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Dialysis Study Guide
| Question | Answer |
|---|---|
| Functions of the kidneys: | -Removes excess waste, fluid, electrolytes, release hormones, and regulates acid base balance. |
| 2 leading causes of renal failure in the U.S.: | Hypertension (HTN) and Diabetes. |
| S/S of an endotoxin exposure: | Fever and Chills |
| What does diffusion remove: | Waste and Electrolytes |
| What does ultrafiltration remove: | Fluid |
| Blood flows ________ the fibers of the dialyzer: | Inside |
| Dialysate flows ________ the fibers of the dialyzer: | Outside |
| The blood compartment of the dialyzer is: | Sterile |
| The dialysate compartment is: | Non-Sterile |
| KDOQI standard for adequacy: | >/= 1.2 |
| Purpose of Dialysate: | Removes: -Waste -excess electrolytes Replace: -calcium -glucose |
| Common carriers of contamination in the dialysis unit: | EVERYTHING! |
| How to minimize risk of infection from infectious agents: | -standard precautions -handwashing -proper disposal of sharps |
| AVF | PATIENTS OWN ARTERY AND VEIN (ARTERIOVENOUS FISTULA) |
| Advantages of AVF: | -reduced clotting -low complications -greatest longevity -puncture sites heal -avoid allergic response to synthetic material |
| Disadvantages of a Graft: | -higher chance of clotting -life expectancy of 2 years -puncture sites DON'T heal |
| Disadvantages of Central Venous Catheter: | -increase infections -increase clotting -decrease BFR (Blood Flow Rate) -possible air embolism -stenosis of vessel |
| Infiltration: | Blood leaks outside vessel wall |
| How does infiltration occur: | when needle punctures vessel and allows blood to leak into tissue. |
| Why should water used to make dialysate be treated? | patients are exposed to so much |
| Hemolysis: | -bursting of RBCs (Red Blood Cells) -release of potassium |
| Blood leak: | when dialyzer membrane tears and blood escapes blood compartment into the dialysate |
| How to place a pt at risk for air embolism: | Trendelenburg on LEFT side |
| Most important safety monitor during treatment | STAFF |
| To ensure safety of patients, machines should be: | -checked and calibrated -verify PH and Conductivity by independent monitor (Myron meter) -all alarms tested prior to each tx |
| What does dialysate CONDUCTIVITY measure? | Electrolyte composition |
| Anaphylaxis: | IMMEDIATE, SEVERE reaction |
| S/SX of anaphylaxis: | -itching -hives -wheezing -swelling of throat and eyes -LIFE THREATINING |
| Function of semi-permeable membrane: | -allow certain size particles to cross -separates the blood and dialysate compartments |
| S/SX of an impending clot/thrombosis: | -decrease bruit and thrill -increase venous pressure -prolong bleeding -difficulty cannulating -difficulty obtaining the BFR -lighting color of Arterial blood during flush/rinse back |
| Arterial needle placement: | direction of blood flow and against blood flow |
| Venous needle placement: | ONLY in direction of blood flow |
| Aneurysm: | -ballooning/ bulging/ weak spot in vessel |
| How to prevent aneurysm: | ROTATE NEEDLE SITES |
| Diffusion: | Solutes go from an area of INCREASED concentration to an area of DECREASED concentration |
| HTN (low B/P) may lead to: | -clotting of access -seizures -cardiac arrest -mental changes |
| Recirculation: | Clean blood return to dialyzer to get cleaned again |
| What occurs if "recirculation" happens? | decrease adequacy of dialysis |
| How to tell if person is at their dry weight: | -No swelling -normal breathing -normal B/P |
| Hemoglobin: | -measure and diagnose anemia -O2 carrying component of RBCs |
| 3 factors that can cause anemia in dialysis pt: | -lack of erythropoietin -iron deficiency -vitamin dificiency |
| ACUTE renal failure: | sudden loss of function and MAY be reversible |
| CHRONIC renal failure: | Long, slow, progressive loss of function; NOT usually reversible |
| Substances in dialysate: | -GLUCOSE -CALCIUM -BICARB -SODIUM -ETC... ***(NEVER UREA OR CREATINE!!!!!!!) |
| Purpose of air detector: | helps prevent an AIR EMBOLISM |
| what happens if you forget to arm air detector???? | TERMINATION!! :( |
| If a machine alarm fails and can't be corrected: | Move pt to empty station or get a back-up machine |
| FOUR parts of a dialyzer: | -plastic casing -semi-permeable membrane -blood compartment -dialysate compartment |
| Conductivity alarm indication: | safe machine |
| When will the machine go into BIPASS? | When it is out of range to prevent pt from being exposed to unsafe dialysate |
| UREA: | -waste product of protein breakdown -measured by BUN -can build up between TX |
| BRUIT: | SOUND |
| THRILL: | FEEL |
| Dialyzer with large surface area: | create more diffusion, which removes MORE WASTE |
| If clotted, the surface area of the dialyzer: | DECREASE |
| PPE includes: | -shoe covers -protects from large bodily fluid spills |
| Standard Precautions: | -basic infection control measures -treat ALL pts as if they are infectious -protects you and others and is NOT optional |
| What to do with contaminated clothing? | -dispose in biohazard immediately and you will be compensated |
| MOST prominent source of infection: | -skin -lining of nose, mouth and bowel |
| How does communicable diseases spread? | -direct and indirect contact -breathing and touching from person to person |
| CONDUCTIVITY RANGE: | 12.8-14.4 |
| pH RANGE: | 6.5-8.0 |
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