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M3 Test 3
Dialysis Army School M3
| Question | Answer |
|---|---|
| What is the most commonly used Anticoagulation in Hemodialysis? | Heparin |
| If a thrombus occurs in the kidney fibers what will be diminished? | Dialysis Clearance |
| If using saline flushes do you have to add the fluid given to your goal? | yes |
| If anticoagulation was excessive during Treatment how long do you hold sites after? | 15 minutes. |
| What is an early sign of heparin overuse? | Increased needle site bleeding time. |
| What are late signs of heparin overuse? | Pericardial effusion, pleural effusion, osteoporosis, leukocytopenia, inhibition of aldosterone biosynthesis |
| If a patient has had a recent surgery or is going to surgery would you increase or decrease their heparin? | Decrease |
| What medication would make you consider decreasing or eliminating heparin? | Aspirin, Coumadin, Ibuprofen, Dextran, Persantine, Phenylbutazone, Indomethacin, Hydroxychloroquine |
| What medication would make you consider increasing the heparin? | Digitalis, tetracycline, nicotine, antihistamines |
| what blood tests are required for a trisodium citrate dialysis treatment? | Pre and post calcium levels |
| Load bolus of heparin is given how long before dialysis treatment? | 3-5 minutes |
| How long before the end of treatment do you stop the continous infusion of heparin? | 1 hour |
| For a patient without risk of bleeding the intradialytic clot time should be? | 1.5-2.0 times their baseline |
| For a patient with risk of bleeding the intradialytic clot time should be? | 1.25-1.4 times their baseline |
| When infusing a patient with trisodium citrate and calcium chloride which is sdministered pre bloodpump? | Trisodium citrate |
| What is a complication of trisodium citrate use? | hypocalcemia |
| What are some signs and symptoms of hypocalcemia? | EKG dysrhythmia, numbness, tingling, seizures |
| If signs and symptoms hypocalcemia occur what tests and treatments do you do? | Stat ionized calcium test, Calcium Chloride 10cc IVP |
| What are the two types of flushes for anticoagulation free dialysis treatment? | Dialyzer bolus flush 100-150 q 15-30min OR continuous flush of 200-800ml/hr |
| What does documentation provide? | Permanent record of events, communication, reimburshment. |
| What does documentation monitoring provide? | Changes in baseline, history, identify potential problems, effectiveness of treatments |
| What are the predialysis safety checks? | CRANT: Conductivity, Residual Disinfectant, Alarms, Name of water room checker, Temperature |
| What are the elements of the predialysis Assessment? | desired weight loss (Current Weight - Dry Weight), Vitals, Access site, Respiratory, Patient status, Cardiovascular, GI. |
| How often do we check patient vitals? | Predialysis, initiation, q30min, post dialysis, and PRN |
| To prevent infection of an open catheter site what ppe is used by both patient and staff? | Face mask |
| Do you flush a catheter before aspirating blood? | No, First you aspirate the heparin then you flush. |
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