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Dialysis M3
Exam 6
| Question | Answer |
|---|---|
| What is Hemolysis? | Acute destruction of RBC's which lead to acute onset of anemia. |
| Dialysate causes of Hemolysis include: | Conductivity, metals, overheated dialysate, blood transfusion reaction. |
| Non-dialysate causes of Hemolysis include: | hypotonic solution, occlusion of blood pump rollers, kinks in blood tubing post blood pump, arterial pressure > -250 mmHg |
| Symptoms of Hemolysis? | HA, ABD pain, hypotension, Dyspnea, dysrhythmias, clear or cherry red or burgundy colored blood, pink tinged serum, drop in HCT, hyperkalemia, seizures and cardiac arrest |
| Management of Hemolysis include: | 1. STOP BLOOD PUMP, 2. DO NOT RETURN BLOOD, 3. VS/LABS, 4. CALL MD, 5. TREAT CONDITIONS. |
| What can cause an AIR EMBOLISM? | Air leakage, Needle dislodgment, disconnection, connections, IV bag, low levels in drip chambers. |
| Major sign/ symptom of Air Embolism? | ℅ Rushing of air, CP, dyspnea |
| TX of Air Embolism include: | 1. STOP BLOOD PUMP, 2. Clamp venous line, 3. LF side trendelenburg, 4. O2, 5. Call MD |
| Prevention of Air Embolism include: | Always use air/foam detection, double clamp side arm, inspect/secure lines, rinse with NS only. |
| Causes of Seizures are? | Hypotension, DDS, improperly prepared dialysate, electrolyte imbalances, low BS, hypoxemia |
| TX of Seizures? | Open airway, do not restrict, Treat cause. |
| Prevention of Seizures? | Use osmotic agents to proven large shifts of fluid, avoid rapid drops in BUN, proper bath |
| Treatment/Prevention of muscle cramps include? | Infusion of NS, hypertonic saline or Dextrose 50%, reduce UF, correct dialysate modeling, |
| Most common cause of NV? | What is Hypotension? |
| Treatment/Prevention of Hypotension? | What is administer .9 NS in 100-200 increments |
| Symptoms occur toward end of RX or within 8-12 hours post-dialysis. | What is DSS (Dialysis Disequilibrium) |
| Symptoms of DSS may include: | Restless, HA, HTN, widening pulse pressure, NV |
| Treatment of DSS? | Short, frequent dialysis sessions, use less efficient dialyzer or low bfr, mannitol. |
| DSS HA TX? | what is Hypertonic saline or D50 |
| DSS NV TX | what is Antiemetic's (compazine) |
| DSS HTN TX | what is Rapid acting acting antiHTN |
| Seizure TX | what is valium, anticonvulsants |
| For 1st dialysis tx you will need? | Patients signed consent, nursing assessment, data base, med sheet and 12 lead EKG |
| A clotted dialyzer is caused by? | Improper heparin, malfunctioning heparin pump, and poor blood flow |
| Air leaks are caused by? | Empty NS bag |
| The lines will jump when? | the lines are clotting |
| _____ dones not cross the placenta | Heparin |
| Emergency response follow up? | Patient care, emotional support, necessary recording, critique, prevent |
| TPA? | What is anticoagulant |
| What to do if you have a blood leak? | Check for blood, Turn off pump, Clamp lines, DO NOT RINSE BACK, change kidney |