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M3 Test 3

Dialysis Army School M3

QuestionAnswer
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.
Created by: 663267758