Dialysis Flashcards by Sharlene T

Recent labs indicated the patient’s KT/V is 1.0 and URR is 60.5. What is the significance of this result?

The treatment time should be increased

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The total pressure in the blood circuit is a result of

Dialysate flow rate

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The air detector monitors for the presence of air/foam in

the arterial blood line

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Heparin is used in hemodialysis to

Prevent clots from forming in the extracorporeal circuit

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A patient experiencing pericarditis may display which of the following symptoms?

Chest pain, fever, friction rub

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What care to expect the physician to order for a patient with pericarditis?

No heparin dialysis, increased intensity of dialysis, Increase the patient’s dry weight

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Careful rinsing of a reuse dialyzer before use by the patient is done primarily to remove?

Residual disinfectent

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What is the expected effect of sodium modeling during a hemodialysis treatment?

It may decrease episodes of hypotension

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The movement of solutes through a semipermeable membrane from an area of high solute concentration to an area of low concentration is

Diffusion

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Medical Director

Is ultimately responsible for maintaining the facility’s hemodialysis water quality

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Medications used in the treatment of secondary hyperparathyroidism

Calcijex, Zemplar, Sensipar

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Light-headed, pale, cyanotic pt respiratory rate and depth are increase

Hypoxia

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Pyrogenic Reaction is caused from?

Bacterial exposure from water

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Conductivity meter function and results dependent on

Passing a small electric current through the dialysate

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The number assigned to a dialyzer indicating the membrane’s permeability for a particular molecule or particular molecule or particle is called?

The mass transfer coefficient (KoA)

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The primary factor causing anemia in patients with chronic renal failure is?

Insufficient production of the hormone erythropoietin

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The Technician should be aware that the blood pump stops during this alarm conditions

High or low venus pressure alarm

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During treatment, patient complains of suddenly feeling chilled

Take the patients temperature

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Infiltration

Leakage of a substance into body tissues. If needles puncture the back of the vessel wall.

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RO membrane(s)

Purify water to ANSI/AAMI standards

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Reverse Osmosis (RO) pump

Increase water pressure across the RO membrane; made of high-grade steel, inert plastics, or carbon graphite-wetted parts.

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Ultrapure dialysate should be

> 0.1CFU/mL

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Bacteria must not exceed to

200

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ANSI/AAMI standards of bacteria in dialysis water

<100CFU/mL Action level>50CFU/mL

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Brine Tank

Contains salt pellets to make brine for the water softener

Arteriovenous fistula

Thrombosis, infection, stenosis, arterial steal syndrome

Endotoxemia

endotoxins in the blood

Dialysate temp

37c+1c

Conventional dialysate, bacteria must not exceed

200CFU

Conventional dialysate must have a level of less than

2EU/mL

Dialysate action level

1EU/mL

Magnesium

A metallic found in the body as an electrolyte in the intercellular fluid.

Cartridge filter

Placed before the RO to catch carbon fines, resin beads, debris, and other particles that could damage the RO

Gram-negative bacteria

Porygenic

Evacuation procedures, fire safety and CPR techniques

JCAHO

Purification

ensuring the water is free of chemicals and germs

Preparing the water before it reaches the fragile nerves osmosis (RO) membrane

Pretreatment

A carbon filter must always come before a DI system so cancer-causing nitrosamines ultrafilter, or other way to remove microbes, must be used after(downstream) the DI tank to capture microbes.

Deionization (DI)

Keeps microbes that might have slipped past the RO from reproducing

UV Light

Back up the light and remove microbes that remain

Submicron and ultrafilters

Distribution

bringing the product water to the point of use

Removes minerals that could form scale on the RO

Water softener

Layers of media ranging in size from gravel to sand trap large particles

Multimedia Filter(s)

mixes hot and cold water to reach an RO membrane industry standard temperature, around 77F

Blending valve

Anemia

Decreased erythropoietin

Backflow prevention device

Keeps treated dialysis water from backing up into the tap water

Distribution

bringing the product water to the point of use

Booster pump

Keep water pressure constant flow

will send the water to the stations-or to a storage tank

Distribution pump

Chest pain, dyspnea, pericardial friction rub, and uremia

Uremic Pericarditis

Colony Forming Units

CFU stands for?

ensuring the water is free of chemicals and gems

Purification

Primary Carbon Tank

Removes chlorine and chloramines

which type of vascular access has fewest complications

A/V fistula

First use syndrome

Dialysis disequilibrium syndrome

The absence of pathogens

Asepsis

What organization establishes dialysis water quality standards

Association for the Advancement of Medical Instrumentation

Red blood cell rupture

Hemolysis

The amount of heparin sodium concentration commonly used in hemodialysis is

1ml:1000 units

If the extracorporeal circuit clots it would be most important to monitor the patient's

Hemoglobin

one reason normal saline is used to prime the extracorporeal circuit prior to initiating treatments to

Remove air

AV/ fistula is red and warm to the touch, symptoms of?

