Prep Course Exam Review

The correct answer is "Urine flows from the kidneys, to the ureters, to the bladder, to the urethra." This is the correct path of urine flow through the urinary tract. Urine is produced in the kidneys, then it travels through the ureters to reach the bladder, where it is stored. When it is time to urinate, the urine flows out of the bladder through the urethra and out of the body.

A central venous catheter may be used as a vascular access when a patient has inadequate blood vessels in the limbs. This means that the patient's blood vessels are not suitable for other types of vascular access, such as a peripheral IV line or an arteriovenous fistula. In these cases, a central venous catheter can be inserted into a large central vein, such as the jugular vein or the subclavian vein, to provide a reliable and long-term access for medications, fluids, or blood products.

Dialysis patients are more likely to become infected with germs like MRSA because they usually have weak immune systems. Dialysis is a treatment for people with kidney failure, and it involves filtering waste and excess fluids from the blood. However, dialysis cannot completely replace the function of healthy kidneys, leading to a weakened immune system. This makes dialysis patients more susceptible to infections, including MRSA, which is a type of bacteria that is resistant to many antibiotics.

While disinfecting a dialysis station or cleaning a blood spill, it is important to wear personal protective equipment (PPE) to prevent exposure to potentially harmful pathogens. Gloves are necessary to protect the hands from direct contact with the contaminated surfaces. A gown provides full-body coverage and prevents any splashes or spills from reaching the clothing. A face shield or mask is necessary to protect the face and eyes from any splashes or aerosols. Goggles are also necessary to provide additional protection for the eyes. Therefore, the correct answer is gloves, gown, face shield or mask, and goggles.

Venous needle infiltration refers to the unintentional insertion of the venous needle outside the vein during dialysis. This can cause an increase in venous pressure because the blood flow is obstructed, leading to a backflow of blood and an increase in pressure within the vein.

The patient's symptoms of feeling terrible and vomiting up blood indicate that they may have experienced bleeding during their previous dialysis treatment. Decreasing the heparin dose, which is an anticoagulant, can help reduce the risk of bleeding during the next treatment.

When the kidneys stop producing calcitriol, it leads to a decrease in the absorption of calcium from the intestines. This results in low levels of calcium in the blood. In response, the parathyroid glands release parathyroid hormone (PTH) to increase the levels of calcium in the blood by stimulating the release of calcium from the bones. Over time, this can lead to bone disease in kidney patients due to the constant breakdown of bone tissue.

Dialysate conductivity measures the total electrical charge of a solution. Conductivity is a measure of how well a solution can conduct electricity, and it is influenced by the concentration of ions in the solution. Therefore, by measuring the conductivity of dialysate, we can determine the total electrical charge present in the solution. This information is important in dialysis, as it helps to monitor the composition and quality of the dialysate solution used in the process.

When drawing a post-BUN, the first thing you should do is turn off the ultrafiltration rate (UFR) and dialysate flow rate (DFR). This is important because it allows you to stop the removal of fluid and dialysate from the patient's blood, ensuring that you have an accurate sample for the post-BUN measurement. By turning off the UFR and DFR, you can prevent any further changes in the patient's fluid and electrolyte balance, which could affect the accuracy of the post-BUN results.

A pH measurement of 7.0 is safe for dialysate because it is considered neutral. Dialysate is the fluid used in dialysis to help remove waste and excess fluid from the body. It is important for the pH of the dialysate to be balanced in order to maintain the proper chemical environment during the dialysis process. A pH measurement of 7.0 indicates that the dialysate is neither too acidic nor too alkaline, ensuring the safety and effectiveness of the dialysis treatment.

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A yellow AMP light indicates that the projected spkt/v is less than 1.4.

The water supply to the water treatment system is called "feed water" because it refers to the water that is being fed into the system for treatment. This water is typically sourced from various places such as rivers, lakes, or wells, and it undergoes treatment processes to remove impurities and make it safe for consumption or other uses. "Feed water" is a commonly used term in the water treatment industry to describe the input water that enters the treatment system.

A patient who is fluid overloaded may experience tachycardia (rapid heart rate), hypertension (high blood pressure), and dyspnea (shortness of breath). These symptoms occur because the excess fluid puts a strain on the heart, causing it to beat faster (tachycardia) and leading to increased blood pressure (hypertension). The fluid may also accumulate in the lungs, leading to difficulty breathing (dyspnea). These symptoms can vary in severity depending on the extent of fluid overload.

