CCHT Electrolyte Balance 3

Question 1

What is the relationship between vitamin D deficiency and calcium/phosphorus imbalance in ESRD?

Accepted Answer

Vitamin D deficiency impairs intestinal calcium absorption, promoting hypocalcemia and secondary hyperparathyroidism

Answer

Vitamin D deficiency causes hypernatremia

Answer

Vitamin D deficiency directly causes hyperphosphatemia

Answer

Vitamin D has no role in calcium regulation in dialysis patients

Question 2

Which laboratory value most directly reflects a patient's dialysis adequacy and should guide treatment adjustments?

Accepted Answer

Kt/V (urea clearance index)

Answer

Serum creatinine level

Answer

Serum phosphorus level

Answer

Hemoglobin concentration

Question 3

A patient's serum sodium is 128 mEq/L before dialysis. The dialysate sodium is 138 mEq/L. What is the expected effect on sodium balance?

Accepted Answer

Sodium will be added to the blood from dialysate, raising serum sodium toward normal

Answer

Sodium will decrease further as dialysis removes sodium preferentially

Answer

No change because sodium does not cross dialysis membranes

Answer

Potassium will rise to compensate for low sodium

Question 4

What happens to glucose levels in diabetic dialysis patients during a treatment using standard glucose-containing dialysate (200 mg/dL glucose)?

Accepted Answer

Blood glucose may increase as glucose diffuses from dialysate to blood if serum glucose is below dialysate level

Answer

Blood glucose always drops precipitously during dialysis

Answer

Dialysate glucose has no effect on blood glucose in diabetic patients

Answer

Glucose is completely removed by dialysis, causing hypoglycemia

Question 5

Which electrolyte imbalance is most likely to cause a dialysis patient to experience tetany (involuntary muscle contractions)?

Accepted Answer

Hypocalcemia

Answer

Hyperkalemia

Answer

Hypernatremia

Answer

Hypermagnesemia

Question 6

What is the recommended target pre-dialysis serum potassium range for a stable chronic hemodialysis patient?

Accepted Answer

3.5 to 5.5 mEq/L

Answer

2.0 to 3.0 mEq/L

Answer

5.0 to 6.0 mEq/L

Answer

6.0 to 7.0 mEq/L