Show:
Take My Blood!
Fresenius K/K2
Water, Water, Everywhere
Tx Complications
Can I have a profile?
100
When cannulating a fistula or graft, I must first check for the __________ , by ___________ .
What is the thrill, checked by palpation?
100
To be sure that our solution is isotonic, we check this: ___________.
What is conductivity?
100
It is imperative we check the __________ tanks every 4 hours (every pt shift) to be sure the level of _______________ is below ________________.
What is carbon, chlorine/chloramines, (0.5/chlorine, 0.1/chloramine).
100
Removing too much fluid too fast can result in ______________.
What is hypotension?
100
Increased sodium levels during treatment to assist with fluid movement within the patient as well as maintaining pt's BP.
What is a sodium profile or sodium modeling.
200
Before I begin the tx for a catheter patient, I must first wash my hands, put on new gloves, remove the dwell and assess the ease of removal and flushing of the ports. The next step is to check ___________ .
What is the exit site for infection?
200
Airlock
What is what can happen if the acid and bicarbonate lines are not completely connected to the acid and bicarbonate jugs or wall connection (or the machine when txs are over).
200
The RO system and DI (if your clinic has DI) system must be checked ___________.
What is daily?
200
The patient is asymptomatic, but BP has been rechecked and remains significantly lower than the last BP taken. The next step I take is ______________.
What is to notify the RN, and perhaps put the patient on sodium profile (modeling) and MAYBE a UF profile (but make sure the rate changes to a LOWER rate as a result). Lower the goal or match the goal/turn off UF for 10 or 15 minutes.
200
Different "patterns" of fluid removal, instead of one steady, flat hourly rate of removal.
What are UF profiles?
300
25 - 30 degrees and 45 degrees
What is the angle for needle insertion for a fistula (AVF) (25 - 30), and graft (45 degrees)?
300
This measures how well the blood is flowing from the patients access to the top of the blood pump.
What is arterial pressure. (reads negative because it is "pulling" blood from the patient)
300
The clinic's dialysate delivery system (lines, pipes, tanks, and machines) must be cultured at least ______________.
What is monthly?
300
The patient is complaining of cramping or feeling light-headed/dizzy. I will __________.
What is administer 100 - 200 cc's of NS. I will open the saline line and watch the NS bag deplete this amount and then clamp the saline again (both line clamps and blue scissor clamp). Notify the RN.
300
The calculation of fluid removal per hour based on the total amount of fluid to be removed (goal) and the amount of tx time on the pt's order.
What is UF rate?
400
I begin the patient's tx, QB @ 200 ml/min, when the patient yells, "OW!". The first thing I do is ___________.
What is turn off the blood pump!
400
This measures how well the blood is flowing as the patient's blood is being sent to the dialyzer and back to the patient.
What is venous pressure. (reads in a positive number because the blood is being "pushed" back to the patient)
400
Bacteria and edotoxins must not exceed the AAMI limits of ______ and _________.
What is 200 colony forming units/CFU (bacteria), and 2 endotoxin units/EU (endotoxins).
400
The patient complains of cramping, dizziness, and within seconds "passes out" - or - when you speak to the patient, you do not get a coherent answer or they do not answer. The first thing I do is ________________.
What is YELL for help, open the saline, clamp the arterial line, turn off the UF, put the patient in Trendelenberg position. Do not administer more than 500 cc without RN supervision/instruction. RN should begin CPR, if necessary, call 911 if necessary.
400
The purpose of the UF profile.
What is to remove fluid at a higher rate at different levels throughout tx, so that the patient's body has time to refill the vascular compartment during the times the rate is at the lower levels.
500
Reinsertion of the venous needle above the first site, ice and heat alternating every 20 - 30 minutes over the first site.
What is treatment of an infiltration.
500
Dialysate will not flow when: _________________.
What is when manually put into "bypass" mode, conductivity is out of parameters, temperature is out of parameters, or when the Hansen door is open.
500
The water hardness test should reveal a hardness less than ___________
What is 1 grain per gallon (gpg)?
500
You notice that the blood in the patient's lines during tx is a darker color in the arterial line (before the dialyzer) than the color in the venous line (after the dialyzer). It appears to look like Cool-Aid. This is likely indicative of ___________.
What is hemolysis. What should you do?
500
2 liters/hour
What is the maximum amount of fluid any patient should ever have removed.