- Hemodialysis
- A treatment that filters wastes and removes excess fluid from the blood through a dialyzer when the kidneys have failed.
- Dialyzer
- The 'artificial kidney' — a cartridge of semipermeable hollow fibers where blood and dialysate exchange wastes and water.
- Dialysate
- The fluid (purified water plus acid and bicarbonate concentrate) on the dialysate side of the membrane that wastes diffuse into.
- Diffusion
- Movement of solute wastes (urea, creatinine, potassium) from blood to dialysate down a concentration gradient — how dialysis clears toxins.
- Ultrafiltration
- Removal of water from the blood driven by the transmembrane pressure gradient — how fluid is taken off to reach dry weight.
- Convection
- Solute dragged along with water during ultrafiltration ('solvent drag'), which removes larger middle molecules.
- Osmosis
- Movement of water across a semipermeable membrane toward the side with the higher solute concentration; a minor contributor in dialysis.
- Countercurrent flow
- Blood and dialysate flowing in opposite directions through the dialyzer to maximize the gradient and clearance.
- Transmembrane pressure (TMP)
- The pressure difference across the dialyzer membrane that governs the ultrafiltration rate.
- AV fistula
- The preferred long-term vascular access — the surgeon joins the patient's own artery and vein; matures over 6–12 weeks.
- AV graft
- A synthetic tube surgically placed to bridge an artery and a vein; the second-choice access, usable in about 2–3 weeks.
- Central venous catheter (CVC)
- A catheter in a large central vein; the last-resort access with the highest bloodstream-infection risk.
- Thrill
- The continuous vibration felt over a patent AV fistula or graft, confirming blood flow through the access.
- Bruit
- The whooshing sound heard with a stethoscope over a working AV fistula or graft.
- Cannulation
- Inserting the dialysis needles (arterial and venous) into the vascular access.
- Rope-ladder technique
- Rotating cannulation sites up and down the access to prevent aneurysm formation.
- Infiltration
- Blood leaking into surrounding tissue when a needle perforates the vessel wall, causing swelling and pain.
- Access stenosis
- Narrowing of the access vessel; signs include high venous pressures, prolonged bleeding, and a changed thrill/bruit.
- Steal syndrome
- When the access diverts blood from the hand, causing a cool, pale, painful, numb hand distal to the access.
- Dry weight
- The lowest weight a patient tolerates without symptoms of fluid overload or depletion — the post-dialysis target.
- Interdialytic weight gain
- Fluid weight gained between treatments; large gains require higher ultrafiltration and risk hypotension.
- Ultrafiltration goal
- The fluid volume to remove during a treatment — roughly the pre-dialysis weight minus the dry weight.
- Intradialytic hypotension
- A drop in blood pressure during treatment — the most common complication, usually from too-rapid fluid removal.
- Trendelenburg position
- Head-down, feet-up positioning used to treat intradialytic hypotension along with a lower UF rate and saline.
- Muscle cramps
- Painful cramps late in treatment from excess or rapid fluid removal; treated by lowering the UF rate and giving saline.
- Dialysis disequilibrium syndrome
- Headache, nausea, restlessness, or seizures from rapid urea and water shifts, common in a patient's first treatments.
- Hemolysis
- Rupture of red blood cells in the circuit — a cherry-red blood line — from chloramine, overheated/hypotonic dialysate, or a kinked line.
- Air embolism
- Air entering the bloodstream from the circuit — a true emergency the air/foam detector is designed to prevent.
- Air embolism position
- Left lateral with the head and chest tilted down (Trendelenburg) to trap air in the right heart, away from lungs and brain.
- Heparin
- The anticoagulant infused during treatment to keep the extracorporeal circuit from clotting.
- Hyperkalemia
- A dangerously high blood potassium level that can cause cardiac arrhythmias — a key reason for dialysis.
- URR (urea reduction ratio)
- The percent drop in BUN across a treatment; the minimum adequacy target is about 65%.
