Dialysis Technician Exam Study Guide – Flashcards
Unlock all answers in this set
Unlock answersquestion
What foods are high in phosphorus
answer
Dairy, Meats, Nuts, Peanuts, Dried Beans & Peas, Whole Grains, Chocolate, Colas
question
What foods are high in potassium
answer
Avocados, Mangos, Bananas, Orange Juice, Dried Fruit, Cantaloupe, Dried Peas, Beans, Tomato Sauce, & Potatoes
question
What are the two hemodialysis delivery systems?
answer
Extracorpeal (blood) & Dialysate
question
During dialysis, ultrfiltration occurs when:
answer
Water is removed from blood because there is a pressure gradient across a membrane
question
What are the hemodialysis treatment options?
answer
In-Center, Nocturnal, Short Daily
question
What development in dialysis came first?
answer
Dr. Kolff's rotating drum
question
What is the definition for dry-weight?
answer
Post-dialysis weight at which all or most excess fluid has been removed
question
How are clinics paid by Medicare for dialysis?
answer
Composite Rate
question
The primary cause of the anemia of ESRD is:
answer
Erythropoietin Deficiency
question
What isn't a component of the Extracorpeal Circuit?
answer
Blood Leak Detector
question
What waste product of muscle metabolism is removed by healthy kidneys?
answer
Creatinine
question
What line is a negative pressure?
answer
Arterial
question
What is the leading cause of chronic kidney disease for adults in the U.S.?
answer
Diabetes
question
What are the symptoms of puritis?
answer
Itching
question
Why must water used for dialysate be treated?
answer
Dialysis patients are exposed to large volumes of water during dialysis
question
What is the U.V. light and what does it do?
answer
Invisible radiation that destroys microorganisms
question
Which patients may benefit from an increased bicarbonate concentration?
answer
Poorly compliant with regards to fluid intake
question
If an air embolism occurs, how should a patient be placed?
answer
Trendelenberg on the left side
question
What symptom is "cherry pop" colored blood?
answer
Hemolysis
question
When does first-use syndrome usually appear?
answer
15-30 minutes of starting treatment
question
What are the two main types of dialysis?
answer
Hemodialysis & Peritoneal Dialysis
question
What is the functional unit of the kidney, or the structure in the kidney that does the work?
answer
Nephron
question
Severe chest pain and dyspnea are symptoms of what?
answer
Air Embolism
question
What are the symptoms of first use syndrome?
answer
Back pain 15 minutes into treatment
question
What are symptoms of anemia?
answer
Weak, Syanotic, Dizzy
question
What are three signs or symptoms of an access infection?
answer
Drainage, Fever, Swelling
question
What is the pressure across the dialyzer membrane?
answer
TMP -Transmembrane Pressure
question
What are the symptoms of an air embolism?
answer
Shortness of breath, Coughing, Confusion
question
What is a long-term complications of a fistulae?
answer
Thrombosis
question
What are the symptoms of a pyrogen reaction?
answer
Fever, Chills
question
What are the symptoms of disequilibrium syndrome?
answer
Headache
question
What would a rapid pulse of 104 beats per minute indicate?
answer
Tachycardia
question
What does infiltration mean?
answer
A needle tip that punctures a vessel and goes out the other side, so blood escapes into the tissues
question
According to AAMI standards, when should bacteriologic testing for water and dialysate take place?
answer
Monthly
question
What is the first step in the port/catheter pre-dialysis assessment?
answer
Assessing the ease of heparin removal and saline flushing before connecting bloodlines
question
What would be a cause of hypotension during and after dialysis?
answer
Removing too much fluid
question
How frequently should the carbon tanks be checked for chlorine and chloramines?
answer
Each shift
question
What complication can happen to grafts if the needle sites are not rotated?
answer
Pseudoaneurysm
question
What can cause a dialyzer membrane leak?
answer
Any damage to the dialyzer
question
What is included in the dialysate delivery system monitors?
answer
Conductivity, pH, Flow Rate
question
What is the measurement of ions or particles that carry an electrical charge known as?
answer
Conductivity
question
Who must check the dialyzer to verify quality control information?
answer
Two people, one of whom should be the charge nurse
question
What symptom occurs due to dialysate that is too hot?
