Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CV Perf Tech II > Dialysis- Final Exam > Flashcards

Dialysis- Final Exam Flashcards

1
Q

Dialysis

A

filtering metabolic waste products from blood; separation of dissolved substances from a solution by allowing the solution to diffuse through a semipermeable membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Hemodialysis

A

Removing waste products such as creatinine and urea, as well as free water from the blood when the kidneys are in renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Peritoneal Dialysis (PD)

A

a Tx for patients with severe chronic kidney disease; uses patient’s peritoneum as a membrane across which fluids and dissolved substances are exchanged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What substances are exchanged with peritoneal dialysis?

A

Electrolytes, urea, glucose, albumin and other small molcules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Continuous Ambulatory Peritoneal Dialysis (CAPD)

A

Fluid is introduced through a tube in the abdomen and flushed out either every night while the patient sleeps or via regular exchanges throughout the day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is used as an alternative to hemodialysis, especially in kids?

A

Peritoneal dialysis (PD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dialysate solution

A

dialysis solution in the dialyzer helps remove wastes/fluid from blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Dialyzer

A

artificial kidney filter designed to provide controllable transfer of solutes and water across a semi-permeable membrane separating flowing blood and dialysate streams

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does a dialysate solution contain?

A

Chemicals in concentrations similar to blood, a mixture of purified water and measured chemicals, which flows countercurrent on the outside.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What substances that must remain in the blood stream?

A

Glucose sodium calcium magnesium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Substances that must remain the in blood stream are in what concentrations in the dialysate solution?

A

Concentrations similar to blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does the composition of dialysate determine?

A

Which solutes pass out of and which stay in teh blood during dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What transfer processes occur in a dialyzer?

A

Diffusion (dialysis) and convection (ultrafiltration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the three basic dialyzer designs?

A

Coil, parallel plate, hollow fiber configurations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is one of the major modes of mass transfer?

A

Convection (diffusion is another; diffusive transport)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of kidney failure do we create on bypass?

A

Acute renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Acute renal failure (ARF)

A

A sudden loss of kidney function caused by an illness, an injury, or a toxin that stresses the kidneys (kidney function may recover)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Chronic Kidney Disease (CKD)

A

A long and usually slow process where the kidneys lose their ability to function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why type of kidney failure will you get with stenosis in the renal artery?

A

CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

End-stage renal disease (ESRD)

A

When the kidneys have completely and permanently shut down

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Would we give mannitol for ESRD?

A

no because it’s cleared in the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Renal failure defintiion

A

decrease in GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How is renal failure detected biochemically?

A

Elevated serum creatinine level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How do we characterize ARF?

