BONENT CHT flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Target spKt/V

For thrice-weekly hemodialysis the minimally adequate single-pool Kt/V is 1.2, which corresponds to a urea reduction ratio of at least 65 percent.

Urea reduction ratio formula

URR equals pre-dialysis BUN minus post-dialysis BUN, divided by pre-dialysis BUN, times 100; it estimates urea clearance as a percentage.

Dialysis disequilibrium syndrome

Cerebral edema caused by overly rapid urea removal during dialysis; risk is greatest in the first treatments and is reduced by slower blood flow and shorter early sessions.

Intradialytic hypotension criteria

A systolic pressure drop of at least 20 mmHg, or mean arterial pressure drop of at least 10 mmHg, accompanied by symptoms such as cramps, nausea, or dizziness.

Dry weight

The lowest weight a patient tolerates at the end of a dialysis session without hypovolemic symptoms or evidence of fluid overload; it sets the ultrafiltration goal.

Fistula rule of sixes

A mature arteriovenous fistula has flow of at least 600 mL/min, diameter of at least 6 mm, depth no more than 6 mm, and is usable about 6 weeks after surgery.

Carbon tank function

Granular activated carbon removes chlorine and chloramine from feed water by adsorption; total chlorine must be tested before each shift and kept at or below 0.1 mg/L.

Reverse osmosis rejection

RO membranes reject roughly 90 to 99 percent of dissolved ions, bacteria, and endotoxins; declining percent rejection indicates membrane damage or fouling.

Product water bacterial limit

AAMI and ISO standards limit water used to prepare dialysate to no more than 100 CFU/mL with endotoxin below 0.25 EU/mL.

Water softener mechanism

An ion-exchange resin swaps sodium for calcium and magnesium, preventing scale; hardness is checked daily and the resin is regenerated with brine.

Deionization limitation

Deionization removes dissolved ions but not bacteria or endotoxin, and an exhausted bed can release adsorbed ions and organics into the product water.

Ultrafiltration coefficient Kuf

Kuf is the milliliters of fluid removed per hour per mmHg of transmembrane pressure; UF rate equals Kuf multiplied by TMP.

High TMP alarm

A rising transmembrane pressure at a fixed UF goal usually signals clotting fibers, a kinked line, or inadequate dialysate flow; inspect the dialyzer and circuit.

Conductivity normal range

Dialysate conductivity is typically 13 to 15 mS/cm at 25 degrees Celsius, roughly equal to a sodium concentration of 140 mEq/L, and is verified with an independent meter.

Air detector alarm action

The blood pump stops automatically; clamp the lines and do not return any blood to the patient until the air has been removed from the circuit.

Blood leak detector

A photometric sensor in the dialysate path detects blood; it stops dialysate flow and ultrafiltration, and blood is not reinfused until the leak is excluded.

Total cell volume criterion

For dialyzer reuse, total cell volume must remain at least 80 percent of the original value; below that threshold the dialyzer is discarded.

Hepatitis B isolation rule

Patients who are hepatitis B surface antigen positive are dialyzed in a separate room with dedicated equipment because hepatitis B is the most transmissible bloodborne virus in dialysis units.

Hepatitis C precautions

Hepatitis C and HIV do not require isolation or dedicated machines; standard precautions with dedicated patient equipment and routine disinfection are sufficient.

Blood spill disinfection

Routine blood spills are decontaminated with a 1:100 household bleach dilution (about 500 to 600 ppm chlorine); gross contamination uses a 1:10 dilution.

Needlestick post-exposure steps

Wash with soap and water, report immediately, and start HIV post-exposure prophylaxis ideally within 2 hours and no later than 72 hours.

Hand hygiene indications

Perform hand hygiene before patient contact, after glove removal, after touching blood or contaminated equipment, and whenever moving between patients.

Technician scope of practice

The certified hemodialysis technician delivers treatments under RN or nephrologist supervision and does not independently diagnose, prescribe, or change the dialysis prescription.

Unsafe order decision rule

If an order or machine condition seems unsafe, stop the action, clarify with the supervising RN or physician, document the concern, and escalate through the chain of command.

Late entry documentation

Record the time the event actually occurred, add the time the note was written, label it as a late entry, and never alter or backdate the original record.

Patient confidentiality rule

Protected health information is shared only for treatment, payment, or health care operations, or when the patient authorizes release in writing.

BONENT recertification cycle

BONENT certifications are time-limited, renewed on a four-year cycle through continuing education or re-examination as required to maintain active credential status.

Conditions for Coverage

CMS regulations at 42 CFR Part 494 establish minimum health, safety, and quality requirements for ESRD facilities and are enforced through state surveys.

OSHA bloodborne pathogens standard

29 CFR 1910.1030 requires a written exposure control plan, engineering controls, personal protective equipment, training, and free hepatitis B vaccination for at-risk employees.

AAMI RD47 and RD52

AAMI RD47 addresses dialyzer reprocessing and RD52 addresses dialysate quality; the RD62 and ISO 23500 series cover water treatment for dialysis.

Teach-back method

The learner explains or demonstrates the instruction in their own words; this confirms comprehension and is preferred for patients with low health literacy.

Plan of correction

A facility's written response to survey deficiencies that states the corrective action, the person responsible, and the date the correction will be completed.