Questions and Answers
The primary electrolyte in both our blood and the dialysate is...
When should the conductivity meter be calibrated?
Prior to daily use
When the dialysate sodium level is higher than the level in the blood, diffusion will cause sodium to move into the blood.
True
How often should the calibration of the conductivity meter be completed?
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Hypernatremia can lead to which of the following?
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Comparing the displayed machine conductivity and your manual conductivity reading helps to...
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What is the maximum allowable difference between a manual conductivity reading and the applicable machine conductivity reading?
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What should one do if the difference between manual and machine conductivity remains greater than 0.4 mS/cm after recalibrating?
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A manual conductivity reading should not be completed when the machine is in bypass mode.
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The primary reason for comparing manual conductivity with the applicable machine conductivity is to assure patient safety.
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When are machine alarm tests performed?
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What is the maximum recirculation time for a dialyzer once set up for treatment?
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What must the manual conductivity match for the Fresenius dialysis delivery system?
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How do you prepare a 1:100 bleach solution?
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What happens if bleach and peracetic acid are mixed?
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What is the correct procedure for residual bleach testing after chemical disinfection?
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What is the safe range for dialysate pH?
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Why is a 'strikethrough' of an external pressure transducer protector of concern?
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Why is it important for patient care teammates to know when the water treatment system is disinfected?
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What is a 1:10 bleach solution used for?
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What are the three processes that make up the water treatment system for hemodialysis?
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After how many minutes of RO operation should pre-treatment water samples for chlorine testing be collected?
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If a Total Chlorine sample is collected before the RO has operated for the minimum time, test results could be falsely negative.
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What should be done if the confirmed result of Total Chlorine testing indicates a level greater than 0.1 ppm?
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If the result of Total Chlorine testing is too high from the primary carbon filter, but normal from the secondary carbon filter, what should be done?
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When is Total Water Hardness checked?
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What is the role of the licensed nurse in regard to the Daily Water Treatment Log?
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Study Notes
Electrolytes and Conductivity
- Sodium is the primary electrolyte in blood and dialysate.
- Conductivity meters must be calibrated when inaccurate readings are suspected, and prior to daily use.
- Dialysate sodium levels higher than blood levels lead to diffusion of sodium into the blood.
- Calibration of the conductivity meter should occur at least daily.
- The difference between manual conductivity reading and machine reading should not exceed 0.4 mS/cm.
Hypernatremia and Patient Safety
- Hypernatremia symptoms include excessive thirst and decreased weight gains between treatments.
- Comparing machine conductivity with manual readings ensures patient safety and helps identify malfunctions in the machine's systems.
- If the difference in conductivity readings exceeds 0.4 mS/cm after recalibration, the machine should be tagged and reported to biomed.
Alarm Testing and Treatment Preparation
- Machine alarm tests are required before each patient treatment initiation.
- Dialyzer recirculation time must not exceed 2 hours once set up for treatment.
Chemical Safety and Procedures
- A manual conductivity reading should not be conducted when the machine is in bypass mode.
- Mixing bleach and peracetic acid produces toxic chlorine gas.
- Residual bleach testing should occur after bleach disinfection and prior to usage of equipment.
pH Levels and Water Treatment
- The safe range for dialysate pH is between 6.9 and 7.6.
- "Strikethrough" of an external pressure transducer protector is concerning due to potential contamination of the internal protector.
- Understanding when the water treatment system is disinfected is critical as it affects the dialysis delivery system through the water inlet lines.
Bleach Solutions and Disinfection
- A 1:100 bleach solution is made by mixing 1 part bleach with 99 parts water.
- A 1:10 bleach solution is appropriate for cleaning visible or gross blood spills.
- Total Water Hardness is checked at the end of the treatment day.
Water Treatment Processes
- The water treatment system for hemodialysis consists of Pre Treatment, Water Purification, and Distribution.
- Pre-treatment water samples for chlorine testing should be collected after the RO has run for at least 15 minutes.
- If Total Chlorine readings before the minimum RO operation time are collected, results may be falsely negative.
Carbon Filter Testing
- If Total Chlorine levels are greater than 0.1 ppm in the primary carbon filter, testing proceeds to the secondary carbon filter.
- For high chlorine levels from the primary filter but normal levels from the secondary, breakthrough testing is performed every 30 minutes.
Nurse's Responsibilities
- Licensed nurses are responsible for reviewing the Daily Water Treatment Log, ensuring proper documentation and compliance.
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Description
Test your knowledge with these flashcards focusing on key concepts in dialysis, particularly the role of sodium and calibration procedures. Perfect for healthcare professionals working in dialysis units. Enhance your understanding of essential electrolyte management.
