FREE Certified Nephrology Nurse Trivia Questions and Answers
Diana Walsh, a 62-year-old woman receiving hemodialysis, complains of constant scratching.
Question: When the patient's Kt/V is 1.1, and Ms. Walker's itchiness doesn't go away, the first dialysis adjustment should be to
Explanation:
The dialysis modification should raise the Kt/V to greater than 1.2 if the itching of a hemodialysis patient continues and their Kt/V is 1.1. To prevent the patient's level from dropping below 1.2, the typical objective is 1.4. Although the data is unclear, improving the quality of dialysis may help some patients get some relief from itching. Elevated levels of the minerals calcium, phosphorus, and parathyroid hormone may also trigger some individuals' itching.
Dialysate glucose must be heat sterilized at a low pH to
Explanation:
To reduce the production of glucose degradation products (GDPs), which might irritate the peritoneal membrane, glucose in dialysate must be heat sterilized at a low pH. Dialysate is heated at 5.5 pH for single-compartment dialysate bags since a lower pH solution would be too unpleasant for installation. The glucose-containing dialysate However, heat is sterilized at roughly 3.2 pH in a double-compartment suitcase, while the other compartment is sterilized at an alkaline pH. The two cases are then combined before injection.
Which of the following represents collegial communication when thinking about interdisciplinary communication?
Explanation:
When considering interdisciplinary communication, the nurse’s reporting on a patient’s condition in a team meeting is an example of collegial communication (AKA inter-collegial communication). The three basic types of communication are social (chatting about vacation), therapeutic (answering a patient’s questions and providing one-on-one instruction), and collegial (communicating with colleagues). Collegial communication may be in spoken form (such as reporting on a patient’s condition) or written form (such as writing a summary of the patient’s condition or problems).
What does the peritoneal equilibration test measure?
Explanation:
The peritoneal equilibration test measures the amount of urea and creatinine filtered into the dialysate throughout a 4-hour stay and the amount of glucose absorbed from the dialysate. This is one way to gauge how well peritoneal dialysis is working. Due to their potential for rapid glucose absorption and the potential requirement for shorter stay durations, patients with a high transport rate may also benefit from this test's ability to detect them. The patient could require a longer dwell time or more exchanges if not enough urea and creatinine are being filtered.
The use of an amino-based dialysate solution is primarily for
Explanation:
An amino-based dialysate solution is used for PD primarily as a dietary supplement because it helps skeletal muscles absorb amino acids. The amino-based solution is limited to one daily dose to avoid acidosis and elevated serum urea levels. The solution is most effective after meals to promote protein synthesis because it is typically absorbed within 4 to 6 hours. Osmotically, the amino-acid solution is similar to 1.36% glucose.
Melissa Cheng, a 62-year-old woman receiving hemodialysis, complains of constant scratching.
Question: If replacing Ms Walker's dialyzers and modifying her Kt/V do not relieve her itching, the most recommended step is:
Explanation:
Dry skin is typically the most prevalent cause of itching; thus, if altering a patient's Kt/V and switching dialyzers do not help the itching, moisturizers and oil baths should be recommended remedies. Itching may be brought on, notably by high phosphorus levels. Antihistamines like Benadryl or other treatments like UV lamps or gabapentin may be tried if emollients cannot reduce irritation. Itching that is severe and chronic may be relieved by tacrolimus or naltrexone.
The gradient of a substance's concentration, such as urea, during peritoneal dialysis
Explanation:
During peritoneal dialysis, the concentration gradient of a substance, such as urea, decreases. More urea diffuses into the instilled dialysate when the concentration is low than when the concentration increases. To compensate for this change in a concentration gradient, more frequent exchanges can be done (such as is familiar with APD), or dwell volume may be increased, although this typically cannot exceed 2.5 to 3 L.