Dialysis Technician Exam Study Guide

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What foods are high in phosphorus

Dairy, Meats, Nuts, Peanuts, Dried Beans & Peas, Whole Grains, Chocolate, Colas

What foods are high in potassium

Avocados, Mangos, Bananas, Orange Juice, Dried Fruit, Cantaloupe, Dried Peas, Beans, Tomato Sauce, & Potatoes

What are the two hemodialysis delivery systems?

Extracorpeal (blood) & Dialysate

During dialysis, ultrfiltration occurs when:

Water is removed from blood because there is a pressure gradient across a membrane

What are the hemodialysis treatment options?

In-Center, Nocturnal, Short Daily

What development in dialysis came first?

Dr. Kolff's rotating drum

What is the definition for dry-weight?

Post-dialysis weight at which all or most excess fluid has been removed

How are clinics paid by Medicare for dialysis?

Composite Rate

The primary cause of the anemia of ESRD is:

Erythropoietin Deficiency

What isn't a component of the Extracorpeal Circuit?

Blood Leak Detector

What waste product of muscle metabolism is removed by healthy kidneys?

Creatinine

What line is a negative pressure?

Arterial

What is the leading cause of chronic kidney disease for adults in the U.S.?

Diabetes

What are the symptoms of puritis?

Itching

Why must water used for dialysate be treated?

Dialysis patients are exposed to large volumes of water during dialysis

What is the U.V. light and what does it do?

Invisible radiation that destroys microorganisms

Which patients may benefit from an increased bicarbonate concentration?

Poorly compliant with regards to fluid intake

If an air embolism occurs, how should a patient be placed?

Trendelenberg on the left side

What symptom is "cherry pop" colored blood?

Hemolysis

When does first-use syndrome usually appear?

15-30 minutes of starting treatment

What are the two main types of dialysis?

Hemodialysis & Peritoneal Dialysis

What is the functional unit of the kidney, or the structure in the kidney that does the work?

Nephron

Severe chest pain and dyspnea are symptoms of what?

Air Embolism

What are the symptoms of first use syndrome?

Back pain 15 minutes into treatment

What are symptoms of anemia?

Weak, Syanotic, Dizzy

What are three signs or symptoms of an access infection?

Drainage, Fever, Swelling

What is the pressure across the dialyzer membrane?

TMP -Transmembrane Pressure

What are the symptoms of an air embolism?

Shortness of breath, Coughing, Confusion

What is a long-term complications of a fistulae?

Thrombosis

What are the symptoms of a pyrogen reaction?

Fever, Chills

What are the symptoms of disequilibrium syndrome?

Headache

What would a rapid pulse of 104 beats per minute indicate?

Tachycardia

What does infiltration mean?

A needle tip that punctures a vessel and goes out the other side, so blood escapes into the tissues

According to AAMI standards, when should bacteriologic testing for water and dialysate take place?

Monthly

What is the first step in the port/catheter pre-dialysis assessment?

Assessing the ease of heparin removal and saline flushing before connecting bloodlines

What would be a cause of hypotension during and after dialysis?

Removing too much fluid

How frequently should the carbon tanks be checked for chlorine and chloramines?

Each shift

What complication can happen to grafts if the needle sites are not rotated?

Pseudoaneurysm

What can cause a dialyzer membrane leak?

Any damage to the dialyzer

What is included in the dialysate delivery system monitors?

Conductivity, pH, Flow Rate

What is the measurement of ions or particles that carry an electrical charge known as?

Conductivity

Who must check the dialyzer to verify quality control information?

Two people, one of whom should be the charge nurse

What symptom occurs due to dialysate that is too hot?

Hemolysis

What activity does the water softener perform?

Removes calcium and magnesium from water

What is a way to prevent infection in catheters?

Wash hands and change gloves prior to touching the catheter

Which organization sets the standards and recommendations for dialyzer reprocessing?

AAMI

What substance may be added to municipal drinking water supplied to make the water cleaner?

