CHT Bonent Exam (2026 Update)
Questions With Correct Verified And
Well Analyzed Answers Graded A+
In center hemo must be done
3x a week for about 4 hours
Cons of in center HD
Most limitation on Diet, fluid than other modalities
Requires the most medication
Most symptoms
Patients who run 4 hour tx
Are 30% less likely to die than pts who run shorter times
Each 30 mins extra of tx increase life by 7%
Patients are 50% more likely to die after
2 day no treatment weekend, the last 12 hours of the 2 days the risk of
death triples
diastolic blood pressure
When the heart is at rest.
Benefits of nocturnal in center
You get 2x as many TX’s as standard because it is longer and more
gentle with fluid removal
Rarely cramp
Easy on heart
Fewer limitations on food and drink
Free days
72% better survival rate than standard in center
,You check blood pressure with
Stethoscope and sphygmomanometer
Nocturnal in center hemo must be done
3x a week about 8 hours per tx
If BP site is below the heart....
The reading will be too high
Benefits of nocturnal home hemo
Better protein level
Don't need binders
No fluid limits
Fewer symptoms
Less heart damage
Live as long as people who get a deceased kidney transplant
If BP site is above the heart....
The reading will be too low
Home hemo must be done
3x a week 4-6 hours per tx
Benefits of PD
Can do alone at home or work
Only need 1-2weeks of training
Allows for a more normal diet
Allows pt to feel more normal
peritonitis
inflammation of the peritoneum, this can scar the peritoneum and
make PD no longer possible, can be avoided by doing a sterile
exchange
2 types of PD
Continuous ambulatory peritoneal dialysis (CAPD)
Automated peritoneal dialysis (APD)- uses cycled at night done 8-10
hours during sleep
,During in center HD how much blood is outside of body at a time
1/2 cup
Short Daily Home Hemodialysis must be done
5-6days a week for the 2.5-4 hour per tx
a bp cuff that is too small will cause a
Higher reading
Nocturnal home hem must be done
At home 3-7 nights a week 8 hours per tx
A no cuff that is too big for a patient’s arm ...
Lower reading
Why would someone want to do more HD than standard?
Longer or more frequent HD is gentle and cause fewer symptoms and
may help Pt live longer, home puts pt in charge
peritoneal dialysis
the lining of the peritoneal cavity acts as the filter to remove waste
from the blood through tiny blood vessels.
Placed in abdomen and sometimes chest wall
Dialysate sits in catheter for a few hours and excess water and waste
flows from BV to the dialysate. The dialysate is then drained and
replaced. (Exchange)
Pt can use a cycle machine while they sleep
Can also be done by hand 4xa day and can be done anywhere.
In dialysis patients the reason BP drops during or close to the end of
tx is because
The total blood volume drops, from the water removal
regular respiration rate
12-16 breaths per minute
In dialysis patients’ water may enter the lungs due to water weight
gains this can cause
, Sob or trouble breathing
Payment for dialysis
Medicare pays for 80% of dialysis
Medicare makes rules a clinic must follow to provide coverage of tax.
Pt who don't have Medicare before CKD a pt must wait 3 months for it
to cover in center but it will cover home-hemo right away.
2011 change how they pay for dialysis and created a "bundle"
(composite rate, labs, drugs and home training)
Quality Incentive Program
Pay for performance, Cuts pay by 2% if measures aren't met. (Kt/v and
hemoglobin)
ESRD networks
Oversees quality of care, 18 mostly nonprofit organizations.
Renal physicians’ association (RPA)
1993 nephrologist made first clinical practice guidelines, including
minimum dose of HD, when to start and stop HD and care for kidney
disease for pt not on HD
National Kidney Foundation (NKF)
1995, experts set guidelines for anemia, adequacy, and vascular
access
KDOQI
Kidney Disease Outcomes Quality Initiative, improves care and
outcomes of all people with kidney disease
Dialysis Outcomes and Practice Pattern Study - DOPPS
Help pts love longer by finding patterns incenter that can be changed
to improve outcome
state survey
An inspection of the facility by state surveyors for compliance with
rules and regulations of Medicare. If clinics don't follow, they must
make a plan of correction.
