CCHT Interventions 3

Question 1

When managing a patient with dialysis disequilibrium syndrome, which dialysis modification is most important to prevent recurrence in future treatments?

Accepted Answer

Use shorter, more frequent treatments with lower blood flow rates initially for new patients

Answer

Use a higher dialysate sodium concentration

Answer

Increase dialysate bicarbonate to correct acidosis faster

Answer

Use a larger surface area dialyzer for more efficient clearance

Question 2

A patient develops cardiac arrhythmia with a wide QRS complex during dialysis. Serum potassium is 6.5 mEq/L. What is the priority intervention?

Accepted Answer

Notify the physician immediately, obtain 12-lead ECG, and prepare for potential emergency interventions

Answer

Administer oral potassium binders and continue dialysis as planned

Answer

Increase the dialysate flow rate to speed potassium removal

Answer

Stop treatment and send the patient to the emergency department

Question 3

What is the recommended management for a patient who experiences hypoglycemia (blood glucose less than 70 mg/dL) during hemodialysis?

Accepted Answer

Administer 15 to 20g of fast-acting glucose (orange juice, glucose tablets), recheck glucose in 15 minutes

Answer

Stop dialysis immediately and transfer to the ED

Answer

Increase dialysate glucose concentration to correct hypoglycemia

Answer

Give insulin to stabilize blood glucose

Question 4

What immediate action should a technician take upon discovering that a patient's needle has become dislodged and is bleeding under the skin (infiltration)?

Accepted Answer

Stop the blood pump, clamp lines, remove needle, apply pressure, notify nurse, and assess patient hemodynamics

Answer

Reinsert the needle at the same site and continue treatment

Answer

Apply pressure over the infiltration and continue treatment at a lower blood flow rate

Answer

Ignore if the patient reports only mild discomfort

Question 5

A patient on erythropoiesis-stimulating agents (ESAs) has a hemoglobin of 13.5 g/dL during a routine check. What is the concern and appropriate action?

Accepted Answer

Hemoglobin is above target; notify physician as ESA dose may need reduction to avoid thrombotic events

Answer

Hemoglobin is too low; increase ESA dose immediately

Answer

This level is ideal; continue current treatment

Answer

Hemoglobin of 13.5 is critical; transfuse immediately

Question 6

What is the appropriate intervention if a patient reports severe back and chest pain coinciding with a pink-tinged dialysate in the waste line?

Accepted Answer

Stop treatment immediately, do not return blood, clamp all lines, and call for emergency assistance

Answer

Give the patient analgesics and continue treatment

Answer

Slow the blood pump speed and monitor for improvement

Answer

Check patient's blood pressure and increase UF rate