Flashcard Set Preview
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| 1 |
Acute renal failure
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Sudden onset: illness, injury or toxin. May be temporary.
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Chronic renal failure
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Long slow process, destruction of nephrons, may not be symptomatic until advanced stage. ESRD.
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ESRD
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End Stage Renal Disease, glomerular filtration rate decreased to 10% of normal. Complete and...
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Air embolism
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When air eters the bloodstream, and is carried to a vessel small enough to be blocked. Can...
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Alum
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Aluminum compound added to city water to make the water clearer, can build up in HD pts,...
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ARBD
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Aluminum-Related Bone Disease, caused by prolonged aluminum exposure in diaysis water, cookware,...
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| 7 |
Amyloidosis
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Build up of beta2-microglobulin. A starch-like protein that is removed by healthy kidneys....
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Albumin
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Blood protein that regulates osmotic pressure. Low serum levals <3.5 g/dL indicates malnutrition....
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| 9 |
Anaphylaxis
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Severe reaction to allergen. Symptoms: have, itching, wheezing. May devolp into anyphylactic...
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| 10 |
Anastomosis
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Another name for a surgical connection, such as AVF.
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| 11 |
Anemia
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Shortage of RBC's. Common in pts, caused by: insuffinceient erythropoietin, iron deficiency,...
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| 12 |
Angioplasty
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Procedure where a balloon is threaded through a blood vessel, and inflated to dialate areas...
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| 13 |
Anterograde
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Means with the direction of flow (away from the anastomosis). Aterial needle can be placed...
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| 14 |
Anticoagulant
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Heparin is a blood thinner used to prevent blood clots in circuit.
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| 15 |
Arterial pressure
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Is measured as a negative pressure between the arterial access and the blood pump. Is read...
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AVF
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Arteriovenous Fistula. A surgical connection of an artery and a vein. Created in...
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| 17 |
Artery
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A blood vessel that carries oxygenated blood away from the heart, to every part of the body.
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| 18 |
Ascites
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Caused by liver damage, heart failure, malnutrition. Is a buildup of fluid in the abdomen.
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Asepsis
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Absence of disease-producing microorganisms. Accomplished by disinfection, maintaining equipment,...
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AAMI
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Association for the Advancement of Medical Instrumention. Develops voluntary standards...
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| 21 |
Ausculation
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Listening with a stethoscope. Do this the help diagnose problems such as stenosis or thrombosis...
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| 22 |
Backfiltration
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Movement of dialysate across dialyzer membrane and into pts. blood. Can occur with high-flux...
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| 23 |
Bacteria
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Microscopic single celled organisms that cause disease. May be Gram-positive or Gram-negative.
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| 24 |
Base
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PH greater than 7.0 Bicarbonate is a base. Bases are capable of accepting a hydrogen ion.
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| 25 |
Bicarbonate
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A buffer found in the blood. Reabsorbed by healthy kidneys. Is used to neutralize acids formed...
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| 26 |
Blood leak detector
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Shines a beam of light through the dialysate, any break in the beam d/t blood cells triggers...
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| 27 |
BUN
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Blood Urea Nitrogen. Healthy kidneys remove urea. HD pts. have a build up of urea in the blood...
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| 28 |
Brachiocephalic fistula
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Most common type of AVF. Is located in the upper arm by surgical connection of the brachial...
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Bruit
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The buzzing or swooshing sound of the AVF or graft. Can be heard with a stethoscope at the...
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| 30 |
Buffer
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Maintains the PH of a solution at a constant level, despite the addition of an acid or base....
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Calcitriol
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Activated form of vitamin D. Produced by healthy kidneys, needed to absorb calcium from food....
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Calcium
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An electrolyte needed for nerve and muscle function, bone formation. Is an element that is...
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Capillaries
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In the kidneys, each glomerulus is a tiny ball of capillaries that filter waste from the blood....
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Carbon tank
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Part of water tx system that removes chlorine and chloramines from the water. Have 2! Must...
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Catabolism
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Breakdown of proteins to simpler substances in the body producing waste products. Removed with...
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Catheter
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K/DOQI guidlines recommend use of internal jugular vein for HD caths when possible to prevent...