- Kt/V
- A calculated dialysis-adequacy index; a common minimum target is about 1.2 per treatment.
- ESRD
- End-stage renal disease — irreversible kidney failure requiring dialysis or transplant.
- Orthostasis
- A blood-pressure drop on standing; assessed before and after dialysis to gauge fluid status and removal.
- Hemostasis
- Stopping bleeding at the needle sites after treatment by holding firm, even pressure until the access seals.
- Extracorporeal circuit
- The blood path outside the body — access, lines, blood pump, dialyzer, and monitors.
- Blood pump
- The roller pump that moves blood through the circuit at the prescribed blood flow rate (commonly 300–500 mL/min).
- Arterial pressure monitor
- Reads the negative pre-pump pressure; a strongly negative reading suggests poor arterial inflow or an access problem.
- Venous pressure monitor
- Reads the pressure returning to the patient; a high reading suggests a venous-needle obstruction or a clotting circuit.
- Air/foam detector
- A safety monitor that stops the pump and clamps the venous line if air is detected, preventing an air embolism.
- Blood leak detector
- A monitor that alarms if blood crosses the membrane into the dialysate, signaling a ruptured dialyzer.
- Conductivity
- A measure of dialysate electrolyte concentration that verifies the concentrates were mixed in the correct ratio.
- Acid concentrate
- One of the two dialysate concentrates, kept separate from bicarbonate until the machine proportions them with water.
- Bicarbonate concentrate
- The buffer concentrate proportioned with acid concentrate and water; mixed at full strength it would precipitate calcium/magnesium.
- Dialysate temperature
- Kept near body temperature (~37 °C); overheated dialysate causes hemolysis.
- Machine self-test
- The pressure and alarm checks a dialysis machine runs before a patient is connected; a failure takes it out of service.
- Saline prime
- Flushing the circuit with saline before use to remove air and any residual sterilant before the patient is connected.
- Blood flow rate (BFR)
- The speed the blood pump moves blood through the circuit, set per the physician's order (commonly 300–500 mL/min).
- Dialysate flow rate
- The rate dialysate runs through the dialyzer, typically 500–800 mL/min, set to support adequate clearance.
- Dialyzer reprocessing
- Cleaning, testing, and disinfecting a dialyzer so the SAME patient can reuse it — never shared between patients.
- Total cell volume (TCV) test
- A fiber-bundle test on a reprocessed dialyzer; it must measure at least 80% of the original to be reused.
- Residual germicide test
- Confirming the disinfectant is rinsed below the safe limit before a reprocessed dialyzer touches a patient.
- Reverse osmosis (RO)
- The core water-purification step that rejects most dissolved ions, bacteria, and endotoxin.
- Carbon tanks
- Activated-carbon tanks that remove chlorine and chloramine — the most safety-critical stage of the water system.
- Chloramine
- A water disinfectant that causes hemolysis if it reaches a patient; removed by the carbon tanks.
- Water softener
- An ion-exchange unit that removes calcium and magnesium hardness to protect the downstream RO membrane.
- Sediment filter
- A depth filter that removes particulates, sand, and rust from incoming city water before the rest of the train.
- Deionization (DI)
- A mixed-bed resin step that further removes ions after RO; often paired with an ultrafilter for endotoxin.
- Distribution loop
- The continuous piping that carries product water to the machines with no dead-end branches that breed bacteria.
- Endotoxin
- A pyrogen from gram-negative bacterial cell walls that causes fever/chills if present in water or dialysate.
- AAMI standards
- The ANSI/AAMI water and dialysate quality standards that set chemical and microbiological limits for hemodialysis.
- Free chlorine limit
- The AAMI maximum for free chlorine in product water — about 0.5 mg/L; excess causes hemolysis.
- Chloramine limit
- The AAMI maximum for chloramine in product water — about 0.1 mg/L; the carbon tanks' key job.