Adverse event is defined as a failure to follow established procedure, treatment prescriptions, or an event that causes patient injury or death. This term encompasses any negative outcome that occurs as a result of a deviation from standard protocols or guidelines. It includes errors in medication administration, surgical mistakes, and other preventable incidents that harm patients. Adverse events are important to identify and address in order to improve patient safety and prevent future harm.

An ultrafilter is a part of the water treatment system that is specifically designed to remove endotoxins. It is a type of membrane filter that has very small pores, allowing it to effectively remove particles, bacteria, and endotoxins from the water. The resin bed, deionization tank, and softener are other components of the water treatment system that serve different purposes but do not specifically target the removal of endotoxins.

Uremia refers to the buildup of waste products in the blood that are normally excreted by the kidneys. When the kidneys are not functioning properly, these waste products, such as urea and creatinine, accumulate in the blood. This can lead to various symptoms and complications, including fatigue, nausea, edema, and electrolyte imbalances. Therefore, the technician should explain to the patient that uremia means an increase of wastes in the blood.

To clean up a blood spill greater than 10ml, a concentration of bleach is required. The correct answer suggests using a concentration of 1:10 followed by 1:100. This means that the bleach should be diluted with water at a ratio of 1 part bleach to 10 parts water, and then further diluted at a ratio of 1 part diluted bleach to 100 parts water. This two-step dilution process ensures that the bleach is at an appropriate concentration to effectively clean up the blood spill.

If the arterial chamber level is low, it can cause air to enter the blood lines and dialyzer because there may not be enough pressure to prevent air from entering the system. As a result, air can be drawn into the blood lines and potentially enter the patient's bloodstream during dialysis.

The patient experiencing faintness, double vision, and clammy hands is most likely experiencing hypoglycemia. Hypoglycemia occurs when blood sugar levels drop too low, leading to symptoms such as dizziness, blurred vision, and sweating. This can happen if the patient has not eaten for a long time or if they have taken too much insulin or diabetes medication. Hyperglycemia, on the other hand, is high blood sugar levels, and would not typically cause the symptoms described. Hypertension refers to high blood pressure, and hyperkalemia is high levels of potassium in the blood, neither of which would explain the patient's symptoms.

The correct answer is "It is ultrapure". Dialysate is the fluid used in dialysis to remove waste and excess fluid from the blood. It needs to be ultrapure to prevent any contamination or introduction of harmful substances into the patient's bloodstream. Sterility is a requirement for dialysate, but it is not the defining characteristic. Urea is a waste product that is removed by dialysis, so it would not be present in the dialysate. Chlorine is not typically present in dialysate as it can be harmful to the patient. Therefore, the statement that dialysate is ultrapure is the most accurate.

An arterial needle can be placed against the flow of blood because it is inserted directly into an artery, which carries oxygenated blood away from the heart. On the other hand, a venous needle is inserted into a vein, which carries deoxygenated blood towards the heart. Therefore, a venous needle cannot be placed against the flow of blood.

The normal body temperature taken orally is 98.6°F. This is the average temperature that is considered to be within the normal range for a healthy adult. It is important to note that individual body temperatures can vary slightly, and factors such as time of day and activity level can also affect body temperature. However, 98.6°F is generally accepted as the standard normal body temperature.

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Diffusion is the movement of particles from an area of higher concentration to an area of lower concentration. This process occurs due to the random motion of particles, where they spread out to achieve a more uniform distribution.

Too much sodium or hypernatremia can lead to various symptoms and complications. Headaches can occur due to the increased pressure on the blood vessels in the brain. High blood pressure can result from the body retaining excess fluid to dilute the sodium concentration. Shriveling of red blood cells or crenation can occur when there is an imbalance of sodium inside and outside the cells, causing them to lose water and shrink. These symptoms indicate the potential harm that can be caused to the patient if the dialysate has too much sodium.

