Fresenius Water Treatment Exam, Fresenius
Hemodialysis Study Guide
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
Hemodialysis Study Guide
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