- Bacteria limit (product water)
- AAMI limits bacteria in dialysis product water to under 200 CFU/mL, with an action level of 50 CFU/mL.
- Endotoxin limit (product water)
- AAMI limits endotoxin in product water to under 2 EU/mL, with an action level of 1 EU/mL.
- Carbon breakthrough test
- Testing chlorine/chloramine between the two carbon tanks before each treatment day to catch breakthrough early.
- Standard precautions
- Treating every patient's blood and body fluids as potentially infectious through hand hygiene, gloves, and PPE.
- Hand hygiene
- Hand washing/sanitizing before and after every patient and after glove removal — the single most important infection-control measure.
- PPE
- Personal protective equipment — gloves, gown, mask, and eye/face protection used by task and exposure risk.
- Dialysis precautions
- CDC additions to standard precautions: dedicate supplies per station and never share carts or vials between patients.
- Station disinfection
- Cleaning and disinfecting the chair, machine surfaces, and shared items between every patient run.
- Sharps container
- A closable, puncture-resistant, leak-proof, labeled container for used needles, which are never recapped by hand.
- Hepatitis B isolation
- Dialyzing HBV-positive patients in a separate room with dedicated machines, staff, and supplies, and no reuse.
- Hepatitis C handling
- HCV-positive patients are NOT routinely placed in a separate room; strict standard precautions are used instead.
- Bloodborne pathogens
- Infectious agents in blood — chiefly hepatitis B, hepatitis C, and HIV — that dialysis precautions guard against.
- Hepatitis B vaccine
- Recommended for susceptible dialysis patients and offered free to at-risk staff under OSHA rules.
- Designated equipment
- Items dedicated to a single patient or station (e.g., for HBV isolation) to prevent cross-contamination.
- Hepatitis survey status
- A patient's documented hepatitis serology, used to assign isolation and reuse status per CMS requirements.
- Biohazard waste disposal
- Discarding blood-contaminated waste and SHARPS into labeled, leak-proof biohazard containers per protocol.
- CMS Conditions for Coverage
- Federal ESRD-facility regulations (42 CFR §494) governing dialysis care, safety, and technician certification.
- Discharge instructions
- Patient teaching on diet, fluid intake, and the medication regimen given before the patient leaves the unit.
- Phosphate binders
- Medications taken WITH meals to lower phosphorus absorption and limit bone and vascular disease in ESRD.
- Erythropoiesis-stimulating agent (ESA)
- A medication that stimulates red-cell production to treat the anemia of kidney failure.
- Acute renal failure
- A sudden, often reversible loss of kidney function — distinct from the irreversible failure of ESRD.
- Continuing education (CE)
- Ongoing nephrology learning the technician completes (e.g., 8 contact hours after every 3rd exam attempt) to stay current.
- Professional boundaries
- Maintaining appropriate limits with patients — declining gifts and personal involvement — while staying caring.
- QAPI
- Quality Assessment and Performance Improvement — the facility process technicians help drive to improve care and safety.
- Incident documentation
- Objective, prompt recording of emergencies, equipment/device events, and patient-care events as the legal record.
- Charting error correction
- Draw a single line through the error, write 'error,' then initial and date — never erase or use correction fluid.
- Patient confidentiality
- Sharing protected health information only on a need-to-know basis; phone/family requests are referred to the nurse.
- Role of the preceptor
- An experienced technician who orients, teaches, and evaluates new staff during their training.
- Treatment modalities
- The forms of kidney-failure therapy — in-center and home hemodialysis, peritoneal dialysis, and transplant.
- Multidisciplinary care plan
- The team plan (nephrologist, RN, technician, dietitian, social worker) coordinating each patient's care.
- Nephron
- The kidney's functional unit (glomerulus plus tubule) that filters blood and forms urine; humans have about one million per kidney.
