PCT test (Davita) Questions and Answers 2022

what is REM and what is used to submit? - Correct answer-Risk Event Management and unsafe condition, near miss, and an adverse event Sterile means - Correct answer-free of all living microorganisms and spores clean means - Correct answer-not sterile, but disinfected such as a clean dialysis chair contaminated means - Correct answer-that a sterile or clean item has come in contact with non-sterile object dirty means - Correct answer-neither sterile or clean, but visibly contaminated Alcohol-bases hand rubs must contain - Correct answer-60-95% ethyl alcohol, isopropyl alcohol, or a combination of both How long should you wash your hands for? - Correct answer-20 seconds PPE includes what? - Correct answer-gloves, gowns, masks, protective eye gear environmental surfaces are cleaned with appropriate disinfectant such as a bleach solution - Correct answer-1:100 one part bleach and 99 part water for visible blood or gross blood spills, a ______ bleach solution must be utilized - Correct answer-1:10 1 part bleach and 9 parts water when preparing patient assignments, teammates who care for confirmed or suspected hep B surface antigen (HBsAg) positive patient(s) will only be assigned to simultaneously care for surface - Correct answer-antibody positive (immune) patients Although dialysis is a complex procedure, it is based on simple principles - Correct answer-use of a semipermeable membrane, diffusion, ultrafiltration, convection, and osmosis what are the 3 treatment goals to achieve in dialysis? - Correct answer-1. Remove waste from the blood e excess water from the blood 3. balance blood electrolytes semipermeable membrane - Correct answer-thin sheet of natural or synthetic material that allows some small particles to pass through, while blocking other, larger ones. what is a dialyzer and the 2 compartments - Correct answer-artificial kidney and blood site and dialysate site what happens if the blood site and dialysate site mix? - Correct answer-= blood leak what is dialysate (3 things)? - Correct answer-RO water, acid bath, and bicarbonate what is an extracorporeal circuit? - Correct answer-bloodline, saline, and dialyzer=set up What is diffusion? - Correct answer-movement of dissolved particles across a semipermeable membrane from the side with the higher concentration to the side with the lower concentratio n. What is ultrafiltration? - Correct answer-removes water from the blood by pushing it across the semipermeable membrane What is convection? - Correct answer-or solute drag is when solutes move with the water across the semipermeable membrane. What is osmosis? - Correct answer-is the movement of water across a semipermeable membrane from the side with the lower solute concentration to the side with the higher solute concentration After a chemical disinfection with bleach, how do you verify that the machine is free of residual bleach before you start setting up? - Correct answer-check the fluid from the drain hose with residual chlorine test strip What is an acceptable test result when verifying the absence of residual bleach? - Correct answer-less than or equal to 0.5ppm What is strikethrough? - Correct answer-Saline rises in transducer allows for inaccurate readings. The back of transducer is checked for wet. If wet can contaminate machine. Pull for bio med. what is the only fluid we use to prime the blood lines and dialyze? - Correct answersodium chloride 0.9% (normal saline) what is proportioned dialysate? - Correct answer-even amounts of RO water, acid bath and bicarbonate The manual conductivity must match the dialysis delivery system displayed conductivity_________ - Correct answer-+/- 0.4 mS of the theoretical conductivity (TCD) for Fresenius delivery systems The maximum recirculation time after a machine has been set up prior to treatment initiation cannot exceed _____ hours. - Correct answer-2 hours What is the rationale for limiting recirculation time? - Correct answer-bacterial proliferation in the extracorporeal circuit may occur Some blood lines are equipped with external transducer protectors. What is the correct procedure to be followed once strikethrough of an external transducer protector has occurred? - Correct answer-upon completion of treatment, the delivery system is to be removed from service and labeled with date, time, description of problem and name the teammate reporting the problem. the internal transducer protector will be changed by boomed tech. and delivery system will be disinfected prior to return use The acceptable range for proportioned dialysate pH is ____________ - Correct answer6.9-7.6 When are dialysate conductivity and pH testing required to be performed? - Correct answer-prior to initiating a treatment and whenever dialysate concentrate(s) (acid or bicarb) are changed or replaced during the course of the treatment If bleach and peracetic acid are mixed, a chemical reaction occurs, producing - Correct answer-toxic chlorine gas What are the two requirements that must be met prior to initiating system disinfection? - Correct answer-the treatment area must be patient free and no other processes are using the