CCHT Electrolyte Balance 2

Question 1

A patient's pre-dialysis potassium level is 6.8 mEq/L with peaked T waves on ECG. Which dialysate potassium concentration would be most appropriate?

Accepted Answer

1.0 mEq/L

Answer

Severe hyperkalemia with ECG changes requires aggressive potassium removal using a 1.0 mEq/L dialysate, which maximizes the gradient for potassium diffusion from blood to dialysate.

Question 2

What is the physiological consequence of using dialysate with a calcium concentration lower than the patient's serum calcium?

Accepted Answer

Calcium will move from blood into dialysate, potentially lowering serum calcium

Answer

When dialysate calcium is lower than serum calcium, the concentration gradient causes calcium to diffuse out of the blood into the dialysate, lowering serum levels.

Question 3

Which acid-base disturbance is most common in ESRD patients before dialysis treatment?

Accepted Answer

Metabolic acidosis

Answer

ESRD patients develop metabolic acidosis because the kidneys can no longer excrete acid or regenerate bicarbonate, causing accumulation of organic acids.

Question 4

Why is hyperphosphatemia particularly dangerous for hemodialysis patients beyond the known bone disease effects?

Accepted Answer

It promotes vascular and soft tissue calcification, increasing cardiovascular mortality

Answer

Elevated phosphorus combines with calcium to form calcium-phosphate deposits in blood vessels and soft tissues (vascular calcification), dramatically increasing cardiovascular risk.

Question 5

What effect does bicarbonate concentration in dialysate have on the patient's serum pH?

Accepted Answer

Higher bicarbonate dialysate increases serum pH by adding bicarbonate to blood

Answer

Bicarbonate in dialysate diffuses into the blood down its concentration gradient, increasing serum bicarbonate and normalizing low pH (metabolic acidosis).

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT Electrolyte Balance 2