answer
Hemolysis
question
What activity does the water softener perform?
answer
Removes calcium and magnesium from water
question
What is a way to prevent infection in catheters?
answer
Wash hands and change gloves prior to touching the catheter
question
Which organization sets the standards and recommendations for dialyzer reprocessing?
answer
AAMI
question
What substance may be added to municipal drinking water supplied to make the water cleaner?
answer
Bleach
question
What is dialysate a mixture of?
answer
Acid, Bicarbonate, Water
question
Why should you rotate needle sites on a fistula?
answer
To prevent aneurysms
question
What is the most likely source of staphylococcus aureus?
answer
Nasal drainage or Discharge
question
What could large amounts of aluminum in water used for dialysate cause?
answer
Bone Disease
question
What are sign and symptoms of Steal Syndrome?
answer
Pale, Bluish nail beds of the access hand. Cold feeling in access limb. Pain in access limb (hand or fingers)
question
What are symptoms of hemolysis?
answer
Bright red colored blood
question
What are some complications of "flipping" the needle in AVF cannulation?
answer
Infiltration, Stretching the needle hole, Tearing the lining of the vessel
question
What is the condition that can develop from using the subclavian vein for catheter placement?
answer
Central Venous Stenosis
question
When assessing a fistula or graft, what needs to be felt prior to starting dialysis?
answer
Pulse and Thrill
question
Contamination of water by bacteria endotoxins may cause what reaction?
answer
Pyrogenic
question
When drawing a blood specimen from a double lumen catheter, what should the clinician always do?
answer
Discard the first 4-5 ml of blood before obtaining the sample
question
What medication is used to prevent blood from clotting in the extracorporeal circuit?
answer
Heparin
question
What is oxygen carrying red pigment of red blood cells?
answer
Hemoglobin
question
What is a severe loss of blood?
answer
Exsanguination
question
What is low blood sugar?
answer
Hypoglycemia
question
What can misuse of mishandling result in?
answer
Illness, Injury, Death
question
What is a symptom of Hypotension?
answer
Yawning
question
How far should needle insertion be done from the anastomosis in a fistula or graft?
answer
One inch
question
What is high phosphorous?
answer
Hyperphosphatemia
question
To determine the amount of urea removed from a patient during a specific dialysis treatment, what tests are needed?
answer
Pre-BUN, Post-BUN, URR
question
What is a symptom of Disequilibrium Syndrome?
answer
Headache, Restlessness
question
What can the development of bacteria in bicarbonate concentrate lead to?
answer
Pyrogen Reactions and Innfections
question
What is the normal range of resting respirations in an adult?
answer
12-20 breaths per minute
question
What happens when molecules of dissolved solute are dragged along?
answer
Convection
question
What is high potassium?
answer
Hyperkalemia
question
What is the breakdown of red blood cells with a concurrent loss or liberation of hemoglobin and large amounts of potassium?
answer
Hemolysis
question
When assessing a fistula or graft, what needs to be listened for prior to starting?
answer
Bruit
question
What is Hypoglycemia?
answer
High Blood Sugar
question
How long can Hepatitis B Virus survive on surfaces?
answer
One Week
question
What should be done to prevent needle sticks?
answer
Throwing used needles into puncture-resistant, color coded containers
question
If the dialysate conductivity moves outside the pre-set limits, what will occur within the dialysate delivery system?
answer
Dialysate will bypass to drain. Audio and visual alarms
question
How often should the RO operating parameters be checked?
answer
Daily
question
What is low calcium?
answer
Hyocalcemia
question
What is the most common way that water treatment systems are disinfected?
answer
Chemical
question
What is the most important activity that you can perform to prevent the spread of infectious diseases?
answer
Hand Washing
question
What is Hyponatremia?
answer
Low Sodium
question
What method kills bacteria, but will not destroy all of them completely?
answer
Dissinfection
question
Why are dialyzers mainly reprocessed?
answer
Reprocessing reduces the cost of dialysis treatments
question
What is the empty bed contact time of chlorine tanks?
answer
5 minute/tank
question
What is low phosphorous?
answer
Hypophospatemia
question
What is molecular weight?
answer
How big the holes are
question
Blending valve keeps water at what temperature?
answer
77 Degrees
question
What is Hypercalcemia?
answer
High Calcium
question
What prevents water from going back out?
answer
Backflow Prevention Valve
question
What is dialysate buffered to?
answer
Helps regulate the patients pH
question
What is a step of the CQI process?
answer
Implement the PDCA Style
question
What is high sodium?
answer
Hypernatremia
question
What is the most common cause of pruritus in patients?
answer
Hyperphosphatemia or Uremia
question
What is a transducer protector?
answer
A device inside the machine that converts air pressure into an electronic signal
question
T or F: Double acid hook-ups for a dialysis treatment is potentially lethal.
answer
True
question
T or F: Steal Syndrome may occur with AV fistulas or AV Grafts.
answer
True
question
What is low potassium?
answer
Hypokalemia
question
Which ion doesn't dialyze easy?
answer
Protein, Phosphorous
question
Higher bicarbonate concentration in dialysate are needed when plasma bicarbonate levels drop below:
answer
22 mEq/L
question
Where is the heparin pump infusion line located?
answer
On the arterial tubing before the dialyzer
question
Muscle cramps are primarily caused by the shifting of what ion during treatment?
answer
Sodium
question
What is the Health Insurance Portability & Accountability?
answer
A law that created national rules about the security and privacy of health data
question
What does intravascular mean?
answer
Inside the blood vessels
question
During dialysis, levels of waste in the blood should:
answer
Decrease
question
What is one way to remove solutes?
answer
Convection
question
What is not a dialyzer characteristic?
answer
Capacity
question
A nephron is made up of:
answer
Glomerulus, Tubule
question
What isa solution a mixture of?
answer
A Solvent and a Solute
question
A semipermeable is a filter that:
answer
Allows only certain sized particles to cross
question
Diffusion is movement of particles .....
answer
From an area of higher concentration to an area of lower concentration
question
What does AAMI stand for?
answer
Association for the Advancement of Medical Instrumentation
question
What is covered by the standardsof AAMI?
answer
Dialyzer Reprocessing
question
Whatare symptoms of pericarditis?
answer
Chest pain relieved after sitting upright
question
What is a Chief iron-storage protein in the body?
answer
Serum Ferritin
question
How can you prevent a patient from having a dialyzer reaction?
answer
Use cellulose acetate dialyzer membrane
question
What does the conductivity of dialysate reflect?
answer
Electrolyte levels of the dialysate bath
question
What is the syndrome that cerebral edema can cause by the too rapid removal of urea nitrogen from the blood?
answer
Dialysis Disequilibrium Syndrome
question
How much blood is outside the patients body at any time during dialysis?
answer
150-250 ml
question
What factor affects the rate of diffusion?
answer
Surface area of the membrane
question
What are symptoms of a dialyzer reaction?
answer
Back Pain
question
What are the steps for dialyzer reprocessing after a dialysis treatment?
answer
Pre-Cleaning, Performance Tests, Dialyzer Rejection, Disinfection
question
What are symptoms of anaphylaxis?
answer
Hives, Trouble Breathing, Hypotension, Anxiety
question
What is the length of dialysis treatments based on?
answer
Clearance, Blood Flow Rate, Fluid Gains, Patients Health
question
What is Pressure Gradient or TMP?
answer
Difference between blood and dialysate pressure
question
A patient who is fluid overloaded will probably have which symptoms?
answer
Tachycardia, Hypertension, Dyspnea
question
What conditions could alter or affect dialysate flow rates?
answer
Low water pressure, Dialysate pump failure, Obstruction in dialysate flow path
question
What are the symptoms of Hypotension?
answer
Dizziness, Tachycardia
question
What level of calcium concentration usually at?
answer
2.5-3.5 mEq
question
What medical problems may occur due to chronic kidney disease?
answer
Anemia, Sleeping Problems, Pericarditis
question
What are the steps for reprocessing the first time?
answer
Dialyzer labeling, Total Cell Volume, Reprocessing
question
What will increase the amount of solutes that will diffuse across the semi-permeable membrane?
answer
High Concentration Gradient
question
What are symptoms to Hyperkalemia?
