Patient Assessment and Monitoring 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 and Monitoring flashcards as text
At the beginning of a hemodialysis treatment, which of the following assessments should the technician perform before initiating treatment?
Answer: Obtain vital signs, pre-dialysis weight, assess vascular access, and review the treatment prescription
A comprehensive pre-treatment assessment includes vital signs (BP, HR, temperature, respirations), pre-treatment weight (to calculate ultrafiltration volume), vascular access assessment (bruit/thrill, appearance), and review of the treatment prescription to ensure all parameters are correct for that session.
A patient's blood pressure drops from 148/88 mmHg at treatment start to 82/50 mmHg at 90 minutes into dialysis. Which parameter should the technician check first?
Answer: The ultrafiltration rate and total volume removed so far
A sudden significant drop in blood pressure during dialysis is most commonly caused by aggressive ultrafiltration (removing fluid faster than the vascular refilling rate). The technician should immediately check the ultrafiltration rate and the volume already removed to determine if over-ultrafiltration is the cause.
During hemodialysis, a patient complains of severe headache and nausea 2 hours into treatment. Their blood pressure is 185/110 mmHg. What complication should the technician suspect?
Answer: Dialysis disequilibrium syndrome or hypertensive emergency
Severe headache and nausea with hypertension during dialysis suggests either dialysis disequilibrium syndrome (from rapid urea and osmolality shifts causing cerebral edema) or a hypertensive emergency. Both require immediate nursing and physician evaluation.
During a routine hemodialysis treatment, the venous pressure alarm sounds repeatedly and the reading shows persistently elevated pressure. What is the most likely cause?
Answer: A clot or kink in the venous blood return line or access
Persistently elevated venous pressure indicates increased resistance in the blood return path from the dialyzer to the patient. The most common causes are a kink in the venous line, clotting in the venous line or venous needle, or outflow resistance at the vascular access (stenosis, needle malposition).
What does a decrease in the bruit (audible sound) of an arteriovenous fistula suggest?
Answer: Possible stenosis or early thrombosis of the fistula
A decrease or change in the bruit of an AV fistula—particularly a change from a soft, continuous, low-pitched bruit to a high-pitched, discontinuous, or absent sound—indicates reduced blood flow, which may be due to stenosis or early thrombosis. This is a critical finding that must be reported immediately.
At the end of a hemodialysis treatment, which of the following assessments is essential before the patient is discharged?
Answer: Obtain post-dialysis vital signs, post-dialysis weight, and assess the patient's clinical status for safe discharge
Essential post-treatment assessments include post-dialysis vital signs (to confirm hemodynamic stability), post-dialysis weight (to verify target weight achievement), and clinical assessment of the patient's status before they leave the facility.