FRESENIUS ANNUAL COMPETENCY
EXAM COMPLETE COMPREHENSIVE
SCRIPT QUESTIONS AND SOLUTIONS
GRADED A
⩥ What factors impact the rate of diffusion . Answer: Concentration
gradient, temperature, molecular weight of solutes, nature of the
solution, membrane permeablilty, surface area, flow geometry
convection ( solvent drag)
⩥ At what point during the hemodialysis treatment will diffusion cease
to occur . Answer: Diffusion will continue throughout the dialysis
treatment until the concentration of each electrolyte found in the patients
blood is equal to the electrolyte concentration in the dialysate.
⩥ What is countercurrent flow . Answer: Blood and dialysate flow in
opposite directions - called countercurrent flow. Blood flows down into
the dialyzer (areterial to Venous) dialasate flows up (venous to arterial).
This opposite flow allows for better clearance and diffusion.
⩥ What happens to diffusion when dialyzer fibers clot ?. Answer: When
dialyzer fibers clot - either from inadequate heperanization or an
improperly primed dialyzer, diffusion is decreased. Clotted fibers cause
the permeability of the fiber to be reduced or eliminated causing a
decrease in treatment adequacy.
,⩥ What are the compartments of the dialyzer and what seperates them ?.
Answer: The dialyzer is composed of two compartments housed inside a
plastic casing. The blood compartment is seperated from the dialysate
compartment by a semi- permeable membrane. The blood and dialysate
do not mix together. There is a potting material on both ends of the
dialyzer to assure seperation of blood and dialysate.
⩥ What are three types of solutions ?. Answer: Hypotonic - containing
less particles
Isotonic - containing equal particles
Hypertonic - containing more particles
⩥ When is it known that a patient has developed sensitivity to a
dialyzer?. Answer: Patients develop mild to severe reactions in some
cases, usually seen the first half hour of treatment. Sneezing, itching,
pain at the access site, chest pain, rashing, hives, fever
⩥ How ling can a dialyzer recirculate with saline before it is considered
unsafe to use ?. Answer: 4 hours
after 2 hours recirculate
⩥ What volume should be used for fresh fill/ run off ?. Answer: Fresh
fill / run off must be performed prior to the initiation of every treatment.
50 ml of saline should be drained from the arterial line and 250 ml
, should be drained from the venous line before lines are connected to the
patient.
⩥ When dialyzing a patient what position should the dialyzer be in
during hemodialysis ?. Answer: place the dialyzer arterial end up
⩥ What should be checked on a dialyzer before machine set up ?.
Answer: the dialyzer should be checked for sterility I the dialyzer should
be intact in the original packaging or if out of the package should have
all the ports capped), in the structural damage and be the size and brand
that was ordered by the doctor.
⩥ What are electrolytes ?. Answer: charged particles that can conduct an
electrical current. Electrolytes in the body control motor, muscle and
nerve function, and maintain the body's homeostasis.
⩥ The most important electrolytes to consider in uremic patients are ?.
Answer: sodium ( Na+) Potassium (K+) Calcium ( Ca++) Magnesium (
Mg++)
⩥ Fluid removed during hemodialysis comes from which body fluid
compartment ?. Answer: During dialysis fluid is removed from the
intravascular fluid compartment or bloodstream.
Intravascular = inside the blood vessels
EXAM COMPLETE COMPREHENSIVE
SCRIPT QUESTIONS AND SOLUTIONS
GRADED A
⩥ What factors impact the rate of diffusion . Answer: Concentration
gradient, temperature, molecular weight of solutes, nature of the
solution, membrane permeablilty, surface area, flow geometry
convection ( solvent drag)
⩥ At what point during the hemodialysis treatment will diffusion cease
to occur . Answer: Diffusion will continue throughout the dialysis
treatment until the concentration of each electrolyte found in the patients
blood is equal to the electrolyte concentration in the dialysate.
⩥ What is countercurrent flow . Answer: Blood and dialysate flow in
opposite directions - called countercurrent flow. Blood flows down into
the dialyzer (areterial to Venous) dialasate flows up (venous to arterial).
This opposite flow allows for better clearance and diffusion.
⩥ What happens to diffusion when dialyzer fibers clot ?. Answer: When
dialyzer fibers clot - either from inadequate heperanization or an
improperly primed dialyzer, diffusion is decreased. Clotted fibers cause
the permeability of the fiber to be reduced or eliminated causing a
decrease in treatment adequacy.
,⩥ What are the compartments of the dialyzer and what seperates them ?.
Answer: The dialyzer is composed of two compartments housed inside a
plastic casing. The blood compartment is seperated from the dialysate
compartment by a semi- permeable membrane. The blood and dialysate
do not mix together. There is a potting material on both ends of the
dialyzer to assure seperation of blood and dialysate.
⩥ What are three types of solutions ?. Answer: Hypotonic - containing
less particles
Isotonic - containing equal particles
Hypertonic - containing more particles
⩥ When is it known that a patient has developed sensitivity to a
dialyzer?. Answer: Patients develop mild to severe reactions in some
cases, usually seen the first half hour of treatment. Sneezing, itching,
pain at the access site, chest pain, rashing, hives, fever
⩥ How ling can a dialyzer recirculate with saline before it is considered
unsafe to use ?. Answer: 4 hours
after 2 hours recirculate
⩥ What volume should be used for fresh fill/ run off ?. Answer: Fresh
fill / run off must be performed prior to the initiation of every treatment.
50 ml of saline should be drained from the arterial line and 250 ml
, should be drained from the venous line before lines are connected to the
patient.
⩥ When dialyzing a patient what position should the dialyzer be in
during hemodialysis ?. Answer: place the dialyzer arterial end up
⩥ What should be checked on a dialyzer before machine set up ?.
Answer: the dialyzer should be checked for sterility I the dialyzer should
be intact in the original packaging or if out of the package should have
all the ports capped), in the structural damage and be the size and brand
that was ordered by the doctor.
⩥ What are electrolytes ?. Answer: charged particles that can conduct an
electrical current. Electrolytes in the body control motor, muscle and
nerve function, and maintain the body's homeostasis.
⩥ The most important electrolytes to consider in uremic patients are ?.
Answer: sodium ( Na+) Potassium (K+) Calcium ( Ca++) Magnesium (
Mg++)
⩥ Fluid removed during hemodialysis comes from which body fluid
compartment ?. Answer: During dialysis fluid is removed from the
intravascular fluid compartment or bloodstream.
Intravascular = inside the blood vessels