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Chloramines
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Formed by minxing chlorine and ammonia, or when chlorine combines with organic material.Ammonia...
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Clearance
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A measure of dialyzer performance. The quantitiy of blood in mL that is completely cleared...
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Clinical practice guidelines
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Managed by K/DOQI. The Kidney Disease Outcomes Quality Initiative. Covers anemia, HD adequacy,...
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KUF or UFR
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Coefficent of Ultrafiltration, or Ultrafiltration Rate. Is the amount of fluid the dialyzer...
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Composite Rate Reimbursement System
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U.S. government payment for dialysis tx. Facilities are paid a fixed, limited amount for each...
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Concentration
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The amount of solutes (potassium, sodium)dissolved in a measured amount of fluid.
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Conductivity
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The ability of a fluid to conduct electricity. If dialysate is out of conductivity, alarm...
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CHF
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Congestive heart failure. When the heart cannot pump out all the blood it receives, excess...
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CAPD
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Continuous Ambulatory Peritoneal Dialysis. A type of PD, 4-5 fluid exchanges are made per day...
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CCPD
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Continuous Cycling Peritoneal Dialysis. A type of PD using a machine (cycler) to put fluid...
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CQI
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Continuous Quality Improvement. Management theory to constantly improve. Includes cycles of...
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Creatinine
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A waste product of creatine and creatine phosphate, (muscle breakdown) that is normaly...
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Crenation
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Shriveling of BC's. Blood will appear dark red, can be fatal. Can be caused by not diluting...
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Cyanosis
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Blue skin, lips, gums, fingernail beds. Can be caused by exposure to nitrates in dialysate...
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Dialysate
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Precise mixture of treated water and chemicals such as sodium, calcuim, magnesium, chlordie,...
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Countercurrent flow
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Blood moves across dialyzer in one direction, dialysate in opposite direction, keeping blood...
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| 53 |
What is the limit for total chlorine in dialysis?
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0.1 ppm
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| 54 |
Is the RO capable of rejecting chlorine?
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Yes
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| 55 |
How often do the timers on the water tx eqip. need to be checked?
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Daily, prior to first pt. shift.
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| 56 |
What type of filtration is used in an RO?
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Crossflow
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| 57 |
As the conductivity of water decreases, the purity of water _______
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increases
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| 58 |
What are the two main types of water system desgins?
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Direct feed and storage systems.
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| 59 |
What does a UF filter remove in the water system?
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Bacteria and endotoxins.
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| 60 |
To effectively remove endotoxins, what type of ultrafilter should be used?
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0.05 microns or less
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| 61 |
Pyrogens can be removed by one of the following, pick one....bleach or renalin, DI tanks, reverse...
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Reverse osmosis.
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| 62 |
What does a water softner do?
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Exchanges calcium ions for sodium ions.
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| 63 |
What do the "back up" DI's do?
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Exchanges hydroxl ions for fluoride ions.
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| 64 |
What does an RO machine do?
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Removes pyrogens from the water.
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| 65 |
What main contaminants does a carbon tank remove?
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Free chlorine and magnesium.
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| 66 |
What is the recommended empty bed contact time for chlorine removal?
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10 minutes (five minutes each tank)
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| 67 |
How often should chlorine testing be completed?
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Just prior to each pt. shift.
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| 68 |
True or false
These items can cause less permeate flow from the RO - higher water temperature,...
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True
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| 69 |
What is the functional unit of the kidneys called?
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Nephron
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| 70 |
A nephron is made up of what?
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A glomerulus and a tubule.
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| 71 |
What is the leading cause of ESRD for adults in the USA?
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Diabetes.
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| 72 |
The endocrine functions of the kiney include what?
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Making erythropoietin and the active form of vitamin D.
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| 73 |
Patients that c/o itching that like likely caused by what?
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Hyperphosphatemia
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| 74 |
The primary cause of anemia in ESRD is caused by what?
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Erythropoietin definciency.
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| 75 |
Why do pts. often have bone disease?
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The kidneys stop producing calcitriol.
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| 76 |
What are symptoms that a pt. requires more dialysis time?