- Glomerular filtration rate (GFR)
- The volume of plasma filtered by the kidneys per minute; ESRD requiring dialysis is generally a GFR under 15 mL/min.
- Blood urea nitrogen (BUN)
- A nitrogenous waste from protein metabolism measured to assess uremia and, before/after, dialysis adequacy.
- Creatinine
- A muscle-metabolism waste cleared by the kidneys; a rising serum level reflects worsening kidney function.
- Uremia
- The toxic syndrome of accumulated nitrogenous wastes in kidney failure, causing nausea, fatigue, pruritus, and pericarditis.
- Semipermeable membrane
- The dialyzer membrane that lets water and small solutes pass while retaining blood cells and large proteins.
- Hollow-fiber dialyzer
- The standard dialyzer design — thousands of tiny capillary fibers carrying blood, bathed by dialysate outside the fibers.
- Buttonhole technique
- Repeated cannulation of a fistula at the exact same site and angle to form a tunnel track; requires dull needles and strict antisepsis.
- Access aneurysm
- A bulging, weakened area in a fistula from repeated same-site cannulation; risks thinning skin and rupture.
- Access thrombosis
- Clotting of a fistula or graft, marked by loss of the thrill and bruit; an emergency needing prompt evaluation.
- Recirculation
- Already-dialyzed blood re-entering the arterial needle, lowering clearance; suggests access stenosis or needles placed too close.
- Arterial needle
- The needle that draws blood from the access to the circuit; placed downstream (toward the heart is the venous side) of the venous needle to limit recirculation.
- Venous needle
- The needle returning dialyzed blood to the patient; dislodgement is a life-threatening exsanguination risk.
- Venous needle dislodgement
- A separated venous needle that can cause rapid, fatal blood loss; access sites must stay visible and lines secured throughout treatment.
- Fluid overload
- Excess body water above dry weight causing edema, hypertension, shortness of breath, and risk of pulmonary edema.
- Pulmonary edema
- Fluid in the lungs from severe overload, causing crackles and dyspnea; a reason for urgent ultrafiltration.
- Hypervolemia
- Increased blood volume from interdialytic fluid retention, driving hypertension and heart strain.
- Hypovolemia
- Low blood volume, often from too-rapid or excessive ultrafiltration, leading to hypotension and cramps.
- Ultrafiltration rate (UFR)
- The hourly fluid-removal rate; keeping it under about 13 mL/kg/hr reduces intradialytic hypotension and mortality risk.
- Sodium modeling
- Programmed variation of dialysate sodium during treatment to ease fluid shifts and reduce cramps and hypotension.
- Dialysate sodium
- Sodium in the dialysate, typically about 135–140 mEq/L; a level set too high promotes thirst and weight gain.
- Dialysate potassium
- Potassium in the dialysate (commonly a '2K' or '3K' bath); low baths clear potassium faster but raise arrhythmia risk.
- Normal serum potassium
- Roughly 3.5–5.0 mEq/L; ESRD patients commonly arrive elevated and are corrected during dialysis.
- Hypokalemia
- A low blood potassium level that can cause muscle weakness and cardiac arrhythmias, sometimes from an aggressively low dialysate bath.
- Normal serum sodium
- About 135–145 mEq/L; sodium balance drives thirst, fluid gains, and blood pressure in dialysis patients.
- Hyperphosphatemia
- High blood phosphorus from impaired renal excretion; chronically elevated levels drive bone disease and vascular calcification.
- Normal serum phosphorus
- About 3.0–4.5 mg/dL; dialysis patients are managed with phosphate binders and diet because dialysis clears phosphorus slowly.
- Hypocalcemia
- A low blood calcium level that can cause tetany, numbness, and Chvostek/Trousseau signs; common in renal failure.
- Normal serum calcium
- About 8.5–10.5 mg/dL; calcium balance ties to phosphorus, PTH, and vitamin D in renal bone disease.
