Podcast
Questions and Answers
The role of the RN in a dialysis facility is to implement the __________ and the patient __________.
The role of the RN in a dialysis facility is to implement the __________ and the patient __________.
plan of care, education plan
The number one cause of chronic renal failure is __________.
The number one cause of chronic renal failure is __________.
diabetes
When going from a dirty area to retrieve supplies in a clean area, staff are required to complete hand hygiene.
When going from a dirty area to retrieve supplies in a clean area, staff are required to complete hand hygiene.
True (A)
Hazardous Material Identification System HMIS labels are required on all hazardous materials, including individual bicarbonate containers.
Hazardous Material Identification System HMIS labels are required on all hazardous materials, including individual bicarbonate containers.
What solution should be used to disinfect a large blood spill area, greater than 10 mL?
What solution should be used to disinfect a large blood spill area, greater than 10 mL?
The main route of transmission of Hepatitis B in Hemodialysis facilities is by exposure to infected __________ and __________.
The main route of transmission of Hepatitis B in Hemodialysis facilities is by exposure to infected __________ and __________.
When caring for a patient who is Hepatitis B positive, after disconnecting the bloodlines, the technician MUST perform which 3 actions before documenting?
When caring for a patient who is Hepatitis B positive, after disconnecting the bloodlines, the technician MUST perform which 3 actions before documenting?
According to CDC, patients who are Hepatitis B surface Antigen (HBsAg) positive should be dialyzed in a __________ area of the dialysis center, on a __________ machine.
According to CDC, patients who are Hepatitis B surface Antigen (HBsAg) positive should be dialyzed in a __________ area of the dialysis center, on a __________ machine.
What PPE should you wear when documenting in the isolation room?
What PPE should you wear when documenting in the isolation room?
What two things MUST the dialysis technician do prior to getting clean supplies after a rinseback on a patient?
What two things MUST the dialysis technician do prior to getting clean supplies after a rinseback on a patient?
Urine flows through the __________ from the kidneys, to the __________ to the __________, and to the __________.
Urine flows through the __________ from the kidneys, to the __________ to the __________, and to the __________.
The Transmembrane Pressure (TMP) measures the __________ difference across the dialyzer membrane.
The Transmembrane Pressure (TMP) measures the __________ difference across the dialyzer membrane.
__________ is the term used to describe the movement of fluid through a semi-permeable membrane from an area of low solute concentration to an area high solute concentration.
__________ is the term used to describe the movement of fluid through a semi-permeable membrane from an area of low solute concentration to an area high solute concentration.
__________ can be defined as the movement of particles through a semi-permeable membrane from a greater to a lesser concentration.
__________ can be defined as the movement of particles through a semi-permeable membrane from a greater to a lesser concentration.
A major factor affecting ultrafiltration is __________.
A major factor affecting ultrafiltration is __________.
A rise in __________ during hemodialysis is likely to indicate clotted fibers.
A rise in __________ during hemodialysis is likely to indicate clotted fibers.
Water in the dialysate may also be referred to as __________ water.
Water in the dialysate may also be referred to as __________ water.
A __________ is considered the access of choice because they have the lowest complication rate.
A __________ is considered the access of choice because they have the lowest complication rate.
What type of access is preferable for a patient with severe hypertension starting hemodialysis without diabetes or cardiac problems?
What type of access is preferable for a patient with severe hypertension starting hemodialysis without diabetes or cardiac problems?
Countercurrent flow of blood and dialysate increases the rate of __________.
Countercurrent flow of blood and dialysate increases the rate of __________.
Use of a dialysate filter (diasafe) allows the production of __________.
Use of a dialysate filter (diasafe) allows the production of __________.
__________ is the ability of a substance to conduct an electrical charge.
__________ is the ability of a substance to conduct an electrical charge.
Normal __________ is used to rinse and prime the tubing of the extracorporeal circuit to remove sterilant and air.
Normal __________ is used to rinse and prime the tubing of the extracorporeal circuit to remove sterilant and air.
