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Fresenius annual exam Questions With Complete Solutions
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Fresenius annual exam Questions With Complete Solutionsacute renal failure Correct Answer sudden onset, severe,
usually reversible, Drug toxicity, motor vehicle accident,
dehydration
After the Heparin has been given, how long must you wait
before initiating the treatment ? Correct Answer A 3 - 5 minute
mandatory wait time is required after the Heparin has been given
before the treatment can be initiated. This is to allow for the
heparin to become systemic, which provides the heparinization
of the blood throughout the patient's body.
At what blood pump speed is the extracorporeal circuit primed ?
Correct Answer Prime the dialyzer and circuit at 150 mL per
minute.
At what point during the hemodialysis treatment will diffusion
cease to occur ? Correct Answer Diffusion will continue
throughout the dialysis treatment until the concentration of each
electrolyte found in the patients blood is equal to the electrolyte
concentration in the dialysate.
At what point during the priming process shoud the Hanson
connectors ( dialysate lines) be connected to the dialyzer ?
Correct Answer The Hanson connectors should be connected
after the dialyzer and lines have been filled with saline, the
arterial and venous blood lines have been connected in
preparation for circulation, the automatic test sequence has been
completed, and conductivity and pH testing are completed using
an independent meter such as the Phoenix meter.
,Chronic renal failure Correct Answer slow onset, progressive,
permanent, diabetes - diabetic nephropathy or
glomerulosclerosis, Hypertension causing nephrolosclerosis,
glomerulonephtitis
Clearance of the urea is best described as ? Correct Answer
The amount of urea cleared from the blood in millimeters per
minute ( ml/min). It is a measure of dialysis effectiveness.
conductivity levels about 14.5 can cause ? Correct Answer over
14.5 reflect hypertonic dialysate and can cause crenation
( shrinkage of red blood cells)
conductivity under 13.5 can cause? Correct Answer below 13.5
reflect a hypotonic dialysate and can potentially cause homolysis
( the rupture or destruction of red blood cells)
Define pericarditis. Correct Answer and inflammation of the
membrane that surrounds the heart due to fluid and waste build
up. The classic triad of symptoms include fever, chest pain, and
pericardial friction rub.
During initiation of treatment, when is the lab work drawn and
from which needle site ? Correct Answer When initiating the
treatment, lab work is drawn prior to administering Heparin. Lab
work is drawn from the arterial needle with a vacutainer.
extracellular Correct Answer outside the cells
,Fluid removed during hemodialysis comes from which body
fluid compartment ? Correct Answer During dialysis fluid is
removed from the intravascular fluid compartment or
bloodstream.
Intravascular = inside the blood vessels
For how long may a patient's blood be re-circulated during
treatment interruption ? Correct Answer Blood recirculated for
longer than 15 minutes may lose oxygen and cannot be returned
to the patient. Therefore, if recirculation is anticipated to take
longer than 5 to 10 minutes, reinfuse the blood if possible. If the
patient's blood has be reinfused, the blood tinged saline may be
recirculated for a maximum of 120 minutes and a system refresh
performed at 60 minutes.
How can we measure how well we clean our patients blood?
Correct Answer By measuring the amount of wastes in the
patient's blood before and after dialysis, we can calculate the
amount of clearance we achieve.
How can we measure the effectiveness of a dialysis
prescription? Correct Answer Using UKM or Urea Kinetic
Modeling and On-Line Clearance with AMP we can determine
the effectiveness of the dialysis prescription, by measuring the
KT/V. Bloodd is drawn monthly for a pre and post BUN, and
patient data flows into ecube clinicals. The patient is dialyzed on
the prescribed time, blood flow, dialysate flow, and dialyzer.
These treatment parameters can be adjusted to help improve
clearance. Patients running the the "green" light indicate
meeting the clearance goal; those in "yellow" will need their
prescription changed to dialyze effectively.
, How can we tell wheater a dialysis treatment is effective ?
Correct Answer UKM (Urea Kinetic Modeling) is considered
the best method currently available for determining treatment
effectiveness and is mandatory in all FMC clinics. Kt/V and
URR are two other methods of determining adequacy. All these
methods rely on the pre/post BUN being drawn correctly. UKM
is considered the best adequacy monotoring method because it
takes many other factors besides the BUN into consideration.
How can you tell if a dialyzer is clotting ? Correct Answer
Inidications of a clotting dialyzer are a rising TMP, rising
venous pressure, dark blood in the dialyzer and air detector
alarms. A venous line that is clotting will show an increase in
venous pressure.
How do you clean the patients skin in preparation for needle
insertion ? Correct Answer 1- carefully select cannulation sites.
2- clean each site with Betadine or an alcohol pad in a circular
motion from the insertion site out to cover a 2-3 inch wide area
for 30 seconds.
....if Betadine is used, allow to dry 3 - 5 minutes
.....the sites should not be touched prior to needle insertion or the
site will have to be cleaned again.
How do you distinguish the arterial side from the venous side on
a horseshoe graft ? Correct Answer 1- depress the midpoint of
the graft to partially obstruct the flow, feel for the strongest thrill
and listen for the strongest bruit. The stronger thrill or bruit is
the arterial side.
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