DaVita ICHD Nurse PCT Test Exam Updated Version Questions and 100% Verified Correct Answers Scored 100% adequacy of dialysis monitored with - Ans Kt/V
K=clearance t=time of session V=Volume
Advanced Cannulator - Ans TM who has completed all competencies listed on NFACT skills checklist and who also has expert assessment and cannulation skills
Air Embolism - Ans Definition: Air bubbles enter blood stream and are carried to a vessel small enough to be blocked by air
S/S: visible air in venous line, chest tightness or reports of pain, Dyspnea and coughing, cyanosis, restlessness & confusion, visual disturbances, convulsions/ seizures, cardiac arrest
Interventions: stop pump, clamp CVC limb, place pt in trendelenburg position on left side, contact EMS and MD, aspirate air from arterial line, attach saline bag with administration line to arterial access, give O2
Anaphylaxis - Ans Definition: rapid, severe immune response to an allergen, may be caused by ETO allergy, rxn to germicide left in blood lines, or medication allergy
S/S: difficulty breathing, wheezing, tachycardia, hives, itching, periorbital edema, hypotension, anxiety, restlessness, chest tightness, cardiac arrest
Intervention: stop the medication, stop blood pump. d/c treatment, do not return blood, notify MD, call EMS
Aneurysms - Ans an excessive localized baloon like enlargement of an artery caused by a weakening of the vessel wall.
can occur when old insertion sites are not given sufficient time to heal & needles are repeatedly placed
Angina - Ans Definition: Chest pain or discomfort due to Coronary Heart Disease.Occurs when heart muscle doesn't get as much blood as it needs. May also feel discomfort in neck, jaw, shoulder, back or arm. Uncomfortable pressure, fullness, squeezing pain in center of chest.
S/S: Chest pain, difficulty breathing, nausea 1 / 2
Interventions: Reduce BFR to 150, reduce UFR, give O2, monitor cardiac rhythm/VS
Arterio-venous Fistula (AVF) - Ans gold standard due to lasting the longest with fewest complications surgically connected artery and vein can be created on arm or leg
Arterio-venous graft - Ans used if pt doesnt have adequate vessels to create fistula, does not require time to mature.higher rate of complications ( i.e. clotting) created by tunneling synthetic or biologic tubing underneath skin
Beginner Cannulator - Ans TM with less than 6 mo of dialysis experience & less than 10 successful cannulations on established fistulae
Blood Loss - Ans Definition: loss of blood typically due to dislodged needle, bleeding at access site, disconnection of lines, system clotted and unable to return blood.
S/S: hypotension, loss of consciousness, blood on floor, chair or clothing, blood lead detector alarm, VP alarm if needle dislodged or line separate, TMP alarm, visible clots in chamber
Interventions: Manage symptoms, give saline replacement if needed, give O2, fix cause
Cardiac Arrest: - Ans Definition: Cessation of heart beat.
Signs/Symptoms: Absence of pulse, lack of respiration, unresponsiveness
Interventions:Assess ABC's, get help, CPR, return blood, keep access open, call EMS, maintain patency of needles or CVC ports with NS
Central Venous Catheter (CVC) - Ans intravenous access device inserted into large veins such as the subclavian, jugular, or femoral veins in the center of the body.Highest occurrence of complications (i.e. blood flow and infections) Advantageous b/c it can be used immediately
Clotted Dialyzer - Ans Definition: Dialyzer membrane clotted
S/S: decrease in VP with no change in BFR, visible clots in the venous drip chamber or line, dark blood, unable to rinse back pt's blood
Intervention: ensure proper use of heparin, monitoring pressures, maintain proper BFR.Change set up, determine cause
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