A
  1. Rapid loss of kidney function (hypovolemia)
  2. Causes include low blood volume
  3. Exposure to harmful substances
  4. Obstruction of urinary tract
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What lab findings help us diagnose acute kidney injury?
Elevated blood urea nitrogen level (BUN) Elevated creatinine Inability of the kidneys to produce sufficient amounts of urine
26
What are some complications of ARF?
``` Metabolic acidosis High K+ levels Uremia Changes in body fluid balance (big shift) Effects to other organ systems ```
27
How is chronic kidney disease identified?
Significantly elevated creatinine
28
What do higher levels of creatinine indicate?
Falling GFR; and as a result decreased capability of the kidneys to excrete waste products
29
What are creatinine levels in early stages of chronic kidney disease?
may be normal
30
Problems frequently encountered in kidney malfunction
- Abnormal fluid levels in body - deranged acid levels - Abnormal potassium, calcium, phosphate - anemia - hematuria (blood loss in urine) - proteinuria (protein loss in urine)
31
Long-term kidneys problems have significant repercussions on other diseases such as what?
Cardiovascular disease
32
Ultrafilters/ Hemoconcentrators
Removed total body water on the principle of hydrostatic pressure gradients
33
What is used to treat renal failure?
Dialysis; removal of diffusable solutes based on the principle of concentration gradient and solute drag established by dialysate solution
34
Describe the diffusion of molecules.
Spread evenly
35
How do you control water?
Controlling transport of sodium
36
Solvent drag
influence exerted by a flow of solvent through a membrane on the simultaneous movement of a solute through the membrane
37
Types of dialyzers
Coil Parallel Plate Hollow fiber
38
Describe the blood compartment of a coil dialyzer.
Blood compartment consisted of one or two long membrane tubes placed between support screen and wound around a plastic core
39
Why are coil dialyzers restricted in use?
Serious performance limitations; coil design did not produce uniform dialysate flow distribution across the membrane
40
Describe the setup of a parallel plate dialyzer.
Sheets of membrane are mounted on plastic support screens, and then stacked in multiple layers range from 2 or 20 or more.
41
What do parallel plate dialyzers allow?
Multiple parallel blood and dialysate flow channels (lower resistance to flow)
42
Major improvements in parallel plate dialyzer allow what (3)?
1. Thinner blood and dialysate channels with uniform dimensions 2. Minimal masking or blocking of membranes on the support 3. Minimal stretching or deformation of membranes across the supports
43
What dialyzer has the most effective design?
Hollow Fiber Dialyzer
44
Describe the design of the hollow fiber dialyzer.
Low-volume high efficiency with low resistance to flow. Fiber bundle are potted in polyurethane at each end of the fiber bundle in the tube sheet, which serves as the membrane support.
45
__________ machines offer tremendous flexibility in adjusting dialysis regimens.
Hemodialysis
46
What type of system do hemodialysis machines use?
Single pass system where the dialysate circulates through the dialyzer once and is then discarded
47
What 3 components do all dialysis systems require?
1. Dialysate Heater (to warm to body temp) 2. Dialysate pump/flow meter (regulate rate of delivery) 3. Sensors/alarms (pressure, temp, conductivity, air or blood leaks)
48
Dialysis Types
Hemodialysis | Peritoneal Dialysis
49
When dialyzing, patient blood is on one side and what type of solution is on the other side?
Hypotonic solution (dialysate)
50
What creates movement of molecules across membrane in hemodialysis?
Movement from hypertonic blood to hypotonic solution (dialysate)
51
What substances in the blood decrease in hemodialysis?
BUN, creatinine, electrolytes
52
HOw can fluid pass through semipermeable filter membrane in hemodialysis?
By applying suction on the far side of the membrane
53
What creates a transmembrane pressure gradient?
Vacuum
54
What happens when you use vacuum?; What is meant by convective transport or solvent drag?
Small solute molecules get dragged out through the membrane pores along with the water
55
Convective Flux
The movement of solutes through the membrane ("convective flux") is calculatable
56
Almost all single-patient hemodialysis machines use a ______________, where the dialysate circulates through the dialyzer once and is then discarded.
Single-pass system
57
What temperature should the dialysate be?
Body temp, 37
58
What is more effective: peritoneal dialysis or hemodialysis?
Peritoneal dialysis
59
When is peritoneal dialysis effective?
Very labile cardiac states | Tx of choice in kids
60
What is an advantage of peritoneal dialysis?
Allows more patient freedom
61
What are some convection based alternative hemodialytic techniques?
CAVH (continuous arteriovenous hemofiltration) | CVVH (continuous venovenous hemofiltration)
62
What are some diffusive therapy based alternative hemodialytic techniques?
CAVHD (continuous arteriovenous hemodialysis) | CVVHD (continuous venovenous hemodialysis)
63
How does blood circulate in continuous arterio-venous hemofiltration?
With or without a blood pump thrugh a small hollow-fiber hemofilter; through the hemofilter wherein the plasma and water is filtered and collected in the collection bag
64
Where do you get access in CAVH?
Femoral artery and vein
65
Where is heparin infused in CAVH?
Proximal to the dialyzer
66
Where is replacement volume infused in CAVH?
Into venous return line
67
Why is CVVH replacing CAVH mode?
Pump assisted and achieves higher clearance. Because of its effectiveness, it is replacing the pumpless CAVH mode
68
Where do you get access in CVVH?
Double lumen catheter in the femoral, SC, or IJ vein
69
How is continuous diffusive solute transport achieved in CVVH?
Infusing a dialysate flui
70
What is the counter-current rate in CVVH?
15 ml/min or 1 L/hr
71
CAVH/CVVH Mechanism of Action
Convection - Solute removed by solvent drag - roller pump creates hydrostatic pressure - drives solute through membrane - pore size limits transfer - more efficient removal of larger molecules than diffusion - enhanced cleared of autologous cytokines
72
CAVH/CVVH has enhanced clearance of what?
Autologous cytokines
73
Describe the technique of CAVHD.
Infusion pump, dialyzer membrane and dialysate solution. Infusion pump pushes a flow of dialysis fluid dialyzer. The blood/dialysate interfaces on the membrane. CAVHD uses the process of diffusion dialysis to rid the body of fluid, electrolytes and nitrogenous wastes.
74
What process does CAVHD use to rid the body of wastes?
Diffusion dialysis
75
What wastes does CAVHD get rid of?
Fluid, electrolytes, nitrogenous wastes
76
What is the preferred arterial access site for CAVHD?
Femoral artery
77
What is more effective: CAVHD or CVVHD? Why?
CAVHD, becuase the lower pressure venous system does not filter as much blood per unit of time
78
CAVHD/CVVHD Mechanism of Action
Diffusion (predominantly) - Solute diffuses electrochemical gradient - diffusive movement; smaller molecule have greater KE removed based on size of gradient - convection due to UF - solute removed proportion to size - dialysate flow is low that BFR - solute removal directly proportion to dialysate flow rate
79
What type of cannulas are used for dialysis access?
duel lumen dialysis catheters
80
Arteriovenous fistula
Surgically created arteriovenous fistulas are preferred over catheters for patients with chronic renal failure for ease of access and a lower infection risk
81
What is one the most common errors of dual lumen cathters?
Placement of arterial and venous ports on the catheters
82
What is used for anticoagulation?
Citrate (CPD) | heparin
83
What are some advantages of Citrate as an anticoagulant?
Citrate has the effect of anticoagulating the CVVVH system itself. Citrate interrups the clotting cascade by soaking up (chelating) free ionized calcium. the citrate is cooked off (metabolized) into the form of bicarb
84
What systems use heparin as an anticoagulant?
CVVH and CVVHD

CV Perf Tech II (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions