CCHT Nutrition and Fluid Management 2

Question 1

What is the recommended daily protein intake for a stable adult hemodialysis patient?

Accepted Answer

1.0–1.2 g/kg/day with at least 50% from high biological value sources

Answer

KDOQI and NKF guidelines recommend 1.0–1.2 g/kg/day of dietary protein for stable maintenance hemodialysis patients, with at least 50% from high biological value (HBV) sources. Hemodialysis patients have higher protein needs than non-dialyzed CKD patients because amino acids are lost during dialysis.

Question 2

A hemodialysis patient consistently gains 4–5 kg between treatments (interdialytic weight gain, IDWG). Which of the following dietary changes would most directly address this problem?

Accepted Answer

Reduce dietary sodium intake to decrease thirst and fluid consumption

Answer

High dietary sodium intake causes thirst, which drives fluid consumption. Reducing sodium intake (target <2000 mg/day) directly reduces thirst and thereby reduces the amount of fluid consumed between dialysis sessions, reducing IDWG.

Question 3

Which of the following foods should a hemodialysis patient most strictly limit to prevent hyperkalemia?

Accepted Answer

Bananas, oranges, and potatoes

Answer

Bananas, oranges, and potatoes are among the highest-potassium foods. Hemodialysis patients must limit high-potassium foods to prevent dangerous hyperkalemia, as dialysis is the primary route of potassium excretion in the absence of significant residual renal function.

Question 4

What is the recommended daily fluid intake limit for most anuric hemodialysis patients?

Accepted Answer

1000 mL/day + previous day's urine output

Answer

The standard fluid recommendation for dialysis patients is 1000 mL (1 liter) per day plus the volume of the previous day's urine output. For anuric patients (no urine output), this limits daily fluid intake to approximately 1000 mL.

Question 5

What is the goal of dry weight assessment in hemodialysis patients?

Accepted Answer

To identify the post-dialysis weight at which the patient is euvolemic (normotensive without signs of fluid overload or depletion)

Answer

Dry weight (also called target weight or estimated dry weight) is the post-dialysis weight at which the patient is euvolemic—blood pressure is controlled, there are no signs of fluid overload (edema, pulmonary congestion), and the patient does not experience hypotension or cramps.

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT Nutrition and Fluid Management 2