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Important Question for Dialysis Technician

1. 8steps to washed our hand before and after treatment:

1) Palm to palm
2) Back of the hand
3) Between the finger.
4) Finger inter lock.
5) Base of the thumb
6) Finger tips
7) Rinse
8) Wrist .

2. Symbol of electrolyte :-
1) Sodium : Na
2) Calcium: Ca+
3) Potassium : K
4) Magnesuim : Mg .
5) Mercury : Hg
6) Hemoglobin :-Hb

3. Full form:-
1) SLED : Sustained Low Efficiency Disease.
2) CRRT: Continuous Renal Replacement Theraphy.
3) IHD: Intermittent Hemodialysis.
4) TDS :Total Dissolve Solid.
5) TMP: Trans Membrane Pressure.
PBO :Blood outlet Pressure
PDO : Dialysis Outlet Pressure
6) PPE : Personal Protective Equipment.
7) PPM : Part Per Million.
8) CAPD: Continuous Ambulatory Peritoneal Dialysis.
9) APD: Automated Peritoneal Dialysis.
10) ESRD : End stage Renal Disease
11) KFT : Kidney function Test.
 12) LMWH : Low molecular Weight Heparin.
13) DTI : Direct Thrombin Inhibitor.
14) TCV :Total Cell volume,
15) URR : Urea Reduction Ratio,
16) CPR : Cardio Pulmonary Resuscitation
17) DCT : Distal Convoluted Tabule
18) PCT: Proxinal Convoluted Tabule
19) DSS: Disequilibrium Syndrome
20) BUN :Blood Urea Nitrogen.
21) GFR: Glomerulus Filtration Rate
22) BFR: Blood Flow Rate.
23) AVG : Arterial Venous Graft.
24) AVF : Arterial Venous Fistula.
25) IVJ : Intra venous Jugular (hajan ryndang)
26) IVF : Intra venous Femoral.(hajan lybong)
27) UTI : UrinaryTract Infection.
28) AMU : Atomic Mass Unit.
29) PVP : Polyvinyl Pyrrolidole.
30) EDW : Estimated Dry Weight.
31) CLS :- Clinical Laboratory Scientist.
32) PT :- Prothrombin time
33) PTT:- Partial thromboplastin time.
34) UKM :- UREA KINETIC MODELLING
35) KDOQI :- Kidney Disease Outcome Quality Initiative.
36) PCR :- Protein catabolic Rate.
37) ACT : Activated Clotting Time.
38) CLIA :- Clinical Laboratory IMPROVEMENT Amendments Act.
39) TDMS :- Theraphy Data Management System.
40) AAMI :- Asiocation for the Advancement of the Medical Instrumentation.
41) ETO :- Ethylene Oxide.

4. Fullform:
1) MMOL/L : Millimolar /litre.
2) MG/DL : Milligram /Decilitre.
3) MEQ/L : Milli Equivalent /Litre.
4) MMHg :millimeter of Mercury.
5. Organ System Defined :
An organ system is a group of anatomical structure that work together to perform a
specific function.
In the human body there are 11 organ system they are :-
1) Integumentary system:- includes our skin,hair,nail, sweat glands.
2) Muscular system :- Brain, spinal cord, nerves (help the body)
3) Skeletal system:- Bones, ligaments, cartilage.
4) Nervous system:- Includes the brain, spinal cord.
5) Circulatory system:- Includes heart, blood vessels and blood.
6) Lymphatic system:- Which travel with our blood vessels.
7) Respiratory system:- Nose, Mouth,
8) Endocrine system.
9) Urinary/ excretory system:- Kidneys, Urinary Bladder, urethra.
10) Reproductive system:- Private Part for Female and Male.
11) Digestive system:- Heart, blood vessels, blood.
 Normal Range:-
1 Normal Systolic(Jingheh) 100 - 140mg/dl
2 Normal Diastolic(Jingrit) 60 – 90 mg/dl.
3 Normal Creatinine(electrolyte) 0.5 – 1.5 mg/dl.
4 Normal Level Potassium(K) 3.5 -5.5 mg/dl.
5 Normal Calcium (Ca+) 8.5-10.5 mg/dl.
6 Normal Level Sodium (Na) 135-145 mg/dl.
7 Normal Chloride (Cl) 98-107 mmol/dl
8 Normal Urine 20-40mg/dl.
Normal Hemoglobin(Hb)
9 Female(10-14gram) Male : (12-16gram)
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10 Normal Heartbeat 60-100 beat Per minute.

