CCHT Interventions 2

Question 1

A patient develops hypotension (BP 80/50) during dialysis with associated diaphoresis and pallor. After stopping ultrafiltration, what is the next immediate intervention?

Accepted Answer

Place patient in Trendelenburg position and administer a normal saline bolus

Answer

Trendelenburg positioning (legs elevated) increases venous return to the heart, and saline bolus rapidly expands intravascular volume to treat dialysis-induced hypotension.

Question 2

What is the first-line intervention for a patient experiencing first-use syndrome during hemodialysis?

Accepted Answer

Stop dialysis, clamp and discard blood lines, administer antihistamine and notify physician

Answer

First-use syndrome (Type A anaphylactic reaction) requires immediate treatment discontinuation with blood discarded (not returned), antihistamine administration, and physician notification.

Question 3

During hemodialysis, a patient develops sudden severe chest pain, dyspnea, and becomes cyanotic. The blood in the venous line appears pink/clear instead of dark red. What emergency is occurring?

Accepted Answer

Hemolysis (red cell destruction from mechanical or chemical causes)

Answer

Pink/clear blood (hemolyzed blood) indicates massive hemolysis, a life-threatening dialysis emergency where red blood cells are being destroyed.

Question 4

What is the appropriate response when a dialysis patient develops seizures during treatment?

Accepted Answer

Protect the patient from injury, stop UF, reduce blood pump speed, notify nurse/physician, and prepare to terminate treatment

Answer

Seizures during dialysis require patient protection from injury, immediate reduction in treatment intensity, and urgent notification of the nurse and physician.

Question 5

A patient on hemodialysis suddenly develops fever of 39.5 degrees C and shaking chills during treatment. What is the most likely cause and appropriate action?

Accepted Answer

Pyrogen reaction or bacteremia; stop treatment, take blood cultures, notify physician, administer antipyretics as ordered

Answer

Fever with rigors during dialysis suggests pyrogen reaction (bacterial endotoxin contamination) or bacteremia from the vascular access, requiring immediate evaluation.

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT Interventions 2