CCHT Medication Administration and Anticoagulation 3

Question 1

Which electrolyte imbalance most commonly requires emergent treatment during hemodialysis, and what medication may be given IV?

Accepted Answer

Hyperkalemia treated with calcium gluconate or dextrose/insulin

Answer

Hyponatremia treated with furosemide

Answer

Hypocalcemia treated with magnesium sulfate

Answer

Hyperphosphatemia treated with sodium bicarbonate

Question 2

What is the purpose of administering normal saline (0.9% NaCl) boluses during a hemodialysis session?

Accepted Answer

Treat intradialytic hypotension

Answer

Correct hypernatremia

Answer

Flush excess potassium

Answer

Reduce blood urea nitrogen

Question 3

When administering medications through the dialysis circuit, the CCHT must be aware that some drugs are removed by dialysis. Which drug class is most efficiently cleared during hemodialysis?

Accepted Answer

Small water-soluble drugs with low protein binding

Answer

Large protein-bound drugs

Answer

Lipophilic drugs

Answer

Highly protein-bound antibiotics

Question 4

A hemodialysis patient receives IV vancomycin for a catheter-related bloodstream infection. Why is post-dialysis dosing often preferred?

Accepted Answer

Dialysis significantly removes vancomycin, so post-dialysis dosing replaces what was cleared

Answer

Vancomycin is unstable in dialysate

Answer

Vancomycin increases clotting risk if given before dialysis

Answer

It improves patient compliance

Question 5

What action should the CCHT take if a patient reports sudden chest tightness and urticaria shortly after IV iron administration is started?

Accepted Answer

Stop the infusion, call the nurse/physician, and prepare for anaphylaxis management

Answer

Increase the infusion rate to push the reaction through

Answer

Administer more antihistamine and continue

Answer

Document the finding and continue monitoring

Question 6

Which of the following is a key difference between 'heparin-free' dialysis and standard anticoagulated dialysis?

Accepted Answer

Heparin-free dialysis relies on frequent saline flushes and higher blood flow to minimize clotting

Answer

Heparin-free dialysis uses citrate in the dialysate

Answer

Heparin-free dialysis requires a different dialyzer type

Answer

Heparin-free dialysis is only used for CRRT

Question 7

A physician orders 5,000 units of heparin as a bolus for a 70 kg patient. The available concentration is 1,000 units/mL. How many mL should be administered?

Accepted Answer

5 mL

Answer

1 mL

Answer

7 mL

Answer

0.5 mL