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Renal Lesson # Pt2

Which type of CRRT uses mainly diffusion to remove solutes/wastes

What best describes the process of convection?

Renal Lesson #1 Pt1

Which of the following dialysis modalities is done inside the body?

When should a patient be started on dialysis?

Renal Lesson #1 Quiz

While studying documents regarding the weapon, you realize that the schematics have all been mixed up! Which part is the bottom? Which is the top? It all looks like a jumble mess!

Help organize the parts for the weapon by matching the terms up with the definition to unlock the next lesson!

A progressive kidney disease that is marked by increase proteinuria (loss of proteins such as albumin in the urine) and a glomerular filtration rate (GFR) <60 mL/min for 3 months or more.

A type of dialysis that uses the inside lining of your abdomen called your peritoneum to filter wastes.

Reversible damage to the kidneys characterized by an increase of >0.3 mg/dL of Scr over < 48 hours in a patient with previously normal renal function.

A type of dialysis that filters waste from the blood by utilizing an external artificial kidney called a dialyser usually thrice a week for 4-6 hours.

Continuous dialysis in which removal of solutes/wastes occurs by convection.

Continuous dialysis in which removal of solutes/wastes occurs by diffusion.

Continuous dialysis in which removal of solutes/wastes occurs by diffusion AND convection.

Continuous dialysis focused on volume control with minimal clearance of solutes; used for patients who are mainly volume overloaded.

Renal Lesson #2 Pt4

Dr. Vanko's Scr increased to 2.8 mg/dL. What is your dosing approach?

Renal Lesson #2 Pt3

Dr. Vanko's random level came back at 19 mcg/mL. What is your plan?

Renal Lesson #2 Pt2

The nurse administers the loading dose at 10pm on 8/3. Dr. Vanko's renal function has remained stable at 2.1 mg/dL What time do you want to schedule your random level?

Renal Lesson #2 Pt1

If Dr. Vanko develops an AKI because of decrease fluid intake (due to stressing about the location of that weapon) and is diagnosed with sepsis, what loading dose would start him on? (65 years old, weight = 72 kg, height =176 cm)

Renal Lesson #2 Quiz

Eureka! After piecing the schematics of the weapon together, you realize that it was built with an internal GPS that has not been turned on. Luckily, it can be activated remotely but requires additional research and testing on your part!

Finish the next puzzle and determine how to activate the GPS from Dr. Vanko’s laboratory by placing the steps for pulse dosing in order using the dropdown menu.

Step 1:

Step 2:

Step 3:

Step 4:

Step 5:

Renal Lesson #3 Pt4

Dr. Vanko's level came back at 13 mcg/mL drawn 1 hour after dialysis. What would be the best approach?

Renal Lesson #3 Pt3

Dr. Vanko's prehemodialysis level came back at 12 mcg/mL and we are trying to treat his sepsis. What would be the best next step?

Renal Lesson #3 Pt2

The nurse administers the loading dose at 8 pm last night. You work Dr. Vanko up in the morning and realize that he is scheduled for hemodialysis that morning. Do you give him a supplemental dose?

If you do decide to give a supplemental dose, what dose do you give?

What maintenance dose would be appropriate to start Dr. Vanko on if he receives vancomycin after hemodialysis (assuming a high permeability dialyzer was used)? (65 years old; weight = 72 kg; height =176 cm)

Renal Lesson #3 Pt1

Poor Dr. Vanko Scr has jumped to 4.1 mg/dL and he is developing metabolic acidosis. The team decides to put him on intermittent dialysis. You find that his previous vancomycin doses were never administered. what loading dose would you order if the plan is to give it after hemodialysis? (65 years old; weight = 72 kg; height =176 cm)

Renal Lesson #3 Quiz

Answer the questions about dosing a patient on hemodialysis to reveal what the GPS directions are
(Hint: capitalized letters in the correct answer choices will lead the way)

What is the recommended loading dose for hemodialysis patients?

If a patient receives hemodialysis the same day or the very next day after a loading dose was administered, what should you do?

True/False: Loading doses are recommended in all patients

Once two consecutive prehemodialysis therapeutic levels are obtained, monitoring of vancomycin levels can done...

Which of the following is TRUE regarding hemodialysis dosing?

Patients not on a stable dialysis schedule should be dosed according to which dosing strategy?

Pulse dosing should be used for which patients?

What does the GPS directions say? (HINT: the capitalized letters in the correct answers will spell it out)

Renal lesson #4 Pt2

Dr. Vanko's lab assistant, Mr. Mycin, got placed on peritoneal dialysis and developed peritonitis. What dose should he be started on? (53 years old; weight = 81 kg, height = 174 cm)

When do you want to order a level for Mr. Mycin?

If Mr. Mycin's level comes back <15 mcg/mL, what is your plan?

Renal lesson #4 Pt1

Dr. Vanko's lab assistant, Mycin, had an acute renal failure due to septic shock and was placed on CVVHDF. What loading dose should you give Mr. Mycin? (53 years old; weight = 81 kg, height = 174 cm)

What maintenance dose and interval would you start Mr. Mycin on? (53 years old; weight = 81 kg, height = 174 cm)

When would you order a vancomycin level for Mr. Mycin?

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