Final CCHT Exam
Questions and Complete
Solutions Graded A+
Abscess - Answer: An abscess is an infection under the skin. It looks lika blister or pimple filled with fluid
or pus. If needles are inserted into or near an abscess, infection of a dialysis access or other tissues may
occur.
Access - Answer: An access -vascular access- is a route into the bloodstream that allows enough blood
flow for hemodialysis. For permanent access, a surgeon connects a vein to an artery.
This can be done directly - fistula- or with a piece of synthetic tubing - graft. For short term access, a
catheter may be placed in a large central vein. - Answer:
Acid - Answer: An acid is substance with a pH below 7.0 that can donate a hydrogen ion -H+. In the
human body, acids form when protein and other foods are broken down by cell metabolism.
Acquired Immunodeficiency Syndrome - AIDS - Answer:
Acute Kidney Failure - Answer: Acute kidney failure has a sudden onset. It is most often caused by an
illness, injury, or toxin that stresses the kidneys. Some patients who survive acute kidney failure can
recover kidney function. Others die or go on to develop chronic kidney failure.
Alum - Answer: Alum is an aluminum compound. It is often added to city water supplies to remove
sediment and make the water clearer.
Aluminum can build up in the bodies and brains of dialysis patients. Aluminum in dialysis water must be
kept at low levels with water treatment. - Answer:
,Aluminum-Related Bone Disease - ARBD - Answer: ARBD is cause by long-term exposure to aluminum.
Aluminum builds up in the tissues at the point where new bone forms and be seen on X-ray. Sources of
aluminum include dialysis water, medications, and cookware.
Phosphate binders with aluminum are also a source, but these are rarely used today. Symptoms of ARBD
can include deep bone pain, muscle weakness, and fractures. - Answer:
Amyloidosis - Answer: Amyloidosis occurs when aproteingcalled beta-2-microglobulin -B2M- builds up in
soft tissues, bones, and joints. The deposits can cause joint and or bone pain. High-flux membranes and
or noctournal hemodialysis remove more B2M, which may help prevent or treat this problem.
Anaphylaxis - Answer: Anaphylaxis is a fast severe immune response to an allergen. Hives, itching, or
wheezing may occur. Anaphylactic shock may cause blood pressure drop; change in heart rhythms or
arrest; and swelling of the lips, tongue, and throat. This problem can be fatal.
Anastomosis - Answer: An anastomosis is a surgical connection beteen two blood vessels. Dialysis
needles should not be inserted into the area of the anastomosis in a fistual or graft.
Adsorb - Answer: Adsorb means to attract and hold. The dialyzer membrane adsorbs blood proteins to
the walls of the hollow fibers during a treatment.
This can make reused dialyzers more biocompatible than new ones - if bleach is not used to remove the
protein coating. - Answer:
Advance Directives - Answer: Advance directives outline a patient's wishes for medical treatment in case
he or she becomes too ill to make such choices. A living will is one type of advance directive.
The patient's family and other members of the care team should be told of the patient's wishes when an
advance directive is done and given a copy to keep. - Answer:
Afferent - Answer: means toward an organ.
,Air Detector - Answer: The air - or foam detector checks blood in the venous line of the extracorporeal
circuit for air. Air in a patient's bloodstream can stop the blood flow or heartbeat, causing death.
If the detector finds air, an alarm will sound, the blood pump will stop, and the venous bloodline will
clamp to keep air from reaching the patient. - Answer:
Air Embolism - Answer: An air embolism occurs when air bubbles enter the bloodstream and flow into a
vessel small enough to be blocked by the air. The air in the vessel acts like a clot, blocking the flow of
blood.
Dialysis machines have an air detector on the venous bloodline to help prevent this problem, which can
be fatal. - Answer:
Albumin - Answer: Albumin is a blood protein. Lo serum albumin levels -<3.5 g/dL- may mean a patient is
undernourished. Malnutrition is a common in dialysis patients and raises their risk of death.
Anemia - Answer: Anemia is a shortage of oxygen-carrying red blood cells. It causes sever fatigue,
trouble with metal focus, reduced immune function, and many other problems.
Anemia is common in kidney failure due to less erythropoietin, iron deficiency, and loss of blood through
tests and dialysis itself. - Answer:
Anesthetic - Answer: An anesthetic is a drug that numbs the body to reduce pain. Local anesthetics can
be injected into a spot, such as the skin around a puncture site, before needle placement. Or, gels or
creams can be put on the skin to prevent pain at that site.
Aneurysm - Answer: An aneurysm is a ballooning or bulging of a weak spot in a blood vessel. Severe
bleeding can occur if an anerurysm ruptures, so great care must be taken with a patient who has one.
Aneurysms can occur if needles are placed too often into the small area of a fistula.
Angioplasty - Answer: Angioplasty is a procedure to open a narrowed blood vessel - stenosis. It may be
used for vascular access repair. A small balloon is threaded through the vessel into the access and gently
inflated to push the walls of the vessel open.
, Anion - Answer: An anion is a negatively-charged ion.
Antegrade - Answer: Antegrade means forward-moving. In dialysis, it means in the direction of blood
flow. The venous needle should always be placed antegrade. The arterial needle is placed antegrade or
retrograde, though there is some evidenc that antegrade is better. .
Anticoagulant - Answer: An anticoagulant is a blood-thinning drug used to keep clots from forming.
Anticoagulants, such as heperain, are used to prevent clotting in the extracorporeal circuit during
hemodialysis.
Antidiuretic Hormone- ADH - Answer: Antidiuretic hormone - ADH or vasopressin- is released by the
pituitary gland in the brain. ADH helps prevent excess fluid loss by telling healthy kidneys to reabsorb
water. ADH also tells the blood vessels to constrict - tighten.
Apical Pulse - Answer: The apical pulse is felt on the chest wall over the heart.
Apnea - Answer: Apnea is a period when breathing stops.
Arterial Pressure - Answer: In hemodialysis, arterial pressure is measured in the extracorporeal circuit
between the arterial needle and the dialyzer.
Pre-pump arterial pressure is measured from the patient's access to the blood pump. Post-pump arterial
pressure is measured after the blood pump, but before the dialyzer. - Answer:
Arrhythmia - Answer: An arrhythmia is an irregular heartbeat. It may be felt as an extra pulse or heard
over the heart.
Arterial pressure Monitor - Answer: A pressure sensor monitors pre-pump arterial pressure in the
extracorporeal circuit between the patient's access and the blood pump. A post-pump arterial pressure
monitor measures pressure beten the blood pump and the dialyzer.
If the pressure reading is outside of set limits, an alarm will sound and the blood pump will stop. -
Answer:
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