Water CCHT QUESTIONS AND ANSWERS GRADED A
Why is water treatment necessary for dialysis? Correct Answer: -Patient safety
*very large exposure volume
*little or no renal excretion
*dialyzer membrane is sole barrier
-Prevent equipment damage
How much water does the average person drink per week? Correct Answer: 10-14L
What is the average amount of water a dialysis patient is exposed to per week? Correct Answer:
360L
Water contaminants aluminum, chloramines, copper, and zinc can cause what symptom? Correct
Answer: Anemia
Water contaminants aluminum and fluoride can cause what symptom? Correct Answer: Bone
Disease
Water contaminants chloramines, copper, and nitrates can cause what symptom? Correct
Answer: Hypertension
Water contaminants calcium and sodium can cause what symptom? Correct Answer:
Hypotension
Water contaminants sulfates and low pH can cause what symptom? Correct Answer: Metabolic
Acidosis
Water contaminants bacteria, calcium, copper, endotoxin, low pH, magnesium, nitrates, sulfates,
and zinc can cause what symptom Correct Answer: Muscle weakness
Water contaminant aluminum can cause what symptom? Correct Answer: Nausea and Vomiting
Who sets the recommended standards for water used in the hemodialysis procedure? Correct
Answer: -International Organization of Standardization(ISO)
-Association for the Advancement of Medical Instrumentation(AAMI)
What is the acceptable level of water/dialysate culture parameters? Correct Answer: 50 cfu/ml
What is the action level for water/dialysate culture parameters? Correct Answer: 50-99 cfg/ml
What is the unacceptable level for water/dialysate culture parameters? Correct Answer: 100
cfg/ml
What is the acceptable water endotoxin parameter level? Correct Answer: Below 0.12 EU/ml
, What is the action level for water endotoxin parameter? Correct Answer: 0.12 EU/ml to less
than 0.25 EU/ml
What is an unacceptable level for water endotoxin parameter? Correct Answer: 0.25 EU/ml or
greater
What is an acceptable level for dialysate endotoxin parameters? Correct Answer: Below 0.25
EU/ml
What is the action level for dialysate endotoxin parameters? Correct Answer: 0.25 EU/ml to less
than 0.50 EU/ml
What is the unacceptable level of dialysate endotoxin parameters? Correct Answer: 0.50 EU/ml
or greater
What are the water treatment processes? Correct Answer: 1. Pre-Tx
-before the RO
2. Purification
-removes chemical and bacterial contaminants
3. Distribution Loop
What does the back flow preventer do? Correct Answer: Prevents water from flowing back into
city water
Water Softener Correct Answer: -Primarily for RO protection
-Removes "hardness ions" (calcium and magnesium)
-Regenerate with pellet salt
Primary & Secondary Carbon Tanks/Filters are... Correct Answer: -Responsible for the removal
of chlorine and chloramines from city water
Delta pressure must not exceed... Correct Answer: 15psi
Carbon Filter Monitoring Correct Answer: -Test before first treatment of the day
**Test every 4 hours after
How long must the RO run before testing? Correct Answer: 15 minutes
What are acceptable results for total chlorine? Correct Answer: 0.1mg/L or less
What should you do if total chlorine levels are too high after primary carbon tank? Correct
Answer: Repeat, check after second tank
If post secondary carbon tank is within range, how often do we monitor? Correct Answer: Every
30 minutes and document
Why is water treatment necessary for dialysis? Correct Answer: -Patient safety
*very large exposure volume
*little or no renal excretion
*dialyzer membrane is sole barrier
-Prevent equipment damage
How much water does the average person drink per week? Correct Answer: 10-14L
What is the average amount of water a dialysis patient is exposed to per week? Correct Answer:
360L
Water contaminants aluminum, chloramines, copper, and zinc can cause what symptom? Correct
Answer: Anemia
Water contaminants aluminum and fluoride can cause what symptom? Correct Answer: Bone
Disease
Water contaminants chloramines, copper, and nitrates can cause what symptom? Correct
Answer: Hypertension
Water contaminants calcium and sodium can cause what symptom? Correct Answer:
Hypotension
Water contaminants sulfates and low pH can cause what symptom? Correct Answer: Metabolic
Acidosis
Water contaminants bacteria, calcium, copper, endotoxin, low pH, magnesium, nitrates, sulfates,
and zinc can cause what symptom Correct Answer: Muscle weakness
Water contaminant aluminum can cause what symptom? Correct Answer: Nausea and Vomiting
Who sets the recommended standards for water used in the hemodialysis procedure? Correct
Answer: -International Organization of Standardization(ISO)
-Association for the Advancement of Medical Instrumentation(AAMI)
What is the acceptable level of water/dialysate culture parameters? Correct Answer: 50 cfu/ml
What is the action level for water/dialysate culture parameters? Correct Answer: 50-99 cfg/ml
What is the unacceptable level for water/dialysate culture parameters? Correct Answer: 100
cfg/ml
What is the acceptable water endotoxin parameter level? Correct Answer: Below 0.12 EU/ml
, What is the action level for water endotoxin parameter? Correct Answer: 0.12 EU/ml to less
than 0.25 EU/ml
What is an unacceptable level for water endotoxin parameter? Correct Answer: 0.25 EU/ml or
greater
What is an acceptable level for dialysate endotoxin parameters? Correct Answer: Below 0.25
EU/ml
What is the action level for dialysate endotoxin parameters? Correct Answer: 0.25 EU/ml to less
than 0.50 EU/ml
What is the unacceptable level of dialysate endotoxin parameters? Correct Answer: 0.50 EU/ml
or greater
What are the water treatment processes? Correct Answer: 1. Pre-Tx
-before the RO
2. Purification
-removes chemical and bacterial contaminants
3. Distribution Loop
What does the back flow preventer do? Correct Answer: Prevents water from flowing back into
city water
Water Softener Correct Answer: -Primarily for RO protection
-Removes "hardness ions" (calcium and magnesium)
-Regenerate with pellet salt
Primary & Secondary Carbon Tanks/Filters are... Correct Answer: -Responsible for the removal
of chlorine and chloramines from city water
Delta pressure must not exceed... Correct Answer: 15psi
Carbon Filter Monitoring Correct Answer: -Test before first treatment of the day
**Test every 4 hours after
How long must the RO run before testing? Correct Answer: 15 minutes
What are acceptable results for total chlorine? Correct Answer: 0.1mg/L or less
What should you do if total chlorine levels are too high after primary carbon tank? Correct
Answer: Repeat, check after second tank
If post secondary carbon tank is within range, how often do we monitor? Correct Answer: Every
30 minutes and document
