Safety
Nursing Care/Interventions
Assessment/Nursing Diagnosis
Equipment/Testing
Treatment/Teaching
100
To ensure patency of a fistula, you should always assess/auscultate for ______?
What is a thrill or bruit.
100
You should always _____ the patient before and after dialysis to determine fluid loss, and save pre-dialysis measurements for comparison.
What is weigh.
100
Indications for dialysis use include: (Select All That Apply) A. Uremia B. Persistent low potassium levels C. Metabolic Acidosis D. Persistent low fluid imbalances E. Continued fluid overload F. Uremic pericarditis G. Encephalopathy
A, C, E, F, G. B is incorrect because it would be persistent high potassium levels.
100
True or False: Hemodialysis is also used to treat life threatening sodium levels.
True.
100
Dialysis and Kidney Transplants are considered a treatment for _____ _____ _____ and ______ ______.
What is end-stage kidney disease (ESKD) and kidney failure. However, these treatments are not considered a "cure".
200
When a patient has a fistula, shunt, or Graft for Hemodialysis, you should avoid doing what on that extremity? (Select all that apply) A. Draw Blood B. Take Blood Pressure C. Hand flexing exercises D. Start an IV E. Administer injections F. Wave goodbye
A, B, D, and E.
200
Tingling, discomfort in extremity, and inability to palpate thrill/auscultate bruit is a sign of what?
What is clotting.
200
During subclavian dialysis catheter insertion, the nurse should monitor for manifestations of a _________ or _______ _______.
What is pneumothorax or subcutaneous emphysema.
200
How is catheter placement determined? A. Laboratory testing B. Chest X-Ray C. Palpation D. Blood return during aspiration
What is B. Chest X-Ray.
200
A nurse is planning discharge teaching for patients with AV fistulas or AV grafts. What should she teach them to avoid?
Avoid taking blood pressure measurements on that arm. Avoid wearing restrictive clothing.
300
True or False: Most medications should be held pre-dialysis.
True, especially medications such as Digoxin, anti-hypertensive, water-soluble vitamins, and certain antibiotics should be held.
300
A patient in hemodialysis with a left arm fistula is at risk for arterial steal syndrome. The nurse knows that which manifestations are signs of this complication? A. Edema and red discoloration of left arm. B. Pallor, diminished pulse, and pain in left hand. C. Warmth, redness, and pain in left arm. D. Aching pain, pallor, and edema in left arm.
What is B. Arterial Steal Syndrome results from a vascular insufficiency after creation of a fistula. Client will have diminished pulse, pain in affected hand, and pallor.
300
A patient is receiving continuous arteriovenous hemofiltration with dialysis (CAVHD). During the hourly assessment of the vital signs, the nurse notes a significant decrease in blood pressure. What action should the nurse take?
She should stop the CAVHD immediately. It indicates intolerance and put the patient at risk for shock and impairment of kidney perfusion. After stopping the CAVHD, the nurse should assess for cardiovascular stability.
300
What are the 3 main sites for hemodialysis catheter insertion? (Select all that apply) A. Radial B. Subclavian C. Internal Jugular D. Femoral E. Popliteal
B, C, D.
300
Which blood-thinning IV medication is used to lock hemodialysis catheters?
What is Heparin.
400
True or False: Vital signs are taken post-dialysis. It is normal for a patient's temperature will be slightly elevated due to the warming of the dialysis machine.
True. A slightly elevated temperature is normal. However, if the temperature becomes high, the hcp should be notified. This is a possible sign of sepsis.
400
True or False: Patients on hemodialysis can eat peanut butter, nuts, seeds, dried beans, peas, and lentils.
What is false. Although high protein diets are recommended, dialysis patients should also be on low potassium and phosphorus diets. The above items are high in protein but are also high in potassium and phosphorus therefore should be avoided.
400
What are two nursing diagnoses for a patient during hemodialysis?
What is risk for bleeding r/t use of anticoagulant during HD and risk for infection r/t cannulation.
400
What are two common problems related to hemodialysis catheter use? (Select all that apply) A. Skin lesions near catheter insertion site. B. Catheter-related blood stream infection (CR-BSI) C. Bleeding D. Vein thrombosis E. Catheter leaking
B and D.
400
Why should a patient avoid any invasive procedures for at least 4 to 6 hours after hemodialysis?
Heparin remains in the body for 4 to 6 hours and increases risk for bleeding.
500
If a patient is showing signs and symptoms of an air embolism, what actions should the nurse take? (Select all that apply) A. Place patient in semi-fowlers position and turn on right side. B. Administer O2. C. Assess vital signs with pulse oximetry. D. Continue the hemodialysis and monitor for more symptoms. E. Notify health care provider immediately.
B, C, and E. First stop hemodialysis. Turn patient on left side and in Trendelenburg. Administer O2. Assess v/s with pulse oximetry. Notify HCP. Document the event.
500
With AV fistulas and AV grafts, it is important for the nurse to monitor which main complications? A. Headache, nausea, fatigue. B. Dizziness, infection, clotting. C. Bleeding, infection, clotting. D. Bruising, nausea, fatigue.
What is C. Bleeding, infection, clotting
500
What common problems should the nurse monitor for after a patient is done with hemodialysis? (Select all that apply) A. Hypotension B. Headache C. Nausea, Vomiting, and Dizziness D. Malaise E. Muscle cramps F. Hypertension
A, B, C, D, E.
500
What are three risks for using the femoral site for catheter placement?
What is restricted mobility, infection, and hematomas.
500
What is Protamine Sulfate? A. Antidote for heparin B. Antiemetic C. Substitute for heparin D. Loop diuretic
What is A. Antidote for heparin.
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