11 Normal Pulse 60-90 or 60-100.
12 Normal Respiration 12-20 breaths per minute.
13 Normal Body Temperature 36.5-37.5 Celsius and 97.6-99.6
Fahrenheit.

14 Normal Random Sugar Level in body 130-140mg/dl.

15 Normal Fasting Sugar Level 90-100mg/dl.
16 Normal phosphorus (P) 2.5-4.5 mg/dl.
17 Normal free Heparin 150-250ml of NS in every 15minute.
18 Unfractionate Heparin Unit 15000 -20000 DA.
19 LMWH : Less than 8000DA.
20 Angle of Fistula : 20-35 degree.
21 Angle of Graft : 35-45 degree.
22 Normal conductivity : 13.5-14.5(good Bicarbonate)
23 Normal Angle in the arm surface : 15-30( Degree)
24 Normal TDS drinking Water : 300-500.
25 Normal Kt/V : 1.2 OR 1.3.
26 Normal URR: 65 % above.
27 Ratio of CPR : 2:30 OR 30:2.
28 Normal TDS : Not more than 15(as less as possible)

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6. COMPLICATION:-
1. Intradialytic Hypotension(BP Low) : During Dialysis the BP fall down.
2. Reason : Removing of too much water from the patient body.
 If the PT take medicine of controlling blood pressure(Depin Blood Control
Medicine)
 If there is some mixing problem in the B Part.
3. Symtom : Sweating, headache, vomiting etc.
4. Management of Hypotension:-
 Check BP.
 Give Normal Saline(NS)
 Reduce the blood pump.
 Stop UF
 Sodium Modeling.
 Anti trenlenbury position (Head down position.
1. Intradialytic Hypertension(High BP) : During Dialysis the blood pressure high.
2. Reason : Remove extra fluid and If the PT have already Hypertension.
3. Symptom:- Chest pain, Headache, Nose Bleeding.
4. Management of Hypertension :
 Give some medicine (Depin) to control BP.
 When the PT have 120/120 we have to give 2mg and 3-5drops Depin.
 When the PT have 180/120 we have to give 5mg 5-6 drops.
 Decrease blood pump.
 Disconnect the patient from dialysis treatment or from the machine.
1. Muscle Cramps : When the PT have too much water and fluid is called Muscle Cramps.
2. Reason : we have to give NS.
1. Hyperglycemia(Glucose): Before starting Dialysis Treatment the PT take insulin and the
sugar level fall down or low.
2. Management of Hyperglycemia : Give 25% of Dentose or give sugar or chocolate.

Sir Sabir/-
  VASCULAR ACESS : which is used for removing waste product from our blood.
 Types of Access : 1) Temporary Access. 2) Parmanent Access.
Temporary Access :
Parmanent Access :
 Fistula : The connection of vein and Artery or cephalic vein and radial artery is called
Fistula.
 Type of Fistula : 1) Radio Cephalic Fistula. 2) Brahio Cephalic Fistula.
Radio Cephalic Fistula(Lower Arm): The joining of vein and Radial Artery.
Brahio Cephalic Fistula(upper Arm): The Joining of brachial artery and cephalic vein.
Note ; the care of Fistula is have to exercise with one ball by fisting and opening the
hand.(U PT haba u pyndonkam da u Fistula u dei ban exercise da kaba pyndnkm daka
ball ne push )

Advantage of Fistula Dis-advantage of Fistula

 To easy Process for Dialysis
 PT hand look like pale.
 After few days the Fistula hand will
be black.
 The Pt every time
tolerates(jingiaishah) the pain of the
pricking needle of the fistula.
 The colour hand will change the
colour.

Note : AV Graft is the directed connection between artery and vein through a cynthetic tube and
plastic tube. Those Pt vein is not clear or small vein they have to used a graft.

GRAFT FISTULA
 Plastic tube  No plastic tube,
 After 10days we can use Graft.  After 45days we can use fistula.
 It is not save.  It is Save.
 It is 3 to 5 year process  It is life for long process.

Note : Angle of Fistula : 20-35 degree and Angle of Graft: 35-45 degree.

Sir Sabir/-