CCHT Medication Administration and Anticoagulation 1 — Questions and Answers
Question 1: What is the primary anticoagulant used during hemodialysis to prevent clotting in the extracorporeal circuit?
- Warfarin
- Heparin (Correct answer)
- Aspirin
- Enoxaparin
Correct answer: Heparin
Heparin is the standard anticoagulant used during hemodialysis because of its rapid onset and the ability to reverse it with protamine sulfate if needed.
Question 2: A patient receiving hemodialysis has a heparin allergy. Which alternative anticoagulation method is most commonly used?
- Warfarin infusion
- Citrate anticoagulation (Correct answer)
- Aspirin infusion
- Clopidogrel
Correct answer: Citrate anticoagulation
Citrate anticoagulation is the preferred alternative to heparin for patients with heparin-induced thrombocytopenia (HIT) or heparin allergy.
Question 3: What is the typical initial bolus dose range of unfractionated heparin administered at the start of hemodialysis?
- 100–500 units
- 1,000–5,000 units (Correct answer)
- 10,000–15,000 units
- 50–100 units
Correct answer: 1,000–5,000 units
A typical initial heparin bolus is 1,000–5,000 units, adjusted based on patient weight, bleeding risk, and clotting tendency.
Question 4: Which medication is used to reverse the anticoagulant effects of heparin in cases of overdose or emergency bleeding?
- Vitamin K
- Fresh frozen plasma
- Protamine sulfate (Correct answer)
- Tranexamic acid
Correct answer: Protamine sulfate
Protamine sulfate binds and neutralizes heparin, rapidly reversing its anticoagulant effect.
Question 5: When administering erythropoiesis-stimulating agents (ESAs) to a dialysis patient, what is the primary goal?
- Reduce blood pressure
- Treat anemia of chronic kidney disease (Correct answer)
- Lower serum phosphorus
- Prevent infection
Correct answer: Treat anemia of chronic kidney disease
ESAs such as epoetin alfa stimulate red blood cell production to treat the anemia associated with chronic kidney disease in dialysis patients.
Question 6: Which iron preparation is commonly administered intravenously during hemodialysis sessions to treat iron deficiency anemia?
- Oral ferrous sulfate
- Iron sucrose (Correct answer)
- Vitamin B12 injection
- Ferric citrate oral tablet
Correct answer: Iron sucrose
Iron sucrose is a commonly used IV iron formulation that can be administered during hemodialysis to replenish iron stores.
Question 7: Before administering IV iron during dialysis, which assessment is most important to perform?
- Check blood glucose level
- Assess for signs of anaphylaxis risk and verify allergy history (Correct answer)
- Measure blood pressure
- Check patient weight
Correct answer: Assess for signs of anaphylaxis risk and verify allergy history
Assessing allergy history and anaphylaxis risk is critical before IV iron administration because hypersensitivity reactions can occur.
CCHT Medication Administration and Anticoagulation 1
What is the primary anticoagulant used during hemodialysis to prevent clotting in the extracorporeal circuit?