Dialysis Exam Review - Chapters 1-8 Question and Answers

Medulla - Answer- Innermost part of the kidney. Area of the kidney where filtration and concentration of wastes takes place, Henle's loops, pyramids of converging tubules. Tubules - Answer- Tubule has multiple parts: PROXIMAL TUBULE, the LOOP of HENLE, and the COLLECTING TUBULE. In the tubules, chemicals and water the body needs are REABSORBED into the blood, and the rest empties into the CALYCES then flows into URETER to be excreted as URINE. Calyces - Answer- Collecting area for urine within the kidney before it passes through to renal pelvis. Glomerulus - Answer- Convoluted tubule(s) where filtration is performed. Tangled ball of capillaries surrounded by membrane called Bowman's capsule. The glomerulus plus the Bowman's capsule are called the RENAL CORPUSCLE. Concentration Gradient - Answer- The greater the concentration gradient the greater the amount of diffusion. Means a difference in concentration, it is necessary to accomplish solute removal in dialysis. Concentration gradients cause fluid to move between compartments. Reverse Filtration - Answer- Backfiltration. Occurs when the dialysate pressure is greater than the pressure on the blood side of the dialyzer. Negative pressure (fluid to blood) develops. Causes dialysis fluid to move into the blood. The dialysis fluid is not sterile. Can carry endotoxins and breakdown wastes into patient's bloodstream. MOLECULAR FILTER can be placed in fluid delivery line ahead of the dialyzer to remove suspended particles of molecular size but NOT dissolved SOLUTES. BACTERIA and PYROGENS are REJECTED by the filter. Uremia - Answer- Uremic Syndrome. Urine in the blood. Encompasses a complex of symptoms and findings resulting from kidney failure. Signs of Uremia - Answer- Pallor of the skin, Edema, Loss of Appetite, High BP, Nausea/vomiting, Itching, Restlessness, S.O.B, Fatigue, Weakness, Mental changes, Depression, Mental Slowness Metabolic Acidosis - Answer- Occurs when excess HYDROGEN IONS build up in the blood. The pH lowers and patient will respond physically in effort to help eliminate the excess hydrogen ions. Under normal conditions the kidney would eliminate more hydrogen ions in the urine to compensate. Solute Drag - Answer- Solute transfer across semipermeable membranes by pressure induced water flow Flow Velocity - Answer- ... TMP (Transmembrane Pressure) - Answer- The pressure difference across the dialyzer membrane is called the TMP. Diffusion - Answer- The movement of particles (ions or molecules) from an area of HIGHER concentration tTO an area of LOWER concentration. Osmosis - Answer- The passage of water from a region of HIGH water concentration to a region of LOW water concentration. Semipermeable membrane - Answer- Thin layer of tissue or material that has small pores in it. The pores allow particles of a certain size to pass through it. (Ex: coffee filters and tea bags, they let the tiny flavor particles pass through but not the grounds) pH - Answer- The potential or power of hydrogen. Indicates the concentration of hydrogen ions in a solution. Normal ph in human body is 7.35-7.45. pH of 7 considered neutral. Less that 7 = Acid, higher than 7 = alkali or base. Solution - Answer- Mixture of fluid and dissolved particles or molecules. Solute - Answer- Soluble material. Dissolves in a solvent (a fluid). Reuse - Answer- Refers to reprocessing a dialyzer after it's been used. Involves flushing dialyzer to remove most of blood residuals, cleaning, usually done with chemicals such as Renalin, testing to verify that the membranes will remove waste products as expected. Disinfected with either a chemical or heat. One fluid ounce = ______________mls - Answer- 29.57 mls. (usually rounded off to 30 mls.) ICF or Intracellular Fluid - Answer- Fluid contained inside the cells ECF or Extracellular Fluid - Answer- Fluid that is outside the cells and bathes each cell Intravascular Fluid - Answer- Fluid that is the blood inside our blood vessels Electrolytes - Answer- Charged particles in our blood that are used in many cell functions. Sodium and other electrolytes control movement of water in the body. HFAK or Hollow Fiber Artificial Kidney - Answer- Hollow Fiber dialyzers. Most common in use currently. Allows for well controlled and predictable diffusion and ultrafiltration. Clear plastic cylinder containing thousands of tubular fibers. Blood enters at top of dialyzer and exits at bottom. Blood flows through the fibers, from top to bottom. Dialysate flows around the fibers in opposite direction of blood fllow. Hemodialysis - Answer- Blood separation or filtration process U - Answer- ...