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An overview of the key topics covered in a dialysis technician exam, with a focus on infection control and the dialysis delivery system. It covers the main ways diseases can spread in a dialysis clinic, the importance of aseptic technique, the components of the extracorporeal circuit, the role of dialysate, and the safety features of the dialysis delivery system. The document also touches on topics like electrolytes, bypass mode, ph, and ultrafiltration. This comprehensive information could be useful for dialysis technician students or those preparing for the dialysis technician exam, as it covers the essential knowledge required for this role.
Typology: Summaries
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Infection is the second most common cause of death in hemodialysis (HD) patients. Pathogens can enter the body through a break in the skin, a mucous membrane, or the lungs. There are three main ways diseases can spread: direct contact, indirect contact, and droplet spread. In a dialysis clinic, pathogens can be spread by patients, baths, visitors, equipment, water, dialysate, and air.
Direct contact refers to touching an infected person, such as shaking hands or kissing. Indirect contact occurs when we touch objects like dialysis chairs, patient charts, blood pressure cuffs, IV poles, and treatment carts. Droplet spread happens when we breathe in droplets that were coughed or sneezed by an infected person.
Aseptic technique refers to being free from disease-causing germs. Clean means not free from germs, but disinfected and usable for some steps in the treatment. Contaminated means a sterile or clean object was touched by a non-sterile object. Dirty means neither clean nor sterile.
Basic guidelines for aseptic technique include: - Packages are sterile only if the package is closed and sealed. - Wash hands before touching a package containing a sterile item. - Keep sterile packages dry. - A contaminated object can contaminate a sterile one. - Scrub the rubber stopper of a multi- dose vial with disinfectant before use. - All fistula needle syringe tips and needles used to give medications or draw blood must be sterile.
Dialysate is made up of RO water, acid concentrate, and bicarbonate concentrate. The extracorporeal circuit includes the dialyzer, bloodlines, monitoring lines, heparin line, and transducer protector.
Priming removes air and germicide from the bloodlines and dialyzer. During recirculation, ultrafiltration and diffusion help "dialyze off" any remaining germicide.
A bruit is a buzzing or swooshing sound caused by the high-pressure flow of blood through a patient's fistula or graft. If alarms for conductivity, pH, or temperature are working, the machine will go into bypass mode, stopping the flow of fresh dialysate to the dialyzer.
Empty bed contact time (EBCT) is the amount of time feedwater must stay in contact with a charcoal bed to remove chlorine and chloramines.
Electrolytes, such as sodium, potassium, magnesium, chloride, and calcium, send electrical signals along the nerves and muscles, including the heart.
The hemodialysis delivery system has two major subsystems: the dialysate delivery system and the extracorporeal blood circuit. The delivery system mixes and monitors the dialysate, pumps and monitors the patient's blood, and has alarms to protect patient safety.
Safety features include monitoring venous and arterial pressure, blood leaks, patient blood pressure, and dialyzer clearance. A bruit and thrill can indicate access issues.
Transmembrane pressure (TMP) is the pressure difference across the dialyzer membrane, which must be higher on the blood side to prevent dialysate from moving into the bloodstream.
Ultrafiltration is the process by which the kidneys remove water from the glomerular filtrate, with only about 1% becoming urine. The kidneys also remove wastes, maintain water and electrolyte balance, control blood pressure, maintain acid-base balance, and produce hormones.
Conditions mentioned include parathyroid hormone (PTH) imbalance and polycystic kidney disease (PKD). Transferrin saturation (TSAT) is a measure of iron storage.
Charcoal hemoperfusion is used to treat drug overdoses. There are two types of ultrafiltration systems: volumetric UF control and flow control.