Cheat sheet
CCHT Cheat Sheet
Clinical
- 48-52% of exam
- Assessment Access Treatment Complications Patient Education
Technical
- 21-25% of exam
- Machine Circuit Water Dialysate Alarms
Environment
- 13-17% of exam
- Infection Control Disinfection Safety Spills Emergencies
Role Responsibilities
- 10-14% of exam
- Scope Documentation Communication Privacy Team Roles
Quick Facts
- Exam CCHT
- Questions 150 items
- Time 3 hours
- Pass Standard 95
- Correct 74%
- Fee $225
- Validity 3 years
- Largest domain Clinical
Access Check CL
- Listen and feel for access patency
- Bruit: listen Thrill: feel Absent: report
Fistula vs Graft CL
Fistula
- Native vessels
- Preferred access
- Matures slowly
Graft
- Synthetic material
- Quicker use
- Higher infection
- Native vs synthetic
Complication Picker CL
- Cramps during UF → Check UF
- Severe hypotension → Notify nurse
- Chest pain → Notify nurse
- Fever/chills → Report infection
- Needle infiltrates → Stop/reassess
- Air alarm → Protect patient
Dialysis Principles CL
- Diffusion Solutes move
- Osmosis Water moves
- Ultrafiltration Fluid removal
- Convection Solvent drag
- Kt/V Adequacy measure
- URR Urea reduction
- Target weight Postdialysis goal
- IDWG Between-treatment gain
Dialysis Movement CL
- Diffusion solutes; UF fluid
- Diffusion: waste UF: water Convection: drag
Catheter vs AV Access CL
Catheter
- Central line
- High infection
- Sterile care
AV access
- Arm access
- Cannulated
- Check thrill
- Line vs needles
Access Picker CL
- Best long-term → AV fistula
- Synthetic access → AV graft
- No bruit/thrill → Notify nurse
- Central catheter → Sterile care
- Cannulation concern → Ask nurse
- Bleeding persists → Escalate
Clinical Assessment CL
- Pre-weight Before treatment
- Post-weight After treatment
- BP Trend closely
- Edema Fluid excess
- Shortness breath Report promptly
- Access check Before cannulation
- Medication change Tell nurse
- Pain Assess/report
Diffusion vs UF CL
Diffusion
- Solute movement
- Concentration gradient
- Urea removal
UF
- Fluid removal
- Pressure driven
- Weight target
- Solutes vs fluid
Vascular Access CL
- AV fistula Native access
- AV graft Synthetic bridge
- Catheter Central line
- Thrill Palpable vibration
- Bruit Audible whoosh
- Infiltration Needle leak
- Stenosis Narrowed vessel
- Aneurysm Bulging area
Treatment Monitoring CL
- UF goal Fluid target
- Blood flow Pump speed
- Venous pressure Return resistance
- Arterial pressure Pull resistance
- TMP Membrane pressure
- Conductivity Dialysate concentration
- Temperature Dialysate warmth
- Heparin Clot prevention
Complications CL
- Hypotension Low pressure
- Cramps Rapid fluid removal
- Chest pain Notify nurse
- Air alarm Clamp/protect
- Blood leak Stop per policy
- Hemolysis Blood damage
- Fever Infection concern
- Clotting Circuit blockage
Labs + Education CL
- Potassium Cardiac risk
- Phosphorus Bone/mineral
- Calcium Mineral balance
- Albumin Nutrition marker
- Hemoglobin Anemia marker
- BUN Uremia marker
- Creatinine Kidney marker
- Teach-back Confirm understanding
Water Chain TE
- Safe water protects every treatment
- Softener Carbon RO Disinfection
Conductivity vs pH TE
Conductivity
- Ionic strength
- Concentrate mix
- Machine check
pH
- Acid-base
- Dialysate safety
- Independent check
- Strength vs acidity
Technical Picker TE
- Chlorine concern → Carbon check
- Water purity → RO system
- Dialysate strength → Conductivity
- Acid-base check → pH
- Air risk → Air detector
- Pressure alarm → Assess circuit
Machine + Circuit TE
- Dialyzer Artificial kidney
- Blood pump Moves blood
- Arterial line Blood to dialyzer
- Venous line Blood to patient
- Air detector Stops air
- Clamp Stops flow
- Prime Remove air
- Alarm Investigate first
Water + Dialysate TE
- RO Purifies water
- Carbon tank Removes chlorine
- Softener Removes hardness
- Conductivity Concentrate strength
- pH Acid-base check
- Bicarbonate Buffer concentrate
- Cultures Microbial checks
- Disinfection Kill microbes
Environment Safety EN
- Hand hygiene Before/after care
- Gloves Blood contact
- Face shield Splash risk
- Station cleaning Between patients
- Spill Contain/report
- Sharps Puncture container
- Evacuation Know route
- Power failure Follow policy
Role Rule RO
- Assess risk, report fast, document facts
- Observe Escalate Record
Clinical vs Technical RO
Clinical
- Patient status
- Access care
- Complications
Technical
- Machine setup
- Water checks
- Alarms
- Patient vs system
Exam Format RO
- Total 150 questions
- Time 3 hours
- Passing Standard score 95
- Correct About 74%
- Clinical Largest domain
- Application Most items
- Renewal Every 3 years
Scope vs Order RO
Scope
- Technician role
- Policy limits
- Report concerns
Order
- Prescription details
- Provider direction
- Nurse verifies
- Allowed vs prescribed
Role + Communication RO
- Scope Technician limits
- RN Clinical direction
- Documentation Timely accurate
- Privacy Protect dignity
- Confidentiality Protect information
- Incident Report/document
- Advocacy Speak concerns
- Handoff Clear report
Common Traps
Bruit vs thrill
- Bruit is heard ≠ Thrill is felt
UF vs diffusion
- UF removes water ≠ Diffusion removes solute
Tech vs nurse
- Tech reports changes ≠ Nurse evaluates care
Alarm silence
- Investigate alarm ≠ Do not ignore
Catheter care
- High infection risk ≠ Sterile technique matters
Post-weight vs target
- Post-weight is actual ≠ Target is goal
Last Minute
- 1. Clinical is about half
- 2. 150 questions, 3 hours
- 3. Pass = standard score 95
- 4. Bruit heard; thrill felt
- 5. Fistula is preferred
- 6. UF removes fluid
- 7. Diffusion removes solutes
- 8. Conductivity checks mix
- 9. Report chest pain immediately
- 10. Document facts promptly