CDN Dialysis Complications and Emergency Management 3

Question 1

A patient on peritoneal dialysis presents with cloudy dialysate effluent, abdominal pain, and fever. What is the most likely diagnosis?

Accepted Answer

Peritonitis

Answer

Cloudy effluent, abdominal pain, and fever are the classic triad of peritonitis, the most serious complication of peritoneal dialysis.

Question 2

What is the minimum white blood cell count in peritoneal dialysis effluent that is diagnostic of peritonitis?

Accepted Answer

100 WBC/mm³ with >50% neutrophils

Answer

ISPD guidelines define peritonitis as effluent WBC ≥100/mm³ with >50% polymorphonuclear cells after a minimum two-hour dwell.

Question 3

During hemodialysis, the blood pump stops and blood is observed to be dark in the arterial line. What is the most likely cause?

Accepted Answer

Arterial needle clotting or dislodgement

Answer

Dark, de-oxygenated blood backing up in the arterial line suggests the arterial needle has clotted or dislodged, severely limiting blood flow.

Question 4

What is the primary goal of sodium profiling during hemodialysis?

Accepted Answer

Reduce intradialytic hypotension while limiting thirst and interdialytic weight gain

Answer

Sodium profiling uses higher dialysate sodium early in treatment to maintain hemodynamic stability, then lowers it to limit post-dialysis thirst and fluid intake.

Question 5

A patient with end-stage renal disease on hemodialysis suddenly becomes unresponsive with no palpable pulse. What is the nurse's immediate priority?

Accepted Answer

Initiate CPR and activate the emergency response system

Answer

Cardiac arrest requires immediate initiation of CPR and emergency system activation; all other dialysis-specific actions are secondary to life support.

CDN - Certified Dialysis Nurse Practice Test

CDN - Certified Dialysis Nurse Practice Test

CDN Dialysis Complications and Emergency Management 3