FRESENIUS WATER TREATMENT EXAMQUESTIONS WITH CORRECT ANSWERS

Types of water sources? - Surface and Ground Examples of surface water? - lakes, streams, rivers, reservoirs Examples of ground water? - Wells, springs FMC follows water quality standards according to who's standards? - AAMI Bone disease can be caused by ________ in product water? - Aluminum Aluminum in product water put the patient at risk for ________? - Anemia Aluminum, chloramphenicol, copper or zinc may cause _______ when present in water used for dialysis? - Hemolysis The presence of bacteria in the bloodstream is? - Sepsis Parts of a bacteria cell wall, released from dead bacteria is? - Endotoxin What are characteristics of bacteria/viruses? - 1. Grows rapidly 2. Too large to cross an intact dialysis membrane, but can cross a damaged/torn membrane 3. May produce endotoxins or biofilm Safe range for total chlorine is? - Less than 0.1 ppm (0.00-0.09 ppm) A serious side effect if chlorine crosses the dialyzer membrane is? - Hemolysis Chloramphenicol is a combination of ________ and _________ ? - Chlorine and Ammonia Chlorine and chloramphenicol are added to city water for what reason? - To reduce or eliminate bacteria A patient complication due to the exposure of blood to chlorine an chloramines is? - Hemolysis Examples of the symptoms the patient might experience from Hemolysis. - 1. Chest pain 2. Shortness of breath 3. Cherry pop red / translucent blood Where does the water pathway start in the dialysis facility? - City Water Inlet The first piece of equipment that the water goes through in the dialysis facility is the? - Backflow Preventer What is the function of the backflow preventer? - Prevents water from flowing back into the city's water suppl. The recommended water temperature for ideal RO operation is? - 77 degrees F What is the function of the water booster pump? - Boosts incoming city water pressure What is the function of the Captive Air Tank (bladder tank)? - Help maintain a minimum pressure What is the function of the Chemical Feed pump? - Help adjust the pH level of the water What is the function of the Sediment Filters? - Removes larger particles from the incoming water What is the function of the multimedia filter? - Removes particles 10 microns in size or larger What is the size of particulate matter removed by the multimedia filter? - 10 What is the function of the Carbon Filter/Tank? - To remove chlorine and Chloramines and other organic materials. Carbon filters remove chlorine and chloramines by the process of? - Adsorbtion What is the "Empty Bed Contact Time?" - The length of time that the water is exposed to carbon AAMI requires a minimum EBCT of __ minutes, FMC requires a minimum EBCT of __ minutes for new water treatment systems. - 10, 12 RPC Ultra-Low Total Chlorine test strips are used to test for? - Total Chlorine in the water after GAC #1 and Post RO. When and at what frequency is routine total chlorine testing performed per FMS policy? - Prior to the initiation of treatment and at least every 4 hours. The reverse osmosis (RO) machine runs for __ minutes before performing any total chlorine testing. - 15 Total chlorine testing for a central water system must be performed and documented by __ qualified staff members. - 2 A sample container is always rinsed __ times before a sample is collected for testing. - 3 ___ ml is the correct amount of water to collect for total chlorine testing when using RPC Ultra-Low Total Chlorine test strips - 100 How long is the RPC Ultra-Low Total Chlorine test stripe immersed in the sample? - 60 seconds If a chlorine breakthrough occurs post GAC (Carbon) Filter #1, what are the several steps that are taken to ensure patients are safe from harm? - 1. Place all machines in bypass 2. Repeat test (optional) 3. Immediately test after GAC#2/Carbon Tank#2 4. If results are less than 0.1, notify the CM, MD, and ATOM/BMT If total chlorine testing after the second carbon tank shows results above the action limit, what action is immediately taken? - Immediately stop treatments _______ and _______ are removed from water by the softener by the process of ion exchange? - Calcium and Magnesium Water hardness is measured in parts per million (PPM). The FMS acceptable limit for water hardness post softener is __ PPM. Normally, there are __ water hardness tests done daily. - 10, 2 What do hardness strips test for? - Calcium and magnesium The RO must run for how long prior to testing water? - 15 minutes. What is "product water" ? - Water exiting the RO that meets the AAMI standards for water to be used for dialysis