Module 1

Question 1

What are the four transport mechanisms that play a role in hemodialysis?

Answer 1

1) Ultrafiltration
2) Convection
3) Diffusion
4) Osmosis

Question 2

Explain the ultrafiltration transport mechanism.

Answer 2

Fluid is pushed through the semipermeable membrane (SPM).

Question 3

Explain the convection transport mechanism.

Answer 3

Solutes are dragged across the SPM along with fluid.

Question 4

Explain the diffusion transport mechanism.

Answer 4

Particles more from an area of high concentration to low.

Question 5

Explain the osmosis transport mechanism.

Answer 5

Fluid moves from an area of low concentration to high concentration.

Question 6

What are the kidneys’ excretory functions?

Answer 6

To normalize electrolytes, remove wastes, provide fluid and nutrient balance.

Question 7

How do we replace normal excretory kidney functions?

Answer 7

By normalizing electrolytes and providing fluid balance through ultrafiltration.

Question 8

What is the function of the acid concentrate?

Answer 8

Provides the concentration gradient for diffusion.

Question 9

What is the function of bicarbonate in the dialysate solution?

Answer 9

Buffers the acid concentrate.

Question 10

What is the function of bicarbonate when it diffuses into the patient’s blood?

Answer 10

Normalizes body pH.

Question 11

What are the signs and symptoms of Hyperkalemia?

Answer 11

> 6.5 mEq symptoms: extreme muscles weakness, abnormal heart rhythm, and possible cardiac arrest.

Question 12

What are the signs and symptoms of Hypokalemia?

Answer 12

< 3.5 mEq symptoms: fatigue, muscle weakness, paralysis, respiratory failure, cardiac instability, arrhythmias, and cardiac arrest.

Question 13

What is the normal range of of blood pH?

Answer 13

7.35 - 7.45

Question 14

What are the kidneys’ endocrine functions?

Answer 14

Renin secretion, Erythropoietin secretion, and vitamin D activation.

Question 15

How do we replace normal endocrine kidney functions?

Answer 15

Provide medications.

Question 16

How much of normal kidney function is replaced by hemodialysis?

Answer 16

15%

Question 17

What is uremia and what does it affect?

Answer 17

Uremia is a buildup of wastes in the blood due to kidney failure and it affects all body systems.

Question 18

What are the most common causes of CKD in the USA?

Answer 18

Diabetes, Hypertension, and Polycystic Kidney Disease.

Question 19

What are the treatment goals for a patient with CKD?

Answer 19

1) Slowing the progression of CKD.
2) Managing comorbidities and complications.
3) Controlling symptoms.
4) Minimizing effects of CKD on patient’s lifestyle.
5) Kidney replacement therapy modality education.
6) Encouraging patients to actively participate in their healthcare.

Question 20

Why is it so important to know the cause of a patient’s CKD?

Answer 20

So the nurse and PCT can inquire about possible problems during data collection and assessment.

Question 21

What are the signs and symptoms of fluid imbalance?

Answer 21

Hypertension, edema, and shortness of breath.

Question 22

Why is sodium balance important?

Answer 22

Leads to volume expansion, increased CO, increased peripheral vascular resistance, and increased BP.