PCT FRESENIUS EXAM GUIDE
What is hepatitis, and how can the viral forms be spread?
hepatitis: inflammation of the liver with a variety of causes, all are
contagious
hep a: contaminated food, oral, and fecal route
hep b: blood or bodily fluids route, virus can live on surfaces at least 7 days,
patients require isolation if hbsag is reactive or positive
hep c: blood or bodily fluids route, some medications will cure depending on
genotype of virus
hep d: blood or bodily fluids route, a ribonucleic acid virus that require hbv
for replication (uncommon in dialysis patients)
hep e: oral and fecal route, from fecal contaminated food or water sources
(uncommon in dialysis patients)
hep b dialysis requirements
isolation room, dedicated equipment and supplies, door closed during
activities that could cause spurting of blood, all equipment remains in
isolation room (stethoscope and bp cuff). patients surrounding isolation room
must have immunity to create buffer zone
What blood test indicates infection with hep b?
HbsAg test for Hep B antigen, indicates actual viral presence, infection with
hep b, requires pt isolation and implementation of buffer zone
What blood test indicates presence of immunit against hep b?
,anti-hbs and anti hbc required to reflect susceptibility/ immunity status. if
greater than 10mlU/mL, pt is immune. positive anti hbc coupled with anti hbs
greater than or equal to 10 indicates person previously and hbv and immune
system fought against virus and person is no longer infections (lifelong
immunity). negative hbc with hbs 10 or hgiher reflect immunity gained
through vaccination. these individuals must have titers checked annually to
ensure levels remain immune.
Which vaccine provides long-term immunity to hep b?
series of multiple injects from recombivax or engerix b. these vaccines
stimulate immune system to produce hep b antibodies, helping to protect
against getting hep b virus.
What actions are necessary when a patient is suspected of having active tb?
have patient don mask and call physician
How is tb prevented in dialysis clinic?
pt who have active pulmonary or laryngeal tb cannot dialyze in the clinic. pt
must have 3 consecutive negative sputum cultures before returning to clinic
for dialysis. ppd testing and chest x ray performed. active tb is airborne is
considered contagious. tb that is contained does not have to be treated as
active (tb of bone or organ)
How is tuberculosis spread?
tb is caused from tuberculosis bacteria, which is spread by droplet nuclei
produced from infected individuals when they cough, sneeze, sing, or speak.
,positive tuberculin skin test or exposure to tuberculosis
patients with active tb are contagious. latent tuberculosis is not contagious
but can become active without tx
tuberculosis signs and symptoms
night sweats, productive persistent cough, unexplained weight loss, chills,
fever, blood tinged sputum.
What is documented if the pt is stable and resting
pt status, changes in vs, security of connections, and no unusual findings
were observed
Why is QAI so important?
Improve pt outcomes is required by Federal regulations. Identify problems,
create plans to correct, improve care, and to review results of our efforts.
assess success of facility processes in meeting clinical and operational goals
and objectives by reviewing cqs measurement tool.
qai and cqs process drives empowerment to achieve: quality outcomes,
regulatory compliance, day to day operations
When is cardiac arrest suspected with a patient experiencing chest pain?
chest pain, unrelieved by oxygen indicates cardiac arrest
, list some incidents that would require an adverse event report?
abusive/violent behavior, acute and severe psychotic event, air embolus,
blood loss >100 ml, cardiac arrest, congestive heart failure/symptomatic
fluid overload, inability to cannulate, contaminated needle stick by pt only,
fall resulting in inury, incorrect dialyzer or dialysate used resulting in pt
injury, medication errors or omissions
What is a near miss?
a potential hazard or incident that did not result in patient harm yet had the
possibility of doing so
Why is water treated?
patients are exposed to large amounts of water during dialysis, therefor the
water must be treated to ensure it is free from harmful contaminates.
chlorine and chloramines are added to city water to reduce/eliminated
bacteria
AAMI
Association for the Advancement of Medical Instrumentation. develops
voluntary standards for various aspects of dialysis treatment, including
maximum levels of water contaminates
water contaminants
aluminum, chloramine, copper, zinc
What is hepatitis, and how can the viral forms be spread?
