CCHT-A key terms

Removal of fluid from the blood across the dialyzer membrane by a pressure gradient; the rate is set to reach the prescribed target weight.

The pressure difference across the dialyzer membrane that drives fluid removal; calculated from dialysate and blood compartment pressures and adjusted to achieve the ordered fluid removal.

A measure of dialysis dose that compares clearance (K) times treatment time (t) with the urea distribution volume (V); higher values indicate more urea removed.

The percentage drop in blood urea nitrogen from before to after a treatment; a simpler adequacy indicator than Kt/V that is used at the chairside.

A surgically created connection between an artery and a vein in the arm that provides high blood flow for dialysis; preferred access because it lasts longest and has fewer infections.

A synthetic tube implanted to connect an artery and vein for dialysis access, used when native vessels are unsuitable; it requires needle cannulation and carries higher infection and clotting risk than a fistula.

A catheter placed in a large central vein, often the internal jugular, with an external hub used for dialysis; associated with higher infection risk and lower blood flows than fistulas or grafts.

A device containing thousands of hollow fibers that acts as an artificial kidney, allowing wastes and fluid to move from blood into dialysate while retaining blood cells and proteins.

A fluid made by mixing purified water with concentrate that flows past the dialyzer membrane; its electrolyte and bicarbonate content is set to correct the patient's blood chemistry.

The estimated body weight at which a patient is believed to have neither too much nor too little fluid; used to set how much fluid is removed each treatment.

A drop in blood pressure during dialysis, often with symptoms such as dizziness, nausea, cramping, or sweating; commonly caused by fast fluid removal.

A neurological reaction to rapid removal of urea, causing headache, nausea, confusion, or seizures; prevented by slower initial treatments and gradual solute removal.

Air entering the bloodstream, often through a loose connection or an open catheter, which can block blood flow to the heart or brain; a medical emergency.

Breakdown of red blood cells that can occur from chemical or mechanical causes during dialysis, producing dark blood, back pain, and anemia; the treatment must be stopped.

Return of already-dialyzed blood from the venous line back into the arterial needle, reducing treatment adequacy; often caused by poor needle placement or access stenosis.

Repeatedly inserting needles into the same site to create a tunnel track in a fistula, which can reduce pain but requires strict hygiene to prevent infection.

An anticoagulant given during dialysis to prevent blood from clotting in the extracorporeal circuit; the dose is adjusted to the patient's clotting risk.

Cleaning and testing a dialyzer so it can be used more than once for the same patient; requires labeling, volume testing, and monitoring for residual disinfectant.

A water purification process that forces water through a semipermeable membrane to remove dissolved salts, bacteria, and other contaminants; a key step in making dialysis water.

Passing water through activated carbon to remove chlorine, chloramines, and organic material that would otherwise damage the dialyzer membrane or harm the patient.

An ion-exchange tank that replaces calcium and magnesium in feed water with sodium to protect the reverse osmosis membrane from scale.

An ion-exchange process that removes charged minerals from water, producing very pure water; used together with reverse osmosis and monitored for exhaustion.

A test of treated water or dialysate for chlorine and chloramine; must show zero before a treatment because these chemicals can cause hemolysis.

A measure of the electrical current carried by ions in dialysate, used to check that water and concentrate are mixed in the correct ratio.

The standard dialysate made by combining an acid concentrate with a bicarbonate concentrate and purified water; mixed just before use because it can support bacterial growth.

A filter placed in the dialysate line that removes bacteria and endotoxins, improving dialysate purity and reducing inflammation in patients.

Industry limits for contaminants such as bacteria, endotoxin, and chemicals in dialysis water and dialysate; facilities test and document compliance.

A daily limit on how much a patient drinks, taught to control weight gain between treatments and reduce cramps and low blood pressure during dialysis.

Medications taken with meals that bind phosphate in food so it is not absorbed; used to control high phosphate in kidney failure and protect bones and blood vessels.

A teaching method in which the patient explains or demonstrates what was taught in their own words, allowing the educator to confirm understanding and correct gaps.

Patient behaviors that protect the access, such as checking the thrill, keeping the site clean, avoiding pressure or blood draws on that arm, and reporting redness or bleeding.

A person's ability to obtain and understand basic health information needed to make decisions; low literacy requires simpler language, pictures, and repeated teaching.

Following the prescribed dialysis schedule, diet, fluid limit, and medications; missed treatments and skipped medicines raise the risk of hospitalization and death.

Cleaning hands with soap and water or alcohol-based rub at key moments, especially before and after patient contact and before access cannulation; the single most effective infection prevention step.

Infection control practices used for every patient, including gloves, gowns, masks, eye protection, and safe handling of sharps and body fluids.

The series of steps needed for an infection to spread: a germ, a reservoir, a way out, a mode of transmission, a way in, and a susceptible person; breaking any step prevents infection.

An ongoing team approach to find, measure, and fix problems in care processes, using data to test changes and track whether outcomes improve.

A rapid improvement method with four steps: plan a change, try it on a small scale, study the results, and act on what was learned.

The tasks and decisions a technician is legally allowed to perform under state law and facility policy, such as cannulation but not prescribing treatment.