DaVita PCT Study Guide Flashcards

Chlorine/Chloramine Testing

• Conduct tests 15 minutes before each patient shift, every 4 hours.
• Sample collected after the Primary carbon tank sample port.
• Acceptable chlorine/chloramine level: ≤ 0.1 mg/L.
• If levels exceed the acceptable limit, the test must be repeated.

Acute Kidney Injury (AKI)

• AKI encompasses various kidney issues from mild function changes to acute kidney failure.
• Dialysis may be required in outpatient settings until kidney function improves.

Pre-Renal Causes of AKI

• Common causes include obstruction, volume depletion, and impaired cardiac function.

Intra-Renal Causes of AKI

• Examples include:
  • Ischemic Acute Tubular Necrosis (ATN)
  • Sepsis
  • Systemic Inflammatory Response Syndrome (SIRS)
  • Septic shock
  • Anaphylactic reactions to drugs
  • Goodpasture syndrome
  • Acute glomerulonephritis
  • Trauma
  • Open heart surgery

Post-Renal Causes of AKI

• Common causes include obstruction, oliguria, bladder rupture, and complications from pregnancy.

Restoring Kidney Function

• Identify and address the underlying cause of AKI for potential recovery of kidney function.

Protecting Kidneys from Further Injury

• Avoid nephrotoxic substances, such as:
  • Radiographic contrast
  • Amphotericin B
  • Low-dose aspirin
  • Non-steroidal anti-inflammatory drugs (NSAIDs)

Monitoring Weight and Blood Pressure

• Maintain slight fluid retention to support kidney function when they begin filtering again.

Complications in AKI Patients

• Increased risk for hypovolemia and hypotension.

Vascular Access Considerations

• Patients usually have dialysis catheters; risk of catheter-related infections must be minimized.

Differences Between AKI and Chronic Kidney Disease (CKD)

• AKI may allow for recovery of kidney function if the cause is resolved, while CKD results from chronic conditions like hypertension and diabetes that cannot be eliminated.

Treatment Goals for CKD Patients

• Slow CKD progression.
• Manage comorbidities and complications.
• Control symptoms.
• Minimize lifestyle impacts.
• Educate on kidney replacement therapy options.
• Encourage active patient participation in healthcare.

Common Causes of CKD in the USA

• Diabetes mellitus (DM).
• Hypertension (HTN).
• Polycystic kidney disease (PKD).

Importance of Identifying CKD Causes

• Understanding the cause enables targeted inquiries and assessments during patient data collection.

Understanding Kt/V in Dialysis

• 'K' represents urea clearance.
• 't' indicates the duration of the dialysis session.
• 'V' is the volume of urea distribution within the patient’s body water.

Factors Affecting 'K'

• Decrease in 'K' caused by:
  • Inadequate coagulation.
  • Low blood flow rate (BFR).
  • Poor priming of dialyzer.
  • Not adhering to established protocols.
  • Patient non-compliance with treatment.

Factors Increasing 'K'

• Higher 'K' can result from:
  • Increased BFR.
  • Correct dialysate flow rate (DFR).
  • Correct dialyzer usage.
  • Target weight considerations.

Influences on 't'

• Follow physician directives to ensure prescribed treatment duration is met.
• Patients must complete the entire treatment session; premature termination can adversely affect effectiveness.

Influences on 'V'

• Factors affecting volume of urea distribution include:
  • Amputation status.
  • Patient height.
  • Biological sex.
  • Age considerations.
  • Access type, where less efficient access may lower effective volume processing.

Blood Flow Rate (BFR) Guidelines

• Suggested BFR for 17 gauge needles: 200-250 mL/min.
• Suggested BFR for 16 gauge needles: 250-350 mL/min.
• Suggested BFR for 15 gauge needles: 350-450 mL/min.
• Suggested BFR for 14 gauge needles: 450+ mL/min.

Post BUN Lab Draw Procedure

• Methods to follow:
  • Turn off or reduce ultrafiltration (UFR) to 50 mL/min.
  • Set DFR to 300 mL/min or bypass.
  • Reduce BFR to 100 mL/min.
  • Wait 15 seconds before drawing blood.

Mistakes Affecting Kt/V Accuracy

• Factors that may falsely increase Kt/V:

  • Not reducing BFR adequately.
  • Insufficient wait time before sample collection.
  • Collecting post BUN from the venous line.

• Factors that may falsely decrease Kt/V:

  • Diluting pre-treatment arterial BUN with saline.
  • Overwaiting (> 15 seconds) before drawing blood.

This quiz provides essential flashcards for DaVita Patient Care Technicians (PCT) covering crucial topics such as chlorine/chloramine testing procedures and definitions of key medical terms like AKI. Enhance your knowledge and prepare for your patient care responsibilities effectively.