Air is removed from the extracorporeal circuit before initiating treatment because it may cause __________ when trapped in the dialyzer.
Air is removed from the extracorporeal circuit before initiating treatment because it may cause __________ when trapped in the dialyzer.
The most likely cause of contamination of the extracorporeal circuit is: __________ are in the prime bucket with __________ end caps.
The most likely cause of contamination of the extracorporeal circuit is: __________ are in the prime bucket with __________ end caps.
A low-level arterial drip chamber can result in __________ entering the system causing an air embolism or clotting.
A low-level arterial drip chamber can result in __________ entering the system causing an air embolism or clotting.
When blood escapes from the dialyzer blood compartment into the dialysate fluid compartment, this is known as a __________.
When blood escapes from the dialyzer blood compartment into the dialysate fluid compartment, this is known as a __________.
Dialysate used for in-center hemodialysis is: sterile or non-sterile?
Dialysate used for in-center hemodialysis is: sterile or non-sterile?
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Study Notes
Role of RN in Dialysis
- Implement the plan of care and the patient education plan.
Chronic Renal Failure
- The leading cause is diabetes.
Hand Hygiene Protocol
- Staff must perform hand hygiene when transitioning from a dirty area to a clean area.
Hazardous Material Labels
- HMIS labels are mandatory on all hazardous materials, including bicarbonate containers.
Disinfection of Blood Spill
- Use a solution of 1 part bleach to 10 parts water (1:10) to disinfect large blood spills (>10 mL).
Transmission of Hepatitis B
- Main transmission routes in hemodialysis are through exposure to infected blood and body fluids.
Care for Hepatitis B Positive Patients
- Post-disconnection actions include removing gloves, sanitizing hands, and putting on fresh gloves before documenting.
Dialysis for HBsAg Positive Patients
- They should be dialyzed in a separate area on a dedicated machine.
PPE Guidelines
- Clean gloves should be worn when documenting in the isolation room.
Rinseback Procedure
- Before retrieving clean supplies, a technician must remove gloves, wash/sanitize hands, and then get the necessary items.
Urinary Tract Pathway
- Urine flows from the kidneys through the urinary tract, ureters, bladder, and exits through the urethra.
Transmembrane Pressure (TMP)
- TMP measures the pressure difference across the dialyzer membrane.
Osmosis
- Defined as the movement of fluid through a semi-permeable membrane from low to high solute concentration.
Diffusion
- Movement of particles through a semi-permeable membrane from higher to lower concentration.
Factors Affecting Ultrafiltration
- Pressure is a major factor influencing ultrafiltration.
TMP Increase During Hemodialysis
- An increase in TMP is indicative of clotted fibers.
Dialysate Water
- Refers to water treated through reverse osmosis (RO).
Fistula Access Choice
- A fistula is the preferred access type due to its lower complication rate.
Preferred Access for Severe Hypertension
- An arteriovenous fistula is recommended for patients without diabetes or cardiac issues.
Diffusion Enhancement
- Counter current flow of blood and dialysate amplifies diffusion rates.
Dialysate Filter Function
- The use of a dialysate filter (diasafe) produces ultra-pure dialysate.
Conductivity
- Refers to a substance's ability to conduct an electrical charge.
Saline in Dialysis
- Normal saline is used to rinse and prime the extracorporeal circuit, removing sterilants and air.
Air Removal Importance
- Air must be removed from the extracorporeal circuit prior to treatment to prevent clotting in the dialyzer.
Circuit Contamination Risk
- Bloodlines in the prime bucket with open end caps are likely causes of contamination.
Low-Level Arterial Drip Chamber Risk
- A low-level drip chamber can permit air into the system, causing potential air embolism or clotting.
Blood Leak Definition
- Occurs when blood escapes from the dialyzer blood compartment into the dialysate compartment.
Dialysate for In-Center Hemodialysis
- Dialysate used is classified as non-sterile.
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