CCHT practice questions

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which of the following terms indicates a solution that has the same concentration of solutes as blood?
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Terms in this set (300)
which of the following terms indicates a solution that has the same concentration of solutes as blood?
isotonic
a patient's potassium levels has been running high between dialysis treatment, so the patient has been working with the renal dietician to restrict potassium in the diet. which of the following fruits should the patient avoid?
bananas
during osmosis, which of the following movements takes place?
fluid moves from an area of lower concentration to higher.
a patient's granddaughter calls the dialysis center and asks for a progress report on her father, who is a patient in the center. the technician should.
state that patient information cannot be divulged
if a hematoma forms at the access site where a needle infiltrated, the usual intervention is to apply
cold compresses
which of the following actions by a patient increases the risk of blood clots in a venous access?
wearing a top with very tight- fitting long sleeves
a patient is very anxious during an initial hemodialysis treatment and requires extra attention. when the treatment is completed, the patient offers a $20 tip. the technician should
politely decline the tip
which of the following statements by a hemodialysis patient suggests that the patient needs more education?
i should stay on a low protein diet.
the inner part of the kidney is the
medulla
a nephron is comprised of a glomerulus and a
tubule
how much urine does a patient with healthy kidneys usually excrete in 24 hours?1000 to 2000mLwhen removing soiled gloves, the first glove removed should be.grasped in the opposite gloved handwhich of the following hormones is produced by the kidneys?erythropoietinat which stages of chronic kidney disease should a patient being dialysis?5which of the following is a genetic disorder that can lead to kidney failure?polycystic kidney diseasewhich of the following complains by a patient may be an indication of uremia?itchinga patient with a right-sided radiocephalic A fistula (above the wrist) needs to have blood test in the lab for a number of different lab test. the blood should be drawn from theleft handwhen setting up hemodialysis equipment, the four thing that need to be checked are [ 1 ] dialysate, [ 2] extracorporeal circuit, [ 3] dialyzer and, [ 4]machine alarmgenerally, the optimal dialysate flow rate for hemodialysis should be1.5 to 2 times the blood flow ratea patient is receiving hemodialysis with a dialyzer with an ultrafiltration coefficient [ kuf ] of 10 and a transmembrane pressure [TMP] of 100 mm hg. how much fluid should the patient lose per hour of treatment1000 mLunder what circumstances can needle be reused for hemodialysis?under no circumstancesif a emergency ( such as a tornado ) occurs and patients need to be evacuated, which group of patient should be disconnected from dialysis machine first?patients able to ambulate independentlyfor patients on hemodialysis a, 1 kg (2.2 lb.) increased in weight in 24 hours is approximately equivalent to fluid retention of1.0 L.a patient has been advised to avoid foods high in phosphorus. food that the patient should be advised to limit include.dairy productsa patient is scheduled for serum creatinine test and asks the technician about preparation the day before the test. the patient should be advised to.avoid excessive exercisewhich of the following ethnic group is most at risk for development of kidney failure?african americana patient has buttonhole tracts for access. after the access is cleaned and prepped for treatment, what is the next step?use a crab picker/ aseptic tweezer to remove the scabswith buttonhole tracts, the technician should apply pressure as the needle are removed and then for5 to 10 minutesif a buttonhole access frequently has long clots that are very difficult to remove, the most likely reason isfailure to use 2-finger hold for needle removala patient who had an AV fistula in the forearm developed an aneurysm and has had to have a new AV fistula created in the upper arm. the patient has a temporary catheter in place for dialysis until the fistula has matured. which of the following exercise may help strengthen the AV fistula?bicep curlwith buttonhole access sites, what should the technician do to prevent '' hubbing " ?leave 1/16 th to 1/8 inch of the needle exposedif a patient has a dialyzer clearance rate of 250 mL/ min with 4- hour treatment, the total volume of blood cleared is60 L.what is the most important factor in preventing exsanguination from dialysis line separation?access site visibleif a patient states that she has been skipping lunch because she is too tired to eat after dialysis, the best solution is to.report to the nurse and renal dieticianif a patient exhibits signs and symptoms of hemolysis during dialysis, the immediate action should be tostops the blood pump and clamp the blood linesthe amount of dialysis that a hemodialysis patient is prescribed is based on the removal ofureamaturation of a prosthetic arteriovenous graft usually takes3 to 6 weeksthe purpose of the negative germicide test is to ensure thatthe reprocessed dialyzer is free of germicidesif a patient develops angina (chest pain) radiating to the neck, jaw, and left arm and the patient's blood pressure drops during treatment, the