hepatitis: inflammation of the liver with a variety of causes, all are
contagious
hep a: contaminated food, oral, and fecal route
hep b: blood or bodily fluids route, virus can live on surfaces at least 7 days,
patients require isolation if hbsag is reactive or positive
hep c: blood or bodily fluids route, some medications will cure depending on
genotype of virus
hep d: blood or bodily fluids route, a ribonucleic acid virus that require hbv
for replication (uncommon in dialysis patients)
hep e: oral and fecal route, from fecal contaminated food or water sources
(uncommon in dialysis patients)
hep b dialysis requirements
isolation room, dedicated equipment and supplies, door closed during
activities that could cause spurting of blood, all equipment remains in
isolation room (stethoscope and bp cuff). patients surrounding isolation room
must have immunity to create buffer zone
What blood test indicates infection with hep b?
HbsAg test for Hep B antigen, indicates actual viral presence, infection with
hep b, requires pt isolation and implementation of buffer zone
What blood test indicates presence of immunit against hep b?
,anti-hbs and anti hbc required to reflect susceptibility/ immunity status. if
greater than 10mlU/mL, pt is immune. positive anti hbc coupled with anti hbs
greater than or equal to 10 indicates person previously and hbv and immune
system fought against virus and person is no longer infections (lifelong
immunity). negative hbc with hbs 10 or hgiher reflect immunity gained
through vaccination. these individuals must have titers checked annually to
ensure levels remain immune.
Which vaccine provides long-term immunity to hep b?
series of multiple injects from recombivax or engerix b. these vaccines
stimulate immune system to produce hep b antibodies, helping to protect
against getting hep b virus.
What actions are necessary when a patient is suspected of having active tb?
have patient don mask and call physician
How is tb prevented in dialysis clinic?
pt who have active pulmonary or laryngeal tb cannot dialyze in the clinic. pt
must have 3 consecutive negative sputum cultures before returning to clinic
for dialysis. ppd testing and chest x ray performed. active tb is airborne is
considered contagious. tb that is contained does not have to be treated as
active (tb of bone or organ)
How is tuberculosis spread?
tb is caused from tuberculosis bacteria, which is spread by droplet nuclei
produced from infected individuals when they cough, sneeze, sing, or speak.
,positive tuberculin skin test or exposure to tuberculosis
patients with active tb are contagious. latent tuberculosis is not contagious
but can become active without tx
tuberculosis signs and symptoms
night sweats, productive persistent cough, unexplained weight loss, chills,
fever, blood tinged sputum.
What is documented if the pt is stable and resting
pt status, changes in vs, security of connections, and no unusual findings
were observed
Why is QAI so important?
Improve pt outcomes is required by Federal regulations. Identify problems,
create plans to correct, improve care, and to review results of our efforts.
assess success of facility processes in meeting clinical and operational goals
and objectives by reviewing cqs measurement tool.
qai and cqs process drives empowerment to achieve: quality outcomes,
regulatory compliance, day to day operations
When is cardiac arrest suspected with a patient experiencing chest pain?
chest pain, unrelieved by oxygen indicates cardiac arrest
, list some incidents that would require an adverse event report?
abusive/violent behavior, acute and severe psychotic event, air embolus,
blood loss >100 ml, cardiac arrest, congestive heart failure/symptomatic
fluid overload, inability to cannulate, contaminated needle stick by pt only,
fall resulting in inury, incorrect dialyzer or dialysate used resulting in pt
injury, medication errors or omissions
What is a near miss?
a potential hazard or incident that did not result in patient harm yet had the
possibility of doing so
Why is water treated?
patients are exposed to large amounts of water during dialysis, therefor the
water must be treated to ensure it is free from harmful contaminates.
chlorine and chloramines are added to city water to reduce/eliminated
bacteria
AAMI
Association for the Advancement of Medical Instrumentation. develops
voluntary standards for various aspects of dialysis treatment, including
maximum levels of water contaminates
water contaminants
aluminum, chloramine, copper, zinc
