Fresenius Water Test-Answered

Two sources of water available to a dialysis facility - ANSWER-Ground Surface Examples of ground water - ANSWER-Wells Springs Examples of surface water - ANSWER-Lakes Rivers Streams Ponds Unsafe water places the dialysis patient at risk for _____ or even _____ - ANSWER-Physical harm Death Exposure to aluminum can cause __________ - ANSWER-anemia bone disease Neuro/Encephalopathy Bone disease can be caused by exposure to ________ - ANSWER-Aluminum Fluoride Bacteria and virus can cross through a _____ or _______ membrane - ANSWER-Torn Damaged Bacteria and virus can cause _____ - ANSWER-Sepsis Part of a bacteria cell wall, released with it is destroyed or killed - ANSWER-Endotoxin S/S of a pyrogenic reaction - ANSWER-Fever Uncontrollable shakes Chills Hypotension N/V Organic contaminants that may be found in source water located close to golf course or farms - ANSWER-Pesticides Herbicides Inorganic contaminants that may require the use of a multi-media filter - ANSWER-Mud Silt Sand Bound chlorine is also ______ chlorine - ANSWER-Combined Free chlorine is ______ - ANSWER-Unbound _____ and _____ combine to make chloramine - ANSWER-Chlorine Ammonia The acceptable range for Total Chlorine is ____-_____ - ANSWER-0.00-0.09 Total Chlorine testing is done initially _____ and then ______ - ANSWER-Before 1st pt Tx every 4 hours Exposure to high levels of chlorine can lead to ______ - ANSWER-Hemolysis Destruction of red blood cells - ANSWER-Hemolysis S/S of hemolysis - ANSWER-Chest pain SOB N/V In hemolysis, blood will be ______ - ANSWER-translucent cherry pop colored City water entering the facility begins the _____ pathway - ANSWER-Fluid The purpose of the backflow preventors is to ______ - ANSWER-prevent water flowing back into city water and contaminating local water supply Optimal temperature of incoming water is ____ - ANSWER-77 degrees The booster pump works together with the captive air tank to _________ - ANSWER-provide the volume of water required for different needs of the facility pH is adjusted with the use of a ____ - ANSWER-Chemical Feed Pump The sodium bifulsite injection system aids pH control and in the removal of chlorine. It is considered a _____ system - ANSWER-SMART Multi-media tanks (sediment filters) are designed to remove large particles. The size of the particles removed is ____ microns - ANSWER-10+ Carbon tanks remove _____ and ______ - ANSWER-Chlorine Chloramine Time water must be in contact with carbon - ANSWER-Empty bed contact time AAMI requirement for EBCT is ____ - ANSWER-minimum 10 minutes The purpose of adding chlorine and chloramine to city water is ____ - ANSWER-To reduce or eliminate bacterial growth Prior to testing the RO must be running for ______. This is important to allow the staff member to collect a _____ sample. - ANSWER-15 minutes Fresh At the start of the day the first Total Chlorine sample is taken from ________ and the second is taken ______ - ANSWER-1. Post carbon tank/Filter 1 2. Post RO The Total Chlorine test requires ___ signatures from qualified staff - ANSWER-two If the clinic has initiated the "Breakthrough Action Policy", the _________ must sign the TCL-2 log in order to resume normal operation - ANSWER-Medical director If the Total Chlorine post filter 1 is 0.10, an immediate action would be to: - ANSWER-Immediately test Post Carbon Tank 2, and initiate Breakthrough Action Plan If Total Chlorine post RO is 0.10, the immediate action would be: - ANSWER-immediately stop all Tx Temperatures of the fed water that exceed ____ will cause damage to the ______. This alarm will engage when the temperature is too high. - ANSWER-90 degrees. RO membranes Warm water will cause the RO to produce: - ANSWER-Poor quality water Water softeners remove ____ and ____ - ANSWER-Calcium Magnesium A delta pressure that exceeds ______ psi would be unacceptable for the water softener - ANSWER-10 psi The "hard water" limit is ____ ppm. - ANSWER-10 ppm Hardness tests done daily under normal conditions are performed: - ANSWER-1. Prior to first pt Tx 2. End of last pt run of the day. If no water softener is in the facility, water hardness is done _____ - ANSWER-Weekly The water softener uses the process of ______ exchange to "soften" hard water - ANSWER-ionic Invisible radiation used to alter the DNA of bacteria is provided by a: - ANSWER-Ultraviolet (UV) light Wave length of the UV light is _____ nanometers - ANSWER-254 nanometers Pre filters for the RO machine are sized at ___ microns - ANSWER-5 microns A delta pressure of _____ psi would indicate the pre filter needed to be changed - ANSWER-10+ psi the RO should produce water that meets the ______ standards - ANSWER-AAMI Water exiting the RO machine (AKA Permeate or RO water) - ANSWER-Product water The TDS setting of the RO should be set at _____ times the TDS reading - ANSWER-two One method to test the performance of the RO is to calculate: - ANSWER-Percent Rejection: (Feed TDS-Permeate TDS/Feed TDS X 100) When the H. drops to _______, the RO membranes must be replaced - ANSWER- 80% One particle the RO will not remove is ______ - ANSWER-Chlorine/Chloramine. (Carbon tanks perform this task) Water exceeding the TDS alarm limit will cause the product diverter to send water to the ______ - ANSWER-Drain When is the low level alarm set of the holding tank? - ANSWER-Always The loop alarm should run this often. - ANSWER-24 hrs/7 days a week Ultra filters are located: - ANSWER-After the holding tanks, in the loops of the water treatment system The loop piping is usually made of _____ or ______ - ANSWER-PVC pipe Stainless steel The TDS meter is standardized _______ with full calibration done ______ - ANSWER-Daily Weekly Ideal pH of incoming water is ______ - ANSWER-7.0 The HACH meter is verified _________ - ANSWER-Daily prior to use The vial for testing Total Chlorine is filled with _____ mL of sample water - ANSWER-10 mL After adding the pillow packet to the test sample, the sample is read at ____ to ____ minutes - ANSWER-3 to 6 min The purpose of the Residual Chlorine strips is to test for _________ - ANSWER-Residual Bleach RPC strips are used to test: - ANSWER-Total Chlorine when the HACH meter is not available. Hardness strips are used to test for _____ and _____ - ANSWER-Calcium Magnesium If the RO fails the facility would use the "Alternate Water Plan". The method used would be ___________. - ANSWER-Deionization tanks If the TDS meter is set on 10 and the reading is 0.4, the reading is ____. - ANSWER-4 Prior to sampling, the sample container is rinsed ____ times - ANSWER-3 A pHeonix meter can