Certified Dialysis Nurse Flashcards

Which of the following best describes the role of the dialyzer membrane in hemodialysis?

Answer: It allows diffusion of solutes down concentration gradients

The dialyzer membrane allows passive diffusion of solutes from areas of higher concentration (blood) to lower concentration (dialysate).

A dialysis patient presents with sudden onset chest pain, dyspnea, and cyanosis during treatment. Air embolism is suspected. The immediate nursing action is to:

Answer: Stop the blood pump, clamp the venous line, and position patient on left side in Trendelenburg

Stopping blood flow, clamping the venous line, and positioning the patient left lateral Trendelenburg traps air in the right ventricle apex away from the pulmonary circulation.

Which ESRD complication is characterized by elevated PTH, hypocalcemia, and hyperphosphatemia?

Answer: Secondary hyperparathyroidism

Secondary hyperparathyroidism in ESRD results from chronically low calcium and high phosphorus stimulating excessive PTH production.

When teaching a patient about AV fistula care at home, which instruction is most important?

Answer: Avoid blood pressure measurement and blood draws in that arm

Avoiding BP cuffs, blood draws, and IV access in the fistula arm prevents compression and vessel damage that could compromise the access.

A hemodialysis patient develops sudden hypotension during treatment. Which intervention should the nurse perform first?

Answer: Place the patient in Trendelenburg position and reduce ultrafiltration rate

Trendelenburg positioning improves venous return while reducing the ultrafiltration rate addresses the primary cause of intradialytic hypotension.

Which type of vascular access has the highest rate of infection among ESRD patients?

Answer: Tunneled dialysis catheter

Tunneled dialysis catheters have significantly higher infection rates compared to fistulas and grafts due to the direct bloodstream access they provide.

The 'KDOQI first' principle recommends which vascular access as the preferred option for new hemodialysis patients?

Answer: Arteriovenous fistula

KDOQI guidelines strongly recommend the native AV fistula as the first choice due to its superior longevity and lowest complication rates.