technician should notify the nurse anddecreased blood flow rate and ultrafiltrationthe technician is reinforcing a patient's training regarding management of fluid intake. the patient, who still urinates, has a base of 1000 ml intake per day. if the patient urinates 500 ml in a 24-hour period , how much fluid is the patient allowed the following day?1500mlthe greatest risk of bacteremia (infection in the blood) is associated with which type of vascular access?dialysis catheterthe external surface of the hemodialysis machine should be cleaned and disinfected at least.after every patientwhen checking the water temperature in the system, the technician records the temperature at 78 F (25.5 C). in order for the reverse osmosis (RO) equipment that is partof the water treatment system to work properly, the water temperature must be maintained at77' F to 82'F ( 25' C to 28'C )when testing the chlorine levels in the water system, the water sample should be taken from the.first carbon tankwhen considering the chain of infection, the three most common reservoirs of interest include humans, environment andanimalsa solution is a mixture ofsolute and solventwhen reinforcing education about weight gain, a patient should be advised that the usual goal for interdialytic weight gain is less than1.0 kg/dif a high-pressure alarm for arterial pressure (pre-pum ) sounds during hemodialysis, this could indicate.drop in speed of blood pumpif a low- pressure alarm for venous sounds during hemodialysis, this could indicate.clotting in the accessaccording to KDOQI guidelines, when administering hemodialysis to a patient a, facemark should be wornfor all access connectionthe most common complication associated with poor needle site rotation in a graft ispseudoaneurysmin hemodialysis, ultrafiltration refers to extraction offluidthe patient has develop a small aneurysm and asks the technician to cannulate the aneurysm for the hemodialysis treatment because another patient told this patient that it would be less painful that cannulation of the fistula. the best response is toadvise the patient that cannulating an aneurysm may result i rupture.a patient experience a cardiac arrest with no pulse or respiration during hemodialysis. after the technician calls for help, the next action should be tostop dialysis, return blood, and flush access lines with normal saline.when auscultating a patient's AV fistula to listen for the bruit, if the technician notes that the bruit is very high pitched, this may indicatestenosiswhen using the buttonhole technique for vascular access for hemodialysis, the needles are placed in.the same site in a fistulawhen inserting a needle for hemodialysis, which of the following increases the risk of infiltration?rotating the needle 180 degreesthe legal document that assigns a heal care proxy to make decisions in the event that a person is unable to do so is calleddurable power of attorneycarbon filters in the water system are necessary to removechlorine, chloramine, and organic materialbackwashing to free residue from sediment filters in the water system should be done at leastonce dailywith the formula for urea kinetic modeling (UKM), the K in the Kt/V formula stands forurea clearance (mL/ min) plus residual urinary outputwhen inserting needles into a graft for hemodialysis, the needle tips be should be at least how far apart?2.0 inchesif a patient is undergoing hemodialysis and the technician notes that a bloodlines has separated and blood has pooled beneath the access site, the first intervention should be tostop the blood pumpduring hemodialysis, the technician would expect a patient's temperature to rise by about.0.5 Capproximately what percentage of the total blood volume circulate in the veins?65% to 80%patient should be advised to avoid eating during hemodialysis because ingestion of food may result inhypotensionprior to using a reprocessed dialyzer, a recirculating rinse with NS should be completed with recirculating flow rate through the blood compartment and the dialysate compartment of at least.200 mL/min for BFR and 200 mL/ min for DFR.if a hemodialysis patient test positive for hepatitis C virus (HCV), which of the following interventions does the KDIGO guidelines recommend when proving hemodialysis treatment?adherence to strict infection-control proceduresif a dialyzer is to be reprocessed in 3 hours, the dialyzer must berefrigeratedwhen documenting observations about a patient, which of the following is the most appropriate description?patient is sighing and rubbing hands togetherwhich of the following is the most common cause of hypotension developing during hemodialysis?removing excessive volume of fluidwhich of the following interventions is most likely to decrease hypotension that occurs during hemodialysis?decreasing the ultrafiltration rateif an air sector alarm sounds during hemodialysis, the technician should initiallystop the blood pump and clamp the patients venous lineif outflow stenosis of an AV fistula occurs, the thrill usuallyis loud and higher pitched and then discontinuouswhen reviewing a patient's food dairy, the technician advise the patient that which of the following protein sources is of low biological value?dried beanwhich of the following vitamins may be removed by hemodialysisvitamin Bthe renal nutritionist has advised the patient to have a diet high in fiber, but the patient is unsure which foods to choose. which of the following foods per serving is