Labs
What weekly labs do we draw? Why?
Hemoglobin- to make sure patients hemoglobin is staying stable
What blood flow do we rinse back at?
150-200
What does a patient need to sign whenever they request to leave treatment early?
Where are these located
Against Medical Advice (AMA)
Cabinet at nurses station
When sticking a fistula, which needle is the bottom?
which needle is the top?
What is the purpose of each needle
Arterial
Venous
Art.- pulls blood
Ven.- return blood
Who is responsible for citric acid?
Pod 5.
What labs do you draw with a new admit
2 sst, 2 lavenders, blue top, and a post: red tube
What is the maximum range for 17G needles
300
What PPE is required to line machines?
What should happen if you don't have PPE on when lining machines?
Gloves.
Discard lines in garbage, don PPE, and reline
At what blood pressures do you alert the nurse?
How much of a drop in blood pressure before alerting the nurse?
How many times do you readjust the cuff, if any?
>180 <90 systolic >100 or <50
20
1 time
What does the "next day setups" include?
Saline, lines, dialyzers (correct dialyzer), correct packs, correct baths, tape, hemostats, and machines flipped on the correct side for next shift.
What is the order of draw
see diagram
What is the maximum allowed blood flow rate for 16G needles?
400
What should staff and patient have on before accessing a catheter?
mask
How early can you start a patients treatment?
If you hook up later than 15 minutes, are you still within limits?
15 minutes before
No.
Who is responsible for packing labs, printing labels, and putting labs out for the next day?
Who is responsible for spinning labs?
Technically the closer but can be a team effort
Everyone!!
Correct procedure for drawing a post.
What is an acceptable Kt/v number for state and fresenius? Why is this important?
see diagram
1.4- fresenius
1.2- state
What is the maximum allowed blood flow rate for 15G needles
500
Who is responsible for sticking new accesses?
Expert cannulators
What happens when you hook a patient up backwards; Arterial to venous, venous to arterial
recirculation
Who is responsible for putting machines through acid?
Who is responsible for putting machines into bleach?
The person who closes the pod is responsible for making sure machine finishes acid clean and put into heat. Closer is responsible for making sure machines have gone through heat.
Each person is responsible for plugging machine into chemical.
When is it acceptable to not draw a post lab at the first of the month or their first treatment?
Never. Unless they're actively coding.
What happens when you rinse a patient back at a blood flow rate greater than 200?
1. Hemolysis
2. Red blood cells
3. patient feels bad
4. destroys patient access
What is the pH range of dialysate?
What is the numbers you can chart?
6.9-7.6
6.9, 7.2, 7.4, or 7.6
When should you start treatment
when blood hits the dialyzer (not when patient is in the lobby, not when sitting in the chair being hooked up, but when blood hits the dialyzer)
What is patient experience?
Sticking to the schedule of patient on times, running full treatments, correct prescriptions, clearance, and labs.