FRESENIUS PCT UPDATED EXAM SCRIPT QUESTIONS AND
SOLUTIONS RATED A+
✔✔What is dialysate? - ✔✔Dialysate is a non-sterile solution and its function is to
remove waste products from the blood and balance electrolytes
✔✔Dialysate is composed of - ✔✔treated water, acid solution, and bicarbonate solution
✔✔What electrolytes are found in the dialysate? - ✔✔sodium (Na+) potassium (K+)
calcium (Ca++) magnesium (Mg++) chloride (Cl-)
✔✔What is conductivity? - ✔✔Conductivity is the ability of a solution to transmit or
"conduct" an electrical current
✔✔Name four ways dialysate is checked to ensure that it is safe? - ✔✔pH, conductivity,
monitoring the machine temperature, and a negative residual chlorine (bleach) after
routine (weekly) machine disinfection and before the first treatment after the disinfection
✔✔What is Sodium Variation? - ✔✔also called sodium modeling is a physician-ordered
intervention to help prevent hypotension during dialysis treatment. There are three
preprogrammed "profiles" that can be ordered by the physician based on several
different comorbidities
✔✔Why is dextrose added to the dialysate? - ✔✔Dextrose, a form of glucose, is added
to prevent hypoglycemia.
✔✔What is TMP? - ✔✔Transmembrane pressure is the pressure difference across the
dialyzer membrane. It reflects the total pressure across the membrane used to achieve
the desired fluid loss
✔✔How can you tell if a dialyzer is clotting? - ✔✔Indications of a clotting dialyzer are a
rising TMP, rising venous pressure, dark blood in the dialyzer, and air detector alarms.
A venous line that is clotting will show an increase in venous pressure.
✔✔How is dialysis delivered? - ✔✔The Hemodialysis Machine is the Delivery System.
The machine has two sub-systems.
• Blood delivery system circulates the patient's blood
• Dialysate delivery Mixes & circulates dialysate
✔✔What is monitored during treatment? - ✔✔Machine alarms monitor the safe
progression of the dialysis treatment. Alarms are divided into two categories. Blood
related, and dialysate related
, ✔✔What causes increased arterial pressure? - ✔✔Kinks, clamp or occlusion on arterial
line
BFR exceeds vascular access flow
Needle gauge size selected compared to BFR
Needle placement
Clotting, stenosis, vasoconstriction or vasospasms
Malposition of catheter tip, constricting sutures at insertion
site or CVC thrombus
Hypotension
Poor cardiac output
Increased blood viscosity due to high hgb or ultrafiltration
✔✔What causes increased venous pressure? - ✔✔Kinks, clamp or occlusion on venous
line
Infiltration or poor needle placement
Clotting in:
Needle
CVC
Venous chamber
lines or dialyzer
Machine malfunction
Wet or bloody transducer protectors
Venous infiltration
✔✔How do you test for a small blood leak? - ✔✔Testing for a small blood leak consists
of
dipping a FMS approved blood leak test strip into
dialysate obtained from the outflow (arterial/red)
dialysate port. The blood leak test strip will change
color if it is positive for blood. Do not return blood if
the test is positive or if there are visible signs of
blood in the dialysate.
✔✔How is a large/major blood leak treated? - ✔✔In the case of a large/major blood
leak, where the dialysate appears bloody or blood tinged, do not
return the blood
✔✔recommend weight gain for pt? - ✔✔1.5-2.0 kg/day
✔✔Av graft advantages? - ✔✔Large surface area for cannulation
Technically easy to cannulate
Healing time is short
Variety shapes and configurations
Easy to implant, construct, and surgically repair
SOLUTIONS RATED A+
✔✔What is dialysate? - ✔✔Dialysate is a non-sterile solution and its function is to
remove waste products from the blood and balance electrolytes
✔✔Dialysate is composed of - ✔✔treated water, acid solution, and bicarbonate solution
✔✔What electrolytes are found in the dialysate? - ✔✔sodium (Na+) potassium (K+)
calcium (Ca++) magnesium (Mg++) chloride (Cl-)
✔✔What is conductivity? - ✔✔Conductivity is the ability of a solution to transmit or
"conduct" an electrical current
✔✔Name four ways dialysate is checked to ensure that it is safe? - ✔✔pH, conductivity,
monitoring the machine temperature, and a negative residual chlorine (bleach) after
routine (weekly) machine disinfection and before the first treatment after the disinfection
✔✔What is Sodium Variation? - ✔✔also called sodium modeling is a physician-ordered
intervention to help prevent hypotension during dialysis treatment. There are three
preprogrammed "profiles" that can be ordered by the physician based on several
different comorbidities
✔✔Why is dextrose added to the dialysate? - ✔✔Dextrose, a form of glucose, is added
to prevent hypoglycemia.
✔✔What is TMP? - ✔✔Transmembrane pressure is the pressure difference across the
dialyzer membrane. It reflects the total pressure across the membrane used to achieve
the desired fluid loss
✔✔How can you tell if a dialyzer is clotting? - ✔✔Indications of a clotting dialyzer are a
rising TMP, rising venous pressure, dark blood in the dialyzer, and air detector alarms.
A venous line that is clotting will show an increase in venous pressure.
✔✔How is dialysis delivered? - ✔✔The Hemodialysis Machine is the Delivery System.
The machine has two sub-systems.
• Blood delivery system circulates the patient's blood
• Dialysate delivery Mixes & circulates dialysate
✔✔What is monitored during treatment? - ✔✔Machine alarms monitor the safe
progression of the dialysis treatment. Alarms are divided into two categories. Blood
related, and dialysate related
, ✔✔What causes increased arterial pressure? - ✔✔Kinks, clamp or occlusion on arterial
line
BFR exceeds vascular access flow
Needle gauge size selected compared to BFR
Needle placement
Clotting, stenosis, vasoconstriction or vasospasms
Malposition of catheter tip, constricting sutures at insertion
site or CVC thrombus
Hypotension
Poor cardiac output
Increased blood viscosity due to high hgb or ultrafiltration
✔✔What causes increased venous pressure? - ✔✔Kinks, clamp or occlusion on venous
line
Infiltration or poor needle placement
Clotting in:
Needle
CVC
Venous chamber
lines or dialyzer
Machine malfunction
Wet or bloody transducer protectors
Venous infiltration
✔✔How do you test for a small blood leak? - ✔✔Testing for a small blood leak consists
of
dipping a FMS approved blood leak test strip into
dialysate obtained from the outflow (arterial/red)
dialysate port. The blood leak test strip will change
color if it is positive for blood. Do not return blood if
the test is positive or if there are visible signs of
blood in the dialysate.
✔✔How is a large/major blood leak treated? - ✔✔In the case of a large/major blood
leak, where the dialysate appears bloody or blood tinged, do not
return the blood
✔✔recommend weight gain for pt? - ✔✔1.5-2.0 kg/day
✔✔Av graft advantages? - ✔✔Large surface area for cannulation
Technically easy to cannulate
Healing time is short
Variety shapes and configurations
Easy to implant, construct, and surgically repair
