BONENT CHT common mistakes
BONENT CHT · Understand the traps and how to avoid them.
Continues the prescribed ultrafiltration rate after a patient reports cramping, nausea, and light-headedness because the systolic blood pressure is still above the unit's alarm limit.
The candidate relies on numeric alarm thresholds instead of combining vital signs with symptom assessment, so early intolerance is missed.
What to do instead
Stop or reduce UF, assess vital signs and symptoms, reposition the patient supine or Trendelenburg as tolerated, give saline per protocol, notify the RN, and resume only after reassessment.
Programs the UF goal as current weight minus target weight without verifying the prescribed goal or accounting for prime and rinseback volume.
The candidate uses a simplified weight-difference formula and does not reconcile it with the treatment order or machine-delivered volume.
What to do instead
Use the prescribed UF goal, confirm whether it already includes prime/rinseback, calculate net fluid removal consistently, and verify the machine's UF summary against the order.
Tests only free chlorine, or samples only before the carbon tanks, and concludes the carbon tanks are functioning.
The candidate confuses free chlorine with total chlorine and does not understand that chloramine breakthrough can be missed by an incomplete test.
What to do instead
Measure total chlorine at the required post-carbon sample point(s) before patient treatment and at the frequency required by policy and water-treatment standards; investigate any breakthrough before starting dialysis.
Removes gloves after patient care and leaves the station to retrieve supplies without performing hand hygiene.
The candidate thinks glove removal alone ends the contact and overlooks hand hygiene as the final step in PPE removal.
What to do instead
Perform hand hygiene immediately after glove removal and before leaving the station; use soap and water when hands are visibly soiled and alcohol-based rub when appropriate.
Draws the post-treatment BUN from the arterial sampling port immediately after stopping the blood pump, without the prescribed slow-flow wait.
The candidate memorizes the pre/post BUN formula but not the sampling procedure, so the post-BUN sample is contaminated by recirculated blood.
What to do instead
Follow the facility's validated post-BUN procedure: stop UF, reduce blood flow to the specified slow rate for the required time, then draw from the designated arterial sampling site.
Responds to a high venous pressure alarm by checking the arterial needle and arterial tubing first.
The candidate memorizes 'pressure alarm' without mapping pressure to the correct side of the circuit.
What to do instead
Treat high venous pressure as resistance after the blood pump: inspect the venous needle, venous tubing, clamps, connectors, and access; treat low arterial pressure as a pre-pump problem.
Silences and resets an air detector alarm without checking the venous chamber fluid level, tubing connections, and whether air entered the circuit.
The candidate treats alarms as nuisance interruptions rather than safety signals and may reset before identifying the source.
What to do instead
Stop the pump, inspect the venous chamber level and all connections, remove air per protocol, and never bypass the air detector; document the event and notify the RN if air entered the circuit.
After a needle infiltration, recannulates the same site at the next treatment because the swelling has resolved.
The candidate equates visible improvement with healing and does not consider vessel injury and repeat-infiltration risk.
What to do instead
Avoid the infiltrated site until approved per protocol, use an alternative site, apply and document appropriate pressure and cold/warm compresses as ordered, and notify the RN.
Answers scope-of-practice questions by describing what experienced technicians do at the clinic rather than what state law and facility policy authorize.
The candidate learns tasks by shift routine and assumes common practice defines legal scope.
What to do instead
Study the state technician scope of practice, delegation rules, and facility policies; when a task is not authorized, identify the correct escalation to the RN or physician.
Confuses OSHA bloodborne-pathogen requirements with CMS Conditions for Coverage and AAMI water-treatment standards, such as citing OSHA for dialyzer reuse or water culture frequency.
The candidate groups all regulatory and safety rules into one category instead of distinguishing worker-safety, payer/coverage, and technical water standards.
What to do instead
Separate the sources by purpose: OSHA for worker exposure control, CMS for coverage and patient-care conditions, and AAMI/standards plus manufacturer instructions for water and equipment testing frequencies.