DaVita PCT Study Guide
3 skills of reflective listening - ANS - 1. Restating or rephrasing
2. deducing
3. summarizing
5 stages of grief - ANS - Denial
anger
bargaining
depression
acceptance
Air / Foam detector - ANS - Alarm causes air in blood lines
Do not return blood with air in system
Air embolism - ANS - Air bubbles enter the blood stream and are carried to a vessel
small enough to be blocked by air
Aluminum in water used for dialysis causes - ANS - Anemia, bone disease, nausea,
and vomiting
Anaphylaxis - ANS - Allergic reaction
difficulty breathing wheezing hives and itching
stop the medication and discontinue treatment and do not return blood
Arterial pressure - ANS - High alarm/ more negative causes: arterial needle clotted,
infiltrated, or poorly positioned
check needle placement, ensure lines are linked
low alarm more positive causes: separation of blood tubing from arterial access-
decrease in blood pump speed
Verify connections are secure
At what time are medications containing a preservative discarded? - ANS - 28 days
BEST TIPS (complications and prevention) - ANS - B- bleeding
E- erosion
,S- stenosis
T- thrombosis
I- infection
P- pseudo aneurysm
S- steal syndrome
Blood leak detector - ANS - Alarm causes air bubbles in dialysate
Check the dialysate connections, bleach machines
Blood loss - ANS - Dislodgment of needle, bleeding at access site, clotting
observe the patient and maintain visible access
Cardiac arrest - ANS - Call EMS
initiate CPR
return blood if possible
protect needles/ CVC
Causes of air embolism - ANS - Unarmed air detector, empty saline bags, leak or
loose connection in circuit
Causes of hypertension - ANS - Disease process, fluid overload, non-adherence with
medication, renin-angiotensin cycle
Causes of hypotension - ANS - Rapid or inappropriate fluid loss, antihypertensive
drugs, low blood volume, food ingestion, unstable cardiovascular condition
Chest pain/ angina - ANS - Decrease BFR
decrease UFR
Chlorine in water used for hemodialysis causes - ANS - Hemolysis
Chlorine/ Chloramine testing
acceptable result: - ANS - Less then or equal to 0.1 mg/l
Chlorine/ Chloramine testing
F/U if secondary test results are too high: - ANS - Stop dialysis
Chlorine/ Chloramine testing
F/U if secondary test results are within limits: - ANS - Every 30 minutes
, Chlorine/ Chloramine testing
action if results are too high post primary tank: - ANS - Repeat the test, if still too high
- move into secondary port and test *remember to notify biomes and FA*
Chlorine/ Chloramine testing
when: - ANS - R/o runs 15 mins before patient shift every 4 hours
Chlorine/ Chloramine testing
where: - ANS - After primary carbon tank sample port
Clotted dialyzer - ANS - Decrease in vp with no change in BFR, visible clots in venous
chamber or line, unable to rinse back patients blood
ensure proper use of heparin and monitoring pressures
Conductivity and pH - ANS - Alarm: dialysate is mixed incorrectly, no water, acid or
bicarbonate
intervention: recheck conductivity, place machines in bypass
Consequences of organ stunning - ANS - Heart: acute stress on the cardiovascular
system
gut: releases endotoxin into circulation
kidneys: causes fibrosis
brain: causes multiple sites with white matter injury
Convection - ANS - Solutes dragged across semipermeable membrane along with
fluid
Define Acute Kidney Injury (AKI) - ANS - term incorporates a wide spectrum of kidney
issues
includes acute kidney failure as well as less catastrophic kidney function changes
may dialyze in an out-patient facility until kidney function recovers
Definition of established AVF - ANS - prescribed BFR and max needle size for 2
months
Definition of mature AVF - ANS - intermediate teammate can cannulate, AVF is at
prescribed BFR matching needle gauge size
Definition of newly mature AVF - ANS - new fistula has post op surgical exam, meets
the rules of 6's, can be cannulated by NFACT trained teammates
