Question Title

* Hemolysis in hemodialysis patients can be caused by

The correct answer is b. kinked blood tubing.

Rationale: Hemolysis means rupture of red blood cells. It is a life-threatening problem that requires immediate medical treatment. Hemolysis has many causes, including dialysate that is too hot or that contains bleach or chlorine, blood pump rollers that are too tight, excessive negative arterial pressure, and kinked blood tubing.

Reference:  Medical Education Institute. (2018). Core Curriculum for the Dialysis Technician, 6th ed., pp. 124, 168, 346; Kallenbach, J. Z. (2016). Review of Hemodialysis for Nurses and Dialysis Personnel, 9th ed., p. 171.

Question Title

* Due to a water main break, the municipal water provider has alerted the dialysis unit of its temporary plan to increase the concentration of disinfectant (chlorine/chloramines) in the water source. To ensure patient safety, the CCHT-A should increase the

The correct answer is frequency of water testing.

Rationale: Increased concentration of disinfectant (chlorine/chloramines) in source water can prematurely exhaust carbon adsorption of these chemicals. According to CMS, when chlorine levels in water increase, more frequent testing of chlorine/chloramines must be performed (every 30-60 minutes).

Reference: Center for Medicare and Medicaid Services (CMS), Conditions for Coverage, V177
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