CCHT flashcards

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

Normal adult heart rate

A resting heart rate for adults is typically 60 to 100 beats per minute; report rates outside this range or a significant change from the patient's baseline.

Intradialytic hypotension signs

Symptoms include dizziness, nausea, sweating, cramps, yawning, and a systolic blood pressure drop of more than 20 mm Hg or below 90 mm Hg.

Dry weight

The target weight after dialysis that reflects the patient's estimated fluid-removed state; it is used to calculate ultrafiltration goal and is reassessed for symptoms and blood pressure.

Thrill and bruit

A palpable vibration (thrill) and audible whoosh (bruit) over an arteriovenous access indicate blood flow; their absence requires immediate notification and access evaluation.

Access arm precautions

The arm with a hemodialysis access should not be used for blood pressure measurement, venipuncture, or intravenous lines because compression or needle injury can damage the access.

Muscle cramps during dialysis

Common causes include rapid ultrafiltration, low dialysate sodium, and hypovolemia; treatment may include reducing ultrafiltration, saline, or hypertonic saline per protocol.

Post-dialysis assessment

After treatment, check weight, blood pressure, access bleeding, dizziness, cramping, and mental status; compare findings with pre-dialysis values and report abnormal changes.

Air detector function

The air detector alarms and stops the blood pump when air is detected in the extracorporeal circuit; alarms must never be bypassed or ignored.

Venous pressure alarm low

A low venous pressure alarm may indicate a disconnected venous line, needle dislodgement, or reduced blood flow; stop treatment and assess the circuit and access.

Conductivity check

Bicarbonate dialysate conductivity is typically about 13 to 15 mS/cm; verify within facility limits before connecting the patient and investigate alarms.

Transmembrane pressure

TMP is the pressure difference across the dialyzer membrane; it influences ultrafiltration and is monitored to avoid excessive pressure or membrane damage.

Ultrafiltration rate calculation

Divide the ultrafiltration goal in milliliters by the treatment time in hours to get the hourly ultrafiltration rate; compare with the prescribed and safe range.

Blood leak detector

The blood leak detector monitors dialysate for blood; it alarms and should stop or divert flow to prevent contaminated dialysate from reaching the patient.

Machine disinfection residual

After chemical disinfection, test for residual disinfectant before use according to policy; residual chemical in the dialysate pathway can cause patient injury.

Chloramine testing

Carbon tanks remove chlorine and chloramine from feed water; test treated water before each shift and after carbon backwash because chloramine can cause hemolysis.

Reverse osmosis rejection

RO membranes remove dissolved ions and contaminants; percent rejection is calculated from feed and permeate conductivity and monitored to confirm membrane performance.

Water hardness testing

A water softener removes calcium and magnesium; test hardness daily or per policy because hardness breakthrough can damage RO membranes and affect dialysate.

Dialysate bicarbonate mixing

Bicarbonate dialysate must be mixed according to manufacturer instructions, checked for conductivity and pH, and used within the facility's time limit.

Dialysate temperature alarm

Dialysate is typically warmed to about 37°C; high temperature can cause hemolysis and low temperature can cause chills, so alarms must be investigated.

Deionization tank exhaustion

Deionization tanks exchange ions but can release previously captured ions when exhausted; monitor resistivity and replace or regenerate tanks per policy.

Hand hygiene indications

Perform hand hygiene before and after patient contact, after glove removal, and after contact with blood, body fluids, or contaminated equipment.

Access site antisepsis

Clean the dialysis access site or catheter hub with an approved antiseptic and allow it to dry completely before cannulation or connection to reduce bloodstream infection.

Hepatitis B isolation

Patients positive for hepatitis B surface antigen generally require a separate room and dedicated machine in hemodialysis units; follow facility policy and vaccination recommendations.

Needlestick response

Wash the needlestick site with soap and water, report immediately, and follow post-exposure evaluation and prophylaxis protocols; do not squeeze or scrub the wound.

Blood spill cleanup

Use gloves and absorbent material, remove visible blood, then disinfect with an approved agent such as 1:10 bleach at the required contact time.

Standard precautions

Standard precautions require gloves for contact with blood or body fluids and masks, eye protection, or gowns when splashes are likely.

CCHT scope of practice

The certified clinical hemodialysis technician performs dialysis tasks under registered nurse or physician supervision and does not independently diagnose, prescribe, or change prescriptions.

Teach-back method

Teach-back asks patients to explain information in their own words; it confirms understanding of access care, diet, fluids, and medications before discharge or treatment end.

Dialysis documentation

Document pre- and post-dialysis weights, vital signs, medications, access assessment, alarms, interventions, and patient response accurately and in a timely manner.

HIPAA privacy rule

Protected health information may be shared only with authorized persons who need it for care, payment, or operations; avoid discussing patient details in public areas.

Adverse event reporting

Errors, injuries, and near misses are reported through the facility's incident reporting system promptly so risks can be evaluated and patient safety improved.

Continuing certification requirements

CCHT certification requires renewal through continuing education and adherence to certification body requirements; technicians also maintain current CPR/BLS per employer policy.