DaVita PCT Final Exam

What mechanical issues cause an inaccurate BP reading?

Deflating the BP cuff by squeezing, kinked lines, velcro, etc.

What is Left Ventricular Hypertrophy? How does LVH occur?

When the heart's lower left pumping chamber has thickened and is not pumping efficiently and is caused from hypertension that was caused by fluid overload.

What type of products should dialysis pts with dermatological issues use?

Hyperfatted lotions and soaps

What is your role in fluid and electrolyte management?

Do not overload patient with Na or Saline, Correct fluid removal goal, Educate and talk to patients, Report symptoms to nurse

What are the hematological systemic effects of dialysis?

Anemia, platelet dysfunction, and fibrous growths

What does CKD-MBD stand for?

Chronic Kidney Disease Mineral and Bone Disorder

What does CKD-MBD lead to?

Bone disease, Soft tissue calcification, and abnormalities in Vit D, Ca, and PO4 metabolism.

What is a wet crash?

A hypotensive patient who is fluid overloaded.

How do you convert pounds to kilograms?

Divide by 2.2

How do you convert milliliters to kilograms?

Move decimal left twice.

What is TRAMP when charting medications?

Time, Route, Amount, Medication, & Patient

What does SMART stand for in DaVita communication?

Simple, Meaningful, Actual, Read, & Teach

How do you respond to a Final Water Quality Alarm?

Put all

How many days after opening must you throw away a medication or vaccine & how do you label a new case?

Discard after 28 days and label new case with initials and date to toss.

According to CMS guidelines, when are stations to be cleaned & disinfected?

Only after a patient is declared clinically stable and has vacated the station.

Why is friction important when cleaning environmental surfaces?

Using friction while using a 1:100 bleach solution removes dirt and debris which could protect microorganisms from the low-level disinfectant.

What bleach solution do you use to clean visible blood/gross blood spills and how?

1:10 bleach solution must be used and the area must be cleaned a 2nd time with a new soaked towel.

How many patients die from Candia Auris?

1 in 3 patients

Why are gloves not sufficient enough to eliminate hand hygiene?

Due to glove permeability & skin contact with contaminated side, alcohol based hand rub of 60-90% can replace hand washing, but hands must be washed if visibly soiled.

Which microorganism causes most vascular access infections?

BLANK, through catheters, skin graphs, etc.

What are V-Tags 110-148?

CMS regulations and interpretive guidance related to infection control.

What is the difference between data collection and assessment?

A PCT performs data collection noting vitals, edema, pt and machine parameters, while a RN assesses and determines if vitals require attendance, edema depth, etc.

What are facts about missing ONE treatment?

Chance of hospitalization increases by

Explain Kt/V

It means clearance of urea multiplied by length of dialysis session divided by the total volume of the pt's body water (where urea is distributed)

What does DaVita define as a fever?

Any temperature over 100 or an increase of temperature of 2 degrees WITH symptoms

What is a pyrogenic reaction?

Reactions caused by pyrogens (things we introduced) within the first 45 - 75 minutes of tx such as vomiting, back pain, seizures, that usually occur in clusters of pts.

What position to you place pts with air embolism?

Into left side trendelenberg

Which needle gauges go with which BFR?

17 g: 200 - 250 ml/min

16 g: 250 - 350 ml/min

15 g: 350 - 450 ml/min

14 g: >450 ml/min

What are the KDOQI rule of 6s?

6 mm below the skin

6-8 wks after surgery

0.6 cm vessel diameter or greater

600 ml/ min blood flow

What is a beginner cannulator?

< 6 mo of experience and < 10 successful cannulatuon on established fistulas

What is a intermediate cannulator?

6 mo of experience and 10 successful cannulatuon on established fistulas

What is an advanced cannulator?

Completed all competencies on NFACT skills checklist expert assessment and cannulation skills documented May cannulate NEW AVF

What is access evaluation?

Look, listen, feel, maturation, complication, cannulation

What does BESTIPS stand for?

Bleeding, Erosion, Thrombosis, Infection, Pseudo- aneurism/ Aneurisms, Steal syndrome

At what angle do you cannulate?

AVF - 25 degree & AVG - 45 degree

Where does venous cannulation begin?

Antegrade, or with the blood flow

How far apart should needle tips be?

1.5 inches

When should you administer a heparin bolus during treatment?

3 to 5 minutes before treatment initiation.

Sudden drops of how many mmHg indicates too much intravascular fluid is being lost too quickly?

20 mmHg, but if the starting BP was < 100 then 10 mmHg

During treatment, how do you treat a patient with angina?

Lower UFR, and reduce the blood flow to 150 ml/min.

Although can occur without visible change, hemolysis turns blood what color?

Bright, cherry red

What medications can PCTs draw up and administer?

Heparin, lidocaine, and normal saline.

How do spray topical anesthetic spray?

Until blanching occurs, with blanching occurs numbness.

What is erythropoiesis?

the production of RBCs

What is hypervolemia?

Excess fluid in the blood