Medication Administration and Anticoagulation Flashcards

A hemodialysis patient receives intravenous sodium bicarbonate during treatment. What is the primary indication for this medication?

Answer: Metabolic acidosis

IV sodium bicarbonate is administered to correct metabolic acidosis, which is common in end-stage renal disease patients.

Which phosphate binder is commonly administered with meals to dialysis patients to control serum phosphorus levels?

Answer: Calcium carbonate or sevelamer

Calcium carbonate and sevelamer are commonly used phosphate binders taken with meals to reduce phosphorus absorption from food.

When using a continuous heparin infusion during dialysis, what laboratory test is used to monitor anticoagulation levels?

Answer: Activated clotting time (ACT) or APTT

The activated clotting time (ACT) or activated partial thromboplastin time (APTT) is used to monitor heparin anticoagulation during dialysis.

A patient on hemodialysis develops heparin-induced thrombocytopenia (HIT). Which finding on laboratory results would support this diagnosis?

Answer: Platelet count drop of >50% from baseline

HIT is characterized by a significant drop in platelet count (>50% from baseline) occurring 5–10 days after heparin initiation due to antibody formation.

What is the purpose of administering vitamin D analogs (e.g., calcitriol) to hemodialysis patients?

Answer: Suppress secondary hyperparathyroidism and manage bone disease

Active vitamin D analogs suppress parathyroid hormone (PTH) secretion to manage secondary hyperparathyroidism and renal osteodystrophy in dialysis patients.

Which route of administration is preferred for erythropoiesis-stimulating agents (ESAs) in hemodialysis patients?

Answer: Intravenous or subcutaneous

ESAs are most commonly given IV (directly into the dialysis circuit) or subcutaneously; IV is convenient during dialysis sessions.

A dialysis patient's hemoglobin rises above 13 g/dL while on ESA therapy. What is the appropriate action?

Answer: Reduce or hold the ESA dose

ESA dose should be reduced or held when hemoglobin exceeds target levels (typically >13 g/dL) to avoid increased cardiovascular risk associated with high hemoglobin.