterity of the patient
distance to the neares hospital
knowledge level of the patient on PD
Relative contraindication on selection criteria for peritoneal dialysis
poor vision
metastastic malignancy
extensive peritoneal fibrosis
Severe macrovascular disease
Which of the following is the most significant sign of peritoneal infection?
swelling in the legs
cloudy dialysate fluid
poor drainage of the dialysate fluid
Redness at the catheter insertion site
The following action should be taken by patient when Continuous Ambulatory Peritoneal Dialysis
(CAPD) outflow is less than inflow
contact the physician
increase dwelling time
Place the patient side to side
stop the peritoneal dialysis infusion
Mr B was diagnosed as chronic kidney disease (CKD) stage 5, and planned for continuous
ambulatory peritoneal dialysis(CAPD). Below are the early complication of peritoneal dialysis seen
in first 3 days except
bladder perforation
fluid leak from exit site
interperitoneal bleeding
prolapse intervertebral disk
Nursing education for post tenchkoff catheter training in CAPD patient include
allow swimming
do dressing once a week
avoid mobilization of tenchkoff catheter
increase intake of phosphate more than 800mg/day
Mr L an 85 years old male with CKD stage 5 opted for conservative management. The following is
the conservative management for RRT
Perform CAPD as usual
re-evaluate RRT option for patient
prepare the patient for palliative care
allow patient to consume fluids and foods that he prefers
Madam X had kidney transplantation 2 weeks ago. The rehabilitation aspect that need to be
advised to Madam X include
educate on complication of kidney transplant
encourage strenuous activity such as mountain climbing
reduce immunosuppressive drugs during active infection
actively involved in sexual intercoursewithout any precoutions
Which of the health educations is given to post transplant patients regarding sex and family
planning
Can be pregnant even though kidney function is not normal
Avoid pregnancy before 1-2 years after kidney transplantation
some medicines can be passed on through breast milk and it is safe to the baby
women of child bearing age can use contraception devices without consulting with their transplant physician
Health educations given to post transplant patients regarding nutrition includes all the following except
protein intake of 0.8g/kg/day
protein should comprise 25% of total calories
Calories intake should be 25-30kcal/kg/day to maintain reach ideal body weight
Fat should comprise <30% of total calories <10% saturated 10-15% monosaturated & 10% polyunsaturated
Mr J has pledge as an organ donor. In which following clinical condition the client fulfil the
requirements for cadaveric donor?
Doll’s eye movement absent
spontaneous breathing absent
Spinal reflexes in trunk or extremities may be seen
Unconscious no reaction to speech but respond to pain
The management of patient with hyperposphatemia in CAPD is to
change treatment modality to APD
use dialysate solutions of 2.5% frequently
advice of calcium based phosphate binder
consume 1200-1600 mg of phosphate per day
Mr G has been instructed to undergo CAPD training by the nephrologist. During the training the
nurse educated the patient on recurrent peritonitis. She has to reinforced recurrent peritonitis as
below
An episode occurs more than 4 weeks with same organism
Failure of the effluent to clear after 5 days of appropriate antibiotic
An episode occurs less than 4 weeks of completion of therapy with same organism
An episode occurs within 4 weeks of completion of therapy with different organism
