QUESTIONS WITH SOLUTIONS GRADED A+
✔✔What is the purpose of checking the dialysate? - ✔✔That it is compatible with
human pH
Conductivity and temp to prevent hemolysis and crenation
✔✔Name four ways dialysate is checked - ✔✔pH
conductivity
temp
check for chlorine after weekly disinfectant
✔✔What should the temp be? - ✔✔36-39
Set by an MD
✔✔Why do we use a biocompatible membranes in the dialyzer? - ✔✔Closer to human
cells and tissues
less of an immue response
✔✔How to select a dialyzer for a patient - ✔✔Size
Clearance needs
UF needs
Membrane biocompatibilty
✔✔Dialyzer sensitivity - ✔✔Sneezing
Itching
Rash
Hives
Fever
Pain at the access site
Chest pain
Usually within the first half hour
Using one sterilized with an electron beam
✔✔How is the blood compartment separated from the dialysate? - ✔✔Semi-permeable
membrane
✔✔What is a semi-permeable membrane? - ✔✔Only certain molecules can fit through
the pores
Molecules larger than the pore size will not fit
Red blood cells and proteins are too large to pass through
✔✔What can pass through the semi permeable membrane - ✔✔Urea
Sodium
Potassium
, Water
✔✔What should be checked before machine set up? - ✔✔Dialyzer for sterility
✔✔Why does the dialysate flow bypass the dialyzer? - ✔✔Temperature
Conductivity
Dialysis flow rate
TMP
Blood leaks in the dialyzer
pH measure
✔✔What happens if you prime the machine higher than 150 ml/min - ✔✔Gas vapor lock
Not all the fibers open
✔✔How long can a dialyzer recirculate with saline before it is considered unsafe to use?
- ✔✔Four hours
✔✔What three processes occur in the dialyzer simultaneously? - ✔✔Osmosis
Diffusion
Ultrafiltration
✔✔What is ultrafiltration in dialysis? - ✔✔The use of more than one type of pressure,
positive and negative, to remove fluid
✔✔How do blood and dialysate flow travel through the dialyzer - ✔✔Countercurrent flow
Blood flows down (arterial to venous)
Dialysate flows up (venous to arterial)
✔✔How to tell if your dialyzer is clotting - ✔✔Rising TMP
Rising venous pressure
Dark blood in dialyzer
Air detector alarms
✔✔Heparin - ✔✔Heparin does not dissolve clots
Anticoagulant effect 5-10 minutes after injection
90 minute half life
✔✔After heparin is given, how long must you wait before starting the treatment? - ✔✔3-
5 minutes
✔✔When might the heparin dose be decreased? - ✔✔Treatment time and dialzyer size
is reduced