Term
| what should a technician test for if a chain of patients are suffering from anemia? |
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Definition
| check the water for aluminum, chloramines, copper, & zinc, |
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Term
| what should a technician test for is a chain of patients are experiencing hemolysis? |
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Definition
| chloramines, copper, and nitrates |
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Term
| if multiple patients from the same clinic on the same shift are experiencing symptoms of bone disease, what should the clinics test for? |
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Definition
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Term
| if an outbreak of nausea and vomiting occurs, what should you check for? |
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Definition
| copper, zinc, calcium, endotoxins, low ph, & Bacteria |
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Term
| if an outbreak of hypertension occurs, what should you test for? |
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Definition
| test the water for calcium and sodium |
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Term
| if patients are complaining of muscle cramps what should the tech do? |
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Definition
| test the water for calcium and magnesium. administer saline per clinics policy, help the patient stretch the affected area, report to nurse. |
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Term
| if patients are showing symptoms of metabolic acidosis what should you test the water for? |
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Definition
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Term
| how do you calculate the patients gain post tx? |
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Definition
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Term
| how do you calculate patients available weight? |
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Definition
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Term
| how do you calculate the target weight? |
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Definition
| available weight (+) .5 for saline prime and rinseback |
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Term
| how to convert target weight from kg to ml |
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Definition
| multiply target weight by 1000 |
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Term
| the triangle symbol means? |
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Definition
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Term
| what are the primary components of dialysate formula? |
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Definition
| calcium, potassium, sodium, magnesium, chloride, glucose, bicarbonate, and treated water |
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Term
| what is metabolic acidosis and what component helps treat metabolic acidosis? |
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Definition
metabolic acidosis is too much acid in the body.
bicarbonate will help treat metabolic acidosis |
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Term
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Definition
| dialysate is ultra pure but is not sterile |
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Term
| what does the venous pressure do? |
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Definition
| measures pressure as blood is being returned from the dialyzer through the venous line and back to the venous side of the access |
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Term
| what 2 electrolytes can the doctor alter? |
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Definition
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Term
| what alarms causes the blood pump to stop and the venous line clamp to engaged? |
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Definition
| arterial, venous, tmp, air detector, and a blood leak alarm |
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Term
| what is the difference in hemodialysis and peritoneal dialysis? |
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Definition
| HD main 2 principles is diffusion and ultrafiltration while PD uses osmosis and diffusion. |
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Term
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Definition
| osmosis is the movement of fluid through a semi permeable membrane from an area of low solute concentration to an area of high solute concentration. |
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Term
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Definition
| diffusion is the movement of particles through a semi permeable from an area of high solute concentration to and area of low solute concentration. |
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Term
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Definition
| is the removal of additional fluid through a semipermeable membrane with the use of added pressure (using both neg and pos pressure) |
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Term
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Definition
| is a membrane that allows some particles to pass through. the size of the particle determines if it can pass through or not. |
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Term
| what is diffusion effected by? |
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Definition
| diffusion is affected by molecular weight (small molecules diffuse faster than larger one) and concentration gradient ( concentration of particles or fluid on each side of the membrane) |
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Term
| what is the transmembrane? |
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Definition
| the tmp reading on the machine is the total amount of neg and pos pressure exerted in the dialyzer to remove fluid from the patient. |
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Term
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Definition
| amount of fibers in contact with the blood and dialysate |
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Term
| define ultrafiltration coefficient |
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Definition
| the amount of fluid that will pass through the membrane in one hour at a given pressure. |
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Term
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Definition
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Term
| what transport the urine? |
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Definition
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Term
| where is the urine sent after the ureter transports it? |
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Definition
| the urine is stored in the bladder |
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Term
| after the urine is stored in the bladder what happens when the bladder is full? |
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Definition
| the urine is excreted from the body via the urethra. |
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Term
| what are the functional units of the kidneys? |
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Definition
| nephrons they are composed of the glomerulus. |
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Term
| how many functions do the kidneys have and what are they? |
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Definition
| the kidneys have 4 functions and they are excretory, regulatory, filtration, and endocrine. |
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Term
| what parts of the body does renal failure affects? |
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Definition
| digestive,skin, cardiovascular, skeletal, and lungs |
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Term
| when using svs profiles what is the end of treatment protocol and why? |
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Definition
| when using sodium variation system programs is must be stopped 30-45 mins prior to the end of treatment to prevent the patient from being hypernatremic (high serum sodium) post treatment. |
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Term