The dialyzer's ability to remove wastes from the body is influenced by two factors: surface area and molecular weight cutoff. The surface area of the dialyzer determines the amount of contact between the blood and the dialysis solution, allowing for efficient waste removal. The molecular weight cutoff refers to the size of molecules that can pass through the dialyzer membrane. A lower molecular weight cutoff allows for the removal of smaller waste molecules. Therefore, surface area and molecular weight cutoff are important considerations for the effectiveness of a dialyzer in removing wastes from the body.

Both arterial and venous needles can be placed with the flow of blood. The arterial needle is used to access the arterial blood supply, while the venous needle is used to access the venous blood supply. Placing both needles with the flow of blood ensures that the blood can be properly accessed and utilized for medical procedures or treatments.

A Hepatitis B susceptible patient should be placed outside of the buffer zone and away from the isolation room during treatment. This is because the buffer zone is a designated area for patients with contagious diseases, and the isolation room is specifically for patients with airborne diseases. Placing the patient outside of the buffer zone helps to minimize the risk of transmission to other patients in the clinic.

A high venous pressure alarm might indicate a clotting of blood in the access. This means that there is a blockage or obstruction in the venous blood tubing, preventing the blood from flowing properly. This can lead to increased pressure in the vein, triggering the alarm. The other options, such as a decrease in blood flow rate, kink in the arterial blood tubing, or separation of venous blood tubing, would not directly cause a high venous pressure alarm.

Patients with diabetes mellitus should be observed for signs of low blood sugar, known as hypoglycemia. Anxiety and confusion are common symptoms of hypoglycemia, as the brain is not receiving enough glucose for proper functioning. Fever and chills, thirst and weight gain, and decreased blood pressure and heart rate are not typically associated with low blood sugar.

Reusing a dialyzer can lead to reduced dialyzer performance, as the dialyzer may become less effective at removing waste and excess fluid from the blood. Plugged hollow fibers can also occur, which can further impair the dialyzer's ability to filter the blood properly. Additionally, the volume of the fiber bundle within the dialyzer may change over time, which can impact its overall performance. These potential problems are all related to the reuse of the dialyzer.

According to the AAMI standards, the total microbial count of water used to prepare dialysate should not exceed 200 CFU/mL. This is because high microbial counts can increase the risk of infection for patients undergoing dialysis. Keeping the microbial count below this limit helps to ensure the safety and effectiveness of the dialysis process.

A nephron is the functional unit of the kidney responsible for filtering waste from the blood and producing urine. It consists of a glomerulus, which is a network of capillaries, and a tubule. The glomerulus filters the blood, allowing waste products and excess fluids to pass into the tubule, where further processing and reabsorption of essential substances occur. The other options mentioned, such as the nephrons and a capsule, the loop of Henle and the capillary ball, and the bladder and the ureter, are incorrect as they do not accurately describe the components of a nephron.

When the dialysis machine alarms and goes into bypass, it means that there is a problem with the flow of dialysate through the dialyzer. Dialysate is the fluid that helps remove waste and excess fluid from the blood during dialysis. If the dialysate stops flowing, the dialysis process cannot effectively remove waste and excess fluid from the patient's blood, leading to a potential health risk. Therefore, this is the correct answer.

In the extracorporeal circuit, the blood is usually under negative pressure in the arterial line section before the blood pump. This is because the blood pump creates a vacuum effect, pulling the blood from the patient's body into the circuit. The negative pressure in this section helps to ensure proper blood flow and circulation throughout the circuit.

The target weight for a patient is calculated by subtracting the pre-treatment weight from the EDW (Estimated Dry Weight), and then subtracting the volume of prime and rinse. In this case, the EDW is 75.5kg and the pre-treatment weight is 77.0kg. Subtracting 77.0kg from 75.5kg gives a difference of -1.5kg. Then, subtracting the volume of prime and rinse, which is 500ml, or 0.5kg, gives a final target weight of -2.0kg.

Diarrhea is not a symptom of a chemical reaction due to incomplete rinsing of germicide from a reprocessed dialyzer. The other symptoms listed, such as burning in the access site, numbness in the access arm, and blurred vision, could potentially be caused by the chemicals in the germicide. However, diarrhea is not typically associated with chemical reactions in this context.

Vitamin D is needed for healthy bones because it helps the body absorb calcium and phosphorus, which are essential for bone health. Without enough vitamin D, the body cannot properly use these minerals, leading to weak and brittle bones. Therefore, receiving vitamin D therapy is important for maintaining strong and healthy bones.

