HEMO DIALYSIS EXAM QUESTIONS WITH CORRECT AND COMPLETE ANSWERS

The substance which may be added to municipal drinking water supplies to make the water clearer? - alum Gram-negative - class of bacteria that turn pink in a standard laboratory gram's stain. They live in water and form an electrically charged biofilm (slime) that lets them cling to surfaces like dialysate jugs or hoses. Biofilm protects the bacteria from disinfectants, making them difficult to remove. For example, achromobacter is a gram-negative bacteria that can contaminate the dialysis water supply or dialysate. Acinetobacter, aeromonas, alcaligenes, flavobacterium, moraxella, pseudomonas, and serratia are other types of gram-negative bacteria What are the 6 indications for dialysis? - (hint: aeiou) a = acid/base disorders E = electrolyte I = intoxication O = overload of volume U = uremia Esrd with crcl < 15 ml/min The water softener performs the following activity? - removes calcium and magnesium from water What is the most common way that water treatment systems are disinfected? - chemical Contamination of water by bacteria / endotoxins may cause ? - pyrogenic reaction How often should the ro operating parameters be checked? - daily What is acceptable level of post softener hardness? - 0.8 grain per gallon Aami standards for testing bacteriologic for water and dialysate should take place when? - monthly The total allowed by aami for microbial count of dialysate is? - 200 cfu/ml The total allowed by aami for endotoxin count of dialysate is? - 2eu/ml How often should the carbon tanks be checked for chlorine and chloramines? - each shift Large amounts of aluminum in water used for dialysate could cause? - bone disease, encephalopathy, anemia Dialyzers are reprocessed mainly because? - reprocessing reduces the cost of dialysis treatments What organization sets the standards and recommendations for dialyzer reprocessing? - aami What test must be performed on new dialyzers? - tcv (total cell volume) The germicides used for dialyzer reprocessing? - peracetic acid or formaldehyde The definition of "contact time"? - amount of time the germicide remains in the dialyzer According to aami standards who must check the dialyzer to verify quality control information - two people , one of whom should be patient If the dialyzer has improperly prepared germicide it can cause - bacteria or endotoxin contamination The two criteria for rejecting a reprocessed dialyzer are - less than 80% of original fiber bundle volume , aesthetic appearance Mrs. P a 40 year old woman whose kidneys are failing due to hypertension. She does not have diabetes or cardiac problems. If her blood vessels are in good condition what type of access is preferable ? - arteriovenous fistula (avf) When assessing a fistula or graft what do you listen for prior to starting dialysis - bruit One of the main complications for "flipping" the needle in avf cannulation is - infiltration Which direction should the venous needle be placed - antegrade The reason for rotating needle sites on a fistula is to - prevent aneurysms Define infiltration - a needle tip that punctures a vessel and goes out the other side so blood escapes into the tissues A long term complication of a fistula is - thrombosis When assessing a fistula or graft what needs to be felt prior to starting dialysis - pulse and thrill What complication can happen to a graft if the needle sites are not rotated - pseudoaneurysm As tech what can we do to prevent infection in catheters - wash hands and change gloves prior to touching the catheter The pdca cycle is step of - cqi process A solution is a mixture of - a solvent and a solute A semipermeable membrane is a filter that - allows only certain sized particles to cross Diffusion is movement of particles - from an area of higher concentration to an area of lower concentration During dialysis ultrafiltration occurs when - water is removed from blood because there is a pressure gradient across a membrane Blood inside the blood vessels describes - intravascular fluid compartment During dialysis levels of waste in the blood should - decrease The surface area of the membrane affects the rate of - diffusion The functional unit of the kidney - nephron A nephron is made up of - a glomerulus and a tubule The endocrine functions of the kidney include - making erythropoietin and the active form of vitamin d The primary cause of the anemia of esrd is - erythropoietin deficiency Mrs. M a 72 year old ask to have treatment shorten , you explain - its important to get prescribed treatment for every dialysis treatment to avoid medical complications Name two compartments of the dialyzer - blood and dialysate What is the purpose of a proportioning system - make dialysate by mixing fresh concentrate with fixed amounts of treated water Dialysate conductivity measures - the total electrical charge of a solution What condition occurs due to dialysate that is too hot - hemolysis What are the two types ultrafiltration systems - volumetric uf control and flow control The dialysate delivery system monitors are - conductivity, ph, flow rate Lidocaine is administered - intradermally