CCHT Electrolyte Balance 2

Question 1

A patient's pre-dialysis potassium level is 6.8 mEq/L with peaked T waves on ECG. Which dialysate potassium concentration would be most appropriate?

Accepted Answer

1.0 mEq/L

Answer

3.0 mEq/L

Answer

2.0 mEq/L

Answer

0 mEq/L potassium bath

Question 2

What is the physiological consequence of using dialysate with a calcium concentration lower than the patient's serum calcium?

Accepted Answer

Calcium will move from blood into dialysate, potentially lowering serum calcium

Answer

Calcium will move from dialysate into blood, raising serum calcium

Answer

No change occurs because calcium does not cross the dialyzer membrane

Answer

Phosphorus will increase to compensate for calcium loss

Question 3

Which acid-base disturbance is most common in ESRD patients before dialysis treatment?

Accepted Answer

Metabolic acidosis

Answer

Metabolic alkalosis

Answer

Respiratory acidosis

Answer

Respiratory alkalosis

Question 4

Why is hyperphosphatemia particularly dangerous for hemodialysis patients beyond the known bone disease effects?

Accepted Answer

It promotes vascular and soft tissue calcification, increasing cardiovascular mortality

Answer

It directly causes cardiac arrhythmias

Answer

It reduces EPO effectiveness, worsening anemia

Answer

It directly impairs the dialyzer membrane

Question 5

What effect does bicarbonate concentration in dialysate have on the patient's serum pH?

Accepted Answer

Higher bicarbonate dialysate increases serum pH by adding bicarbonate to blood

Answer

Higher bicarbonate dialysate decreases serum pH

Answer

Dialysate bicarbonate has no effect on serum pH

Answer

Dialysate bicarbonate only affects serum pH in patients with intact kidney function

Question 6

A patient on dialysis has a serum magnesium of 0.8 mEq/L. Standard dialysate contains 0.75 to 1.0 mEq/L of magnesium. What would you expect to happen to magnesium levels during dialysis?

Accepted Answer

Minimal change or slight increase since dialysate and serum levels are similar

Answer

Magnesium will continue to decrease during dialysis

Answer

Magnesium will increase significantly due to high dialysate concentration

Answer

Dialysis will have no effect on magnesium levels