Tubes
The top of the dialysis machine is a safe place to store samples.
True or false?
False
When labeling tubes, the barcode label should be placed straight up and down directly over the manufacturer’s label.
True or false?
True
In science volumes are frequently stated in metric units.
How many liters are to a gallon?
1 gallon has 3.785 l
Name two tests that measure hemo dialysis adequacy
URR – Urea Reduction Ratio should be at least 65%
KT/V – should be at least 1.2
Thinking about home hemo patients – they process their blood at home (meaning collection to shipping)
What instrument does each patient need?
A centrifuge
Name two tube types that need to be spun
serum separator tube, SST
gold plasma separator tube, PST (post)
mint green plasma separator tube, PST
Immediately after being filled with blood, tubes should be _______________ in order to adequately mix the blood and tube additive.
a) inverted gently 5-10 times, b) shaken
c) placed on dialysis machine, d) placed in the lab coat pocket
a) invert gently for 5-10 times
To prevent heparin interference and possible dilution, how many milliliters (mL) of blood should be drawn and discarded from each port of the Central Venous Catheter prior to specimen collection?
a) 3 ml, b) 5-8 ml, c) 10 ml, d) 20 ml
b) 5-8 ml
Why is it necessary to monitor potassium (K+)?
A potassium level that is too high or too low may weaken muscles and change your heartbeat. If the levels are high enough, it may cause your heart to stop altogether. (Target 3.5-5.5 mEq/L for dialysis patients)
Centrifuge – to what do you need to pay attention when loading a centrifuge?
The load needs to be balanced
The following tubes should be refrigerated immediately after collection:
a) light blue, b) lavender, c) royal blue
d) all of the above, e) non of the above
d) all of the above
SSTs should be placed upright to stand for _______________ minutes prior to spinning to allow for proper clot formation.
a) 5-10, b) 10-20, c) 30-60, d) 60-90
c) 30-60
Educated guess: how many liters are being filtered by healthy kidneys in a day?
a) 30-50, b) 80-100, c) 140-160, d) 200-250
c) 140-160 liters
In kidney patients what vitamin does not get activated?
Consequence - calcium does not get absorbed from the intestines.
Vitamin D
Renal Technologies sells AquaBplus, a reverse osmosis purification system.
They are advertising one major advantage. What is it?
Reduce water waste by up to 50%.
Which of the following tests require a lavender top tube specimen (select all that apply)?
a) CBC, b) Hemoglobin A1c, c) iPTH, d) BUN
a. CBC
b. Hemoglobin A1c
d. iPTH
Re-spinning a specimen that has already been spun can often correct which specimen condition?
a) hemolysis, b) incomplete separation, c) partially filled tube, d) all of the above, e) non of the above
b) incomplete separation
How many liters of water are hemodialysis patients exposed to per week?
a) 50-100, b) 100-300, c) 300-600, d) 600-750
c) 300-600 liters
Why and when is BUN measured during dialysis treatment?
BUN is measured pre- and post-dialysis dialysis t measure dialysis adequacy and should be at least 65%
Example: If the initial, or pre-dialysis, urea level was 50 mg/dL and the post-dialysis urea level was 15 mg/dL, the amount of urea removed was 35 mg/dL = 70%
Think nutrition - Renal Technologies advertises Optiflux Dialysers by having which advantage?
Albumin can be lost during dialysis treatment – albumin sparing design limits albumin loss
Using numbers, indicate the order in which you should draw the following tubes:
__ lavender, __light blue, __ serum separator tube (SST)
3 lavender
2 light blue
1 serum separator tube
If an SST or PST specimen has pink or red colored serum or plasma after centrifuging, this is an indication of:
a) incomplete separation, b) hemolysis
c) fibrin in serum, d) inadequate clotting time
b) hemolysis
Water quality for dialysis treatment use is regulated by whose recommendations? (pick 2)
a) FDA
b) U.S. Environmental Protection Agency (EPA) drinking water standards under the Safe Drinking Water Act (SDWA)
c) Association for the Advancement of Medical Instrumentation (AAMI)
b) U.S. Environmental Protection Agency (EPA) drinking water standards under the Safe Drinking Water Act (SDWA)
c) Association for the Advancement of Medical Instrumentation (AAMI)
What is the test to evaluate PD efficiency?
The peritoneal equilibration test—often called the PET—measures how much dextrose has been absorbed from a bag of infused dialysis solution and how much urea and creatinine have entered into the solution during a 4-hour dwell