Bleach

What is dialysate a mixture of?

Acid, Bicarbonate, Water

Why should you rotate needle sites on a fistula?

To prevent aneurysms

What is the most likely source of staphylococcus aureus?

Nasal drainage or Discharge

What could large amounts of aluminum in water used for dialysate cause?

Bone Disease

What are sign and symptoms of Steal Syndrome?

Pale, Bluish nail beds of the access hand. Cold feeling in access limb. Pain in access limb (hand or fingers)

What are symptoms of hemolysis?

Bright red colored blood

What are some complications of "flipping" the needle in AVF cannulation?

Infiltration, Stretching the needle hole, Tearing the lining of the vessel

What is the condition that can develop from using the subclavian vein for catheter placement?

Central Venous Stenosis

When assessing a fistula or graft, what needs to be felt prior to starting dialysis?

Pulse and Thrill

Contamination of water by bacteria endotoxins may cause what reaction?

Pyrogenic

When drawing a blood specimen from a double lumen catheter, what should the clinician always do?

Discard the first 4-5 ml of blood before obtaining the sample

What medication is used to prevent blood from clotting in the extracorporeal circuit?

Heparin

What is oxygen carrying red pigment of red blood cells?

Hemoglobin

What is a severe loss of blood?

Exsanguination

What is low blood sugar?

Hypoglycemia

What can misuse of mishandling result in?

Illness, Injury, Death

What is a symptom of Hypotension?

Yawning

How far should needle insertion be done from the anastomosis in a fistula or graft?

One inch

What is high phosphorous?

Hyperphosphatemia

To determine the amount of urea removed from a patient during a specific dialysis treatment, what tests are needed?

Pre-BUN, Post-BUN, URR

What is a symptom of Disequilibrium Syndrome?

Headache, Restlessness

What can the development of bacteria in bicarbonate concentrate lead to?

Pyrogen Reactions and Innfections

What is the normal range of resting respirations in an adult?

12-20 breaths per minute

What happens when molecules of dissolved solute are dragged along?

Convection

What is high potassium?

Hyperkalemia

What is the breakdown of red blood cells with a concurrent loss or liberation of hemoglobin and large amounts of potassium?

Hemolysis

When assessing a fistula or graft, what needs to be listened for prior to starting?

Bruit

What is Hypoglycemia?

High Blood Sugar

How long can Hepatitis B Virus survive on surfaces?

One Week

What should be done to prevent needle sticks?

Throwing used needles into puncture-resistant, color coded containers

If the dialysate conductivity moves outside the pre-set limits, what will occur within the dialysate delivery system?

Dialysate will bypass to drain. Audio and visual alarms

How often should the RO operating parameters be checked?

Daily

What is low calcium?

Hyocalcemia

What is the most common way that water treatment systems are disinfected?

Chemical

What is the most important activity that you can perform to prevent the spread of infectious diseases?

Hand Washing

What is Hyponatremia?

Low Sodium

What method kills bacteria, but will not destroy all of them completely?

Dissinfection

Why are dialyzers mainly reprocessed?

Reprocessing reduces the cost of dialysis treatments

What is the empty bed contact time of chlorine tanks?

5 minute/tank

What is low phosphorous?

Hypophospatemia

What is molecular weight?

How big the holes are

Blending valve keeps water at what temperature?

77 Degrees

What is Hypercalcemia?

High Calcium

What prevents water from going back out?

Backflow Prevention Valve

What is dialysate buffered to?

Helps regulate the patients pH

What is a step of the CQI process?

Implement the PDCA Style

What is high sodium?

Hypernatremia

What is the most common cause of pruritus in patients?

Hyperphosphatemia or Uremia

What is a transducer protector?

A device inside the machine that converts air pressure into an electronic signal

T or F: Double acid hook-ups for a dialysis treatment is potentially lethal.

True

T or F: Steal Syndrome may occur with AV fistulas or AV Grafts.

True

What is low potassium?

Hypokalemia

Which ion doesn't dialyze easy?

