Dialysis Finals Flashcards
How long for soap/water and alcohol rub?
- 40-60 seconds for soap/water
- 20-30 seconds for alcohol rub
PPE cannot be worn before leaving clinical area except?
-transporting medical waste
Order of removal of access needle post treatment?
-preferably arterial first
All PPE are disposed where?
-biohazard waste
How do you deliver medications to each patients?
-separately
Buffer zone of patients that are _____ are placed next to isolation room.
-antibody positive
What is normal GFR?
-100-140 ml/min
Acute renal failure
-urine output less than 400ml/day or less than 20 ml/hr
The three most common causes of chronic renal failure in order?
-diabetes,hypertension, and glumerulonephritis
Signs and symptoms of uremia?
-fatigue, n/v, high BUN and creatinine, HTN, edema, anorexia, and hematuria
What is the dialyser of peritoneal dialysis?
-dextran(dextrose)
What are the two test of HD devices?
-alarm and pressure holding tests
What is steal syndrome?
-blood flow is rerouted to the internal vascular access and there is decreased blood flow to the distal capillaries of the access hand
Desired number(flow of F or G) for baseline of AF?
-fistula is greater than 400 and graft is more than 600
What is clearance?
-the amount of solutes completely removed from one ml of blood in one minute. It is influenced by flow rate of blood and dialysate, and permeability of semipermeable membrane.
What is creatinine clearance?
-urine test that measures the kidney’s ability to remove waste products; elevated levels may indicate kidney failure. Creatinine is by-product of muscle breakdown.
What is EDW and AW?
-EDW is estimated dry weight, is the amount a patient should weigh without excess body fluid. AW is available weight, is the pre-treatment weight minus the EDW.
Signs and symptoms of fluid overload?
-edema, HTN, SOB, JVD, abnormal breath sounds(cough, crackles, rales, ronchi, or wheezing)pulmonary edema
What does adjusting/challenging a patient’s dry weight means?
-dropping or increasing EDW by increments of 0.5 to 1 kg every dialysis treatment until the patient becomes stable and there is no evidence of edema(facial or extremities) or dryness
What is the antidote for heparin?
protamine sulfate
What is pH range?
-6.9 to 7.6
What is AAMI?
-association for the advancement of medical instrumentation, oversee state, local and national water standards
What is albumin?
-is a protein substance that helps maintain fluid balance in the vessel; low level indicate malnutrition, liver disease, chronic inflammation/infection, or albumin loss in peritoneal dialysis or urine. it has been linked to higher hospitalization and death. dialysis patient should be 4.0 and greater.
What is BUN?
-blood urea nitrogen, Urea is an end product of protein metabolism. It is used to indicate levels of wastes in the blood and determine delivered doses of dialysis. Elevated levels usually indicates inadequate dialysis. Low BUN levels can indicate poor nutrition. Dialysis patient should be 60-80 mg/dl
What is creatinine?
-is an end-product of muscle metabolism. Very muscular patient will normally have higher creatinine than small, non-muscular patient. Dialysis patient should be 10-18mg/dl.
What is ferritin?
-is chief iron-storage in the body. iron may be stored as ferritin, which is readily available. serum ferritin is low in iron deficiency. excessive intake of iron intake or multiple blood transfusions can lead to hemochromatosis, massive amount of hemosiderin deposited in the cells of organs and can lead to organ failure. High ferritin levels may also be caused by chronic inflammation, certain anemias, or malignancies
pyrogen reaction?
-fever, chills, and hypotension
Sources of potassium?
-potato, banana, watermelon, cantaloupe, salt substitutes, orange juice
Six rights of medication?
-right(patient, medication, dose, time, route, and documentation)
Acronym: pmdtrd : pull my doctor to read document
Hemolysis
-cranberry(cherry colored), translucent
Air embolism
-cough, SOB, and chest pain. COLT(clamp blood lines, off blood pump, place on left side, and trendelenburg patient)
Infiltration: where to cannulate?
-arterial is above or below and venous is above
What is normal value of KECN?
200-300
BFR of gauges 14,15,16, and 17 needles
14 is more than 450 ml/min,
i15 is more than 350-450,
16 is 300-350, and
17 is less than 300
