2013 Dialysis Tech Study Guide PDF

Dialysis Technician Examination: Study Guide
Review Basic Safety and Infection Control, National Patient Safety Goals, and Pain Management.
Review important aspects of assessment in the hemodialysis setting, including:

Absence of bruit indication of thrombosis of AV fistula
Conductivity alarm, pump continues to operate
Determine direction of blood flow before cannulating loop access: Stop blood flow by pressing a finger
on the anastomosis and feeling the pulse on the arterial side.
High venous pressure reading, assess the venous access site
Symptoms of hypercalcemia: anorexia, weakness; patient who takes paracalcitrol (Zemplar®)
Symptoms of air in line: coughing, labored breathing, air in dialyzer
Symptoms of dehydration: post-dialysis weight=EDW, hoarse voice, hypotension, ears popping, cramps
in legs
Symptoms of infection at catheter site, tenderness, swelling, discharge
Monitor ultrafiltration to minimize intradialytic hypotensive symptoms
Review action, preparation, monitoring, and precautions related to medications commonly used in dialysis,
such as
Epoietin alfa (Epogen®), calculate mL dose from order in units
Epoietin alfa (Epogen®), high H/H: reduce dose and check Hct at next blood draw
Heparin, protocol; used to prevent thrombus formation; calculate mL dose from order in units
Insulin sliding scale
IV drops per minute calculation
Ondansetron (Zofran®), treating nausea and vomiting during dialysis
Paracalcitrol (Zemplar®), symptoms of hypercalcemia
Review important actions in the dialysis setting, including

Angle of insertion for cannulating AV fistula
Cannulation, apply tourniquet tightly enough to engorge the vessel
15-gauge needle, 350 mL/min = recommended gauge and flow for hemodialysis
Minimize recirculation by placing needles 1.5 – 2 inches apart
Use of normal saline as initial approach to manage muscle cramps during dialysis
Treat hypotension during dialysis with bolus of normal saline and reducing ultrafiltration rate
Point venous needle in direction of venous return
Difficulty cannulating, seek assistance from more experienced staff member
If chlorine/chloramine found in testing, report to person responsible for water treatment system
Symptoms of dehydration, anticipate adjusting estimated dry weight
Symptoms of infection at catheter site, report and expect: culture discharge and draw blood for culture
Symptoms of air in line, clamp venous blood line and stop the blood pump
Review principles and practices related to safety and infection prevention, including
Patient identifiers
Use of handwashing rather than sanitizer when patient has C. diff
Technician and patient wear mask during dressing change at venous catheter site
Place cap on, or syringe, in the catheter lumen
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Updated 2013
Dialysis Technician Examination: Study Guide
Review principles and practices of communication with patients and family, including
Patient satisfaction
Avoid getting exit site wet
Reason for rotating sites
Feel for a thrill at the access and call unit if none is felt
Potassium content high in bananas and spinach
First dialysis – recognize and report symptoms of adverse reactions
Never use arm with access for taking blood pressure
Avoid eating immediately before or during dialysis to recue likelihood of muscle cramps and
hypotension
Review troubleshooting practices, including

High venous pressure alarm = venous chamber is clotted
High transmembrane pressure during dialysis = clotted dialyzer
Low transmembrane pressure at start of dialysis=transducer flooded with saline during priming
High arterial pressure = kinking of blood line between patient and monitoring site
Slow blood pump to correct high negative arterial pressure
Blood leak detector alarm = rupture of dialyzer membrane
Dropping conductivity, check bicarbonate and acid bath levels
Review dialysis standards, including

Adequacy of hemodialysis = spKt/V greater than 1.2
Standard for microbial content of water = 6.8 – 7.6
Recommended dialysate pH = 6.8 – 7.6
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Dialysis Technician Examination: Study Guide

Review important aspects of assessment in the hemodialysis setting, including:

Review important actions in the dialysis setting, including

Review troubleshooting practices, including

Review dialysis standards, including

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