Hyperphosphatemia is a condition characterized by high levels of phosphate in the blood. In patients with kidney failure, the kidneys are unable to effectively filter out excess phosphate, leading to its buildup in the blood. This can result in several complications, including itching. The exact mechanism behind the itching is not fully understood, but it is believed that the high levels of phosphate may directly stimulate nerve endings in the skin, leading to the sensation of itching. Therefore, hyperphosphatemia is likely the cause of itching in patients with kidney failure.

Negative pressure is created when fluid is pulled through a restriction. This means that there is a lower pressure on one side of the restriction compared to the other side, causing the fluid to be pulled towards the lower pressure area. This can occur in various situations, such as when a vacuum is created or when a pump is used to draw fluid through a narrow passage.

The dialysis technician is the most important safety monitor during a dialysis treatment because they are responsible for monitoring the patient's vital signs, ensuring the correct functioning of the dialysis machine, and responding to any emergencies or complications that may arise during the treatment. They play a critical role in ensuring the safety and well-being of the patient throughout the entire dialysis process.

When using the emergency hand crank during a power outage, it is important to check that there is 300ml of normal saline (NS) in the bag. This is necessary because the hand crank is used to manually pump the saline solution through the dialysis machine, providing the necessary fluid for the dialysis process. Without the proper amount of saline in the bag, the dialysis machine will not be able to function effectively. Therefore, it is crucial to ensure that there is an adequate amount of normal saline in the bag before using the emergency hand crank.

The correct answer is "Less than 0.1ppm". This suggests that the acceptable limit for total chlorine is less than 0.1 parts per million. This limit is likely set to ensure that the concentration of chlorine in a given substance or environment remains at a safe level. Higher concentrations of chlorine can be harmful to human health and the environment, so it is important to keep the concentration below this threshold.

High concentration gradients will increase the amount of solutes that will diffuse across the semipermeable membrane. Concentration gradient refers to the difference in solute concentration between two regions. When the concentration gradient is high, there is a greater difference in solute concentration, which creates a driving force for diffusion. This means that more solutes will move from an area of high concentration to an area of low concentration, resulting in an increased amount of diffusion across the semipermeable membrane.

Dialysate with a high conductivity will cause crenation, which refers to the shrinking or shriveling of red blood cells due to the movement of water out of the cells. On the other hand, dialysate with a low conductivity will cause hemolysis, which is the rupture or destruction of red blood cells due to the movement of water into the cells.

Seizures during dialysis can be caused by electrolyte imbalances, hypotension, and dialysate composition errors. However, a sudden decrease in dialyzer clearance is not a known cause of seizures during dialysis. The dialyzer is responsible for filtering waste and excess fluid from the blood during dialysis, so a decrease in its clearance would not directly lead to seizures.

Patients developing dialysis disequilibrium syndrome are most likely to exhibit a headache as the first symptom. This syndrome occurs when there is a rapid removal of solutes during dialysis, leading to an imbalance between the solute concentrations in the blood and brain. The resulting osmotic gradient causes fluid to move into the brain, leading to cerebral edema and increased intracranial pressure, which manifests as a headache. Other symptoms such as nausea, vomiting, seizures, and altered mental status may follow, but headache is typically the earliest and most common symptom.

A low conductivity alarm during hemodialysis indicates that the conductivity of the dialysate solution is below the desired level. This can be caused by various factors, but the most common cause is an exhausted concentrate supply. The concentrate is responsible for providing the necessary electrolytes and salts to the dialysate solution, and when it becomes depleted, the conductivity of the solution decreases. This can lead to inadequate dialysis treatment and the need to replace the concentrate supply.

The AAMI standards recommend that quality control activities be performed before a reprocessed dialyzer is used on a patient. These activities include checking the dialyzer for quality control information. According to the given correct answer, two people should check the dialyzer to verify this information. One of these two people should be the patient themselves, as they are the ones who will be directly affected by the use of the dialyzer. The involvement of the patient in the quality control process ensures that they are actively participating in their own healthcare and can provide valuable input regarding their treatment.

Online clearance (OLC) testing is a method used to estimate the clearance of substances in the body. In this case, sodium is used specifically to estimate the clearance of urea. The other options are not correct because OLC tests do not project serum albumin levels and they are not completed 8 times per treatment. The result of an OLC test is not known as a KECN with an expected range of 300-400, so this option is also incorrect.

