RRB Dialysis Technician flashcards
RRB Dialysis Technician · Build recall with a focused review session.
32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Nephron functional unit
- The nephron is the kidney's functional unit, consisting of a glomerulus for filtration and a tubule for reabsorption and secretion; each kidney has about one million.
- Juxtaglomerular apparatus
- Structure where the distal tubule macula densa contacts afferent arteriole juxtaglomerular cells; it senses NaCl and secretes renin to regulate GFR and blood pressure.
- GFR CKD staging
- CKD is staged by GFR: G1 ≥90, G2 60–89, G3a 45–59, G3b 30–44, G4 15–29, G5 <15 mL/min/1.73 m².
- Erythropoietin source
- Peritubular interstitial fibroblasts in the renal cortex produce erythropoietin in response to hypoxia; loss in CKD causes normocytic anemia.
- Convection versus diffusion
- Diffusion moves solutes down a concentration gradient; convection drags solvent and solutes across the membrane during ultrafiltration, clearing middle molecules.
- Kt/V target
- Kt/V quantifies urea clearance (K × time divided by urea distribution volume); target spKt/V is at least 1.2 per session for thrice-weekly hemodialysis.
- Urea reduction ratio
- URR = (pre-dialysis BUN minus post-dialysis BUN) divided by pre-dialysis BUN times 100; target is at least 65% for thrice-weekly hemodialysis.
- Fistula thrill and bruit
- A healthy arteriovenous fistula has a palpable thrill and audible bruit; loss of thrill or a high-pitched bruit suggests stenosis and requires evaluation.
- Access arm precautions
- The arm with a fistula or graft must not be used for blood pressure cuffs, venipuncture, or IV lines; protect it from pressure and injury.
- Cannulation angle
- For AV fistula or graft cannulation, insert the needle bevel up at about 25–35 degrees; flashback confirms entry into the lumen.
- Carbon tank purpose
- Carbon tanks remove chlorine and chloramine from feed water; test before each shift because breakthrough can cause hemolysis in patients.
- Reverse osmosis function
- Reverse osmosis forces water through a semipermeable membrane, removing most dissolved ions and contaminants; conductivity monitors membrane performance.
- Dialysate conductivity
- Conductivity measures the total ionic concentration of dialysate; abnormal readings indicate incorrect mixing and require correction before treatment.
- Air embolism response
- Stop the blood pump, clamp lines, place the patient in Trendelenburg and left lateral decubitus, give 100% oxygen, and call for emergency help.
- Intradialytic hypotension
- A symptomatic systolic drop of at least 20 mmHg or systolic below 90 mmHg during dialysis; reduce ultrafiltration, reposition, and give saline per order.
- Hemolysis signs
- Dark blood in lines, chest or back pain, dyspnea, and hypotension suggest hemolysis; stop dialysis, do not return blood, and check dialysate.
- Dialyzer reaction type A
- Anaphylactic reaction within minutes of starting dialysis with dyspnea, hypotension, and flushing; stop, do not return blood, and treat per protocol.
- Hand hygiene priority
- Hand hygiene before and after every patient contact and after glove removal is the single most effective measure to prevent dialysis unit infections.
- Hepatitis B isolation
- HBsAg-positive hemodialysis patients require a separate room and dedicated machine per CDC guidance; vaccinate patients and staff against hepatitis B.
- Catheter care bundle
- Catheter care includes hand hygiene, maximal barrier precautions, chlorhexidine antisepsis, sterile dressing, and daily review of catheter necessity.
- Dry weight definition
- Dry weight is the post-dialysis weight at which the patient has no excess fluid or edema and remains normotensive; reassess regularly.
- Phosphate binder timing
- Phosphate binders such as calcium acetate or sevelamer must be taken with meals to bind dietary phosphate and reduce absorption.
- Interdialytic weight gain
- Weight gained between treatments reflects fluid intake; target is usually no more than 2–3 kg or about 4–5% of dry weight.
- Protein intake targets
- Hemodialysis patients need about 1.0–1.2 g/kg/day of protein; peritoneal dialysis patients need about 1.0–1.3 g/kg/day.
- Treatment documentation
- Record pre-, intra-, and post-dialysis vitals, weights, machine settings, alarms, interventions, and patient response for every session.
- Chlorine test frequency
- Test feed water for chlorine and chloramine before each shift and after carbon tank changes; document results and take corrective action if limits are exceeded.
- QAPI purpose
- Quality Assessment and Performance Improvement reviews clinical indicators, identifies trends, implements corrective plans, and documents outcomes to improve care.
- Two patient identifiers
- Before any procedure or medication, verify identity using two identifiers, such as full name and date of birth, per safety policy.
- Informed consent elements
- Informed consent requires explaining the procedure, risks, benefits, and alternatives, confirming understanding, and documenting voluntary agreement.
- Speak-up culture
- Any team member who perceives a patient safety risk has the authority and duty to stop the procedure and escalate the concern.
- Buttonhole cannulation
- Buttonhole technique uses the same needle track repeatedly with blunt needles; it requires strict aseptic technique to prevent access infection.
- Recirculation assessment
- Recirculation measures dialyzed blood returning to the dialyzer; elevated values suggest access stenosis or inadequate needle placement.