Patient Safety and Quality Assurance Flashcards

Which of the following is the most critical immediate action when a patient on hemodialysis develops sudden hypotension?

Answer: Place the patient in the Trendelenburg position and administer a normal saline bolus

Sudden hypotension during hemodialysis is managed by placing the patient in Trendelenburg position (legs elevated) and administering a normal saline bolus to restore circulating volume. Increasing ultrafiltration would worsen hypotension.

A CHBT technician notices a patient's access site is bleeding excessively after needle removal. What is the first step?

Answer: Apply direct pressure to the site with sterile gauze

Direct pressure with sterile gauze is the immediate first response to control bleeding from a vascular access site. Continuous pressure for the appropriate time is required, and the nurse must be notified.

What does the term 'Kt/V' measure in hemodialysis quality assurance?

Answer: The adequacy of dialysis, specifically urea clearance relative to body water volume

Kt/V is the standard measure of dialysis adequacy. K = clearance of urea by the dialyzer, t = treatment time, V = volume of distribution of urea (total body water). A Kt/V ≥ 1.2 per treatment is the minimum recommended target.

Which quality assurance measure helps ensure consistent delivery of the prescribed dialysis dose?

Answer: Documenting pre- and post-dialysis BUN values and calculating URR

Urea Reduction Ratio (URR) and Kt/V calculated from pre- and post-BUN values are the primary quality assurance tools verifying that patients received their prescribed dialysis dose.

During a hemodialysis treatment, a patient reports chest pain and shortness of breath. The technician should:

Answer: Stop the treatment immediately, call for emergency assistance, and monitor the patient

Chest pain and shortness of breath are potential signs of a cardiac event or air embolism. Treatment must be stopped immediately, emergency help called, and the patient closely monitored as per emergency protocols.

What is the purpose of a quality assurance water culture in a hemodialysis unit?

Answer: To detect bacterial contamination levels in the water used to prepare dialysate

Monthly water cultures detect bacterial counts in product water and dialysate. AAMI standards require <100 CFU/mL for product water and <200 CFU/mL for dialysate to ensure patient safety.