highest in insulate fibers?kidney beansthe primary purification process of the dialysis water isfiltering with activated carbonif the dialysis center uses hemoclips on dialysis tubing to prevent disconnection, what other precautions should be utilized?visible access sites/line connections and documentation of integrity every 30 minutesif during hemodialysis, blood is evident in the used dialysate, this probably indicatestear in the membraneif a patient asks a question to which the technician does not know the answer, an appropriate response isI 'll find out for you ''during routine hemodialysis, a patient's blood pressure should monitored every30 to 60 minutesif a patient develops painful muscle cramps in the hands, feet, and abdomen shortly after hemodialysis begins, the most likely interventions issaline bolus and/or decreased ultrafiltration rate.if a hemodialysis patient's temperature per tympanic membrane thermometer is 37C in order to reduce incidendence of intradialytic ( during dialysis ) hypotension, the temperature of the dialysate solution should ideally be set at36.5 Cfoam in the venous bloodline of a dialyzer may indicateair embolismprior to initiating hemodialysis, the ph of the dialyste usually ranges from7.0 to 7.4the number one cause of kidney failure in the US isdiabetes mellitus, type 2the use of topical anesthetic, such as EMLA, to reduce discomfort during cannulation is contraindicated withbuttonhole sitesa patient who has been very alert and shown no sign of cognitive impairment seems confused during dialysis and repeatedly asks the same question. the best initial response is tonotify the nursewhen determining if a new AV fistula is maturing the three factors to assess by palpation are thethrill, vessel growth, and vessel firmnesswhich of the following antiseptics used for skin pre for a fistula site has the broadest spectrum antibacterial activity?2% chlorhexidine gluconatewhile a patient is undergoing hemodialysis, chloramine testing of the water system should be conducted every4 hoursif a patient is to undergo heparin-free dialysis, the optimal blood flow rate is300 to 400 ml/minbefore cannulating An AV fistula for a hemodialysis treatment, the technician examines the patient's access arm and finds that the access arm appears slightly edamatous, and the skin is pale. on further examination, the technician notes that there are small purple veins evident on the chest wall near where the arm meets the body. the technician should suspectstenosisin order to increase survival rates. the ultrafiltration rate for hemodialysis patients should be maintained at least than12 ml/kg/mas part of fistula assessment before cannulation, the technician evaluates the thrill and then applies acclusion by placing a finger across the body of the fistula. while the fistula is acceded, the technician palpates and feels both a thrill and a pulse. this probably signifies a (n)accessory pathway ( collateral circulation )how much additional proteins should a patient on hemodialysis ingest every day in comparison to a health person50%weight gain between hemodialysis treatments should not exceed5% of dry weightthe technician has calculate the target weight loss for a patent's hemodialysis session, but the patient insists that the technician has made an error and the target is 1 kg too high. the technician shouldrecalculate the target weight loss.the most important reason for placing hemodialysis needles in antegrade position ( in direction of blood flow) is becauseit causes less scarringwhen preparing dialysate with a 45x concentrate, if the proportioning ratio contains 1.0 part acid and 1.72 parts bicarbonate, how many parts of water are needed?42.28if conductivity monitoring stops dialysate from flowing to the dialyzer but instead sends it to the drain (bypass), this means thatthe conductivity monitor is malfunctioningwhen using a portable digital dialysate meter, such as the D6 (myron L meter ) , to verify that inline meters are accurate regarding conductivity and ph, the technician mustobtain an unused dialysate samplethe target ultrafiltration goal set for the patient is based on the patient'sdry weighta patient is to receive a bolus of ulfrationated heparin (25 IU/kg ) at the onset of dialysis and 800 U at one-hour intervals during treatment, which is scheduled from 1 to 5 PM. the first dose is given at 1 Pm and the last dose at4 pmwhen checking the pump occlusion for the blood pump, the technician nots, that the rollers appear to loose.this may result incracking of the blood pump segment of tubingin the hemodialysis machine, a separate air detector is usually placedbetween the venous pressure gauge and the venous accessat the completion of dialysis treatment, it is important to rinse back as much blood as possible in order toreduce the severity anemiaif a power outage occurs and backup power fails, before using the hand crank to return the patient's blood, the technician mustremove the venous line for the air detectorif a patient's blood pressure is 142/88 before dialysis and 108/72 at the completion of dialysis, the most likely intervention isinfusion of normal saline to increase blood pressureprior to opening a sterile packing, the technician spills sterile normal saline on the package. the technician shoulddiscard the packagewhen washing the hands, the hands should be wet and soap applied and then the hands rubbed together for at least15 secondshow long can hepatitis B virus live on surfaces