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CCHT STUDY SCRIPT 2026 COMPLETE
GRADED A+
โ Dialysis surfaces must be disinfected with what solution? Answer: 1:100 bleach solution โ Large blood spills over 10ml must be disinfected with what solution? Answer: 1:10 bleach solution โ What is Aseptic technique? Answer: Practices and procedures performed under carefully controlled conditions. Minimizing contamination by pathogens. โ When sterile meets sterile.. Answer: It remains sterile โ When sterile meets clean.. Answer: It becomes clean โ When sterile or clean meet dirty.. Answer: It becomes dirty โ PPE Answer: Personal Protective Equipment. Full face shield or mask, eyewear with full side shield, and fluid-resistant gowns and gloves. โ 3 blood borne pathogens that may be found in a dialysis unit Answer: Hepatitis B, Hepatitis C, and HIV
โ What is an exposure incident? Answer: A bloody/body fluid splash/spray occurring to the eyes nose or mouth, or non-intact skin. โ What steps should you take if you have been exposed to the fluids? Answer: Wash/rinse immediately. Report to CM. Seek medical treatment. โ What is hepatitis? Answer: Inflammation of the liver due to various causes โ How can the viral form of hepatitis be spread? Answer: Hep A- via contaminated food and the oral-fecal route Hep B & C- via exposure to blood/body fluids โ Why are patients with Hep B dialyzed in isolation room? Answer: Extremely contagious, lives outside the body for extended periods. (up to 7 days) โ Why do we dialyze Hep C patients in the clinical area? Answer: Not as contagious as Hep B. HCV is not known to survive very long outside the body โ What blood test indicates infection with Hep B? Answer: HbsAg test for Hep B antigen, indicates actual viral presence.
should be worn. CVC dressings should be disposed of in red BIO. DO NOT need isolation. Hands should be washed for 40-60 seconds. โ What is C-Diff? Answer: Clostridium difficile, hand washing is required. โ Why is hand hygiene important? Answer: Single most important infection control measure to prevent the spread of infection. โ What are the anatomical structures of the urinary system in order of urine flow? Answer: 2 kidneys, 2 ureters, 1 bladder, and 1 urethra โ What are the functions of a healthy kidney? Answer: Removal of waste products (creatinine, urea, and uric acid). Regulate fluid, acid base, and electrolytes. โ What is urea? Answer: By-product of protein metabolism โ What is creatinine? Answer: By-product of muscle metabolism โ Uric acid Answer: Naturally in the body, as a result of the metabolism of purine (muscle protein) that enters the body through dietary intake. โ What are the hormonal functions of the kidneys? Answer: Production of renin to help regulate/control BP, production of
erythropoietin (stimulates RBC production), and regulation of calcium/phosphorus balance through the activation of Vit D. โ What is the nephron? Answer: Functional unit of the kidney. Tubular structure, filters blood to form urine. โ What is the glomerulus? Answer: Network of capillaries that performs the first step of filtering blood. Filters water and solutes into Bowman's capsule. โ What are the hormones secreted by the kidney? Answer: Renin and Erythropoietin โ Which of the functions of healthy kidneys can be replaced by dialysis? Answer: Removal of waste products and regulation of fluid balance. โ What is the function of renin? Answer: Hormone produced by the kidneys to regulate blood pressure, and on sodium and potassium balance. โ What is the function of erythropoietin? Answer: Stimulates the bone marrow to produce RBC. โ What is the synthetic form of Erythropoietin? Answer: Recombinant Epoetin Alfa (Epogen)
โ What is the purpose of a phosphate binder? Answer: Binds with phosphorus (from foods) in the gut, and then eliminates the excess phosphorus through the digestive system. โ What are Hectoral, Calcijex, and Zemplar? Answer: Helps patients absorb their dietary calcium in order to bone disease. โ What is anemia? Answer: Lack of RBC โ How is anemia treated? Answer: Epogen is a medication given to stimulate RBC production an keep the patients hemoglobin levels at an acceptable level. โ What is the desired hemoglobin level for dialysis patients? Answer: 10 - 11 g/dL โ How is hypertension treated? Answer: Dialysis treatment removes excess fluid which is a contributing factor or hypertension. Antihypertensive medications may be prescribed for patients โ What is Diabetes? Answer: A disease in which the body either does not produce or does not properly use insulin and therefore cannot properly regulate levels of glucose in the blood โ What are 3 s/s of low blood sugar? Answer: Double vision, hunger, thirst, restlessness, rapid pulse, confusion, seizures, and coma.
