FRESENIUS WATER TREATMENT EXAM,
FRESENIUS HEMODIALYSIS STUDY
GUIDE
n 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)
FRESENIUS HEMODIALYSIS STUDY
GUIDE
n 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)
