Certified Dialysis Nurse Flashcards

A patient on automated peritoneal dialysis (APD) has gained 5 kg since last clinic visit. Which assessment finding would confirm this is fluid rather than true weight gain?

Answer: Pitting edema and hypertension

Pitting edema and hypertension confirm fluid overload as the cause of weight gain, indicating inadequate ultrafiltration.

Which dietary restriction is unique to peritoneal dialysis patients compared to hemodialysis patients?

Answer: Fluid restriction is typically more liberal

Peritoneal dialysis provides continuous fluid removal, so fluid restrictions are generally more liberal than in intermittent hemodialysis.

A dialysis nurse notes the transmembrane pressure (TMP) alarm is triggered repeatedly during treatment. This most likely indicates:

Answer: Clotting in the dialyzer

Rising TMP indicates increased resistance to ultrafiltration, most commonly caused by clot formation within the dialyzer fibers.

A patient with ESRD on hemodialysis is prescribed cinacalcet. The nurse understands this medication works by:

Answer: Increasing sensitivity of calcium-sensing receptors to suppress PTH

Cinacalcet is a calcimimetic that increases calcium-sensing receptor sensitivity, reducing PTH secretion in secondary hyperparathyroidism.

Which of the following findings during hemodialysis requires the nurse to immediately stop treatment and return blood to the patient?

Answer: Venous pressure alarm with clotted graft

A clotted graft with venous pressure alarm indicates access failure requiring immediate discontinuation to prevent further complications.

When a CAPD patient performs an exchange, the effluent appears bloody. After ruling out trauma, the nurse should assess for:

Answer: Menstruation or ovulation in female patients

In female patients, retrograde menstruation or ovulation are common benign causes of bloody peritoneal effluent and should be assessed.

The minimum recommended blood flow rate for effective hemodialysis in most adult patients is:

Answer: 200–300 mL/min

Adult hemodialysis typically requires blood flow rates of 200–300 mL/min to achieve adequate solute clearance within standard treatment times.