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DAVITA RISE FINAL EXAM 2024
QUESTIONS AND ANSWERS GRADED A+
"How do we replace normal excretory kidney functions? - CORRECT ANSWER By normalizing
electrolytes through the use of acid concentrate and providing fluid balance through ultrafiltration"
"What is Uremia and how does it affect the body? - CORRECT ANSWER Uremia is a buildup of
wastes in the blood due to kidney failure and affects all body systems"
"What are the most common causes of CKD in the USA? - CORRECT ANSWER Diabetes,
Hypertension, Polycystic Kidney Disease" "Systemic effects of CKD- what would you advise for a patient who complains of Psychological
Problems (i.e. anxiety/depression) - CORRECT ANSWER Verbalize struggles to IDT (core team)
especially the social worker"
"What is your role in CKD-MBD Management? - CORRECT ANSWER Report symptoms, urge
patients to take medication (home and incenter) Report problems related to nonadherence"
"Define the term AKI - CORRECT ANSWER Term incorporates a wide spectrum of kidney issues
Includes acute kidney failure as well as less catastrophic kidney function changes May dialyze in an out-patient facility until kidney function recovers"
"Explain the difference between AKI and CKD - CORRECT ANSWER Eliminating the cause of the
AKI can often lead to the return of kidney function. You cannot eliminate the cause of CKD which is HTN, Diabetes, genetic disorders (PKD)" "Outline the treatment goals for a patient with AKI dialyzing in the out-patient facility (How do
you protect kidneys from further injury?) - CORRECT ANSWER Avoid substances to the kidney
which may be toxic (radiographic, contrast, amphotericin B, low dose aspirin, NSAIDS)"
"What is important when monitoring weight and BP? - CORRECT ANSWER Keep a little extra
fluid on the patient so it is available to the kidneys when they start filtering/ultra-filtrating on their own"
"Diffusion - CORRECT ANSWER Particles move from an area of high concentration to
concentration"
"Osmosis - CORRECT ANSWER Fluid moves from an area of low concentration to high
concentration"
"What are the kidney's excretory functions? - CORRECT ANSWER to normalize electrolytes,
remove wastes, provide fluid and acid base balance"
"What is the function of the acid concentration? - CORRECT ANSWER Provides the
concentration gradient for diffusion and helps normalize electrolytes"
"What is the function of bicarbonate? (In the dialysate solution?) - CORRECT ANSWER Buffers
the acid concentrate"
"Signs and symptoms of Hypokalemia - CORRECT ANSWER <3.5 mEq Symptoms: fatigue,
muscle weakness, paralysis, and respiratory failure, cardiac instability, arrhythmias, cardiac arrest"
"Normal blood pH range is? - CORRECT ANSWER 7.35-7.45"
"Why is it so important to know what caused your patient's CKD? - CORRECT ANSWER So, the
nurse and PCT can inquire about possible problems during data collection and assessment"
"Signs and symptoms of fluid imbalance - CORRECT ANSWER Hypertension, Edema,
SHortness of Breath"
"Why is sodium balance important? - CORRECT ANSWER Leads to volume expansion,
increased cardiac output, increased peripheral vascular resistance, and increased blood pressure"
"Systemic effects of CKD- what would you advise for a patient who complains of Dry itchy skin? -
CORRECT ANSWER Use hyper-fatted soaps and lotions"
"Outline the treatment goals for a patient with AKI dialyzing in the out-patient facility (What do
you need to consider in regards to their vascular access?) - CORRECT ANSWER Patients will
typically have a dialysis catheter, be careful to avoid catheter related infections"
"AKI patients are at increased risk for which complications? - CORRECT ANSWER Hypovolemia
and hypotension"
“Ultrafiltration - CORRECT ANSWER Fluid pushed through the semipermeable membrane
(SPM) membrane"
"Convection - CORRECT ANSWER Solutes dragged across SPM along with fluid"
"What is the function of bicarbonate? (When it diffuses into the patient's blood?) - CORRECT
ANSWER Normalizes body pH"
"Signs and symptoms of Hyperkalemia - CORRECT ANSWER >5.5 mEq Symptoms: extreme
muscle weakness, abnormal heart rhythm, and possible cardiac arrest"
"What are the kidneys' endocrine functions? - CORRECT ANSWER Renin secretion,
Erythropoietin secretion, Vitamin D activation"
"How do we replace normal endocrine kidney functions? - CORRECT ANSWER Provide
medications"
"How much of normal kidney function is replaced by hemodialysis? - CORRECT ANSWER 15%"
"Outline the treatment goals for a patient with CKD - CORRECT ANSWER Slowing the
progression of CKD Managing comorbidities and complications Controlling symptoms Minimizing the effects of CKD on patients' lifestyles Kidney replacement therapy modality education Encouraging patients to actively participate in their healthcare" "Systemic effects of CKD- what would you advise for a patient who complains of Peripheral
Neuropathy (nerve pain in the extremities) - CORRECT ANSWER monitor patient for changes
in motor function, decreased strength in legs, complaints of restless legs, burning feet. Advise patient not to walk barefoot, have good foot care practices" "Systemic effects of CKD- what would you advise for a patient who complains of GI problems (i.e.
nausea/vomiting) - CORRECT ANSWER Inform RN and physician of any bleeding
problems/constipation/diarrhea/ER visits, take the medications as ordered (stool softeners/Imodium)"
"What is common cause of hypertension in dialysis patients? - CORRECT ANSWER Fluid
overload"
"Left Ventricular Hypertrophy leads to? - CORRECT ANSWER Ischemic heart disease,
arrhythmia, myocardial infarction, sudden death"
"Why are dialysis patients anemic? - CORRECT ANSWER The life span of their red blood cell is
60 days or approximately 1/2 of the normal 120 days"
"What are the four key elements contributing to CKD-Mineral Bone Disorder (MBD)? - CORRECT
ANSWER Calcium, Phosphorus, PTH, Vitamin D (Calcitriol)- All lead to CKD-MBD when they are
abnormal"
"What are symptoms of CKD-MBD in addition to bone disease? - CORRECT ANSWER Soft
tissue calcification, itching, muscle weakness, pathological fractures, tendon ruptures, compression of vertebrae, atherosclerosis, heart disease"
