CHBT case studies
CHBT · Put your knowledge to work in context.
The Certified Hemodialysis Biofeedback Therapist (CHBT) credential is aimed at clinicians who combine two skill sets: a working command of the hemodialysis treatment environment and the ability to deliver biofeedback and relaxation training to patients during or around dialysis sessions. Candidates are typically nurses, dialysis technicians, and allied practitioners who want to help patients manage treatment-related distress, discomfort, and physiological arousal using structured psychophysiological techniques. The exam is multiple choice and spans six domains: renal physiology and hemodialysis fundamentals; biofeedback principles and psychophysiology; modalities and instrumentation; application during dialysis sessions; patient assessment, symptom management, and relaxation training; and professional practice, safety, and ethics. Because the domains are weighted, the two largest areas - fundamentals and session application - deserve the most preparation time, but the ethics and safety domain is easy to under-study and often carries scenario questions. The CHBT case studies are 5 cases and about 1,963 words.
1Intradialytic Hypotension with a Trained Biofeedback Patient
R, 68, has been on in-center hemodialysis for 3 years (3 sessions/week, 4 hours each, dialysate sodium 138 mEq/L, ultrafiltration goal 3.2 L). He has completed 12 sessions of heart-rate variability (HRV) biofeedback and can reliably raise his LF/HF ratio on command.
460 words, about 2 min2Cannulation Pain and a Patient Who Wants to Skip Biofeedback
L, 41, has been on hemodialysis for 8 months and reports needle pain rated 7/10 at each cannulation. She has a documented history of generalized anxiety and takes no anxiolytics.
406 words, about 2 min3Respiratory Biofeedback in a Patient with Fluid Overload
K, 57, has heart failure and is on hemodialysis. He is 4.1 kg above his estimated dry weight, has bibasilar crackles, 2+ pitting edema, and a resting respiratory rate of 26/min.
366 words, about 2 min4A Patient Asking for Biofeedback to Lower Potassium
D, 52, has been on hemodialysis for 1 year. His most recent pre-dialysis potassium was 6.1 mEq/L.
350 words, about 2 min5Declining Cognition and Consent for Biofeedback
S, 79, has been on hemodialysis for 2 years. Over 3 months her daughter reports increasing forgetfulness; Mrs.
381 words, about 2 min