Your FREE CHT Flashcards 2026 – 200+ Cards

A treatment that filters wastes and removes excess fluid from the blood through a dialyzer when the kidneys have failed.

The 'artificial kidney' — a cartridge of semipermeable hollow fibers where blood and dialysate exchange wastes and water.

The fluid (purified water plus acid and bicarbonate concentrate) on the dialysate side of the membrane that wastes diffuse into.

Movement of solute wastes (urea, creatinine, potassium) from blood to dialysate down a concentration gradient — how dialysis clears toxins.

Removal of water from the blood driven by the transmembrane pressure gradient — how fluid is taken off to reach dry weight.

Solute dragged along with water during ultrafiltration ('solvent drag'), which removes larger middle molecules.

Movement of water across a semipermeable membrane toward the side with the higher solute concentration; a minor contributor in dialysis.

Blood and dialysate flowing in opposite directions through the dialyzer to maximize the gradient and clearance.

The pressure difference across the dialyzer membrane that governs the ultrafiltration rate.

The preferred long-term vascular access — the surgeon joins the patient's own artery and vein; matures over 6–12 weeks.

A synthetic tube surgically placed to bridge an artery and a vein; the second-choice access, usable in about 2–3 weeks.

A catheter in a large central vein; the last-resort access with the highest bloodstream-infection risk.

The continuous vibration felt over a patent AV fistula or graft, confirming blood flow through the access.

The whooshing sound heard with a stethoscope over a working AV fistula or graft.

Inserting the dialysis needles (arterial and venous) into the vascular access.

Rotating cannulation sites up and down the access to prevent aneurysm formation.

Blood leaking into surrounding tissue when a needle perforates the vessel wall, causing swelling and pain.

Narrowing of the access vessel; signs include high venous pressures, prolonged bleeding, and a changed thrill/bruit.

When the access diverts blood from the hand, causing a cool, pale, painful, numb hand distal to the access.

The lowest weight a patient tolerates without symptoms of fluid overload or depletion — the post-dialysis target.

Fluid weight gained between treatments; large gains require higher ultrafiltration and risk hypotension.

The fluid volume to remove during a treatment — roughly the pre-dialysis weight minus the dry weight.

A drop in blood pressure during treatment — the most common complication, usually from too-rapid fluid removal.

Head-down, feet-up positioning used to treat intradialytic hypotension along with a lower UF rate and saline.

Painful cramps late in treatment from excess or rapid fluid removal; treated by lowering the UF rate and giving saline.

Headache, nausea, restlessness, or seizures from rapid urea and water shifts, common in a patient's first treatments.

Rupture of red blood cells in the circuit — a cherry-red blood line — from chloramine, overheated/hypotonic dialysate, or a kinked line.

Air entering the bloodstream from the circuit — a true emergency the air/foam detector is designed to prevent.

Left lateral with the head and chest tilted down (Trendelenburg) to trap air in the right heart, away from lungs and brain.

The anticoagulant infused during treatment to keep the extracorporeal circuit from clotting.

A dangerously high blood potassium level that can cause cardiac arrhythmias — a key reason for dialysis.

The percent drop in BUN across a treatment; the minimum adequacy target is about 65%.

A calculated dialysis-adequacy index; a common minimum target is about 1.2 per treatment.

End-stage renal disease — irreversible kidney failure requiring dialysis or transplant.

A blood-pressure drop on standing; assessed before and after dialysis to gauge fluid status and removal.

Stopping bleeding at the needle sites after treatment by holding firm, even pressure until the access seals.

The kidney's functional unit (glomerulus plus tubule) that filters blood and forms urine; humans have about one million per kidney.

The volume of plasma filtered by the kidneys per minute; ESRD requiring dialysis is generally a GFR under 15 mL/min.

A nitrogenous waste from protein metabolism measured to assess uremia and, before/after, dialysis adequacy.

A muscle-metabolism waste cleared by the kidneys; a rising serum level reflects worsening kidney function.

The toxic syndrome of accumulated nitrogenous wastes in kidney failure, causing nausea, fatigue, pruritus, and pericarditis.

The dialyzer membrane that lets water and small solutes pass while retaining blood cells and large proteins.

The standard dialyzer design — thousands of tiny capillary fibers carrying blood, bathed by dialysate outside the fibers.