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Anorexia, fatigue, swelling.
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| 77 |
What is a semipermeable membrane?
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It allows only certain sized molecules to pass through.
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| 78 |
Diffusion is a movemnet of particles....
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from a higher concentration to an area of lower concentration.
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| 79 |
Negative pressure is pressure created when...
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fluid is pulled through a restriction.
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| 80 |
During dialysis, ultrafiltration occurs when...
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water is removed from blood becuase there is a pressure gradient between blood and dialysate.
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| 81 |
At what point in the circuit is blood under negative pressure?
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At the arterial line, before the blood pump.
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| 82 |
The ability to remove wastes from the body is called
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clearance
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| 83 |
What are the two components of a dialyzer?
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blood and dialysate
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| 84 |
Two things that affect eh dialyzers ability re move wastes from the body include
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surface area and molecular weight cutoff.
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| 85 |
what is the most important safety monitor during a dialysis tx?
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the technician
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| 86 |
what is hypernatremia and it's symptoms?
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Hypernatremia is caused by too much sodium in dialysate, symptoms include headaches, high BP,...
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| 87 |
dialysate with too much calcium can cause:
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vomiting, confusion, irritability
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| 88 |
Dialysate with too little sodium can cause:
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low BP, cramping, and bursting of RBC's
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| 89 |
Dialysate that has too much potassium can cause:
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irregular heartbeat, severe muscle weakness.
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| 90 |
What is a sphygmomanometer?
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A tool that measures BP's
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| 91 |
A rapid pulse is known as:
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tachycardia
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| 92 |
The normal range of resting respirations in an adult is:
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12 to 20 breaths/min
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| 93 |
The normal range for a resting pulse in an adult is
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60 to 100 beats/min
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| 94 |
What are cramps caused by?
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The shifting of concentration of sodium ions.
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| 95 |
The TMP has gradually been changing during the last 1-1/2 hrs of tx, you suspect clotting in...
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Rinse the dialyzer with ns.
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| 96 |
When a dialyzer membrane tears, allowing blood and dialysate to mix, what is it called?
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Blood leak. Do not rinse back the pt's blood. Machine must be put through bleach cycle.
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| 97 |
If a pt. has an air embolism, what position should they be placed in?
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Left side trendelenburg position.
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| 98 |
What is the first symptom of dialysis equilibrium syndrome?
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Headache
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| 99 |
A pt. with fluid overload will probably display what symptoms?
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Tachycardia, hypertension, dyspnea
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| 100 |
What is dialysis disequilibrium syndrome?
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Cerebral edema caused by too rapid removal of urea nitrogen from the blood.
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| 101 |
What is the main reason dialyzers are reprocessed?
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Money. To reduced costs.
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| 102 |
First use syndrome symptoms include:
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Back pain, anxiety, tachycardia, wheezing, circulatory collapse
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| 103 |
What is the most important way to reduce the risk of endotoxin contamination of the blood?
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Use water that meets AAMI standards.
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| 104 |
What is an endotoxin?
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Toxin released during the decomposition of bacterial cell walls.
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| 105 |
How many people should check the dialyzer to verify quality control?
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Two, one should be the pt.
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| 106 |
What is the criteria for rejecting a reprocessed dialyzer?
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Less than 80% of original fiber bundle volume, aesthetic appearance.
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| 107 |
Bacteria/endotoxin exposure from water most commoly causes which of the following: blurred...
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Fever/chills
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| 108 |
The following may be added to the public water at municipal tx plants: zinc, copper, exotoxin,...
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Fluoride.
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| 109 |
According to AAMI standards, how often should bacteriologic testing for water and dialysate...
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Monthly.
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| 110 |
According to AAMI standards, the total microbial could of water used to prepare dialysate should...
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200CFU/mL
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| 111 |
According to AAMI standards, the total microbial count of dialysate shall not exceed:
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2000 CFU/mL
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| 112 |
Large amounts of aluminum in the water used for dialysis could cause :
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bone disease and anemia
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| 113 |
Large amounts of calcium in the water used fo dialysis could cause:
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Hard water syndrome.
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