AVF/AVG
How far should you be from a previous needle stick?
1cm or the width of your pinkie finger.
How do you pull a post lab?
Slow the pump speed down to 100 and save the setting. Wait 30 seconds. draw out of the RED port.
How early can we prepare a medication?
A medication is good for 4 hours but should NOT be prepared until the patient arrives.
What needs to be removed before wiping the station down with bleach?
All previous patients supplies and no new supplies. all counter tops and pillows also need to be wiped down.
What should you do if you find a large scab on the access?
inform the nurse and the provider. DO NOT cannulate near it. We do not want it to rupture.
What lab or tube should not be spun?
CBC/Purple tube or any tube without separator serum in it.
T/F the vial top does not need to be wiped of with alcohol since it had a cap on it.
FALSE. The cap is not a sterile seal so you still need to use an alcohol wipe.
What PPE do we currently need to be in contact with a patient?
Mask and eye protection.
Is it okay for an AVG to have an aneurysm
NO. This means that the synthetic tube used has become very thin and weak. further cannulation there could lead to a rupture. Patient may need surgical intervention.
Where do we send most of our labs and why not all of them there?
Ascend. Some patients insurance do not work with ascend and if we need results quicker we send to intermountain core lab.
What should be checked before drawing the medication?
Medication name
Medication strength
Expiration date
The patient should have their access arm wash with soap and water and then cleaned with antiseptic.
Ture. Please encourage patients to wash their access arm before sitting in their chair.
What technique helps prevent large scabs?
Ladder technique.
What test is the post lab for and why is it important?
Kt/v It gives us a value that helps us determine if the patient is receiving enough dialysis. The value needs to be 1.2 or greater.
Where do you administer medications?
You can use the medication line or the blue port. Red port is for labs.
What do you do if a patient does not show up for treatment?
Contact patient and inform them of the risks of missing treatment (hyperkalemia and fluid overload). Offer them another time if able. Tell them to go to the ER if they have any issues.
Contact provider to inform them of the no show.
Chart it with a note and in the dialysis document section.
Why should you use a tourniquet?
It stiffens and enlarges the vessel. This makes it easier to cannulate and decreases the chance of an infiltration. It is best to always use one.
Which line do you pull labs from and why?
Arterial line. If you pull from the venous line you the blood will be post dialysis and "cleaner" than the patients actual blood.
When can you scan a medication?
You must wait for the patient to arrive and the medication must be scanned before giving it. If there is an issue with scanning you must do a 2 person check before giving the medication.
What is the disaster box and where is it located?
The disaster box is an easy grab kit to help during a disaster. It has supplies that may be needed and patient contact information. It is located the the hall cupboards.