โ Intracellular Answer: Inside the cell โ Extracellular Answer: Outside the cell โ Intravascular Answer: Inside the blood vessel โ Interstitial Answer: Between the cells โ What is homeostasis? Answer: Steady internal state of equilibrium in the body. โ What are electrolytes? Answer: Charged particles that can conduct an electrical current. Control motor, muscle, and nerve function. โ What is pH? Answer: The measure of acidity or alkalinity of solution, based on the number of acid ions. โ What is the normal pH of blood? Answer: 7.35-7. โ What is bicarbonate? Answer: A buffer that helps to maintain a constant pH in a solution even if a acid or base is added. โ What is metabolic acidosis? Answer: The state of too much acid in the blood
โ What is dialysate? Answer: Non-sterile solution, composed of purified water, acid solution, and bicarbonate solution. โ What is the function of dialysate? Answer: To remove waste products from the blood and balance electrolytes. โ What electrolytes are found in the dialysate? Answer: Sodium (NA), potassium (K), calcium (Ca), magnesium (Mg), and chloride (Cl) โ Why is dextrose added to dialysate? Answer: To prevent hypoglycemia โ What is the purpose of checking dialysate? Answer: To verify that the dialysate is compatible with human pH โ When should conductivity and pH be checked? Answer: Manually prior to the ignition of every treatment โ What are normal ranges for temperature? Answer: 35-39 C โ What are normal ranges for pH? Answer: 6.9-7. โ What are normal ranges for conductivity? Answer: 12.6-15.
โ Why do we use biocompatible membranes in the dialyzer? Answer: Closely related to the cells and tissues of the human body, less likely to cause allergic reaction โ What are some factors used in the selection of a dialyzer for a patient? Answer: Body size, clearance needs, ultrafiltration needs and membrane biocompatibility. โ What are the compartments of the dialyzer? Answer: 1) Blood compartment
- Dialysate compartment โ What separates the 2 compartments? Answer: The blood compartment is separated from the dialysate compartment by a semi- permeable membrane. โ What is a semi-permeable membrane? Answer: A membrane made from protein, with small pores or holes. Only certain molecules can fit through. โ What should be checked on a dialyzer before machine set up? Answer: Checked for sterility, structure damage, and be the size and brand ordered by the Dr โ How is dialysis delivered? Answer: The Hemodialysis Machine.
โ What direction does blood flow through the dialyzer as compared to dialysate flow? Answer: Blood and dialysate flow in a countercurrent flow. โ What is TMP? Answer: Transmembrane pressure, the pressure difference across the dialyzer membrane. โ How can you tell if a dialyzer is clotting? Answer: Rising TMP, rising venous pressure, dark blood in dialyzer, and air detector alarms. โ What is heparin? Answer: Anticoagulant that prevents clotting โ After heparin is given, how long must you wait before initiating treatment? Answer: 3-5 minutes โ When do you not give a patient heparin? Answer: 1) Allergic to it
- Actively bleeding
- Scheduled for surgery/Post surgery โ For how long can a patients blood be re-circulated during treatment interruption? Answer: 15 minutes, longer than 15 minutes blood needs to be given back โ 1 kg = Answer: 2.2 lbs
โ What does "estimated dry weight" mean? Answer: Estimated weight of the patient without any s/s of edema โ What is adequacy of dialysis? Answer: Measurement of how well we are cleaning waste from the patients blood โ How can we measure how well we clean our patients blood? Answer: By measuring the amount of waste in the patients blood before and after dialysis. โ Clearance of urea is best described as? Answer: The amount of urea cleared from the blood in milliliters per minute (ml/min) โ What improves clearance of urea? Answer: Well-functioning access, proper priming, dialysate flow, blood flow, heparin โ Why is measuring the adequacy of the dialysis treatment important? Answer: When treatment is more effective, patients live longer and have fewer health problems. โ What does Kt/V stand for? Answer: An equation used to determine how well dialysis is occurring. K=Clearance, t=time, and V=total volume of waste in the patient โ What is OLC? Answer: On Line Clearance, measures removal of waste from the bloodstream.
