Infection Control
True or false:
Gloves can be worn when obtaining clean supplies.
False!
Gloves should not be worn when obtaining clean supplies.
How long should the RO system be operating for prior to drawing the total chlorine sample?
What is 15 minutes
True or false:
If unable to perform catheter dressing change before initiation of treatment, lift the dressing using clean gloves to assess the site and then leave it uncovered until you can return to the patient later on.
What is false.
You must either re-cover the site with the same dressing or replace with new dressing, never leave the catheter exit site uncovered.
What lab value can you expect to see a rise in for the following food items: Prunes, Cantaloupe, Avocados Chocolate.
What is potassium.
Patient A calls the clinic and reports of having a fever 101 F, loose stools and productive coughing. Patient denies any interactions with COVID 19 (+) or SPUIs. What category does this patient belong in?
Symptomatic PUI (sPUI) Group C
Patients with symptom(s) consistent with COVID-19 (fever ≥100° F, new SOB, new cough, sore throat, chills, fatigue, headache, muscle aches, new onset loss of taste or smell, nasal congestion or runny nose, nausea, vomiting, diarrhea) whether awaiting test results or not yet tested.
Bleach container should _____ at all times.
What is to be covered.
Bleach container and lid should be opaque to prevent weakening of the bleach solution.
True or false?
BMT should be notified immediately whenever total chlorine test results are >0.01 ppm from either primary or secondary carbon filters.
False!
BMT should be notified immediately whenever total chlorine test results are >0.1 ppm from either primary or secondary carbon filters.
Patient B recently started using his AVF with 1:1 cannulation. Patient is set to remove his right interjugular catheter in about one month. How often should the PCT/CN perform catheter dressing changes for this patient?
Dressing site changes should be every treatment.
Heparin/Sodium Citrate dwell should be every first day of the week.
True or False:
After a blood leak occurs, staff should retain the dialyzer for possible return to the manufacturer and pull out the machine for further evaluation.
False!
Staff should retain the dialyzer for quality testing purposes. Staff can resume dialysis treatment utilizing new bloodlines and dialyzer. There is no need to pull machine from service as a blood leak is failure of a dialyzer, not the machine.
_____ transient visitors are not required to wear gowns when coming into the facility and do not have a designated chair assignment.
What is vaccinated.
True or false:
Separate gloves should be worn for each patient and between stations.
What is true.
True or false?
If results for total chlorine testing from primary carbon filter indicate a level of >0.1 ppm, immediately discontinue treatments.
The test needs to be repeated from primary carbon filter to ensure the results were not "false positive".
Hemaclips should be placed on this bloodline to prevent bloodline tubing disconnection.
What is venous bloodline?
A complication in which the blood will change into a "cherry pop" color due to a low dialysate conductivity and high dialysate temperature.
What is hemolysis.
Patient B was vaccinated last month, reported of chills, fever 100 F, slight redness to catheter exit site. Patient recently came back from a vacation. What are the next steps the clinic should take?
What is notifying the Nephrologist. Blood culture and wound culture should be drawn to rule out catheter infection. Patient should call his/her PCP for orders for COVID 19 test.
Items such as stethoscopes, IV poles, thermometers should be disinfected with _____.
What is a bleach solution of 1:100
Total chlorine testing from secondary carbon filter indicates a level of 0.08 ppm. What should the clinic do in this case?
What is continue with dialysis treatments. But additional testing must be done hourly until primary carbon filters are serviced and replaced.
Apply Chloraprep swab or solution using gentle, back and forth strokes, progressing from the catheter exit site outwards for ____ and allow to dry for _____ .
What is 30 seconds.
A patient becomes unresponsive with a BP of 70/40. CN confirms no pulse and CPR is initiated. The Unit Secretary calls 911. What is the next step?
What is getting the AED and crash cart.
Which three clinics within USRC are accepting COVID 19 (+) patients?
What is Koolau, Ewa Beach and Waipio clinic
_____ should be worn when gathering, containerizing, transporting or destroying waste that has been exposed to blood or other body fluids.
What is full PPE (gloves, gown, mask, face shield).
Name the filter sizes for the RO prefilter and endotoxin filters.
RO prefilter- 5 micron
Endotoxin filters- .03 micron
Upon changing the catheter dressing for a patient, the PCT notices a slight redness and yellow drainage to the catheter site. The CN should prepare to do the following after calling the MD.
What is drawing a blood culture x2 and wound culture to rule out catheter infection?
Placing a patient on the left side in trendelenburg can trap the air in the right side of the heart and prevent which complication from occurring?
What is air embolism.
When can a Group D non symptomatic patient be released to his/her home clinic?
If NOT severely immunocompromised:
1. At least 10 days since the date of the first COVID-19 positive diagnostic test
2. No symptoms.
If severely immunocompromised
1. At least 20 days have passed since the date of the first COVID-19 positive diagnostic test
2. No symptoms have subsequently developed.
or
Two negative COVID-19 PCR or antigen tests from consecutive specimens collected ≥ 24 hours apart and no symptoms have subsequently developed.