Dialysate is a solution used in dialysis to help remove waste and excess fluid from the blood. It needs to have the right balance of electrolytes, including sodium. If the dialysate has too little sodium, it can lead to low blood pressure because sodium helps regulate blood volume. This can cause symptoms such as cramping, as the body tries to compensate for the low blood pressure. Additionally, low sodium levels can cause bursting of red blood cells, a condition known as hemolysis.

When the machine goes into bypass, the RTD clock stops. This means that the clock used to measure the duration of the treatment stops running. The other options, such as cleaning continuing, UF clock stopping, and blood pump stopping, do not occur when the machine goes into bypass.

The word "stabilized" suggests that there may have been some instability or fluctuation in the access. To stabilize access means to make it consistent and reliable. The word "uncovered" implies that the access was previously lacking or incomplete, and therefore, it needed to be stabilized to ensure that it always remains in a complete and reliable state.

"First use syndrome" is a hypersensitivity reaction to a dialyzer, which is a medical device used in dialysis. It is characterized by symptoms such as back pain, anxiety, tachycardia (rapid heartbeat), wheezing, and circulatory collapse. These symptoms can occur during the first use of a new dialyzer and may indicate an allergic reaction or anaphylaxis. Prompt medical attention is required in such cases to prevent further complications.

The symptoms of hypotension, dehydration, and weakness are indicative of a patient needing more dialysis time. Hypotension, or low blood pressure, can occur during dialysis due to fluid removal, and increasing dialysis time can help stabilize blood pressure. Dehydration can also be a result of excessive fluid removal during dialysis, and increasing dialysis time can help prevent this. Weakness can be a sign of inadequate dialysis, as waste products and excess fluid may not be adequately removed from the body. Therefore, increasing dialysis time can address these symptoms and improve the patient's condition.

Ultrafiltration profiling is a technique used during hemodialysis to remove excess fluid from the patient's body. By adjusting the rate at which fluid is removed, ultrafiltration profiling can help minimize the risk of hypotension, which is a sudden drop in blood pressure. This is important because hypotension can lead to dizziness, fainting, and other complications. Therefore, the purpose of ultrafiltration profiling is to minimize hypotension and ensure a safe and effective dialysis session for the patient.

The blood pressure reading of 180/100 is considered high and indicates hypertension. It is important to report this reading to the nurse because it may require immediate medical attention or adjustment of medication. High blood pressure can lead to serious health complications such as heart disease, stroke, and kidney problems. Monitoring and managing blood pressure levels is crucial for maintaining overall health and preventing complications.

During dialysis, ultrafiltration occurs when a higher concentration of sodium causes water to move from body compartments into the dialysate. This is because of the principle of osmosis, where water moves from an area of lower solute concentration to an area of higher solute concentration. In this case, the higher concentration of sodium in the dialysate creates a gradient that causes water to be pulled out of the blood and into the dialysate, allowing for the removal of excess fluid from the body during dialysis.

Excessive calcium in the dialysate can lead to an imbalance in the body's electrolytes, causing symptoms such as vomiting, confusion, and irritability. This occurs because high levels of calcium can disrupt the normal functioning of the nervous system and affect the body's ability to regulate various processes.

Changing the venous bloodline is the first action to take because clotting in the dialyzer can occur due to inadequate blood flow. Changing the venous bloodline helps to ensure proper blood flow and can help resolve the issue of clotting.

The transducer clamps should be in the open position before starting treatment. This is because the open position allows for easy placement and removal of the transducer, ensuring a smooth and efficient treatment process.

Normal saline is used to remove sterilant and air from the extracorporeal circuit. Sterilant refers to any substance or agent that is used to sterilize or disinfect equipment. In the extracorporeal circuit, it is important to remove any sterilant residue to ensure the safety and effectiveness of the circuit. Additionally, air bubbles can form in the circuit, which can disrupt the flow of blood or other fluids. Normal saline is used to flush out these air bubbles and ensure proper functioning of the circuit.