- Renal osteodystrophy
- Bone disease of ESRD from disordered calcium, phosphorus, PTH, and vitamin D metabolism.
- Secondary hyperparathyroidism
- Overactive parathyroid glands driven by low calcium and high phosphorus in kidney failure, worsening bone disease.
- Metabolic acidosis
- Acid buildup from failed kidneys; corrected during dialysis by the bicarbonate buffer in the dialysate.
- Anemia of CKD
- Low red-cell mass mainly from reduced kidney erythropoietin production, treated with ESAs and iron.
- Hematocrit
- The percentage of blood volume that is red cells; monitored to manage anemia, with targets individualized per protocol.
- Iron supplementation
- Oral or IV iron given to support erythropoiesis so ESAs can work effectively in dialysis anemia.
- Heparin loading dose
- The initial heparin bolus given at the start of treatment to anticoagulate the extracorporeal circuit.
- Heparin maintenance dose
- A continuous or intermittent heparin infusion during treatment that maintains circuit anticoagulation after the loading dose.
- Activated clotting time (ACT)
- A bedside test of clotting used to titrate heparin so the circuit stays patent without overanticoagulating the patient.
- Heparin-free dialysis
- Anticoagulant-free treatment with periodic saline flushes, used for patients at high bleeding risk.
- Protamine sulfate
- The agent that reverses heparin's anticoagulant effect in cases of bleeding or overdose.
- Heparin-induced thrombocytopenia (HIT)
- An immune drop in platelets with paradoxical clotting after heparin exposure; requires stopping all heparin.
- Pre-dialysis assessment
- Checking weight, vitals, access, temperature, and symptoms before connecting the patient to set UF goal and flag problems.
- Post-dialysis assessment
- Rechecking weight, vitals, bleeding, and symptoms after treatment to confirm goals were met and the patient is stable.
- Hypertension (dialysis)
- High blood pressure common in ESRD, driven mostly by fluid overload and managed largely by reaching dry weight.
- Chest pain during dialysis
- A symptom requiring immediate evaluation; possible causes include hypotension, angina, arrhythmia, or air embolism.
- Nausea and vomiting (intradialytic)
- Common symptoms often tied to hypotension or disequilibrium; managed by treating the underlying cause and protecting the airway.
- Pyrogenic reaction
- Fever, chills, and hypotension during treatment from endotoxin in water/dialysate or a contaminated circuit.
- First-use syndrome
- Hypersensitivity reactions to a new dialyzer or its sterilant, ranging from itching to anaphylaxis.
- Peritoneal dialysis
- A home modality using the peritoneal membrane and dwelling dialysate to clear wastes, an alternative to hemodialysis.
- Dialysate concentrate ratio
- The fixed proportion (e.g., 1:1.83:34) the machine uses to blend acid, bicarbonate, and treated water into final dialysate.
- Proportioning system
- The machine subsystem that mixes concentrates with purified water to the correct ratio and verifies it by conductivity.
- Conductivity alarm
- An alarm when dialysate conductivity falls outside limits, indicating a mixing error that could harm the patient; dialysate is then diverted from the patient.
- Bypass mode
- A machine state that diverts dialysate away from the dialyzer when temperature or conductivity is out of range, protecting the patient.
- Temperature alarm
- An alarm for dialysate outside the safe range; high temperature risks hemolysis and low temperature causes chills.
- Venous drip chamber
- The chamber on the venous line where air is trapped and venous pressure is sensed before blood returns to the patient.
- Arterial drip chamber
- The pre-pump chamber on the arterial line where pressure is monitored and air can be observed.
- Pre-pump arterial pressure
- The negative pressure between the access and the blood pump; very negative readings indicate poor inflow.
- TMP alarm
- An alarm when transmembrane pressure exceeds set limits, indicating clotting, a clamped line, or an excessive UF demand.
- Volumetric ultrafiltration control
- Machine technology that removes fluid by precise volume balancing rather than by pressure alone, improving UF accuracy.
