Patient Assessment Flashcards
6 cards from real CCHT practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Patient Assessment flashcards as text
What does access recirculation mean in the context of patient assessment, and how does it affect treatment quality?
Answer: Dialyzed blood from the venous needle being immediately re-drawn through the arterial needle, reducing efficiency
Access recirculation occurs when cleaned blood from the venous needle re-enters the arterial needle, diluting uremic blood and reducing dialysis efficiency.
A patient with a new arteriovenous graft (AVG) presents with redness, warmth, swelling, and pain over the graft. What assessment should be performed and what is the concern?
Answer: Assess for signs of graft infection; do not cannulate if infection is suspected until evaluated by a physician
Signs of inflammation/infection over an AVG (erythema, warmth, pain, swelling) require physician evaluation before cannulation, as needling an infected graft can cause bacteremia.
When performing a pre-treatment patient assessment, what key information should be gathered about the patient's interdialytic period?
Answer: Weight gain, dietary adherence, medication compliance, symptoms, and any medical events since last treatment
A comprehensive interdialytic history identifies fluid gain, medication issues, dietary violations, new symptoms, or medical events that affect treatment planning.
What is the clinical significance of a decreasing Kt/V trend over multiple treatments despite no changes in dialysis prescription?
Answer: May indicate access dysfunction, fistula recirculation, shortened treatment times, or increasing patient size
A declining Kt/V without prescription changes suggests access problems (stenosis, recirculation), non-compliance with treatment time, or patient body composition changes requiring evaluation.
Which physical finding during pre-treatment assessment most specifically indicates arterial steal syndrome in a patient with a new upper arm AVF?
Answer: Cold, pale hand that warms when the fistula is manually compressed
Hand ischemia (cold, pale) that resolves when the fistula is compressed (reducing steal) is pathognomonic for arterial steal syndrome.
A patient's urine output has decreased from 300 mL/day to 50 mL/day over the past month. What is the clinical implication for their dialysis management?
Answer: Residual kidney function is declining; dialysis prescription may need to be intensified
Loss of residual kidney function requires increasing dialysis dose to compensate, as the kidneys contributed to overall clearance and fluid removal.