CCHT Patient Assessment 3

Question 1

What does access recirculation mean in the context of patient assessment, and how does it affect treatment quality?

Accepted Answer

Dialyzed blood from the venous needle being immediately re-drawn through the arterial needle, reducing efficiency

Answer

Blood recirculating in the patient's cardiovascular system

Answer

Normal recirculation of dialysate through the machine circuit

Answer

A technique to improve solute removal

Question 2

A patient with a new arteriovenous graft (AVG) presents with redness, warmth, swelling, and pain over the graft. What assessment should be performed and what is the concern?

Accepted Answer

Assess for signs of graft infection; do not cannulate if infection is suspected until evaluated by a physician

Answer

Assess for high venous pressure and proceed with treatment

Answer

This is normal for a new graft; proceed with cannulation

Answer

Assess for arterial steal syndrome only

Question 3

When performing a pre-treatment patient assessment, what key information should be gathered about the patient's interdialytic period?

Accepted Answer

Weight gain, dietary adherence, medication compliance, symptoms, and any medical events since last treatment

Answer

Sleep patterns and stress levels only

Answer

Only weight gain and blood pressure at home

Answer

Employment status and activity level

Question 4

What is the clinical significance of a decreasing Kt/V trend over multiple treatments despite no changes in dialysis prescription?

Accepted Answer

May indicate access dysfunction, fistula recirculation, shortened treatment times, or increasing patient size

Answer

Normal variation that does not require investigation

Answer

Patient is improving and requires less dialysis

Answer

The dialysis machine needs recalibration

Question 5

Which physical finding during pre-treatment assessment most specifically indicates arterial steal syndrome in a patient with a new upper arm AVF?

Accepted Answer

Cold, pale hand that warms when the fistula is manually compressed

Answer

Edema in the ipsilateral hand

Answer

Diminished thrill in the fistula

Answer

Elevated blood pressure in the access arm

Question 6

A patient's urine output has decreased from 300 mL/day to 50 mL/day over the past month. What is the clinical implication for their dialysis management?

Accepted Answer

Residual kidney function is declining; dialysis prescription may need to be intensified

Answer

Urine output is irrelevant once on dialysis; no changes needed

Answer

This indicates the dialysis is too effective and should be reduced

Answer

Fluid restriction should be liberalized since the patient needs fluids