WorksheetsNNRT 1 (Set 3)
Total questions: 35
Worksheet time: 18mins
The purpose of using glucose contained solution in peritoneal dialysis is to
decrease risk of peritonitis
prevent excess glucose removal
increase osmotic pressure to produce ultrafiltation
prevent disequilibrium syndrome
The benefit of newer type of Peritoneal Dialysis solution is
improved nutritional status.
decrease risk of peritonitis.
prevent disequilibrium syndrome.
increase excess glucose exposure.
The standard procedure of peritoneal equilibrium test (PET) at 2 hours is
advice patient to ambulate or sit.
drain dialysate 200mls into drain bag.
reinfuse remaining 170 mls of effluent.
blood for creatinine, urea and glucose at 2 hours.
The following measure to preserve residual renal function in continuous ambulatory peritoneal dialysis
consume more water.
use of ACE i and ARB.
use of icodextrin solution.
consume nephrotoxic without doctors prescription.
The long term complication of continuous ambulatory peritoneal dialysis (CAPD) include
obesity
bleeding
hyperkalemia
hypolipidemia
The following features of peritonitis is
cloudy dialysate fluid
polymorphonuclear cells < 50%.
poor drainage of the dialysate fluid.
redness at the catheter insertion site.
Miss Z, CAPD patient came to clinic with the problem of poor inflow and outflow. The CAPD staff should
change to haemodialysis
give laxative or enema to patient
advice patient increasing the number of exchange
added intraperitoneal antibiotic in dialysate solution stat.
Following Peritoneal Equilibrium Test (PET). The patient was found to be a high transporter. It show
good in both ultrafiltrate and solute removal.
poor in solute removal but good in ultrafiltration.
poor in ultrafiltration but good in solute removal.
poor in boths and needs to change mode of dialysis.
Sign and symptoms of exit site infection include
any purulent drainage.
dark, purplish discoloration of the exit site.
plain granulation tissue in the sinus tract.
epidermis progressing into the sinus tract.
Which the following is the cause of tunnel infection in CAPD
peritonitis.
poor outflow.
catheter migrated.
poor exit site care.
Automated peritoneal dialysis(APD) is suitable mode of dialysis for
mentally ill patient.
client on active lifestyle.
patient with disable hands.
hemodynamically unstable patient
Adequacy of continuous ambulatory peritoneal dialysis (CAPD) can be improved by
using 4.25% dialysate.
using a swan neck catheter.
increase number of exchange.
doing peritoneal equilibrium test (PET).
This process take place during the fill phase of peritoneal dialysis
dialysate in infuse and drain rapidly.
dialysate remains in the peritoneal cavity
dialysate is drained from the peritoneal cavity.
fresh dialysate is introduced into the peritoneal cavity.
Tenckhoff catheter removal is indicated in the following situation
fungal infection.
exit site infection.
poor catheter flow.
kt/V less than 1.7 per week.
The following are indications of Intermittent Peritoneal Dialysis (IPD) EXCEPT
Acute poisoning.
acute kidney injury.
Large pleuro peritoneal fistula.
End stage renal disease as temporary treatment.
A week after kidney transplantation, the client develop febrile, hypertension and kidney is tender. The X-ray show result the kidney transplant is enlarged. Based on this assessment finding, the nurse should suspect which of the following
acute rejection.
kidney infection.
chronic rejection.
kidney obstruction.
In order to maintain fluid and electrolyte balance for post renal transplant, the nurse should monitor for
hemoglobin level.
4 hourly urine output.
arterial blood gases hourly.
central venous pressure reading hourly.
Health education given to post transplant patients regarding imunosuppressive drugs includes all of the following EXCEPT
compliance to drugs.
is given for the lifetime.
increasing the dosage during infection.
understanding the side effects of each drugs.
The rehabilitation that should be advised to post transplant patient is
continue their education.
get pregnant within a year.
mingle around in crowded place.
discontinue the immumosupressive drugs.
Post transplant patient started cyclosphorin therapy to prevent graft rejection. The major side effect is
toxicity.
depression.
hemorrhage.
peptic ulcer disease.
The specific management of acute graft rejection includes
consume 2 hourly water.
carry out immediate hemodialysis.
increase the dose of immunosuppresive drugs.
administering intravenous methylprednisolone.
Mr R was re-admitted to the hospital with acute graft rejection. The finding would be
hypotension.
decreased WBC.
normal body temperature.
elevated BUN and creatinine.
Mr A decided to donate his kidney to his sister. The criteria for donor is
ABO compatibility.
malignant hypertension.
age more than 65 years.
BMI more than 30 -35kg/m2.
The nursing management of patients pre transplant includes
hourly reading of CVP.
send patient for hemodialysis.
taking blood investigation for ABG.
Insert continuous bladder drainage (CBD).
After 2 hours of successful renal transplant, anuria was noted by the nurse. This may be due to:
acute tubular necrosis.
chronic rejection transplant.
pattency of urinary catheter.
pain and tenderness at allograft.
In order to prevent peritonitis, dialysis staff should adhere to the following guideline.
Heat dialysate bag before use.
Flush frequently to remove fibrin clots.
Give intraperitoneal antibiotic in dialysate.
Proper handwashing each time before spiking solution.
Cause of membrane failure is
catheter malposition.
intraluminal blood clot.
mechanical obstruction.
long term use of Peritoneal Dialysis
Post operative care after kidney transplantation is
daily chest x-ray.
isolation nursing.
Bladder catheter removed at day 2.
Urine output measured every 2 hourly.
Preparation for patient who is going for renal transplantation is
vitamin K injection.
hemodialysis on the day prior to operation.
intravenous fluids infusion to avoid dehydration.
diethylenetriaminepentaacetic (DTPA) scanning.
1A patient with chronic kidney disease (CKD) stage 5 has opted for continues ambulatory peritoneal dialysis (CAPD) program. The major advantage of this approach is
Relatively low in cost
Allow the client to be more independent
Faster and more efficient than standard hemodialysis
Has fewer potential complications than standard hemodialysis
While providing education for continues ambulatory peritoneal dialysis (CAPD) patient to implement at home, which intervention will the nurse prioritize to the client?
Adhere to the nutritional restrictions ordered
Keep a record of weight daily, using the same scale
Follow sterile technique when caring for PD catheter
Measure weight before and after performing peritoneal dialysis
The advice to a post Tenchkoff catheter insertion patient include
Apply ointment at the exit site
Allow liquid soap during shower
Kept exit site dressing clean and dry
Change dressing every alternate day
Mr X chronic kidney disease (CKD) stage 4 and choose continues ambulatory peritoneal dialysis (CAPD) as an option of kidney replacement therapy. The management of post tenchkoff catheter insertion includes
Change dressing at exit site alternate stained
Irrigate until clear if effluent is blood stained
Allow shower 2 time/day to prevent infection
Initiate continues ambulatory peritoneal dialysis (CAPD) training after post- operative day7
Which the following is the patient selection criteria for continues ambulatory peritoneal dialysis (CAPD)
Inflammatory bowel disease
Elderly with no family support
Extensive peritoneal fibrosis and adhesions
Diabetes mellitus with vascular access problem
The main reason for continues ambulatory peritoneal dialysis (CAPD) training is to
Prevent complication
Improve residual renal function
Achieve dialysis adequacy
Prevent intradialytic complication