if they are not properly disinfected?7 daysin the event that a fire occurs in a dialysis center, the RACE method of response includesrescue, active alarm, contain/confine fire, and extinguish/evacuateif the technician needs to move boxes of supplies from the floor to elevated shelves, the technician shouldbend down at the knees and keep the back straight while liftingfor documentation in the medical record, which of the following includes a correct0.5 kgfor a hemodialysis cannulation with a blood flow rate of fewer than 300mL/ min, which of the following needle gauge sizes is usually recommended?17if the nephrologist has ordered a pre-dialytic and post-dialytic BUN ( blood urea nitrogen) for a patient with an AV fistula, the pre-dialytic blood sample should be obtained from the.arterial needlethe primary focus of the life safety code is onprotection of peoplethe dialysis prescription is for a 3- hour treatment with 1.5 kg to be removed. during treatment 250 mL is used as saline prime and 200 mL as saline rinseback. the patient ingested 150 mL of fluid that contains oral proteins supplement. the ultrafiltration rate to be removed per hour is700 mlif the ultrafiltration rate to be removed per hour is 600 ml and the dialyzer kuf is 40 what is the transmembrane pressure (TMP)?15 mm hgif using a combination chlorhexidine gluconate and alcohol skin prep (such as chloraprep before cannulation, how much skin contact time is required?30 secondswhich of the following preventive measures is usually the best approach for patients who routinely experience hypotension during dialysis because of volume-related problems associated with large weight gain between treatments?increasing restrictions of sodium intakeif a patient undergoing hemodialysis and in the care of the technician has a persistent cough, standards precautions require that thepatient wear a maskwhat color is arterial blood tubing for hemodialysis most often color-coded?redduring hemodialysis, how much blood is usually outside of a patient's body at one time?100 to 250mLduring the first week of treatment with a new AV fistula, the initial needle size and blood flow rate are usually ~17-gauge needle and blood flow of 200 to 250 mL/min.with an AV fistula, cannulation should usually be done at an angle of25-35a hemodialysis system includes blood volume monitoring to assess changes in the patients democrat.if the hematocrit increases rapidly, this meansblood volume is decreaseda patient has a newly created AV fistula. when assessing the fistula, the technician raises the patients involved arm above the head. in this position, the fistula shouldcollapseduring cannulation, a tourniquet should be usedwhile placing needles in all AV fistulathe difference between a buttonhole needle and a standard needle for hemodialysis is that the buttonhole needle has ablunt tipif a hemodialysis patient has an extreme fear of needle and the physician describe EMLA cream to prevent pain, the cream must be applied60 minutes prior to treatmentfollowing formation of an AV fistula and beginning of hemodialysis, the technician notes that the patient's nailed and skin on the hand below the fistula are cyanotic during hemodialysis, and the patient complains of pain in the hand. this is likely an indication ofsteal syndromeafter a hemodialysis needle is removed at the end of treatment, the correct procedure is to apply pressure toeach access site with two fingers for up to 20 minutesa patient who wants to learn self-cannulation may do so ifthe patient receives appropriate trainingthrombosis is newly-created access may be caused bylow blood pressureif a new patient has Hero (hemodialysis reliable outflow) graft, the cannulation site is generally in theproximal upper arm (below the axilla).if effluent (used dialysate ) spills into the floor, the technician shouldnotify staff trained in hazardous waste removala patient is recovering hemodialysis with 17-gauge needle, but his blood flow rate has been increased to 450ml/min. the patient complains of symptoms consisten with hemodialysis ( breakdown of red blood cells) sudden onset of chest tightness, back pain, dyspnea, reddening ok skin color, and blood in the venous line appearing port-wine in color. what is likely cause of this complication?needle too small for blood flow ratewhen handing off a patient to another staff person, the technician should alwaysfollow the hand-off protocol established by the institutionthe technician should ensure when exposing the opening of a central catheter to air (such as when removing the cap or a syringe) that theclamp is closedthe hemodialysis center has instituted a "zero lift" policy. the primary purpose of such a policy is toprevent injuriesif the dialysis center has an extra hemodialysis machine that has not been used in the previous 2 weeks, how frequently does this machine need to be disinfected?every 48 hoursfive minutes after a patient begins a hemodialysis treatment, the patient has difficulty breathing and rapidly develops generalized hives, itching and swelling about the eyes. after asking the nurse for help, the next action should be to.stop the dialysis and clamps all the linesa patient routinely experiences hypotensive episodes near the end of a session and experiences malaise (tiredness), muscle cramps, and dizziness after dialysis. what is the most likely cause?the dry weight is set too highan adolescent patient has required frequent hospitalization because of nonadherece to be