โ What are disadvantages of an AV graft? Answer: More likely to clot off, more prone to infection over AV fistula, tend to bleed longer at end of treatment, and do not last as long โ Why should needle sites be rotated? Answer: To prevent weakening of the vessel walls and to prevent the formation of aneurysms and scar tissue โ What is an infiltration? Answer: Fluid seepage into the surrounding tissue resulting in pain and swelling. โ What are s/s of infection? Answer: Chills, fever, drainage and pain. Warmth at the site โ What blood pump speed is required for access flow testing? Answer: 300 ml/min โ What is a good access flow reading? Answer: Greater than 600 for grafts Greater than 400 for fistulas โ Why is it important to determine which side is arterial and which side is venous? Answer: If needles are connected the wrong way recirculation will prevent the clearance to deliver an adequate treatment
โ Explain how to clean the patients skin in preparation for needle insertion. Answer: Cleansed with betadine/alcohol pad in circular motion for 30 seconds. Dry 3-5 minutes for betadine. โ What insertion angle should I use for cannulation? Answer: Bevel up - AV graft 45 degree angle - AV fistula 20-30 degree angle โ What direction should the needles be placed for optimal dialysis? Answer: Arterial needle can go with or against the flow, Venus needle must be placed in the direction of the flow of blood โ What is steal syndrome? Answer: Caused by excess arterial blood being shunted into the venous circulation through the anastomosis. Reduction of blood flow to the extremity. โ How can poor flow from a catheter be managed during the treatment? Answer: Lowering pts head or having the pt move from side to sie can improve flow. Asking to cough. Reversing is LAST resort โ What causes hypotensive episodes? Answer: Most common complication during dialysis, too much fluid is removed too fast. โ What are s/s of hypotension? Answer: Low bp, yawming, sweating, nausea, vomiting, increased pulse.
โ What are air embolism? Answer: Empty IV/NS bag and unclamped IV line - Air leak in blood lines - Air detector not alarmed - Loose connections or separation of blood lines. โ Treatment steps for treating an air embolism Answer: Call for help. COLT. C-Clamp O-Off blood pump L-Left Side T-Trendelenberg โ What is hyperkalemia? Answer: High serum potassium level. โ What is anaphylaxis? Answer: Severe allergic reaction resulting in anaphylactic shock. โ Define pericarditis Answer: An inflammation of the membrane that surrounds the heart due to fluid an waste build up โ What is a pyrogenic reaction? Answer: A reaction to pyrogens (foreign substances that cuase fevers, specifically an endotoxin) in the dialysate rather than an actual infection. โ Why must the water for dialysis be treated? Answer: Patients blood is directly exposed to large quantities of water during dialysis. There is no filtering mechanism โ What are some components of the water system? Answer: Blending valve, sediment filter, ultra filters, water softener, carbon tanks, deionization machine, RO machine, and backflow prevention
โ What tests and readings are completed to assure water quality? Answer: Temp, pH, conductivity, total water hardness, total chlorine testing and TDS, an percent rejection โ Why is routine total chlorine testing performed? Answer: To assure that Total Chlorine (Free chlorine and combined chlorine or chloramines) is removed from water used to make dialysate. Testing i performed before the initiation of the first treatment of the day and a minimum of every FOUR hours. โ What components remove the Total Chlorine? Answer: GAC filters (carbon tanks). Water must be exposed to the carbon in the tank for a minimum of TEN minutes to meet AAMI standards. Contact time is called EBCT (empty bed contact time). Minimum of 5 minutes in worker tank(s) an 5 minutes in polisher tank(s) โ What are FMS safe total chlorine levels? Answer: 0.00-0.09 ppm โ How long must RO run before testing? Answer: 15 minutes, an the valve port must be flushed for a minimum of 2 minutes. before obtaining water sample. โ Total water hardness Answer: Checked twice daily, at the start of the day and after the last treatment. Should not exceed 10 ppm. โ TDS Total Dissolved Solids Answer: Measured by using a TDS meter. TDS and conductivity measurements provide information on