Repeated cannulation of a fistula at the exact same site and angle to form a tunnel track; requires dull needles and strict antisepsis.

A bulging, weakened area in a fistula from repeated same-site cannulation; risks thinning skin and rupture.

Clotting of a fistula or graft, marked by loss of the thrill and bruit; an emergency needing prompt evaluation.

Already-dialyzed blood re-entering the arterial needle, lowering clearance; suggests access stenosis or needles placed too close.

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.

The needle returning dialyzed blood to the patient; dislodgement is a life-threatening exsanguination risk.

A separated venous needle that can cause rapid, fatal blood loss; access sites must stay visible and lines secured throughout treatment.

Excess body water above dry weight causing edema, hypertension, shortness of breath, and risk of pulmonary edema.

Fluid in the lungs from severe overload, causing crackles and dyspnea; a reason for urgent ultrafiltration.

Increased blood volume from interdialytic fluid retention, driving hypertension and heart strain.

Low blood volume, often from too-rapid or excessive ultrafiltration, leading to hypotension and cramps.

The hourly fluid-removal rate; keeping it under about 13 mL/kg/hr reduces intradialytic hypotension and mortality risk.

Programmed variation of dialysate sodium during treatment to ease fluid shifts and reduce cramps and hypotension.

Sodium in the dialysate, typically about 135–140 mEq/L; a level set too high promotes thirst and weight gain.

Potassium in the dialysate (commonly a '2K' or '3K' bath); low baths clear potassium faster but raise arrhythmia risk.

Roughly 3.5–5.0 mEq/L; ESRD patients commonly arrive elevated and are corrected during dialysis.

A low blood potassium level that can cause muscle weakness and cardiac arrhythmias, sometimes from an aggressively low dialysate bath.

About 135–145 mEq/L; sodium balance drives thirst, fluid gains, and blood pressure in dialysis patients.

High blood phosphorus from impaired renal excretion; chronically elevated levels drive bone disease and vascular calcification.

About 3.0–4.5 mg/dL; dialysis patients are managed with phosphate binders and diet because dialysis clears phosphorus slowly.

A low blood calcium level that can cause tetany, numbness, and Chvostek/Trousseau signs; common in renal failure.

About 8.5–10.5 mg/dL; calcium balance ties to phosphorus, PTH, and vitamin D in renal bone disease.

Bone disease of ESRD from disordered calcium, phosphorus, PTH, and vitamin D metabolism.

Overactive parathyroid glands driven by low calcium and high phosphorus in kidney failure, worsening bone disease.

Acid buildup from failed kidneys; corrected during dialysis by the bicarbonate buffer in the dialysate.

Low red-cell mass mainly from reduced kidney erythropoietin production, treated with ESAs and iron.

The percentage of blood volume that is red cells; monitored to manage anemia, with targets individualized per protocol.

Oral or IV iron given to support erythropoiesis so ESAs can work effectively in dialysis anemia.

The initial heparin bolus given at the start of treatment to anticoagulate the extracorporeal circuit.

A continuous or intermittent heparin infusion during treatment that maintains circuit anticoagulation after the loading dose.

A bedside test of clotting used to titrate heparin so the circuit stays patent without overanticoagulating the patient.

Anticoagulant-free treatment with periodic saline flushes, used for patients at high bleeding risk.

The agent that reverses heparin's anticoagulant effect in cases of bleeding or overdose.

An immune drop in platelets with paradoxical clotting after heparin exposure; requires stopping all heparin.

Checking weight, vitals, access, temperature, and symptoms before connecting the patient to set UF goal and flag problems.

Rechecking weight, vitals, bleeding, and symptoms after treatment to confirm goals were met and the patient is stable.

High blood pressure common in ESRD, driven mostly by fluid overload and managed largely by reaching dry weight.

A symptom requiring immediate evaluation; possible causes include hypotension, angina, arrhythmia, or air embolism.

Common symptoms often tied to hypotension or disequilibrium; managed by treating the underlying cause and protecting the airway.

Fever, chills, and hypotension during treatment from endotoxin in water/dialysate or a contaminated circuit.

Hypersensitivity reactions to a new dialyzer or its sterilant, ranging from itching to anaphylaxis.

