Free CCHT Emergency Preparedness and Procedures Questions and Answers 1 — Questions and Answers
Question 1: A patient begins to experience shortness of breath, itching, and hives within the first 15 minutes of treatment. The technician should suspect which complication?
- Disequilibrium syndrome
- Anaphylactic reaction (Correct answer)
- Air embolism
- Hemolysis
Correct answer: Anaphylactic reaction
These are classic signs of a severe allergic or anaphylactic reaction, which can be life-threatening. Common causes include reactions to the dialyzer membrane, sterilants, or medications. The treatment must be stopped immediately, and emergency protocols initiated.
Question 2: During a hemodialysis treatment, the blood leak detector alarms. What is the technician's immediate first action?
- Stop the blood pump immediately
- Return the patient's blood
- Visually inspect the dialysate for blood (Correct answer)
- Administer a saline bolus
Correct answer: Visually inspect the dialysate for blood
The first step is to confirm the alarm by visually checking the dialysate effluent line for a pink or red tinge. If blood is present, it confirms a membrane leak, and the treatment must be stopped immediately without returning the blood to the patient to prevent contamination.
Question 3: A patient reports feeling dizzy and their blood pressure has dropped to 90/50 mmHg. What is the most appropriate initial intervention?
- Increase the ultrafiltration rate
- Place the patient in the Trendelenburg position (Correct answer)
- Encourage the patient to drink water
- Increase the blood flow rate
Correct answer: Place the patient in the Trendelenburg position
The symptoms and significant drop in blood pressure indicate hypotension. Placing the patient in the Trendelenburg position (feet elevated above the head) is a rapid first response that uses gravity to increase blood flow to the brain and vital organs while other interventions, like administering saline, are prepared.
Question 4: In the event of a power outage at the dialysis facility and failure of the machine's backup battery, what is the technician's priority?
- Manually crank the blood pump to return the patient's blood (Correct answer)
- Call the power company to report the outage
- Begin documenting the event in the patient's chart
- Evacuate the building immediately
Correct answer: Manually crank the blood pump to return the patient's blood
Patient safety is the top priority. The technician must use the hand crank to manually pump the blood from the extracorporeal circuit back to the patient to prevent the patient from losing that blood and to prevent the circuit from clotting.
Question 5: A patient experiences a seizure during treatment. After calling for help and ensuring the patient is safe from injury, what is the next immediate step related to the treatment?
- Increase the blood flow rate to improve brain perfusion
- Place a tongue depressor in the patient's mouth
- Stop ultrafiltration and reduce the blood flow rate (Correct answer)
- Disconnect the patient from the machine immediately
Correct answer: Stop ultrafiltration and reduce the blood flow rate
The immediate action related to the dialysis treatment is to reduce physiological stress on the patient. Stopping ultrafiltration and lowering the blood flow rate can help stabilize the patient, as seizures can sometimes be triggered by hypotension or disequilibrium syndrome.
Question 6: Hemolysis, the rupture of red blood cells, is a serious complication. Which of the following is a potential cause of hemolysis during dialysis?
- High ultrafiltration rate
- Dialysate temperature being too high (Correct answer)
- Low blood pump speed
- A clotted venous chamber
Correct answer: Dialysate temperature being too high
Red blood cells are sensitive to temperature. If the dialysate temperature is excessively high (e.g., above 42°C), it can cause the cells to rupture, a condition known as hemolysis. Other causes include hypotonic dialysate, kinks in the blood lines, or exposure to chemicals like bleach or chlorine.
Question 7: If an air embolism is suspected, in addition to stopping the blood pump, what is the correct position to place the patient in?
- High Fowler's position
- Supine with head elevated
- Trendelenburg position on the left side (Correct answer)
- Prone position
Correct answer: Trendelenburg position on the left side
If an air embolism is suspected, the patient should be placed in the Trendelenburg position on their left side. This position helps to trap the air in the right ventricle of the heart, preventing it from traveling to the lungs or brain where it could cause a fatal blockage.
Free CCHT Emergency Preparedness and Procedures Questions and Answers 1
A patient begins to experience shortness of breath, itching, and hives within the first 15 minutes of treatment.
The technician should suspect which complication?