Certified Dialysis Nurse Flashcards

A dialysis patient with diabetes has an AV fistula. When assessing the fistula, the nurse palpates a thrill and hears a bruit. This finding indicates:

Answer: Normal fistula function

A palpable thrill and audible bruit indicate adequate blood flow through a patent, functional AV fistula.

Which of the following is a sign of disequilibrium syndrome during hemodialysis?

Answer: Headache, nausea, and altered consciousness

Disequilibrium syndrome presents with neurological symptoms including headache, nausea, and altered mental status due to rapid osmotic shifts.

A patient receiving continuous renal replacement therapy (CRRT) has a filter clotting frequently. Which anticoagulation method is typically used first-line in CRRT?

Answer: Regional citrate anticoagulation

Regional citrate anticoagulation is the preferred first-line method for CRRT as it provides effective circuit anticoagulation with minimal systemic effects.

The target hemoglobin range for dialysis patients receiving erythropoiesis-stimulating agents (ESAs) per KDIGO guidelines is:

Answer: 10–11.5 g/dL

KDIGO guidelines recommend maintaining hemoglobin between 10–11.5 g/dL for dialysis patients on ESAs to balance benefit and cardiovascular risk.

A peritoneal dialysis patient using automated peritoneal dialysis (APD) reports the machine alarming 'drain incomplete.' The nurse's first intervention is to:

Answer: Reposition the patient and check catheter kinks

Repositioning the patient and checking for catheter kinks addresses the most common mechanical causes of incomplete drainage.

Which serum laboratory value is the best indicator of long-term nutritional status in a hemodialysis patient?

Answer: Serum albumin

Serum albumin reflects long-term protein stores and nutritional status, with levels below 3.5 g/dL indicating malnutrition in dialysis patients.

A patient's AV graft has a pseudoaneurysm at a needle insertion site. The nurse should:

Answer: Rotate needle sites away from the pseudoaneurysm and notify the physician

Pseudoaneurysms require physician notification and needle sites should be rotated away to prevent rupture while awaiting surgical evaluation.