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CCHTs can set up machines but cannot start treatment until RN assessment is done. Starting independently (B), involving patients (C), or skipping checks (D) is unsafe.

Cramps near end of dialysis usually result from excessive fluid removal and intravascular depletion. Hyperkalemia (B) causes weakness/arrhythmias. Hypoglycemia (C) presents differently. Infection (D) causes redness/swelling, not acute cramps. Intervention: reduce UF, saline bolus per RN.

Hyperkalemia requires effective potassium removal. A lower-potassium dialysate (1.0–2.0 mEq/L) maximizes the gradient for potassium diffusion into dialysate. Higher potassium baths (B, C, D) are used for patients at risk of hypokalemia or stable levels, not for severe hyperkalemia. The technician does not select the bath independently but must understand the rationale for safety checks.

Explanation (150–250 words):

Overheated dialysate damages red blood cells, leading to hemolysis. Symptoms include nausea, chest/back pain, confusion, and hypotension. The blood may appear cherry-red. The CCHT must immediately place the machine in bypass, stop treatment, do not return blood, and notify the RN/provider. Hypoglycemia (B) produces sweating/tremors. Hypotension (C) occurs from excess fluid removal but not with cherry-red blood. Hyperkalemia (D) is a pre-treatment issue. Monitoring dialysate temperature is a vital safety check.

Biohazard waste must be stored securely in designated areas. Leaving in hallways (B) or patient zones (C) risks exposure. Reusing (D) violates OSHA and infection control.