CCHT Patient Assessment 3

Question 1

What does access recirculation mean in the context of patient assessment, and how does it affect treatment quality?

Accepted Answer

Dialyzed blood from the venous needle being immediately re-drawn through the arterial needle, reducing efficiency

Answer

Access recirculation occurs when cleaned blood from the venous needle re-enters the arterial needle, diluting uremic blood and reducing dialysis efficiency.

Question 2

A patient with a new arteriovenous graft (AVG) presents with redness, warmth, swelling, and pain over the graft. What assessment should be performed and what is the concern?

Accepted Answer

Assess for signs of graft infection; do not cannulate if infection is suspected until evaluated by a physician

Answer

Signs of inflammation/infection over an AVG (erythema, warmth, pain, swelling) require physician evaluation before cannulation, as needling an infected graft can cause bacteremia.

Question 3

When performing a pre-treatment patient assessment, what key information should be gathered about the patient's interdialytic period?

Accepted Answer

Weight gain, dietary adherence, medication compliance, symptoms, and any medical events since last treatment

Answer

A comprehensive interdialytic history identifies fluid gain, medication issues, dietary violations, new symptoms, or medical events that affect treatment planning.

Question 4

What is the clinical significance of a decreasing Kt/V trend over multiple treatments despite no changes in dialysis prescription?

Accepted Answer

May indicate access dysfunction, fistula recirculation, shortened treatment times, or increasing patient size

Answer

A declining Kt/V without prescription changes suggests access problems (stenosis, recirculation), non-compliance with treatment time, or patient body composition changes requiring evaluation.

Question 5

Which physical finding during pre-treatment assessment most specifically indicates arterial steal syndrome in a patient with a new upper arm AVF?

Accepted Answer

Cold, pale hand that warms when the fistula is manually compressed

Answer

Hand ischemia (cold, pale) that resolves when the fistula is compressed (reducing steal) is pathognomonic for arterial steal syndrome.

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT - Certified Clinical Hemodialysis Technician Practice Test

CCHT Patient Assessment 3