| if a patient is hypotensive during treatment what should the tech do? |
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Definition
| trendelenburg with feet elevated, turn uf down or off, notify nurse, give normal saline, document |
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Term
| what should the tech do if the patient is complaining of angina? |
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Definition
| notify the nurse, turn the bfr down, turn The uf off. RN will administer o2 and or nitroglycerin. i( if cardiac arrest occurs while patient is on it the machine must be pulled and the biomed Dept must put it through test before it can be used again. |
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Term
| what should you do if the patient is complaining of faintness, double vision, irritability, and hunger.? |
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Definition
| check glucose, if low notify the nurse and document. |
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Term
| what should you do if the patient is complaining of n/v, headache, confusion, and restlessness? |
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Definition
| notify the nurse and document. |
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Term
| what to do if patient is having sob, angina, and blood in lines are cherry pop red? what could be causes? |
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Definition
| stop treatment, notify RN, do not return blood. cause are hemolysis, hemolysis can be caused by kinks in the lines, hypotonic dialysate, dialysate temp greater that 105, and ap greater than -250. |
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Term
| how to address a blood leak alarm? |
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Definition
| check the affluent dialysate fluid from the red hose with a blood leak strip. if pos don't return blood. |
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Term
| what should the venous pressure be as a rule of thumb? |
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Definition
| v/p is generally half the bfr and is a pos pressure. ( anything that blocks the return of the blood to the access will cause an increase in vp. |
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Term
| what can cause a vp alarm? |
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Definition
| kink on the venous line, infiltrated venous needle, clotted access, clotting from the venous chamber to the access. if clotting is in the venous chamber it will need to be changed |
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Term
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Definition
| Ap is the amount of pressure it takes to pull the blood from the access to get it to the dialyzer. this number will always be neg |
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Term
| as a rule of thumb what should the AP be and why? |
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Definition
| AP should always be -250 or less and anything higher can cause hemolysis as the rbc can't handle anything higher. |
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Term
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Definition
| tmp alarm measures the pressure difference across the membrane fibers inside the dialyzer. as fibers clot off in the dialyzer The tmp rises. |
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Term
| what is hypotonic and hypertonic and what an it cause? |
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Definition
| hypotonic is caused from low conductivity and can cause hemolysis. hypertonic is caused from high conductivity and can cause crenation. |
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Term
| foods high in phosphorus? |
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Definition
| dairy, nuts, cola, dry beans, chocolate |
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Term
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Definition
| lunch meat, chips, canned food, table salt. |
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Term
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Definition
| bananas, oranges, potatoes, tomatoes, & salt substitutes |
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Term
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Definition
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Term
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Definition
| set standards for water used in dialysis and helps increase safety, understanding, and efficacy. |
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Term
| what must the level of chlorine in the water be? |
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Definition
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Term
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Definition
| AEnis a patient only reporting system, events including staff are not documented in AE. |
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Term
| things you should report to the nurse. |
|
Definition
| weight gain of more than 4kg, edema, falls regardless of location, medical procedure, pain, systolic greater than 200 or diastolic greater than 100, drop in bp of 20 between sitting and standing, access changes l, mental change, hospitalization, heart rate below 60 or greater than 100, glucose less than 80 or more than 300, irregular pulse, skin changes, |
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Term
| patient ma expose to high levels of chloramines can develop? |
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Definition
| methemoglobin meaning red blood cells can't carry oxygen or hemolytic anemia meaning a shortage of red blood cells due to red blood cell breakdown |
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Term
| chlorine and chloramines limits? |
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Definition
| chlorine limit is 0.5mg/l and chloramines limit is 0.1mg/l |
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Term
| cms requires testing for chloramines and chlorine how many times a day? |
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Definition
| start of day, start of each shift, and every 4 hours if clinic doesn't have set shift. |
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Term
| AAMI says water should contain how many mg of sodium and potassium? |
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Definition
| 70mg/L for sodium and 8mg/L of potassium |
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Term
| what part of the water treatment removed sodium and potassium? |
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Definition
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Term
| AAMI set standards for bacteria in water is what? |
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Definition
bacteria must not exceed 200 colony forming units
AAMI also states the action level for bacteria in water is 50cfu/ml
for ultrapure the level should be 0.1cfu |
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Term
| symptoms of a pyrogens can reaction are ? |
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Definition
| chills, fever, low bp, n/v and muscle pain |
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Term
| symptoms of a pyrogens can reaction are ? |
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Definition
| chills, fever, low bp, n/v and muscle pain |
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Term
| AAMI says the level of endotoxins are? |
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Definition
less than 2 endotoxins unit/L AAMI action level is 1eu/L
ultrapure must have less than 0.03 |
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Term
| symptoms of flouride in the water? |
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Definition
| n/v, muscle weakness, low bp, and seizures |
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Term
| AAMI standards for flouride in the water? |
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Definition
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Term
| symptoms of nitrates in the water? |
|
Definition
| cyanosis which is blue skin, lips, gums and nail beds. |
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Term
| AAMI standards for nitrates are? |
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Definition
| no more than 2.0mg/l and nitrates are removed by the RO |
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