Questions With Correct Verified And
Well Analyzed Answers Graded A+
In center hemo must be done
3x a week for about 4 hours
Cons of in center HD
Most limitation on Diet, fluid than other modalities
Requires the most medication
Most symptoms
Patients who run 4 hour tx
Are 30% less likely to die than pts who run shorter times
Each 30 mins extra of tx increase life by 7%
Patients are 50% more likely to die after
2 day no treatment weekend, the last 12 hours of the 2 days the risk of
death triples
diastolic blood pressure
When the heart is at rest.
Benefits of nocturnal in center
You get 2x as many TX’s as standard because it is longer and more
gentle with fluid removal
Rarely cramp
Easy on heart
Fewer limitations on food and drink
Free days
72% better survival rate than standard in center
,You check blood pressure with
Stethoscope and sphygmomanometer
Nocturnal in center hemo must be done
3x a week about 8 hours per tx
If BP site is below the heart....
The reading will be too high
Benefits of nocturnal home hemo
Better protein level
Don't need binders
No fluid limits
Fewer symptoms
Less heart damage
Live as long as people who get a deceased kidney transplant
If BP site is above the heart....
The reading will be too low
Home hemo must be done
3x a week 4-6 hours per tx
Benefits of PD
Can do alone at home or work
Only need 1-2weeks of training
Allows for a more normal diet
Allows pt to feel more normal
peritonitis
inflammation of the peritoneum, this can scar the peritoneum and
make PD no longer possible, can be avoided by doing a sterile
exchange
2 types of PD
Continuous ambulatory peritoneal dialysis (CAPD)
Automated peritoneal dialysis (APD)- uses cycled at night done 8-10
hours during sleep
,During in center HD how much blood is outside of body at a time
1/2 cup
Short Daily Home Hemodialysis must be done
5-6days a week for the 2.5-4 hour per tx
a bp cuff that is too small will cause a
Higher reading
Nocturnal home hem must be done
At home 3-7 nights a week 8 hours per tx
A no cuff that is too big for a patient’s arm ...
Lower reading
Why would someone want to do more HD than standard?
Longer or more frequent HD is gentle and cause fewer symptoms and
may help Pt live longer, home puts pt in charge
peritoneal dialysis
the lining of the peritoneal cavity acts as the filter to remove waste
from the blood through tiny blood vessels.
Placed in abdomen and sometimes chest wall
Dialysate sits in catheter for a few hours and excess water and waste
flows from BV to the dialysate. The dialysate is then drained and
replaced. (Exchange)
Pt can use a cycle machine while they sleep
Can also be done by hand 4xa day and can be done anywhere.
In dialysis patients the reason BP drops during or close to the end of
tx is because
The total blood volume drops, from the water removal
regular respiration rate
12-16 breaths per minute
In dialysis patients’ water may enter the lungs due to water weight
gains this can cause
, Sob or trouble breathing
Payment for dialysis
Medicare pays for 80% of dialysis
Medicare makes rules a clinic must follow to provide coverage of tax.
Pt who don't have Medicare before CKD a pt must wait 3 months for it
to cover in center but it will cover home-hemo right away.
2011 change how they pay for dialysis and created a "bundle"
(composite rate, labs, drugs and home training)
Quality Incentive Program
Pay for performance, Cuts pay by 2% if measures aren't met. (Kt/v and
hemoglobin)
ESRD networks
Oversees quality of care, 18 mostly nonprofit organizations.
Renal physicians’ association (RPA)
1993 nephrologist made first clinical practice guidelines, including
minimum dose of HD, when to start and stop HD and care for kidney
disease for pt not on HD
National Kidney Foundation (NKF)
1995, experts set guidelines for anemia, adequacy, and vascular
access
KDOQI
Kidney Disease Outcomes Quality Initiative, improves care and
outcomes of all people with kidney disease
Dialysis Outcomes and Practice Pattern Study - DOPPS
Help pts love longer by finding patterns incenter that can be changed
to improve outcome
state survey
An inspection of the facility by state surveyors for compliance with
rules and regulations of Medicare. If clinics don't follow, they must
make a plan of correction.