A home modality using the peritoneal membrane and dwelling dialysate to clear wastes, an alternative to hemodialysis.

The blood path outside the body — access, lines, blood pump, dialyzer, and monitors.

The roller pump that moves blood through the circuit at the prescribed blood flow rate (commonly 300–500 mL/min).

Reads the negative pre-pump pressure; a strongly negative reading suggests poor arterial inflow or an access problem.

Reads the pressure returning to the patient; a high reading suggests a venous-needle obstruction or a clotting circuit.

A safety monitor that stops the pump and clamps the venous line if air is detected, preventing an air embolism.

A monitor that alarms if blood crosses the membrane into the dialysate, signaling a ruptured dialyzer.

A measure of dialysate electrolyte concentration that verifies the concentrates were mixed in the correct ratio.

One of the two dialysate concentrates, kept separate from bicarbonate until the machine proportions them with water.

The buffer concentrate proportioned with acid concentrate and water; mixed at full strength it would precipitate calcium/magnesium.

Kept near body temperature (~37 °C); overheated dialysate causes hemolysis.

The pressure and alarm checks a dialysis machine runs before a patient is connected; a failure takes it out of service.

Flushing the circuit with saline before use to remove air and any residual sterilant before the patient is connected.

The speed the blood pump moves blood through the circuit, set per the physician's order (commonly 300–500 mL/min).

The rate dialysate runs through the dialyzer, typically 500–800 mL/min, set to support adequate clearance.

Cleaning, testing, and disinfecting a dialyzer so the SAME patient can reuse it — never shared between patients.

A fiber-bundle test on a reprocessed dialyzer; it must measure at least 80% of the original to be reused.

Confirming the disinfectant is rinsed below the safe limit before a reprocessed dialyzer touches a patient.

The fixed proportion (e.g., 1:1.83:34) the machine uses to blend acid, bicarbonate, and treated water into final dialysate.

The machine subsystem that mixes concentrates with purified water to the correct ratio and verifies it by conductivity.

An alarm when dialysate conductivity falls outside limits, indicating a mixing error that could harm the patient; dialysate is then diverted from the patient.

A machine state that diverts dialysate away from the dialyzer when temperature or conductivity is out of range, protecting the patient.

An alarm for dialysate outside the safe range; high temperature risks hemolysis and low temperature causes chills.

The chamber on the venous line where air is trapped and venous pressure is sensed before blood returns to the patient.

The pre-pump chamber on the arterial line where pressure is monitored and air can be observed.

The negative pressure between the access and the blood pump; very negative readings indicate poor inflow.

An alarm when transmembrane pressure exceeds set limits, indicating clotting, a clamped line, or an excessive UF demand.

Machine technology that removes fluid by precise volume balancing rather than by pressure alone, improving UF accuracy.

The syringe pump on the dialysis machine that delivers the prescribed continuous heparin infusion into the circuit.

Clamps on the blood lines used to safely isolate the circuit during alarms, connection, and disconnection.

Filling and rinsing the dialyzer and lines with saline (and sometimes sterilant rinse) so the circuit is air-free and clean before use.

Returning the patient's blood from the circuit with saline at the end of treatment to minimize blood loss.

A highly permeable membrane that clears larger middle molecules and water efficiently; requires ultrapure dialysate.

A less permeable membrane that clears mainly small solutes, with limited removal of larger middle molecules.

The dialyzer's effective fiber area; larger area increases clearance and is matched to the patient and prescription.

The volume of blood fully cleared of a solute per minute by the dialyzer, a key term in the Kt/V adequacy equation.

A mode using one access needle with alternating draw-and-return phases; lower efficiency, used when only one site is available.

Heat or chemical disinfection of the machine's internal fluid pathways between patients to control biofilm and bacteria.

Using hot water to disinfect the machine's hydraulic pathways, avoiding chemical residual concerns.

Periodic acid rinse of the machine to remove calcium and bicarbonate scale that can impair proportioning.

A common chemical germicide used to disinfect dialyzers and machines; must be rinsed and verified below residual limits.

A historical dialyzer-reprocessing germicide; requires strict residual testing and exposure controls due to toxicity.

Verifying the reprocessed dialyzer is labeled with the correct patient name, use number, and a negative germicide test before connection.