- Heparin pump
- The syringe pump on the dialysis machine that delivers the prescribed continuous heparin infusion into the circuit.
- Line clamps
- Clamps on the blood lines used to safely isolate the circuit during alarms, connection, and disconnection.
- Wet prime
- Filling and rinsing the dialyzer and lines with saline (and sometimes sterilant rinse) so the circuit is air-free and clean before use.
- Rinseback
- Returning the patient's blood from the circuit with saline at the end of treatment to minimize blood loss.
- High-flux dialyzer
- A highly permeable membrane that clears larger middle molecules and water efficiently; requires ultrapure dialysate.
- Low-flux dialyzer
- A less permeable membrane that clears mainly small solutes, with limited removal of larger middle molecules.
- Membrane surface area
- The dialyzer's effective fiber area; larger area increases clearance and is matched to the patient and prescription.
- Clearance (K)
- The volume of blood fully cleared of a solute per minute by the dialyzer, a key term in the Kt/V adequacy equation.
- Single-needle dialysis
- A mode using one access needle with alternating draw-and-return phases; lower efficiency, used when only one site is available.
- Machine disinfection
- Heat or chemical disinfection of the machine's internal fluid pathways between patients to control biofilm and bacteria.
- Heat disinfection
- Using hot water to disinfect the machine's hydraulic pathways, avoiding chemical residual concerns.
- Citric acid descaling
- Periodic acid rinse of the machine to remove calcium and bicarbonate scale that can impair proportioning.
- Peracetic acid
- A common chemical germicide used to disinfect dialyzers and machines; must be rinsed and verified below residual limits.
- Formaldehyde (reprocessing)
- A historical dialyzer-reprocessing germicide; requires strict residual testing and exposure controls due to toxicity.
- Dialyzer label check
- Verifying the reprocessed dialyzer is labeled with the correct patient name, use number, and a negative germicide test before connection.
- Pressure holding test
- A reprocessing leak test confirming the dialyzer holds pressure without breached fibers before it can be reused.
- Pretreatment (water)
- The stages before the RO — sediment filter, softener, and carbon tanks — that protect the membrane and remove disinfectants.
- Empty bed contact time (EBCT)
- The time water spends in a carbon tank; adequate EBCT (commonly six minutes) is required to remove chloramine reliably.
- Worker carbon tank
- The first carbon tank in series; chloramine is tested at its outlet (the worker port) before each treatment day.
- Polisher carbon tank
- The second carbon tank that provides backup chloramine removal if the worker tank breaks through.
- RO membrane
- The semipermeable membrane in reverse osmosis that rejects dissolved ions, bacteria, and pyrogens under high pressure.
- RO percent rejection
- The fraction of dissolved solids the RO removes; a falling rejection rate signals a failing membrane.
- Product water
- The purified water leaving the treatment system that is mixed with concentrates to make dialysate.
- Reject water
- The concentrated waste stream the RO sends to drain carrying the rejected contaminants.
- Ultrafilter (water)
- A final endotoxin-retentive filter on the loop that polishes water/dialysate to ultrapure quality for high-flux use.
- Total chlorine test
- A daily test (free chlorine plus chloramine) at the carbon outlet that must stay below the AAMI chloramine limit before treatment.
- Loop disinfection
- Periodic chemical or heat disinfection of the distribution piping to control bacterial biofilm.
- Dead-leg
- A stagnant, dead-end section of piping where bacteria and biofilm grow; eliminated by a continuously circulating loop.
- Ultrapure dialysate
- Dialysate held to stricter limits (under 0.1 CFU/mL and 0.03 EU/mL endotoxin) required for high-flux therapy.
- Limulus amebocyte lysate (LAL) test
- The assay used to measure endotoxin levels in dialysis water and dialysate.
- Heterotrophic plate count
- The culture method used to count bacteria (CFU/mL) in dialysis water to confirm it meets AAMI limits.