The correct answer is 3 to 5 minutes. After administering a heparin bolus, it is important to wait for 3 to 5 minutes before initiating treatment. This waiting period allows the heparin to take effect and start working in the body. By waiting for this duration, the healthcare provider ensures that the heparin has enough time to circulate and exert its anticoagulant effects, which can prevent blood clots from forming or getting larger. Initiating treatment too soon may not allow the heparin to fully take effect, potentially compromising its efficacy.

When determining the initial dosage of medication, a patient's weight is crucial. Many medications are dosed based on weight to ensure efficacy and safety, as body mass can significantly affect how a drug is metabolized and distributed in the body. Accurate dosing minimizes the risk of underdosing or overdosing.

Heparinization is the process of administering heparin, an anticoagulant, during dialysis treatment. It prevents blood clotting in the dialysis machine and allows for smooth blood flow. If heparinization is inadequate or not administered properly, blood clotting can occur within the machine, compromising the effectiveness of the dialysis treatment. This can lead to inadequate removal of waste products and excess fluid from the body, negatively impacting the overall adequacy of the treatment.

Recirculation refers to the process in which the dialyzed blood is returned back to the patient without being adequately filtered. This can occur when there is a problem with the dialysis machine or the dialyzer, causing the blood to bypass the filtration process. As a result, toxins and waste products that should have been removed from the blood during dialysis are not effectively eliminated, compromising the effectiveness of the treatment. Therefore, recirculation can jeopardize the adequacy of a dialysis treatment.

A red and warm vascular access may be a sign of an infection because these symptoms are commonly associated with inflammation and increased blood flow to the affected area, which are typical immune responses to an infection. Infections can cause the blood vessels near the access site to dilate and become more visible, leading to redness. The increased blood flow can also cause the area to feel warm to the touch. Therefore, these signs suggest that there may be an infection present at the vascular access site.

Improperly primed dialyzers and bloodlines can increase the risk of air embolism and clotting in the dialyzer. Air embolism refers to the presence of air bubbles in the bloodstream, which can obstruct blood flow and potentially cause serious complications. Clotting, on the other hand, refers to the formation of blood clots within the dialyzer, which can impair its function and lead to inadequate dialysis treatment. Both air embolism and clotting pose significant risks to patients undergoing dialysis, highlighting the importance of proper priming of dialyzers and bloodlines to minimize these risks.

During dialysis, the patient's access and face must be uncovered. Access refers to the site where the dialysis machine is connected to the patient's bloodstream, typically through a surgically created fistula or graft. It is important for the access site to be uncovered during dialysis to allow easy access for the healthcare provider to connect the machine and monitor the procedure. Additionally, the patient's face must be uncovered to ensure proper ventilation and comfort during the dialysis session.

The orientation of the venous needle is not a matter of contention, as it is responsible for returning blood to the body and should consistently align with the direction of blood flow (antegrade).

When cannulating a new A-V Fistula, it is important to always apply a tourniquet and stay at least 1.5 - 2 inches from the anastomosis. The tourniquet helps to constrict the blood vessels, making it easier to locate and access the fistula for cannulation. By staying at least 1.5 - 2 inches away from the anastomosis, the risk of damaging or disrupting the connection between the artery and vein is minimized. This ensures the longevity and proper functioning of the A-V Fistula for dialysis treatments.

Before cannulating a patient's access, it is recommended to clean the site for at least 30 seconds in a circular motion. This duration ensures thorough cleaning of the area, reducing the risk of infection and ensuring proper hygiene. Cleaning the site in a circular motion helps to cover a larger area and remove any potential contaminants effectively. By following this protocol, healthcare professionals can minimize the chances of complications and promote safe and successful cannulation.

After cannulating an access, placing the tape directly over the butterfly wings of the needle is important because it helps to secure the needle in place and prevent accidental dislodgement. The butterfly wings are the part of the needle that allows for easy handling and control during the cannulation process. By taping over the wings, healthcare professionals ensure that the needle remains in position and reduces the risk of complications or injury to the patient.

When the low arterial pressure alarm sounds, the staff member should investigate the circuit from the arterial needle to the blood pump. This means they should check for any possible issues or malfunctions in the connection between the arterial needle, which is used to access the patient's artery, and the blood pump, which is responsible for circulating the blood during dialysis. By examining this circuit, the staff member can identify any potential problems that may be causing the low arterial pressure alarm to sound.

