Clinician Self-Assessment
1.
Your patient complains that the LOW DRAIN VOLUME alarm occurs frequently during Initial Drain.
How would you correct this?
a. Discontinue use of the cycler and service the unit
b. Recommend that the patient reboot the cycler
c. Review and/or adjust the I-DRAIN alarm setting
d. Tell the patient to bypass the alarm and move to the first Fill Volume
2. What is the recommended I-DRAIN alarm setting for Dry Day patients?
a. 0 mL or a very small volume
b. 1400 mL, the default I-DRAIN alarm value
c. 70% of the Last Fill Volume
d. OFF
3. Setting the I-DRAIN alarm too low may cause
a. a CHECK PATIENT LINE alarm
b. a LOW DRAIN VOLUME alarm
c. an Increased Intraperitoneal Volume (IIPV) situation
d. the patient to experience pain during the Drain phase
4. A patient asks how to handle a suspected IIPV situation. You instruct the patient that if he/she suspects that IIPV has occurred, he/she should do all of the following, except
a. continue with their therapy
b. press STOP immediately, then press the down arrow to perform a Manual Drain
c. contact his/her dialysis center, you or the Nephrologist
5. The Minimum Drain Volume is the product of the Minimum Drain Volume % times the
a. Current UF
b. Fill Volume
c. I-Drain Volume
d. Total UF
6. All of the following are true statements about the Minimum Drain Volume % (MDV %), except
a. a higher MDV% may be advised for patients whose UF Per Cycle is > 10%
b. a LOW DRAIN VOLUME alarm will sound when drain flow rates indicate the peritoneal cavity is empty
but MDV% has not been achieved
c. the maximum allowable MDV% setting is 125% of the Fill Volume
d. the MDV% should be set below the default setting
7.
You need to determine the Total UF value for a patient’s therapy to program the Last Manual Drain. To calculate the expected Total UF value you would
a. compute the Average Daily UF Value by averaging the last seven days’ worth of therapies and set the Total UF value to 70% - 100% of this computed value
b. divide the Fill Volume by 50% of your normal night UF
c. multiply the Fill Volume by the Minimum Drain Volume %
d. subtract the I-Drain Volume from the Last Fill Volume
8. When the Last Manual Drain is set to YES, the device will require a Manual Drain to be performed when the UF Target is not met.
a. True
b. False, a LOW UF alarm appears on the display screen
c. False, a Manual Drain is required during these conditions when the UF Alarm is set to YES
9.
A NEGATIVE UF alarm occurs during a patient’s therapy. You determine that the patient is not empty, but
still has fluid in his peritoneum. What do you do?
a. Decrease the patient’s Minimum Drain % prescription value to prevent this from happening in the future
b. Instruct the patient to press GO to return to Drain, or the down arrow until MANUAL DRAIN appears, then press ENTER
c. Instruct the patient to press the down arrow until BYPASS appears, then press ENTER
d. Instruct the patient to terminate the therapy
10. You would like your patient to have a 15% Reserve Volume during his/her Tidal Peritoneal Dialysis therapy.
To achieve this, set the Tidal Volume % to
a. 12.5% b. 15%
c. 50%
d. 85%
[ 2 ]
11. The Tidal Volume % prescription value is equal to the percentage of the UF Target.
a. True
b. False, it is a percentage of the Fill Volume
c. False, it is a percentage of the Total UF
12. A HomeChoice cycler is going to be used in a hospital by several patients. Which of the following
adjustments in the Nurse’s Menu would you recommend to increase patient safety?
a. Enable Low Fill Mode for adult and pediatric patients
b. Enable the Reset Weight feature
c. Enable the Smart Dwell feature
d. Reduce the Minimum Drain Volume setting below 85%
13. Which of the following scenarios would cause the CHECK FILL VOLUME message to appear on the
display after attempting to program a new prescription in the HomeChoice device?