answer
Muscle Weakness
question
What is ETD?
answer
Germicide in dialyzer
question
How much iron is in the body?
answer
Transferrin Saturation (TSAT)
question
What is the condition that renal patient develop due to kidney inability to reabsorb enough bicarbonate?
answer
Metabolic Acidosis
question
An AV Fistula can routinely be used for cannulation within how many weeks of being created?
answer
2 Weeks
question
What is the target lab value for Serum Ferritin?
answer
>200 ng/mL
question
What is the target lab value for BUN?
answer
5-25 mg/dL
question
What is the target lab for Magnesium?
answer
1.7-2.5 mg/dL
question
What is the target lab for Sodium?
answer
135-146 mEq/L
question
What is the target lab for Creatinine?
answer
10-18 mg/dL .4-1.4
question
What is the lab value for Albumin?
answer
>4.0 g/dL
question
What is the target lab value for Phosphorous?
answer
3.5-5.5 mg/dL
question
What is the target lab value for Calcium?
answer
8.4-9.5 mg/dL
question
The endocrine functions of the kidney include what?
answer
Making erythropoietin and the active form of Vitamin D
question
What is the target lab value for Potassium?
answer
3.5-5.5 mEq/L
question
Negative pressure is pressure created when...
answer
Fluid is pulled through a restriction
question
What is the definition of contact time?
answer
Amount of time the germicide remains in the dialyzer
question
What is the purpose of a proportioning system?
answer
Make dialysate by mixing fresh concentrate with fixed amounts of treated water
question
What is an acceptable level of post softner hardness?
answer
0.8 grain/gallon
question
A dialysate that contains too much potassium causes hyperkalemia. What are the signs and symptoms?
answer
Muscle weakness, Cardiac Arrhythmia, Cardiac Arrest
question
What is the instrument used for measuring blood pressure called?
answer
Sphygomanometer
question
What is the build-up of waxy proteins in soft tissues, bones, and joints?
answer
Amyloidosis
question
Which direction should the venous be placed?
answer
Antegrade
question
What does ETO stand for?
answer
Ethylene Oxide
question
What is the normal pH for a patient?
answer
7.35-7.45
question
What test must be performed on new dialyzers?
answer
TCV (Total Cell Volume)
question
According to AAMI standards, the total endotoxin count of dialysate shall not exceed what ?
answer
2 EU/ml
question
What does dialysate conductivity measure?
answer
the total electrical charge of a solution
question
What are two criteria for rejecting a reprocessed dialyzer?
answer
Less than 80% of original fiber bundle volume aesthetic apperance
question
What is a problem in dialyzer reprocessing that may cause bacteria or endotoxin contamination of the dialyzer?
answer
Improperly prepared germicide
question
What germicide is used for dialyzer reprocessing?
answer
Peracetic Acid
question
What is the target lab value for Transferrin Saturation?
answer
20%
question
What is the target lab value for Hemoglobin?
answer
>11 g/dL
question
What is a limitation of a reverse osmosis system?
answer
Thin film composite membranes break down when exposed to chlorine and chloramines
question
What is the normal GFR?
answer
125 mL/min
question
Stage 1 kidney disease is at what GFR?
answer
>90
question
Stage 5 kidney disease is at what GFR?
answer
<14
question
Stage 3 kidney disease is at what GFR?
answer
30-59
question
What labeling must be on reuse dialyzers?
answer
Patient Name, Color Code, Medical Record #, Warning if 2 Patients have same name, Must say re-use on dialyzer
question
What means you have had the vaccine. You want this to be positive.
answer
Antibody
question
What means you have the actual disease. You want this to be negative.
answer
Antigen
question
Stage 4 kidney disease is what GFR?
answer
15-29
question
Name 2 compartment of the dialyzer.
answer
Blood Dialysate
question
According to AAMI standards, the total microbial count of dialysate shall not exceed...
answer
200 CFU/mL
question
What are 2 types of ultrafiltration systems?
answer
Volumetric UF control and flow control
question
What are the 3 main ways to remove solutes?
answer
Diffusion, Convection, Absorption
question
Shriveling of red blood cells and may be caused by hypertonic
answer
Crenation