A reprocessing leak test confirming the dialyzer holds pressure without breached fibers before it can be reused.

The core water-purification step that rejects most dissolved ions, bacteria, and endotoxin.

Activated-carbon tanks that remove chlorine and chloramine — the most safety-critical stage of the water system.

A water disinfectant that causes hemolysis if it reaches a patient; removed by the carbon tanks.

An ion-exchange unit that removes calcium and magnesium hardness to protect the downstream RO membrane.

A depth filter that removes particulates, sand, and rust from incoming city water before the rest of the train.

A mixed-bed resin step that further removes ions after RO; often paired with an ultrafilter for endotoxin.

The continuous piping that carries product water to the machines with no dead-end branches that breed bacteria.

A pyrogen from gram-negative bacterial cell walls that causes fever/chills if present in water or dialysate.

The ANSI/AAMI water and dialysate quality standards that set chemical and microbiological limits for hemodialysis.

The AAMI maximum for free chlorine in product water — about 0.5 mg/L; excess causes hemolysis.

The AAMI maximum for chloramine in product water — about 0.1 mg/L; the carbon tanks' key job.

AAMI limits bacteria in dialysis product water to under 200 CFU/mL, with an action level of 50 CFU/mL.

AAMI limits endotoxin in product water to under 2 EU/mL, with an action level of 1 EU/mL.

Testing chlorine/chloramine between the two carbon tanks before each treatment day to catch breakthrough early.

The stages before the RO — sediment filter, softener, and carbon tanks — that protect the membrane and remove disinfectants.

The time water spends in a carbon tank; adequate EBCT (commonly six minutes) is required to remove chloramine reliably.

The first carbon tank in series; chloramine is tested at its outlet (the worker port) before each treatment day.

The second carbon tank that provides backup chloramine removal if the worker tank breaks through.

The semipermeable membrane in reverse osmosis that rejects dissolved ions, bacteria, and pyrogens under high pressure.

The fraction of dissolved solids the RO removes; a falling rejection rate signals a failing membrane.

The purified water leaving the treatment system that is mixed with concentrates to make dialysate.

The concentrated waste stream the RO sends to drain carrying the rejected contaminants.

A final endotoxin-retentive filter on the loop that polishes water/dialysate to ultrapure quality for high-flux use.

A daily test (free chlorine plus chloramine) at the carbon outlet that must stay below the AAMI chloramine limit before treatment.

Periodic chemical or heat disinfection of the distribution piping to control bacterial biofilm.

A stagnant, dead-end section of piping where bacteria and biofilm grow; eliminated by a continuously circulating loop.

Dialysate held to stricter limits (under 0.1 CFU/mL and 0.03 EU/mL endotoxin) required for high-flux therapy.

The assay used to measure endotoxin levels in dialysis water and dialysate.

The culture method used to count bacteria (CFU/mL) in dialysis water to confirm it meets AAMI limits.

A daily water-softener check; a rise in hardness signals softener exhaustion threatening the RO membrane.

Contaminants like aluminum, copper, lead, and fluoride that AAMI limits because they can cause toxicity in dialysis patients.

Accumulated aluminum (from water or some binders) causing encephalopathy, anemia, and bone disease in dialysis patients.

The salt reservoir that regenerates the water softener's ion-exchange resin during backwash cycles.

Treating every patient's blood and body fluids as potentially infectious through hand hygiene, gloves, and PPE.

Hand washing/sanitizing before and after every patient and after glove removal — the single most important infection-control measure.

Personal protective equipment — gloves, gown, mask, and eye/face protection used by task and exposure risk.

CDC additions to standard precautions: dedicate supplies per station and never share carts or vials between patients.

Cleaning and disinfecting the chair, machine surfaces, and shared items between every patient run.

A closable, puncture-resistant, leak-proof, labeled container for used needles, which are never recapped by hand.

Dialyzing HBV-positive patients in a separate room with dedicated machines, staff, and supplies, and no reuse.

HCV-positive patients are NOT routinely placed in a separate room; strict standard precautions are used instead.

Infectious agents in blood — chiefly hepatitis B, hepatitis C, and HIV — that dialysis precautions guard against.

Recommended for susceptible dialysis patients and offered free to at-risk staff under OSHA rules.