the treatment plan. the best approach to take with the patient is toask the patient how the staff can help the patient manage better.when the first carbon tank ( the worker) in the water system is exhausted, the next step is toremove the first tank, move the second tank to first position, and add a new tank in second position.following dialysis, the patient's blood pressure in semi-reclining position is 128/86. the technician takes a series of blood pressure over 3 minutes after the patient stands. at which blood pressure should the technician alert the nurse that the patient is exhibiting orthotic hypotension?108/74the technician is able to feel no pulse or thrill along the patient's outflow vein and can detect no bruit. the technician should suspectthrombosisif a dialysis patient is very large in both stature and weight, which of the following is most likely to improve the effectiveness of hemodialysisincrease dialyzer sizethe duties that the technician is allowed to carry out depend primarily on the __________state regulations/standards of practiceif a dialysis center carries out dialyzer reprocessing and uses peracetic acid as the germicide, the contact time needed is _______11 hoursif a dialysis center uses electronic charting, the technician may share his/ her password with__________no onewhen creating a buttonhole tract, how many consecutive cannulations are usually required before the tract is adequately formed?8 to 10if a patient complains of persistent itching, which of the following nonprescription methods may help relieve symptoms?take oatmeal bathswhen testing water for the level of chloramine, the technician finds that the total chlorine levels is 1.1 parts per million (ppm) and the free chlorine is 0.9 ppm. therefore, the chloramine levels is0.2 ppmpatient receiving hemodialysis should be advised to avoid salt substitutes because the substitutes oftencontain potassiumpatients with uremia develop foamy or bubbly urine because _____________proteins leaks into the urinewhich of the following is a function of the end-stage Renal Disease Networks?help resolve patient-staff conflictswhen using a slide board to transfer a patient from the dialysis chair to a wheelchair, at what time angle should the slide board be placed between the two sitting surfaces?45- degreeswhen the technician is teaching a patient to self-cannulate using the tandem-hand technique thepatient places the thumb and finger behind the technician's thumb and finger.a patient has a right internal jagular central venous catheter for hemodialysis, but a pressure alarm sounds during treatment indicating that the blood flow rate is lower than prescribed. on checking, the technician finds that the lines appear clear and there are no signs of kinking, bleeding or air entering the system. the next intervention should be to _____________.lower the patient's head and ask the patient to cough.the PDCA cycle used for continuous quality improvement refers to __________.the plan- do- check -actsubstances that form ions (changed particles) are_____.electrolyteswhich members of the dialysis center team are responsible for carrying out the quality assessment and performance improvement program at a dialysis center?all staffa new female patient is admitted to the dialysis center in the company of a male who appears to be her spouse. if the patient's chart lists her name a mary Jo Johson, how should the patient be addressed?ask the patientinfections in buttonholes tracts are almost always caused by ____________improper scab removalwhat percentage of the water that is filtered out of the blood by the glomeruli is excreted as urine?1%which of the following hormones directs the bone to produce more red blood cells?erythropoietinto reinforce teaching, the technician should remind patients with kidney failure that they should avoid.smokingwhich of the following is a genetic (inherited ) disease that can lead to kidney failure?polycystic kidney diseasewith uremia, as waste products build up in the blood, this can result inammonia breaththe aluminum level in dialysis water should be _______.< 0.01 mg/Lnormal saline has a sodium,m chloride concentration of0.9 %as part of anemia management for patients receiving hemodialysis, the technician should_________.rinse back as much blood as possiblepatients receiving hemodialysis are at risk for amyloidosis. which of the following symptoms may indicate amyloidosis?joint paina patient who experiences numbness, tremors, muscle spasms, and muscle pain may have low levels of _______________-.calciumwhich of the following laboratory tests is often done before and after hemodialysis to measure the effectiveness the dialysis in removing waste products from the body?blood urea nitrogena patient beginning hemodialysis usually has a hemoglobin test every ______________.one to two weeksthe most common treatment for patients with end-stage kidney disease in the united states is_______daytime in-center hemodialysis.which of the following is an indication that a patient may be losing fat and/ or muscle mass even through he or she reaches the target dry weight after treatment?patient become short of breath if lying flat after treatmentwhich member of the hemodialysis care team is responsible for setting up the plan of care for a patient?nephrologyif a patient coms for hemodialysis treatment but weighs less than the target dry weight before treatment, the technician should___________notify the nurse and dietitianthe