A patient receiving CRRT suddenly develops repeated circuit alarms. Inspection reveals dark strands within the tubing near the filter. What is the most likely explanation?
Air embolism
Inadequate anticoagulation resulting in clot formation
Dialysate contamination
Excessive ultrafiltration
A patient receiving CRRT is anticoagulated with citrate. Morning laboratory results demonstrate worsening muscle twitching and new QT interval prolongation. Which electrolyte abnormality should be suspected first?
Hypernatremia
Hyperkalemia
Hypocalcemia
Hyperphosphatemia
A patient receiving CRRT has a core temperature of 35.2°C (95.4°F). Which intervention addresses the most likely cause?
A patient receiving CRRT has a core temperature of 35.2°C (95.4°F). Which intervention addresses the most likely cause?
Apply warming measures and consider a blood warming device
Increase dialysate potassium concentration
Discontinue anticoagulation
A patient with severe cerebral edema develops acute kidney injury requiring dialysis. Why would CRRT generally be preferred?
It removes larger amounts of fluid over a shorter period.
It produces slower fluid removal that is better tolerated.
It eliminates electrolyte abnormalities.
It requires no specialized monitoring.
A patient receiving CRRT has visible bleeding around the central venous catheter insertion site. Which laboratory test would be most useful if heparin is the anticoagulant?
BNP
Lactate
Albumin
aPTT
A patient has been receiving CRRT for three days. Vasopressor requirements have decreased significantly and overall clinical status has improved. Which medication management principle is most appropriate?
Medication doses should remain unchanged for consistency.
Reevaluate medication doses as the patient's clinical condition changes.
Increase all medication doses to prevent underdosing.
Increase all medication doses to prevent underdosing.
A patient receiving CRRT has thrombocytopenia and is started on systemic anticoagulation for circuit patency. Which complication warrants heightened surveillance?
Bradycardia
Hyperglycemia
Bleeding
Hypertension
Why is anticoagulation necessary during CRRT?
To increase toxin removal.
To reduce blood pressure.
To improve renal blood flow
Blood contact with tubing and filters activates the coagulation cascade.
Which intervention is specifically recommended if a patient's temperature begins to fall during CRRT?
Increase dialysis flow rate.
Stop CRRT immediately.
Utilize blood warming devices and external warming measures.
Restrict intravenous fluids.
During interdisciplinary rounds, a nurse asks why electrolyte monitoring remains necessary when dialysate closely resembles plasma. Which explanation is most accurate?
Dialysate continuously adapts to changing patient physiology.
Electrolyte balance is unaffected by kidney failure during CRRT.
Fixed dialysate composition cannot dynamically respond to physiologic changes.
Electrolytes are removed only during intermittent dialysis.