Items dedicated to a single patient or station (e.g., for HBV isolation) to prevent cross-contamination.

A patient's documented hepatitis serology, used to assign isolation and reuse status per CMS requirements.

Discarding blood-contaminated waste and SHARPS into labeled, leak-proof biohazard containers per protocol.

Removing gloves and performing hand hygiene between tasks and patients; gloves are never reused or washed.

Cleaning the cannulation site (e.g., with chlorhexidine or alcohol) before needle insertion to prevent access infection.

Aseptic cleaning and dressing of a CVC exit site at each treatment to prevent catheter-related bloodstream infection.

A serious infection seeded by a central venous catheter; the chief reason catheters are the least preferred access.

Redness, warmth, swelling, drainage, pain, or fever at the access; prompt reporting prevents systemic spread.

The wet dwell time a disinfectant must remain on a surface to kill pathogens before wiping dry.

A medication vial used for one patient only and then discarded; reusing it across patients spreads infection.

Separating medication preparation and clean supplies from areas where used supplies and blood are handled.

A needlestick or blood/body-fluid contact with mucous membranes or non-intact skin requiring immediate reporting and follow-up.

Evaluation and preventive treatment after a bloodborne-pathogen exposure, guided by the source and worker status.

Hepatitis B surface antigen; a positive result identifies an infectious patient who must be isolated with dedicated equipment.

The antibody level confirming hepatitis B immunity; staff and susceptible patients are monitored to ensure protection.

The federal rule (29 CFR 1910.1030) requiring an exposure control plan, free HBV vaccine, PPE, and sharps safety.

Federal ESRD-facility regulations (42 CFR §494) governing dialysis care, safety, and technician certification.

Patient teaching on diet, fluid intake, and the medication regimen given before the patient leaves the unit.

Medications taken WITH meals to lower phosphorus absorption and limit bone and vascular disease in ESRD.

A medication that stimulates red-cell production to treat the anemia of kidney failure.

A sudden, often reversible loss of kidney function — distinct from the irreversible failure of ESRD.

Ongoing nephrology learning the technician completes (e.g., 8 contact hours after every 3rd exam attempt) to stay current.

Maintaining appropriate limits with patients — declining gifts and personal involvement — while staying caring.

Quality Assessment and Performance Improvement — the facility process technicians help drive to improve care and safety.

Objective, prompt recording of emergencies, equipment/device events, and patient-care events as the legal record.

Draw a single line through the error, write 'error,' then initial and date — never erase or use correction fluid.

Sharing protected health information only on a need-to-know basis; phone/family requests are referred to the nurse.

An experienced technician who orients, teaches, and evaluates new staff during their training.

The forms of kidney-failure therapy — in-center and home hemodialysis, peritoneal dialysis, and transplant.

The team plan (nephrologist, RN, technician, dietitian, social worker) coordinating each patient's care.

Recording vitals, weights, UF, blood/dialysate settings, heparin, and events as the legal and clinical record of each run.

ESRD patients' rights to information, privacy, respectful care, and participation in their plan of care under CMS rules.

The defined tasks a certified technician may perform under supervision; acting beyond it risks patient harm and licensure issues.

The patient's voluntary agreement to treatment after risks and alternatives are explained; the technician supports but does not obtain it.

Teaching patients to limit sodium, potassium, phosphorus, and fluid to control labs and interdialytic weight gain.

Coaching patients to limit fluid intake (often guided by urine output plus a set allowance) to keep weight gains safe.

Reviewing and documenting the patient's current medications, including binders, ESAs, and vitamins, at each encounter.

Teaching patients to check the thrill daily, keep the access clean, avoid BP cuffs/blood draws on that arm, and report changes.

Connecting eligible dialysis patients with kidney-transplant evaluation as a preferred long-term modality.

A patient's documented wishes for future care; the team honors it and refers questions to the nurse or social worker.

Delivering respectful, individualized care that accounts for each patient's language, beliefs, and preferences.

The Board of Nephrology Examiners Nursing and Technology, the body that administers the CHT certification exam.

Periodic renewal of CHT certification through continuing-education contact hours to keep the credential active.

The professional standards of honesty, competence, confidentiality, and patient advocacy that guide technician conduct.