first step in treating malnutrition in a dialysis patients is usually to_________encourage the patient to eat more.one-half teaspoon of salt is equal to about how many milligrams of sodium?1000mg.because of increasing phosphorus levels, a patient has been prescribed a phosphate binder, but the patient is unsure when to take the medication. the best advice is to take the medication____________.with mealsif patient is concerned about loss of income because of the need for hemodialysis, the best person to speak to the patient about concern is the.social workerwhen using active listening, which of the following is a good example of sort, ope-end question to use to encourage patient communication?what does the pain in your abdomen feel like?if a patient has refused to participate in eduction, ask no questions, and shows no interest in learning about hemodialysis, the best approach for the technician is to __________.talk through all the steps in the proceduresdiffusion is a process that involves ________movement of solutes though a semipermeable membrane from an area of highera dialysis machine is set up to use 36.1x parts dialysate. if the concentrate proportioning ratio calls for 1.00 part acid and 1.10 parts bicarbonate, how many parts of water are needed?36.1about what percentage of body water is in the intravascular space (inside blood vessels)?10%the mass transfer coefficient of a dialyzer refers to ___how well solutes pass through the dialyzer membranewhen using an alcohol-based hand rub, the hand rub should be applied to one palm and the hands rubbed together________.until drythe three process that affect dialyzer clearance are (1) diffusion, (2) convection, and (3)__________.adsorptionif a dialyzer has a sieving coefficient of 0.6 for a solute, what percentage of the solute should pass through the membrane?60%most dialyzer membrane used today are made ofsyntheticif a dialyzer has urea clearance rate of 200 ml/min and a blood flow rate of 400 ml/ min, what percentage of the 400 ml of blood is cleared of urea in one minute?50%the storage time for a reprocessed dialyzer is ________set by the manufacturerif a low-conductivity alarm sounds, the technician should suspect-lack of concentration in the proportioning system.if the blood leak alarm sounds during a hemodialysis treatment and the blood pump stops and lines clamp but the dialysate appears clear, the technician should_____________.use hemastix to check the extent of the leakwhen using a portable ph monitor to verify that an in-line monitor reading is correct, the technician should first______________.test a solution with a known phif a solution has an equal number of acid and base ions is neutral, the ph is ____________.7.0a volumetric ultrafiltration control system has _________.two identical dialysate chamberthe extracorporeal circuit carries bloodfrom arterial access to dialyzer and back to the venous accessa drip chamber that contains a fine mesh screen should be placed ___________.between the the dialyzer and the venous accessif a low-pressure alarm for arterial pressure (prep ump) sounds during dialysis, this could indicateinfiltration of the arterial needleif a high-pressure alarm for the predialyzer (post pump ) sounds during dialysis, this could indicate____________.clotted dialyzerthe lifespan of an arteriovenous graft is usually _______.3 to 5 yearsthe heart must work harder when patients have an arteriovenous fistula because theblood flow is fasterthe technician should alert the nurse that the patient is experiencing tachycardia (rapid pulse) when the pulse exceeds100a patient has opted to have a buttonhole tracts for hemodialysis. which of the following the most important factor for creation of a buttonhole tract?the same cannulator should do treatments until the tunnel is establishedwhen a patient is utilizing home hemodialysis, the purpose of teaching the patient to "snap and tap" the tubing and filter is to _______________.remove air bubblesan 85-year-old patient with end-stage kidney disease and multiple health problems has started hemodialysis, but the patient is now refusing treatment, stating that death is preference to the loss of independence and continued illness. the technician should ___________.respect the patient's decisionafter a patient receives the initial heparin bolus for hemodialysis, when should dialysis be initiated?within three to five minutes.which of the following signs and symptoms are indications of infection of an arteriovenous fistula or graft?redness, tenderness, and swellingif the patients feels unsure about cannulation a patient's fistula because or irregular vessel shapes, the best solution is to__________.ask a more experience staff member to cannulatewhich of the flowing needle sizes has the largest lumen (diameter )?14 gaugeretrograde (against the blood flow) insertion of arterial dialysis needle can result in______________.increasing scarringthe best method to secure a dialysis needle is probably ________.butterfly technique.when removing an access needle at the complication of hemodialysis, the technician completely removes the needle before applying pressure. this technique ________.is the incorrect procedureif a patient is terrified of needle and often feels faint and nauseated during cannulation, the best position to place the patient in during cannulation is __________.flatif the blood in the arterial line looks very dark( black blood syndrome ''), the likely cause isrecirculationthe