Class Notes on Dialysate
conductivity for final dialysate
+/-0.3 ms/cm of what is displayed on the hemodialysis machine
Bicarbonate
-comes in premix form or powder form. -they used to mix once or twice a day in a huge tub now it comes in single form for single uses.
cleaning and maintenance when using bicarbonate
-the dirtiest thing we do because it tends to grow bacteria because it's high in pH. -Need to dispose of it by midnight. -the jugs use to make/mix bicarb in has to be emptied and disinfected every night. -you have to vinegar and descale the machine after every treatment shift or at the end of the day because bicarb causes plaque build-up in the tubing and machine.
what to check for
-types are listed on the machine which you have to select settings for Acid concentrate and bicarbonate -make sure the ratio dilution is correct on the bottle.
when mixing Bicarbonate you need to make sure
1. The water fill cycle is complete. The measurement will be off if you pour the bicarbonate too early before the water reaches the fill line. 2. Don't want to over mix the solution it will release carbon dioxide or off-gassing which will weaken it.
Acid concentrate
2.0 k 2.5 calcium standard
PH range for final dialysate
6.9-7.6
when mixing Bicarbonate incoming temperature should be
76-98.6° F
What is Dialysate made of
Acid concentrate RO Water Bicarbonate
Devices to test pH and conductivity
Phoenix Meter Test strips
what's conductivity is measuring
conductivity test is the sodium from the machine. in the dialysis machine the sodium is coming from the acid
final dialysate is checked for
pH and conductivity
pH
potential hydrogen