Dialysis Technician Exam (Core Curriculum for Dialysis Technician) Quizzes & Ans… infection is the second most common cause of death in HD patient Infection can occur when pathogens enter the body through • a break in the skin • a mucous membrane • the l

Dialysis Technician Exam (Core Curriculum for Dialysis Technician) Quizzes & Ans… infection is the second most common cause of death in HD patient Infection can occur when pathogens enter the body through • a break in the skin • a mucous membrane • the lungs 3 main ways disease can spread 1. direct contact 2. indirect contact 3. droplet spread In dialysis clinic pathogens can be spread by patient, bath, visitors, equipment, water, dialysate, and air direct contact with an infected person such as shaking hands or kissing indirect contact We touch objects such as dialysis chair, patient chart, blood pressure cuffs, IV poles, and treatment carts droplet spread we breathe in droplets that were coughed or sneezed by an infected person Aseptic free from disease-causing germs clean not free from germs , but disinfected and usable for some steps in the treatment contaminated was sterile or clean but then was touched by a non sterile object dirty neither clean or sterile Basic Guidelines for Aseptic Technique • package sterile items as sterile only if the package is closed and sealed • wash your hands before you touch a package that contain sterile item • keep sterile packages dry • a contaminated object contaminate a sterile one • before you use a multi-dose vial scrub the rubber stopper with disinfectant • all fistula needle syringe tips and needles used to give meds or draw blood must be sterile dialysate made up of : RO water acid concentrate bicarbonate concentrate Extracorporeal Circuit includes: • dialyzer • bloodlines • monitoring lines • Heparin line • transducer protector priming Takes air in germicide out of the Bloodlines and dialyzer during recirculation UF and diffusion help "dialyze off" of any germicide that is left bruit - is a buzzing or swooshing sound caused by the high pressure flow of blood through a patient's fistula or graft. dialysate alarms • conductivity alarm • temperature alarm • pH alarm * if each of the above alarms is working the machine will go into bypass mode (dialysate flow to the do the dialyzer should stop) empty bed contact time EBCT is the amount of time that feedwater must stay in contact with a charcoal bed in a carbon tank during water treatment to remove chlorine and chloramines electrolyte a compound that breaks apart into ions when dissolved in water electrolyte •send electrical signals along the nerves of the muscles, including the heart. example of electrolytes: sodium, potassium, magnesium, chloride, and calcium bypass is a safety feature of the hemodialysis delivery system bypass it cuts off the flow of fresh dialysate to the dialyzer and shunts it to the drain bypass keeps and safe dialysate ( wrong conductivity temperature or pH ) from reaching the patient and causing harm bypass mode a high/low conductivity, high/ low PH, high/low temperature, or blood leaking trigger the delivery system to switch into Bypass Mode check the delivery system before each treatment to be sure that it works properly for all dialysate alarm condition bleach (sodium hypochlorite) pH of 11.0 white vinegar (acid) pH of 2.9 pH of blood 7.35 - 7.45 (slightly alkaline) range of dialysate pH 7.0 - 7.4 Hemodialysis Delivery Systems has two major subsystems: • dialysate delivery system • extracorporeal blood circuit delivery system is the machine that supplies dialysate to the dialyzer and sends it to the drain once it has been used • mixes and monitor dialysate • pump and monitor the patient's blood • have alarms to protect patient safety Delivery Systems Purpose • mix and monitor dialysate • pumps blood • monitors systems to ensure a safe treatment Delivery System safety includes: blood flow dialysate flow dialysate temperature conductivity venous and arterial pressure blood leaks into the dialysate patient blood pressure dialyzer clearance bruit - a high-pitch means there is stenosis of the access bruit - can be heard through a stethoscope at the anastomosis and at some length along the access. thrill is the vibration of blood flowing through the patient's fistula or graft thrill it can be felt by touching a patient access TMP Transmembrane Pressure - is the blood side pressure plus dialysate side pressure across the dialyzer membrane - to keep dialysate from moving into the bloodstream, pressure on the blood side must be equal or more than that of the dialysate side TMP Formula: TMP = (UFR ÷ Hr)/Kuf = mmHg UFR = (Pre-weight - EDW) ultrafiltration How much of water in the glomerular filtrate becomes urine? 1% To keep balance in the body the kidneys: - remove wastes - keep water and electrolyte in balance - control blood pressure - maintain acid-base balance - make hormones PTH parathyroid hormone tells bones to release calcium PKD polycystic kidney disease Genetic disease that causes cysts to form in the kidneys TSAT transferrin saturation measure of iron storage charcoal hemoperfusion used to treat drug overdose two types of ultrafiltration system - volumetric UF control - flow control sphygmomanometer instrument used to measure blood pressure