best method to prevent aneurysm in a fistula is to______.use proper technique when inserting needlesif air detector alarm sounds, the blood pump stop, and the venous line clamp, but the technician notes air in the venous line and is concerned that some air may have entered the patient's vein, the technician should immediately_____________.place the patient in the trendelenburg position (head below heart ) on the left side.the heparin infusion line should generally be placein the arterial line between the blood pump and the dialyzer.if the power goes out during a treatment, the blood in the bloodlines is ____________.returned by hand cranking the blood pumpif a technician notes a high-pitched bruit, a ''water-hammer'' (pounding ) pulse, and evidence of clotting in the extracorporeal circuit during hemodialysis, the technician should suspect__________.stenosisif the skin above an arteriovenous graft appears taut and shiny, and previous needle sites are unhealed, the technician should alert the nurse to possible__________pseudoaneurysmif the rate of blood flow is low, this increases the risk of__________.dialysate is made by mixing water with acid and bicarbonate concentrates. Acid concentrate contains ____________.when a patient's arteriovenous graft has healed and is ready for the first cannulation, what needle size is usually indicated?when placing needles in an arteriovenous graft, how far away from the previous needle sites should cannulation be done?the most common site for development of stenosis in an arteriovenous graft is at ______.which of the following sites for a central venous catheter may prevent future venous access in the limb on the same side?the preferred solution to clean exit sites for central venous catheter is _________what length of needle is usually needed for a forearm arteriovenous (AV) fistula?0.6 inch ( 3/5 inch).when drawing blood sample from the injection port of the arterial bloodline, the personal protective equipment that the technician should wear is _______.gloves, facemark, eye protection, and gownthe first step in teaching a patient to self-cannulate is to tell the patient about _______________.how the patient's graft/ fistula wokswhen using "touch cannulation" to cannulate a buttonhole tract the cannulator. ______________.holds the tubing 1 to 2 cm behind the needlewhen you taking a manual blood pressure reading on a patient's nonaccess arm, the blood pressure should be checked._____________at the heart levelif an item, such as a piece of equipment, s considered " clean ", this means it is _____________.disinfected but not free from all germswhen hanging a new bag of normal saline, the technician touches the spike to the outside of the of the bag. the technician must____________.discard the spike and attached tubbinghow frequently should patients and staff members of a dialysis center have tuberculosis skin tests?once a yearif a patient has completed a dialysis session and is walking toward the door with the technician but becomes unsteady and beings to fall, the first thing the technician should do is to _____.ease the patient to the floorthe first thing to do when using a portable lift device, such as hayer lift, to transfer an obese patient is to _______________.check the lift's weight limit and sling size.a small fire begins in water receptacle, and the technician uses a fire extinguisher to put out the flames. if using the P.A.S.S. protocol, the technician should____________.pull the pin, aim the nozzle, squeeze the handle, and spray from side to sidewhen using reprocessed dialyzerr for treatment, the first thing that the technician should check the dialyzer for is the ___________.remove air and germicidewhen setting up hemodialysis equipment with a reprocessed dialyzer before a treatment, the primary purpose of priming the bloodline and dialyzer with normal saline is tp _______________.patient's namewhich of the following signs or symptoms may indicate that a patient is below dry weight following a hemodialysis treatment?low blood pressurea radial pulse is accessed at thewrist (thumb side)in modern dialysis machines, in order to start a treatment, the technician must enter into the machine the __________.total number of milliliters to be withdrawn and the duration of treatmentif a patient develops hypotension (low blood pressure) during a hemodialysis treatment, and the technician finds that the patient has developed rapid and irregular heartbeat, then the technician should notify the nurse and____________.decrease the ultrafiltration ratea patient is nearing the end of the treatment and complains of headaches and nausea and appears very restless and anxious. the technician checks the vital signs and finds that the blood pressure is 180/100, and the pulse is 72 and is slightly irregular. the technician should suspect__________.disequilibrium syndromethen permeability of a dialyzer membrane to wear is indicated by its __________.ultrafiltration coefficientif a patient requires a blood draw for laboratory test before a hemodialysis treatment, and the laboratory has provided four vacuum tubes for the blood sample, then the technician should _______________.check the order of the drawif a patient is not to receive a saline prime at the beginning of the hemodialysis treatment, and the saline prime is drained into a waste container on the side of the dialysis machine, then the technician must connect the venous line to the access when blood reaches the __________.venous chamberif a patient develops a nosebleed during a hemodialysis treatment, this could indicate that the______.heparin dosage is too higha patient undergoing hemodialysis for the first time does well initially, but at 15 minutes into the treatment, she begins to complain of back pain, itching, slight shortness of breath, and nausea. the most likely cause of these signs and symptoms is _________.first-use syndromethe best method to prevent leg cramps during hemodialysis is tocorrectly calculate the target ultrafiltration goalafter a blood sample is collected into a blood tube, the technician should______________gently invert the tube back and forth about eight timesif the dialysate is too warm, it can result in________hemodialysisafter ringing and cleaning a dialyzer that is to be reprocessed, the performance test or tests that must be performed are____________.total cell volume test and test leak testif the water pressure downstream of a multimedia filter in the water system is decreased, this indicates a need to ______________backwash te filterif a dialyzer is to be reprocessed at the completion of a dialysis treatment, the dialyzer should be __________flushed with normal salineif the water distribution system uses an indirect feed system, the speed of the water flow through the distribution system should be ___________________3 feet per secondhow often should colony counts and limulus amebocyte lysate tests be conducted on the water feeding the bicarbonate mixer?monthlyheparin B is spread through _____________.contact with blood or body fluidsif testing a water sample for bacteria, the sample should be reprocessed at room temperature within.1 to 2 hoursif there patients having dialysis at the same time in a center that uses a central dialysate delivery system complain of sudden onset of nausea, the technician should suspect a problem with the ___________.water systemone fluid ounce is equal to ____________.30 ml.a patient and his and his spouse are undergoing training for in-home hemodialysis, but the patient tells the technician, '' I ' m so nervous. what happens if I can't learn to do this? the best response is ________.you will only do in-home dialysis when you feel ready.''in the estrecorporeal circuit, the highest positive pressure is found at thearterial header of the dialyzer.if testing before a hemodialysis treatment shows that the patient's blood level of potassium is too low, the level of potassium in the dialysate is usually ____________increasedthe factor that has the most influence on a dialysis patients's level of thirst between treatments is _______.salt intakethe purpose of using a water softener in the water distribution system is to _______________reduce levels of calcium and magnesiumpatients receiving high-flux dialysis may have _________.shorter treatment times.if a patient becomes nauseated and vomits during hemodialysis, the initial intervention should _________.assesss for hypotensiona HERO graft is indicated for ______________.patient with stenosis/blockage of central veins leading to the heart.water is removed from a patient's blood during hemodialysis by _______________-.osmosisthe fluid velocity (speed ) of blood through tubbing is based on flow rate andtube diameterwhen a dialysis treatment starts, the first point of restriction is the ____________.needleif there is a kink in the venous bloodline between the venous pressure gauge and the venous access, what type of alarm should sound?high venous pressure alarmin an arteriovenous fistula, the venous portion enlarges because of the _______________.high-pressure flow of blood from an arteryif an arterial venous fistula, is referred to as autogenous, this means that fistula _____________.is made from the person's own blood vesselsbrachiocephalic arteriovenous fistula is located in the ________.upper armif using ethyl chloride spray on an access site to reduce discomfort, ________the patient should not feel the needle at allsigns and symptoms of steal syndrome indicate _______.the hand on side of access feel cold and painfulif the technician is unable to feel a pulse or thrill or to hear a bruit in the outflow vein of an arteriovenous fistula, this may indicate___________.thrombosiswhen preparing to administer hemodialysis through a central venous catheter, the technician is unable to flush the catheter with normal saline because of resistance. the technician should. ______________.hold the treatment and notify the nursewhich of the following kinds of dialysis needles can be used without a safety device to prevent needle stick injuries?buttonhole needleswhich of the following is an extracorporeal alarm rather than a dialysate alarm?air detectora normal respiration rate for most adults is ____________.12 to 16 per minuteswhen a patient is undergoing hemodialysis, all technical systems should be monitored at least__________every 30 minutesafter the onset of hemodialysis, an anaphylactic reaction usually occurs within ______________.5 to 10 minutesif a reprocessed dialyzer has been accidentally exposed to two germicides, the dialyzer _________.must be discardthe most common site for placement of a straight graft is the ____________.forearmwhich of the following is in indication of a pyrogenic reaction to hemodialysis?development of chills and fever 45 minutes into treatmentif a high-pressure alarm for venous pressure sounds during hemodialysis, this could indicate_______________.infiltration of the venous needle