FREE CCHT Role Responsibilities Test 1
Which is the most common cause of chronic kidney failure in the US?
Diabetes mellitus is the leading cause of chronic kidney failure (chronic kidney disease, CKD) in the United States. Chronically elevated blood sugar levels can damage the kidneys over time, leading to CKD and eventual kidney failure if not managed effectively.
Which member of the hemodialysis care team is responsible for setting up the plan of care for a patient?
The nephrologist (specialist in treating kidney disease) is ultimately responsible for setting up the plan of care for a patient, including prescriptions for the amount and frequency of dialysis, lab tests, and medications. The medical director of a dialysis center must be a board-certified nephrologist. The nurse is responsible for coordinating the plan of care. However, all members of the team are essential in ensuring that the plan of care is carried out and that the patient is carefully monitored.
If a patient is concerned about loss of income because of the need for hemodialysis, the best person to speak to the patient about this concern is the ___________.
If a patient is concerned about loss of income because of the need for hemodialysis, the best person to speak to the patient about the concern is the social worker. The social worker will know what programs are available to assist the patient, such as Medicaid, and can help the patient apply for disability payments if necessary. The social worker can also advise the patient about the Americans with Disabilities Act and work accommodations that may help the patient remain employed.
Diffusion is a process that involves _____________.
Diffusion is a method of achieving balance. It involves the movement of solutes through a semipermeable membrane from an area of higher concentration to an area of lower concentration. Diffusion is used in hemodialysis when the blood goes through the dialyzer and solutes move from the blood into the dialysate through the semipermeable dialyzer membrane. However, because the blood moves rapidly, contact time is too short for all of the solutes to be removed.
The first step in treating malnutrition in a dialysis patient is usually to ____________.
The first step in treating malnutrition in a dialysis patient is usually to encourage the patient to eat more. Patients may need assistance from a renal dietician in order to better plan meals. Oral protein supplements may be administered to the patient during dialysis. Intradialytic parenteral nutrition is given intravenously during dialysis treatments, whereas total parenteral nutrition is given intravenously outside of dialysis times. Both of these treatments are invasive and may have numerous adverse effects.
Because of increasing phosphorus levels, a patient has been prescribed a phosphate binder, but the patient is unsure when to take the medication. The best advice is to take the medication ____________.
Phosphate binders must bind with dietary phosphorus in the gut so it can be expelled in the patient's stool, so the best time to take a phosphate binder is with meals and snacks. Hemodialysis is able to remove only some of the excess phosphorus. Phosphate binders cannot remove all dietary phosphorus, so patients should be reminded to avoid foods high in phosphorus, such as dairy products, nuts, dried beans, whole grains, and colas.
When using active listening, which of the following is a good example of a short, open-ended question to use to encourage patient communication?
Active listening involves listening closely to the patient and trying to understand the patient's meaning. The technician should look at the patient and ask questions. Active listening requires short, open-ended questions to encourage communication. Questions that can be answered with a "yes" or "no" or a simple one-word answer serve some purpose but tend to close off communication because these questions ask for no details. An example of an open-ended question is "What does the pain in your abdomen feel like?"
If a patient has refused to participate in education, asks no questions, and shows no interest in learning about hemodialysis, the best approach for the technician is to _____________.
If a patient has refused to participate in education, asks no questions, and shows no interest in learning about hemodialysis, the best approach for the technician is to talk through all the steps in the procedure: "Now I'm going to insert the arterial needle into the fistula." This approach provides passive learning for the patient so that over time the patient should have a good understanding of the procedures. Patients may be reluctant to learn about hemodialysis for many reasons, such as fear, anger, or anxiety.
If a new patient starts with a very high BUN, dialysis is purposely made less efficient to prevent:
When a new patient starts hemodialysis with a very high Blood Urea Nitrogen (BUN), dialysis may be intentionally made less efficient initially to prevent dialysis disequilibrium syndrome (DDS). DDS can occur when solutes are rapidly removed from the blood during hemodialysis, causing a shift in fluid and electrolytes in the brain, leading to symptoms such as headache, nausea, and even more severe neurological complications.
If a patient comes for hemodialysis treatment but weighs less than the target dry weight before treatment, the technician should ______________.
If a patient comes for hemodialysis treatment but is below target dry weight before treatment, the technician should notify the nurse and dietician. The patient should be thoroughly assessed by the nurse to determine the reason. In some cases, such as dehydration, the dialysis prescription may be modified. Weight loss is often related to poor nutrition resulting from a lack of appetite, so the patient may need to meet with a renal dietician. The patient's iron and protein levels may need to be assessed.
What factors should be considered when establishing a patient's dry weight?
When establishing a patient's dry weight in hemodialysis, healthcare providers consider multiple factors:
*Blood pressure: Monitoring blood pressure trends helps determine if the patient is fluid-overloaded or dehydrated.
*Patient well-being: Assessing how the patient feels and functions is crucial in determining the appropriate dry weight.
*Evidence of dehydration or fluid overload: Signs such as edema (fluid overload) or low blood pressure (dehydration) provide important clues to adjust the patient's dry weight.