dialysis quality water What must be done to indicate the presence of disinfectant in the machines during system disinfection? - Correct answer-notification of the type of disinfection is prominently displaced on each delivery system How do we verify the absence of chemical disinfectant following system disinfection on the first treatment day following the disinfection? - Correct answer-facility teammates perform an independent chemical residual test prior to beginning the daily activities What is an acceptable test result when testing for the absence of peracetic acid? - Correct answer-a level or less than or equal to 1 ppm Dialysate with a conductivity that is too low causes.... - Correct answer-hemolysis, the bursting of RBCs. The color of hemolyzed blood is cranberry red. Dialysate with a conductivity that is too high causes... - Correct answer-crenation, a shriveling up of RBCs. The color of the blood will be dark. The transport mechanism of osmosis is responsible for.... - Correct answer-hemolysis and crenation as water leaves or enters RBCs. If the dialysate temperature becomes too hot... - Correct answer-it can hemolyze RBCs. A dialysate temperature too cold - Correct answer-s not life threatening but can chill the patient and cause hypothermic symptoms and may decrease diffusion Dialysate Flow Rate (DFR) - Correct answer-is ordered by the physician as part of the prescription blood leak detector? - Correct answer-checks for blood in dialysate during the treatment, air bubbles can cause false alarm during set up and priming and to correct check Hansen connectors and verify they are tight transmembrane pressure (TMP) - Correct answer-equal to the venous pressure minus the dialysate pressure measured in mmHg. Blood Flow Rate (BFR) - Correct answer-resistance to the flow establishes the pressures in the extracorporeal circuit Arterial Pressure (AP) - Correct answer-blood pump pulls blood from the vascular access, this pressure is negative Venous Pressure (VP) - Correct answer-After the blood leaves the dialyzer and is pushed through the venous drip chamber and back into the body, the pressure reading becomes positive water makes up about.. - Correct answer-90% of dialysate what are the 3 processes that make up the water treatment? - Correct answerpretreatment, water purification, and distribution what does AAMI stand for? - Correct answer-Association for the Advancement of Medical Instrumentation pretreatment consist of? - Correct answer-blending valve, black flow preventer, booster pump, depth filter, water softener, carbon tanks, RO pre-filter blending valve? - Correct answer-Mixes hot and cold water to allow the RO to function at the most efficient temperature, which is 77 F for conventional systems. between 65 F to 85 F Backflow Preventer - Correct answer-Prevents pre-treated water and disinfectants from backing up into the city water supply booster pump - Correct answer-expectation tank catches additional pressure booster pump gives off multimedia or depth filter - Correct answer-Filters out suspended particles like silt and sand in the water and traps solutes and other substances water softener - Correct answer-"Softens" hard water by removing calcium and magnesium from the incoming water carbon tanks - Correct answer-primary and secondary carbon tanks RO pre-filter - Correct answer-Removes fine carbon particles, resin beads and other debris; is placed just before the RO unit purification requires.. - Correct answer-water to pass through RO membranes followed by an ultrafilter the RO unit removes.... - Correct answer-removes bacteria, viruses, endotoxin, salts, particles and other solutes by reversing the transport mechanism osmosis RO membranes are very permeable to water but not to chemicals, substances that are not dissolved, or microorganisms and most substances..... - Correct answer-(90-99%) are rejected from the water. ultrafilter - Correct answer-also known as the pyrogen or endotoxin filter is placed at the end of the water treatment system prior to the first point of use and is capable of removing viruses, bacteria, and most endotoxin Observations and test results listed on the Daily Water Treatment Log are entered each facility operating day ______ to the start of dialysis treatments. - Correct answer-prior A ___________ reviews the Daily Water Treatment Log for completeness and verifies that all parameters are within specified limits. - Correct answer-licensed nurse Total Chlorine testing is done on a daily basis prior to the first patient treatment and every_______ hours until all activities that require use of dialysis quality water are completed. - Correct answer-four All total chlorine samples are to be drawn only after the water system has been operating for at least _____minutes. An acceptable total chlorine test result after the primary carbon tank is less than or equal to _____ppm. - Correct answer-15 minutes and 0.1 ppm The Auto Chlorine Monitoring- Hach CM130- automatically monitors the ____________ every 5 minutes. - Correct answer-chlorine Hardness testing is done on water leaving the water softener at the ______of the treatment day. - Correct answer-end