Hemodialysis Delivery Systems and Machine Components
Conductivity range
12.6-15.9
Dialysate Temp
35-39 C set by MD machine is set to alarms when temp rises or falls 2 degrees beyond set point
Acceptable range for dialysis
6.9-7.6
5 characteristics of the dialyzer that can influence dialysis effectiveness, treatment comfort and patient
Biocompatibility molecular weight cutoff surface area ultrafiltration coefficient clearance
Purpose of Dialysate
Carries away waste products and excess fluid removed form the patient's blood during the dialysis process Prevents excess removal of essential electrolytes during the dialysis process
How do we know if the Dialysate is properly mixed
Conductivity and PH check
Dialysate formula
Na (sodium) Ca calcium K potassium HCO3 bicarbonate baking soda
What must be tested before each treatment
PH and Conductivity
Transmembrane Pressure TMP
Pressure that exist in the dialyzer want the transmembrane pressure to be greater on the blood side than the dialysate side TMP determines how much water is forced across the dialyzer membrane
What is Dialysate
a solution of purified water and electrolytes in concentration similar to blood consist of the following chemicals which we use to clean a pt blood acidified salt solution referred to as acid bicarbonate purified water also contains essential electrolytes to assure theses are not depleted during dialysis
Dialysate
acid concentration electrolytes and is tailored to the pt needs
Clearance has 6 factors
adequate heparinization dialysate flow proper circuit priming procedure blood flow vascular access length of treatment
Clearance
amount of a specific solute that is removed form a patient's blood during dialysis reflects the efficiency of the dialyzer
bicarbonate solution
buffer the acid - preserving the acid base balance of the blood
Blood leak detector
checks for blood in the effluent spent dialysate due to broken dialyzer fiber detector can sense very small amounts of blood machine will alarm, blood pump will stop, clamp woll activate
Extracorporeal Circuit
circuit carries the blood from the patients access to the dialyzer and back to the access needles blood tubing blood pump dialyzer venous line clamp blood flow monitors pressure monitors air detector
Conductivity
ease with which an electric current is carried or conducted through something. to assure that the dialysate is at the proper conductivity to prevent hemolysis or crenation of the patient's blood
Auto flow
flow option allowing for automatic optimal dialysate flow proportionate to the blood flow rate. automatically adjust flow to 1.5 to 2.0 times the the QB
Calcium
helps correct balance in the blood and slows the development of bone disease
Pressure monitoring
is needed to accurately calculate transmembrane pressure TMP and ensure patient safety
crenation
make blood cells look like raisins
conductivity
measure of the ion concentration of a solution
dalton
molecular weight amount of membrane in contact with blood & dialysate permeability
Countercurrent flow
preferred flow geometry for optimal dialysis
hemolysis
red blood cell break
Dialysate isn't
sterile
Biocompatibility
substance does not cause a reaction by the body's immune system dialyzer not compatible, allergic reaction or clotting may occur
purified water
tap water treated to use in dialysate
Disafe Filter testing
testing required every 2 weeks
ph
the scale used to measure the hydrogen ion concentration of a substance
