34 parts of water are required if a dialysis machine is configured to use 36.1X parts dialysate and the concentrate proportioning ratio asks for 1.00 parts acid and 1.10 parts bicarbonate: 1.00 + 1.10 + 34 = 36.1. To avoid mistakes in mixing, concentrates are marked with symbols (such as triangles, ovals, and rectangles) that show which concentrates are compatible. A specific amount of water must be used to dilute each concentrate.
The best strategy for the technician in this situation is to talk the patient through each step of the procedure: "Now I'm going to insert the arterial needle into the fistula." This method provides passive learning for the patient, who should eventually have a solid understanding of the procedures. There are a variety of reasons why patients can be reluctant to learn about hemodialysis, including fear, rage, or anxiety.
When using an alcohol-based hand rub, the product should be placed to one palm and the hands should be rubbed together until the product is dry. Make sure the product is evenly distributed across the surface of the hands, especially in between the fingers. It's crucial to apply the amount of hand cream that the manufacturer advises. If dirt or debris is visible on the hands or if the hands have been in contact with bodily fluids, they should be cleansed with soap and water.
The optimal time to take a phosphate binder is with meals and snacks since they must bond with dietary phosphorus in the gut so that it can be eliminated in the patient's stool. Only a small portion of the extra phosphorus can be eliminated by hemodialysing. Patients should be advised to stay away from foods high in phosphorus like dairy products, nuts, dry beans, whole grains, and sodas as phosphorus binders cannot completely remove all dietary phosphorus.
A dialyzer's mass transfer coefficient describes how easily solutes—typically urea—pass across the membrane. The membrane clearance (Ko) multiplied by the dialyzer's surface area (A) yields the mass transfer coefficient. Higher KoA membranes are more permeable than lower KoA membranes. KoA values for the majority of dialyzer membranes range from 800 to 1600 mL/min. A membrane's KoA ranges from less than 450 mL/min for low efficiency membranes to more than 700 mL/min for high efficiency membranes.
A technique for achieving equilibrium is diffusion. It involves the transfer of solutes from a region of higher concentration to an area of lower concentration through a semipermeable barrier. In hemodialysis, solutes are transferred from the blood into the dialysate through the semipermeable dialyzer membrane when the blood passes through the dialyzer. The contact time, however, is too brief for all of the solutes to be eliminated because of how quickly the blood travels.
The extracellular space (outside of body cells) and intracellular space (inside body cells) are both fluid-filled regions of the body. The intravascular space is found inside blood veins, whereas the interstitial space is found between bodily cells. Only 10% of the body's water is found in the intravascular region, while the remaining 80% is found in the interstitial area. The intracellular space holds the majority of bodily water (70%) in its structure.