a. The Fill Volume does not equal the Last Fill Volume
b. The Fill Volume is too high for the programmed Patient Weight
c. The Fill Volume is too low for the programmed Patient Weight
d. The INITIAL DRAIN alarm is too low for the programmed Last Fill Volume
14. Baxter recommends enabling the Tidal Full Drains feature in the Nurse’s Menu and setting an appropriate value for Full Drains Every in the Change Program Menu to
a. help prevent UF accumulation, which may cause IIPV, over several Tidal cycles
b. permit the patient to bypass the Initial Drain whenever they desire
c. reduce the probability that alarms will occur during Tidal therapy
15. A Tidal patient has 5 night cycles and an average therapy UF of 1000 mL. Which of the following ranges might be an appropriate starting Total UF setting for this patient?
a. 10 mL - 50 mL
b. 200 mL - 500 mL
c. 700 mL - 1000 mL
d. 3500 mL - 5000 mL
16. A CCPD patient has a Fill Volume of 2500 mL, a Last Fill Volume of 2000 mL, and 4 cycles of therapy. Which of the following ranges might be an appropriate starting Initial Drain Alarm Volume?
a. At least 5% of the Last Fill Volume, or 10 mL - 1000 mL
b. At least 70% of the Last Fill Volume, or 1400 mL - 2000 mL
c. Greater than or equal to the Fill Volume, or 2500 mL - 3000 mL
d. OFF or 0 mL
[ 3 ]
17. All of the following are HomeChoice SmartCare software alternating messages, except
a. CALL PD NURSE/HIGH DRAIN XYZ
b. CLOSE ALL CLAMPS/RELOAD THE SET
c. CONNECT BAGS/OPEN THE CLAMPS
d. PRESS STOP/PERFORM MANUAL DRAIN
18. A patient reports a LOW DRAIN VOLUME alarm at the end of Drain 1 of 5. The patient states that the Fill
Volume is set to 2000 mL, and the Current UF value is -1245 mL. The patient has never experienced this alarm. Should you permit the patient to bypass the alarm?
a. No. The patient should check for kinks, reposition, and press GO to continue draining the 1245 mL of retained fluid
b. No. The patient should restart therapy from the beginning because this alarm occurred during the first Drain cycle
c. Yes. A LOW DRAIN VOLUME alarm should always be bypassed
d. Yes. The Current UF value can be ignored when determining when it is appropriate to bypass
19. Which of the following statements about bypassing an I-Drain with the HomeChoice SmartCare software
is correct?
a. A LOW DRAIN VOLUME alarm must occur before a Drain bypass is allowed
b. Bypass can occur only through the hidden Nurse’s Menu
c. The I-Drain can be bypassed when the flow rates are normal
d. The I-Drain can never be bypassed with the HomeChoice SmartCare software
20. A patient has experienced a LOW DRAIN VOLUME alarm during his/her therapy. How would you handle
this alarm?
a. Ask the patient to change position and attempt to drain more fluid
b. Ask the patient to check for kinks in the patient line
c. Check the patient’s Drain Volume and I-DRAIN alarm, and then decide if the I-Drain is appropriate for
the patient
d. All of the above
21. With the HomeChoice SmartCare software, when may the DRAIN NOT FINISHED alarm occur?
a. When attempting to bypass a LOW UF alarm
b. When attempting to bypass Day or Night Drain
c. When attempting to bypass I-Drain
d. Both when attempting to bypass Day or Night Drain or when attempting to bypass I-Drain
[ 4 ]
22. When the Last Manual Drain is set to YES and the UF Target has not been achieved, which of the following is true?
a. A LOW UF message will prompt the patient to change position, press GO, and perform a Last Manual Drain
b. The patient has experienced IIPV in the current therapy
c. The patient must terminate the current therapy, load a new disposable set, and start a new PD therapy to increase UF
d. The patient should always bypass the LOW UF message
23. All of the following statements describe the HomeChoice SmartCare software HIGH DRAIN alarm,
except
a. it indicates an IIPV event may have occurred during the previous therapy
b. it instructs the patient to CALL PD NURSE
c. it is displayed after an unusually high Drain Volume event, indicating IIPV may have occurred in previous therapy
d. it means the actual Drain Time was longer than the programmed Drain Time
24. A patient has experienced a HIGH DRAIN 205 message. You explain to the patient that this means High Drain occurred in a Drain during cycle/Drain number .
a. Day; 5
b. Manual; 5
c. Night; 2
d. Night; 5
Source material: eLearning Module AL11044
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