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

Hyperkalemia is life-threatening in dialysis patients; IV calcium gluconate stabilizes the cardiac membrane, and dextrose/insulin shift potassium intracellularly as temporizing measures.

Question 2

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

Accepted Answer

Treat intradialytic hypotension

Answer

Normal saline boluses are given during dialysis to treat intradialytic hypotension by rapidly expanding intravascular volume.

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

Small, water-soluble, non-protein-bound drugs are most efficiently cleared by dialysis due to their ability to cross the semipermeable membrane.

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

Hemodialysis removes a significant portion of vancomycin, especially with high-flux membranes, so post-dialysis dosing ensures therapeutic levels are maintained.

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

Sudden chest tightness and urticaria after IV iron suggest an anaphylactic reaction; the infusion must be stopped immediately and emergency support initiated.

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT Medication Administration and Anticoagulation 3