3 skills of reflective listening - ANS - 1. Restating or rephrasing
2. deducing
3. summarizing
5 stages of grief - ANS - Denial
anger
bargaining
depression
acceptance
Air / Foam detector - ANS - Alarm causes air in blood lines
Do not return blood with air in system
Air embolism - ANS - Air bubbles enter the blood stream and are carried to a vessel
small enough to be blocked by air
Aluminum in water used for dialysis causes - ANS - Anemia, bone disease, nausea,
and vomiting
Anaphylaxis - ANS - Allergic reaction
difficulty breathing wheezing hives and itching
stop the medication and discontinue treatment and do not return blood
Arterial pressure - ANS - High alarm/ more negative causes: arterial needle clotted,
infiltrated, or poorly positioned
check needle placement, ensure lines are linked
low alarm more positive causes: separation of blood tubing from arterial access-
decrease in blood pump speed
Verify connections are secure
At what time are medications containing a preservative discarded? - ANS - 28 days
BEST TIPS (complications and prevention) - ANS - B- bleeding
E- erosion
,S- stenosis
T- thrombosis
I- infection
P- pseudo aneurysm
S- steal syndrome
Blood leak detector - ANS - Alarm causes air bubbles in dialysate
Check the dialysate connections, bleach machines
Blood loss - ANS - Dislodgment of needle, bleeding at access site, clotting
observe the patient and maintain visible access
Cardiac arrest - ANS - Call EMS
initiate CPR
return blood if possible
protect needles/ CVC
Causes of air embolism - ANS - Unarmed air detector, empty saline bags, leak or
loose connection in circuit
Causes of hypertension - ANS - Disease process, fluid overload, non-adherence with
medication, renin-angiotensin cycle
Causes of hypotension - ANS - Rapid or inappropriate fluid loss, antihypertensive
drugs, low blood volume, food ingestion, unstable cardiovascular condition
Chest pain/ angina - ANS - Decrease BFR
decrease UFR
Chlorine in water used for hemodialysis causes - ANS - Hemolysis
Chlorine/ Chloramine testing
acceptable result: - ANS - Less then or equal to 0.1 mg/l
Chlorine/ Chloramine testing
F/U if secondary test results are too high: - ANS - Stop dialysis
Chlorine/ Chloramine testing
F/U if secondary test results are within limits: - ANS - Every 30 minutes
, Chlorine/ Chloramine testing
action if results are too high post primary tank: - ANS - Repeat the test, if still too high
- move into secondary port and test *remember to notify biomes and FA*
Chlorine/ Chloramine testing
when: - ANS - R/o runs 15 mins before patient shift every 4 hours
Chlorine/ Chloramine testing
where: - ANS - After primary carbon tank sample port
Clotted dialyzer - ANS - Decrease in vp with no change in BFR, visible clots in venous
chamber or line, unable to rinse back patients blood
ensure proper use of heparin and monitoring pressures
Conductivity and pH - ANS - Alarm: dialysate is mixed incorrectly, no water, acid or
bicarbonate
intervention: recheck conductivity, place machines in bypass
Consequences of organ stunning - ANS - Heart: acute stress on the cardiovascular
system
gut: releases endotoxin into circulation
kidneys: causes fibrosis
brain: causes multiple sites with white matter injury
Convection - ANS - Solutes dragged across semipermeable membrane along with
fluid
Define Acute Kidney Injury (AKI) - ANS - term incorporates a wide spectrum of kidney
issues
includes acute kidney failure as well as less catastrophic kidney function changes
may dialyze in an out-patient facility until kidney function recovers
Definition of established AVF - ANS - prescribed BFR and max needle size for 2
months
Definition of mature AVF - ANS - intermediate teammate can cannulate, AVF is at
prescribed BFR matching needle gauge size
Definition of newly mature AVF - ANS - new fistula has post op surgical exam, meets
the rules of 6's, can be cannulated by NFACT trained teammates