Infection

What is the name of the instrument used to measure blood pressure

Sphygmomanometer

TMP

Transmembrane pressure

The movement of fluid from an area of low solute concentration to an area of high solute concentration is called

Osmosis

A complication of chronic renal failure may cause a patient to experience a tingling or numbness in the toes and fingers mostly likely due to

Peripheral neuropathy

when the technician accidentally spills undiluted bleach on the floor which resource will provide the PCT with the appropriate safety information and guidance on how to clean

The MSDS

15 minutes before the end of treatment a patient complains of nausea. This is most likely caused by?

Hypotension

The hemodialysis machine monitors many parameters. which of these parameters must be verified by a second independent means?

PH, andConductivity

Normal blood serum pH range is

7.35-7.45

Which of the following are dialyzed out during a hemodialysis treatment?

Water soluble vitamins(B1, B2, B3, B6, B12, folic acid

which of the following is the most accurate measure of dialysis adequacy?

KT/V (urea)

According to K/DOQI guidelines and recommendations, hemodialysis patients should have a KT/V

1.2

The components of a hemodialysis machine responsible for the precise mixing of fresh dialysate concentrate with fixed amounts of treated water is best described as the

Proportioning system

which of the following dialysate temperature ranges is generally considered optimal?

36-38 degrees

The air detector monitors for the presence of air/foam in?

The venous bloodline

which lab value is not affected by diet and is used as an indicator of renal failure?

Creatinine

Triggers the bone marrow to make red blood cells

Erythropoietin

the primary factor causing anemia in patients with chronic renal failure is?

Insufficient production of the hormone erythropoietin

To determine the patency of an A/V vascular access the dialysis technician should initially palpate for the present of a?

Thrill

what pretreatment component of the water treatment system is required to have a back up?

A carbon tank

When should the water hardness be test be conducted?

At the end of the treatment

when should the water be tested for chlorine and chloramines

Prior to each patient shift

According to industry standards the total microbial content of dialysate should not exceed

200CFU/mL

(CQI) process

Plan, do, check, act

Asepsis

the absence of pathogens

Blood Leak

when blood leaks into the dialysate compartment inside the dialysis

Carbon Tanks

Remove chlorine and chloramines

Removes solute from a solution organic and inorganic

BUN

10:1,20:1

Na+

sodium

K+

Potassium

Ca2

Calcium

Chlorine

Carbon dioxide

Urea

20-40 mg

Creat

0.7-1.2mg

GFR<60

Renal failure

GFR<15

Needs dialysis

Pathogens

bacteria, viruses, fungi

The major functioning of the kidney

Nephron

Anaphylaxis

severe allergic reaction

Canulate angle for A/V fistula?

25-30 degree angle

Hemoglobin

10.0-12.g/dL

Canulate angle A/V graft?

25 degree angle

Hydraulic pressure can be applied to the blood or dialysate compartment of a dialyzer to force water across the membrane

Transmembrane pressure

When fluids cross a semipermeable membrane some amount of solute may be pulled along with it. This transport mechanism is best described as?

Osmosis

Dialysate fluid helps uremic toxins, excess electrolytes, and other waste products diffuse from the patient's blood. The diffusion rate depends on?

Convection

During the set-up of a machine, the alarm test for conductivity fails. Which action would be best for the PCT to take?

Contact the Biomed Equipment Tech

The number one reason for chronic kidney is called?

Diabetes

what is the acid -base imbalance commonly seen in patients with chronic renal failure?

Metabolic acidosis

Approximately what percent of the cardiac output is received by the kidneys?

25 percent

Hyperkalemia may cause

Serious or even deadly changes in the heart rhythm

The technicians should be aware that the blood pump stops during these alarm conditions

High or low venous pressure alarm

The patient is experiencing an air embolism. After stopping the blood pump the PCT should take the following actions:

Place the patient in the Trendelenburg position

The patient complains of pain in the venous needle site. PCT notes swelling distal to the site and venous pressure rising. The PCT should suspect

Infiltration

When a conductivity alarm sounds during a hemodialysis treatment the technician should expect which of these events to have occurred

The flow of dialysate by-passed the dialyzer

Blood in dialysate

a tear in the dialyzer membrane

Sepsis

blood poisoning

Dialysate is kept in the range of?

34.5-36.5 C

The National Kidney Foundation initiative which developed guidelines and recommendations for improving care and outcomes for all people with chronic kidney disease is known as

KDOQI

(CMS) Centers for Medicare and Medicaid Services

Makes the rules that all dialysis clinics must follow if they want to get paid

Muscle weakness, numbness, tingling, nausea

Hyperkalemia

Congress was convinced to help pay for treatment in?

1972

Protein level

4.0 g/dL or higher

Healthy kidneys help keep the constant climate inside the body

Homeostasis

A fluid is?

Solvent

A substance that can be dissolved

Solute

Tells you how much of a solute is fully dissolved

Concentration

A form of dialysis that injects sterile replacement fluid into patients blood to remove more water

Hemodiafiltration

PD Principles

Diffusion, Convection, Osmosis, Adsorption

Dragging some wastes through the membrane pores

Convection

Calcitrol, Renin, PTH, and Cholesterol

Hormones made by kidneys