When performing venipuncture, the three items of personal protective equipment (PPE) required are:

Gloves

Lab coat or gown

Safety goggles or face shield

When the high venous pressure alarm sounds, you should look from the top of the venous chamber through to the end of the venous needle to determine the cause. This means that you need to inspect both the venous chamber and the venous needle to identify the reason for the alarm. The high venous pressure alarm could be triggered by issues such as a kinked needle, a clot in the needle, or a blockage in the venous chamber. By examining both components, you can identify and address the specific cause of the alarm.

This step is crucial to identify any underlying conditions, previous vascular access issues, and current medications that might affect the procedure. It ensures that the healthcare provider can plan appropriately, minimize risks, and choose the best site for the vascular access.

When the needle is flipped after insertion, it can cause damage to the intimal lining of the vessel. Flipping the needle can disrupt the delicate inner lining of the blood vessel, leading to potential injury or damage. This can result in bleeding, hematoma formation, or even more serious complications such as thrombosis or embolism. Therefore, it is important to ensure proper technique and handling of the needle during insertion to minimize the risk of damaging the vessel's intimal lining.

The dialysis technician should immediately notify the Registered Nurse (RN) because a pulse rate of 44/min is considered bradycardia, which is abnormally slow. Even though the patient does not appear to be in distress, it is important to inform the RN so that further assessment and appropriate interventions can be initiated if necessary. Bradycardia can be a sign of underlying health issues or complications that require medical attention.

The arterial chamber must be 85%-95% full at the start of treatment. This range ensures that there is enough blood flow and pressure for the treatment to be effective. If the chamber is too full, it may lead to excessive pressure and potential damage to the arteries. On the other hand, if the chamber is not full enough, there may not be sufficient blood flow to deliver the necessary treatment. Therefore, maintaining the arterial chamber at 85%-95% full ensures optimal conditions for successful treatment.

The venous chamber should be filled 75-85% at the start of treatment. This level ensures proper functioning of the dialysis machine by maintaining adequate pressure and preventing air from entering the system. It also allows for efficient blood flow and optimal dialysis treatment. Monitoring the venous chamber helps in avoiding complications and ensuring patient safety during the procedure.

When a patient's venous needle infiltrates, it means that the needle has gone through the vein and is now outside of it. To correct this, a new needle needs to be inserted above the infiltrate site, ensuring that it goes into the vein properly. Applying ice to the area can help reduce swelling and discomfort caused by the infiltration.

The needle should be engaged while removing it from the patient's access to ensure that it is securely held in place and does not cause any damage or injury during the removal process. This helps to prevent any potential complications or accidents that may occur if the needle is not properly engaged.

The correct answer is to place the patient's arterial needle in the direction of intergrade (with the flow) or retrograde (against the flow). This means that the needle should be inserted in the same direction as the flow of blood or against the flow of blood, depending on the specific situation.

Before applying the blood pressure cuff on a new patient, it is important for the patient care technician to examine both the patient's arms for the presence of an access. This is necessary because if the patient has an access, such as a fistula or a catheter, in one arm, the blood pressure measurement should not be taken on that arm as it may interfere with the access or cause harm to the patient. By examining both arms, the technician ensures that the blood pressure measurement is taken on the appropriate arm without compromising the patient's access.

Pre-pump arterial pressure should not exceed -250 mm/Hg because this level of pressure is extremely low and can cause damage to the arterial system. Arterial pressure is the force exerted by blood against the walls of the arteries, and it is important to maintain a certain level of pressure to ensure proper blood flow and organ perfusion. Excessive negative pressure can lead to arterial collapse, decreased blood flow, and tissue hypoxia. Therefore, it is crucial to avoid exceeding -250 mm/Hg to prevent potential harm to the arterial system.

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The given answer states that any pulse rate less than 60bpm or greater than 100bpm should be reported to the nurse. This indicates that a pulse rate within the range of 60-100bpm is considered normal, while anything outside of this range may indicate a potential health issue. It is important to monitor and report abnormal pulse rates to ensure the well-being of the patient.

The available weight gain is determined by subtracting the pre-treatment weight from the estimated dry weight (EDW). This means that the EDW represents the target weight that the individual should aim for, and any weight gained beyond the pre-treatment weight up to the EDW is considered as the available weight gain.