Dialysis Flashcards
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
The total pressure in the blood circuit is a result of
Dialysate flow rate
The air detector monitors for the presence of air/foam in
the arterial blood line
Heparin is used in hemodialysis to
Prevent clots from forming in the extracorporeal circuit
A patient experiencing pericarditis may display which of the following symptoms?
Chest pain, fever, friction rub
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
Careful rinsing of a reuse dialyzer before use by the patient is done primarily to remove?
Residual disinfectent
What is the expected effect of sodium modeling during a hemodialysis treatment?
It may decrease episodes of hypotension
The movement of solutes through a semipermeable membrane from an area of high solute concentration to an area of low concentration is
Diffusion
Medical Director
Is ultimately responsible for maintaining the facility’s hemodialysis water quality
Medications used in the treatment of secondary hyperparathyroidism
Calcijex, Zemplar, Sensipar
Light-headed, pale, cyanotic pt respiratory rate and depth are increase
Hypoxia
Pyrogenic Reaction is caused from?
Bacterial exposure from water
Conductivity meter function and results dependent on
Passing a small electric current through the dialysate
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)
The primary factor causing anemia in patients with chronic renal failure is?
Insufficient production of the hormone erythropoietin
The Technician should be aware that the blood pump stops during this alarm conditions
High or low venus pressure alarm
During treatment, patient complains of suddenly feeling chilled
Take the patients temperature
Infiltration
Leakage of a substance into body tissues. If needles puncture the back of the vessel wall.
RO membrane(s)
Purify water to ANSI/AAMI standards
Reverse Osmosis (RO) pump
Increase water pressure across the RO membrane; made of high-grade steel, inert plastics, or carbon graphite-wetted parts.
Ultrapure dialysate should be
> 0.1CFU/mL
Bacteria must not exceed to
200
ANSI/AAMI standards of bacteria in dialysis water
<100CFU/mL Action level>50CFU/mL
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
RO
Removes solute from a solution organic and inorganic
BUN
10:1,20:1
Na+
sodium
K+
Potassium
Ca2
Calcium
CL
Chlorine
CO
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
