Fresenius Water Treatment Exam, Fresenius Hemodialysis
Study Guide Questions with Verified Solution.
Types of water sources? - ANS Surface and Ground
Examples of surface water? - ANS lakes, streams, rivers, reservoirs
Examples of ground water? - ANS Wells, springs
FMC follows water quality standards according to whose standards? - ANS AAMI
Bone disease can be caused by ________ in product water? - ANS Aluminum
Aluminum in product water put the patient at risk for ________? - ANS Anemia
Aluminum, chloramphenicol, copper or zinc may cause _______ when present in water
used for dialysis? - ANS Hemolysis
The presence of bacteria in the bloodstream is? - ANS Sepsis
Parts of a bacteria cell wall, released from dead bacteria is? - ANS Endotoxin
What are characteristics of bacteria/viruses? - ANS 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? - ANS Less than 0.1 ppm (0.00-0.09 ppm)
A serious side effect if chlorine crosses the dialyzer membrane is? - ANS Hemolysis
Chloramphenicol is a combination of ________ and _________? - ANS Chlorine and
Ammonia
Chlorine and chloramphenicol are added to city water for what reason? - ANS To
reduce or eliminate bacteria
A patient complication due to the exposure of blood to chlorine and chloramines is? -
ANS Hemolysis
Examples of the symptoms the patient might experience from Hemolysis. - ANS 1.
Chest pain
2. Shortness of breath
3. Cherry pop red / translucent blood
Where does the water pathway start in the dialysis facility? - ANS City Water Inlet
The first piece of equipment that the water goes through in the dialysis facility is the? -
ANS Backflow Preventer
What is the function of the backflow preventer? - ANS Prevents water from flowing back
into the city's water suppl.
The recommended water temperature for ideal RO operation is? - ANS 77 degrees F
, What is the function of the Chemical Feed pump? - ANS Help adjust the pH level of the
water
What is the function of the Sediment Filters? - ANS Removes larger particles from the
incoming water
What is the function of the multimedia filter? - ANS Removes particles 10 microns in
size or larger
What is the size of particulate matter removed by the multimedia filter? - ANS 10
What is the function of the Carbon Filter/Tank? - ANS to remove chlorine and
Chloramines and other organic materials.
Carbon filters remove chlorine and chloramines by the process of? - ANS Adsorption
What is the "Empty Bed Contact Time?" - ANS 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. - ANS 10, 12
RPC Ultra-Low Total Chlorine test strips are used to test for? - ANS 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?
- ANS 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. - ANS 15
Total chlorine testing for a central water system must be performed and documented by
__ qualified staff members. - ANS 2
A sample container is always rinsed __ times before a sample is collected for testing. -
ANS 3
___ Ml is the correct amount of water to collect for total chlorine testing when using
RPC Ultra-Low Total Chlorine test strips - ANS 100
How long is the RPC Ultra-Low Total Chlorine test stripe immersed in the sample? -
ANS 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? - ANS 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? - ANS Immediately stop treatments
_______ And _______ are removed from water by the softener by the process of ion
exchange? - ANS Calcium and Magnesium
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