- Hardness test
- A daily water-softener check; a rise in hardness signals softener exhaustion threatening the RO membrane.
- Trace metals (water)
- Contaminants like aluminum, copper, lead, and fluoride that AAMI limits because they can cause toxicity in dialysis patients.
- Aluminum toxicity
- Accumulated aluminum (from water or some binders) causing encephalopathy, anemia, and bone disease in dialysis patients.
- Brine tank
- The salt reservoir that regenerates the water softener's ion-exchange resin during backwash cycles.
- Glove change
- Removing gloves and performing hand hygiene between tasks and patients; gloves are never reused or washed.
- Access site antisepsis
- Cleaning the cannulation site (e.g., with chlorhexidine or alcohol) before needle insertion to prevent access infection.
- Catheter exit-site care
- Aseptic cleaning and dressing of a CVC exit site at each treatment to prevent catheter-related bloodstream infection.
- Catheter-related bloodstream infection
- A serious infection seeded by a central venous catheter; the chief reason catheters are the least preferred access.
- Access infection signs
- Redness, warmth, swelling, drainage, pain, or fever at the access; prompt reporting prevents systemic spread.
- Surface disinfectant contact time
- The wet dwell time a disinfectant must remain on a surface to kill pathogens before wiping dry.
- Single-use vial
- A medication vial used for one patient only and then discarded; reusing it across patients spreads infection.
- Clean versus contaminated areas
- Separating medication preparation and clean supplies from areas where used supplies and blood are handled.
- Exposure incident
- A needlestick or blood/body-fluid contact with mucous membranes or non-intact skin requiring immediate reporting and follow-up.
- Post-exposure prophylaxis
- Evaluation and preventive treatment after a bloodborne-pathogen exposure, guided by the source and worker status.
- HBsAg
- Hepatitis B surface antigen; a positive result identifies an infectious patient who must be isolated with dedicated equipment.
- Anti-HBs titer
- The antibody level confirming hepatitis B immunity; staff and susceptible patients are monitored to ensure protection.
- OSHA Bloodborne Pathogens Standard
- The federal rule (29 CFR 1910.1030) requiring an exposure control plan, free HBV vaccine, PPE, and sharps safety.
- Treatment record documentation
- Recording vitals, weights, UF, blood/dialysate settings, heparin, and events as the legal and clinical record of each run.
- Patient rights
- ESRD patients' rights to information, privacy, respectful care, and participation in their plan of care under CMS rules.
- Scope of practice
- The defined tasks a certified technician may perform under supervision; acting beyond it risks patient harm and licensure issues.
- Informed consent
- The patient's voluntary agreement to treatment after risks and alternatives are explained; the technician supports but does not obtain it.
- Renal diet education
- Teaching patients to limit sodium, potassium, phosphorus, and fluid to control labs and interdialytic weight gain.
- Fluid restriction teaching
- Coaching patients to limit fluid intake (often guided by urine output plus a set allowance) to keep weight gains safe.
- Medication reconciliation
- Reviewing and documenting the patient's current medications, including binders, ESAs, and vitamins, at each encounter.
- Vascular access self-care education
- Teaching patients to check the thrill daily, keep the access clean, avoid BP cuffs/blood draws on that arm, and report changes.
- Transplant referral
- Connecting eligible dialysis patients with kidney-transplant evaluation as a preferred long-term modality.
- Advance directive
- A patient's documented wishes for future care; the team honors it and refers questions to the nurse or social worker.
- Cultural competence
- Delivering respectful, individualized care that accounts for each patient's language, beliefs, and preferences.
- BONENT
- The Board of Nephrology Examiners Nursing and Technology, the body that administers the CHT certification exam.
- Recertification
- Periodic renewal of CHT certification through continuing-education contact hours to keep the credential active.
- Code of ethics
- The professional standards of honesty, competence, confidentiality, and patient advocacy that guide technician conduct.