Protein, Phosphorous

Higher bicarbonate concentration in dialysate are needed when plasma bicarbonate levels drop below:

22 mEq/L

Where is the heparin pump infusion line located?

On the arterial tubing before the dialyzer

Muscle cramps are primarily caused by the shifting of what ion during treatment?

Sodium

What is the Health Insurance Portability & Accountability?

A law that created national rules about the security and privacy of health data

What does intravascular mean?

Inside the blood vessels

During dialysis, levels of waste in the blood should:

Decrease

What is one way to remove solutes?

Convection

What is not a dialyzer characteristic?

Capacity

A nephron is made up of:

Glomerulus, Tubule

What isa solution a mixture of?

A Solvent and a Solute

A semipermeable is a filter that:

Allows only certain sized particles to cross

Diffusion is movement of particles .....

From an area of higher concentration to an area of lower concentration

What does AAMI stand for?

Association for the Advancement of Medical Instrumentation

What is covered by the standardsof AAMI?

Dialyzer Reprocessing

Whatare symptoms of pericarditis?

Chest pain relieved after sitting upright

What is a Chief iron-storage protein in the body?

Serum Ferritin

How can you prevent a patient from having a dialyzer reaction?

Use cellulose acetate dialyzer membrane

What does the conductivity of dialysate reflect?

Electrolyte levels of the dialysate bath

What is the syndrome that cerebral edema can cause by the too rapid removal of urea nitrogen from the blood?

Dialysis Disequilibrium Syndrome

How much blood is outside the patients body at any time during dialysis?

150-250 ml

What factor affects the rate of diffusion?

Surface area of the membrane

What are symptoms of a dialyzer reaction?

Back Pain

What are the steps for dialyzer reprocessing after a dialysis treatment?

Pre-Cleaning, Performance Tests, Dialyzer Rejection, Disinfection

What are symptoms of anaphylaxis?

Hives, Trouble Breathing, Hypotension, Anxiety

What is the length of dialysis treatments based on?

Clearance, Blood Flow Rate, Fluid Gains, Patients Health

What is Pressure Gradient or TMP?

Difference between blood and dialysate pressure

A patient who is fluid overloaded will probably have which symptoms?

Tachycardia, Hypertension, Dyspnea

What conditions could alter or affect dialysate flow rates?

Low water pressure, Dialysate pump failure, Obstruction in dialysate flow path

What are the symptoms of Hypotension?

Dizziness, Tachycardia

What level of calcium concentration usually at?

2.5-3.5 mEq

What medical problems may occur due to chronic kidney disease?

Anemia, Sleeping Problems, Pericarditis

What are the steps for reprocessing the first time?

Dialyzer labeling, Total Cell Volume, Reprocessing

What will increase the amount of solutes that will diffuse across the semi-permeable membrane?

High Concentration Gradient

What are symptoms to Hyperkalemia?

Muscle Weakness

What is ETD?

Germicide in dialyzer

How much iron is in the body?

Transferrin Saturation (TSAT)

What is the condition that renal patient develop due to kidney inability to reabsorb enough bicarbonate?

Metabolic Acidosis

An AV Fistula can routinely be used for cannulation within how many weeks of being created?

2 Weeks

What is the target lab value for Serum Ferritin?

>200 ng/mL

What is the target lab value for BUN?

5-25 mg/dL

What is the target lab for Magnesium?

1.7-2.5 mg/dL

What is the target lab for Sodium?

135-146 mEq/L

What is the target lab for Creatinine?

10-18 mg/dL
.4-1.4

What is the lab value for Albumin?

>4.0 g/dL

What is the target lab value for Phosphorous?

3.5-5.5 mg/dL

What is the target lab value for Calcium?

8.4-9.5 mg/dL

The endocrine functions of the kidney include what?

Making erythropoietin and the active form of Vitamin D

What is the target lab value for Potassium?

3.5-5.5 mEq/L

Negative pressure is pressure created when...

Fluid is pulled through a restriction

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