what is REM and what is used to submit? - Ans-Risk Event Management and unsafe condition, near miss, and an adverse event
Sterile means - Ans-free of all living microorganisms and spores
clean means - Ans-not steri
...
what is REM and what is used to submit? - Ans-Risk Event Management and unsafe condition, near miss, and an adverse event
Sterile means - Ans-free of all living microorganisms and spores
clean means - Ans-not sterile, but disinfected such as a clean dialysis chair
contaminated means - Ans-that a sterile or clean item has come in contact with non-sterile object
dirty means - Ans-neither sterile or clean, but visibly contaminated
Alcohol-bases hand rubs must contain - Ans-60-95% ethyl alcohol, isopropyl alcohol, or a combination of both
How long should you wash your hands for? - Ans-20 seconds
PPE includes what? - Ans-gloves, gowns, masks, protective eye gear
environmental surfaces are cleaned with appropriate disinfectant such as a bleach solution - Ans-1:100 one part bleach and 99 part water
for visible blood or gross blood spills, a ______ bleach solution must be utilized - Ans-1:10 1 part bleach and 9 parts water
when preparing patient assignments, teammates who care for confirmed or suspected hep B surface antigen (HBsAg) positive patient(s) will only be assigned to simultaneously care for surface - Ans-antibody positive (immune) patients
Although dialysis is a complex procedure, it is based on simple principles - Ans-use of a semipermeable membrane, diffusion, ultrafiltration, convection, and osmosis
what are the 3 treatment goals to achieve in dialysis? - Ans-1. Remove waste from the blood
2.remove excess water from the blood
3. balance blood electrolytes
semipermeable membrane - Ans-thin sheet of natural or synthetic material that allows some small particles to pass through, while blocking other, larger ones.
what is a dialyzer and the 2 compartments - Ans-artificial kidney and blood site and dialysate site
what happens if the blood site and dialysate site mix? - Ans-= blood leak
what is dialysate (3 things)? - Ans-RO water, acid bath, and bicarbonate
what is an extracorporeal circuit? - Ans-bloodline, saline, and dialyzer=set up
What is diffusion? - Ans-movement of dissolved particles across a semipermeable membrane from the side with the higher concentration to the side with the lower concentratio n.
What is ultrafiltration? - Ans-removes water from the blood by pushing it across the semipermeable membrane
What is convection? - Ans-or solute drag is when solutes move with the water across the semipermeable membrane.
What is osmosis? - Ans-is the movement of water across a semipermeable membrane from the side with the lower solute concentration to the side with the higher solute concentration
After a chemical disinfection with bleach, how do you verify that the machine is free of residual bleach before you start setting up? - Ans-check the fluid from the drain hose with residual chlorine test strip
What is an acceptable test result when verifying the absence of residual bleach? - Ans-less than or equal to 0.5ppm
What is strikethrough? - Ans-Saline rises in transducer allows for inaccurate readings. The back of transducer is checked for wet. If wet can contaminate machine. Pull for bio med.
what is the only fluid we use to prime the blood lines and dialyze? - Ans-sodium chloride 0.9% (normal saline)
what is proportioned dialysate? - Ans-even amounts of RO water, acid bath and bicarbonate
The manual conductivity must match the dialysis delivery system displayed conductivity_________ - Ans-+/- 0.4 mS of the theoretical conductivity (TCD) for Fresenius delivery systems
The maximum recirculation time after a machine has been set up prior to treatment
initiation cannot exceed _____ hours. - Ans-2 hours
What is the rationale for limiting recirculation time? - Ans-bacterial proliferation in the extracorporeal circuit may occur
Some blood lines are equipped with external transducer protectors. What is the correct procedure to be followed once strikethrough of an external transducer protector has occurred? - Ans-upon completion of treatment, the delivery system is to be removed from service and labeled with date, time, description of problem and name the teammate reporting the problem. the internal transducer protector will be changed by boomed tech. and delivery system will be disinfected prior to return use
The acceptable range for proportioned dialysate pH is ____________ - Ans-6.9-7.6
When are dialysate conductivity and pH testing required to be performed? - Ans-prior to initiating a treatment and whenever dialysate concentrate(s) (acid or bicarb) are changed or replaced during the course of the treatment
If bleach and peracetic acid are mixed, a chemical reaction occurs, producing - Ans-toxic chlorine gas
What are the two requirements that must be met prior to initiating system disinfection? - Ans-the treatment area must be patient free and no other processes are using the dialysis quality water
What must be done to indicate the presence of disinfectant in the machines during system disinfection? - Ans-notification of the type of disinfection is prominently displaced on each delivery system
How do we verify the absence of chemical disinfectant following system disinfection on the first treatment day following the disinfection? - Ans-facility teammates perform an independent chemical residual test prior to beginning the daily activities
What is an acceptable test result when testing for the absence of peracetic acid? - Ans-a level or less than or equal to 1 ppm
Dialysate with a conductivity that is too low causes.... - Ans-hemolysis, the bursting of RBCs. The color of hemolyzed blood is cranberry red.
Dialysate with a conductivity that is too high causes... - Ans-crenation, a shriveling up of RBCs. The color of the blood will be dark.
The transport mechanism of osmosis is responsible for.... - Ans-hemolysis and crenation as water leaves or enters RBCs.
If the dialysate temperature becomes too hot... - Ans-it can hemolyze RBCs.
A dialysate temperature too cold - Ans-s not life threatening but can chill the patient and cause hypothermic symptoms and may decrease diffusion
Dialysate Flow Rate (DFR) - Ans-is ordered by the physician as part of the prescription
blood leak detector? - Ans-checks for blood in dialysate during the treatment, air bubbles can cause false alarm during set up and priming and to correct check Hansen connectors and verify they are tight
transmembrane pressure (TMP) - Ans-equal to the venous pressure minus the dialysate pressure measured in mmHg.
Blood Flow Rate (BFR) - Ans-resistance to the flow establishes the pressures in the extracorporeal circuit
Arterial Pressure (AP) - Ans-blood pump pulls blood from the vascular access, this pressure is negative
Venous Pressure (VP) - Ans-After the blood leaves the dialyzer and is pushed through the venous drip chamber and
back into the body, the pressure reading becomes positive
water makes up about.. - Ans-90% of dialysate
what are the 3 processes that make up the water treatment? - Ans-pretreatment, water purification, and distribution
what does AAMI stand for? - Ans-Association for the Advancement of Medical Instrumentation
pretreatment consist of? - Ans-blending valve, black flow preventer, booster pump, depth filter, water softener, carbon tanks, RO pre-filter
blending valve? - Ans-Mixes hot and cold water to allow the RO to function at the most efficient temperature, which is 77 F for conventional systems. between 65 F to 85 F
Backflow Preventer - Ans-Prevents pre-treated water and disinfectants from backing up into the city water supply
booster pump - Ans-expectation tank catches additional pressure booster pump gives off
multimedia or depth filter - Ans-Filters out suspended particles like silt and sand in the water and traps solutes and other substances
water softener - Ans-"Softens" hard water by removing calcium and magnesium from the incoming water
carbon tanks - Ans-primary and secondary carbon tanks
RO pre-filter - Ans-Removes fine carbon particles, resin beads and other debris; is placed just before the RO unit
purification requires.. - Ans-water to pass through RO membranes followed by an ultrafilter
the RO unit removes.... - Ans-removes bacteria, viruses, endotoxin, salts, particles and other solutes by reversing the transport mechanism osmosis
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