Fresenius ~ Water Treatment Study Guide

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the FMS action level for endotoxin for water in the tank, piping & distribution loop

.125 EU/ml

the FMS action level for endotoxin in Product water exiting RO

.125 EU/ml

FMS action level for bacteriain Product water exiting RO

.125 cfu/ml

safe range for total Chlorine

0.00-0.09

AAMI requires a minimum for EBCT

10 minutes

correct amount of water to collect for total chlorine testing when using RPC Ultra-Low Total Chlorine test strips

100ml

FMC requires a minimum for EBCT

12 minutes

how long does the Reverse Osmosis (RO) machine run before performing any total chlorine testing

15 minutes

Total chlorine testing for a central water system must be perfomed by and documented by how many Qualified staff members

2

how many water test done daily

2

the FMS action level for bacteria for water in tank, piping & distribution loop

20 cfu/ml

Ultra Violet (UV) Lights are effective when they have a wave length of

254 nanometers

how many times is sample container rinsed before sample is collected for testing

3

how long is RPC Ultra-Low total Chlorine test strip immersed in the sample

60 seconds

recommended water temperature for ideal RO operation

77 degrees F

FMC follows water quality standards according to _____

AAMI Standards

Function of the Chemical Feed Pumps

Adjust pH by adding acid or sodium bisulfate

Aluminum, chloramines, copper or zinc may cause _____ when present in dialysis water

Anemia

Sepsis

Blood infection

Hardness strips test for presence of

Calcium & Magnesium

what is removed from the water by the softer

Calcium & Magnesium

Symptoms of Hemolysis

Chest pain, SOB, Death

Chloramine is a combination of

Chlorine & Ammonia

RPC Ultra-Low Total Chlorine test strips are used to test

Chlorine levels

CFU

Colony-Forming Units

when is the Phoenix Meter verified

Daily prior to 1st use

what method of water treatment compnent is used during ht RO failure and is part of the "Alternate Water Supply Plan"

Deionization Tank

symptoms of pyrogenic reaction

Fever, uncontrolable Shakes, Chills, Hypotension, N/V

Bone disease can be caused by what in the product water

Fluoride & Aluminum

Carbon filters remove chlorine and chloramines by the process of

Granular Activated Carbon (GAC)

Types of source water are_____ & _____

Ground & Surface

Example of surface water source

Lakes, Ponds & Rivers

Function of the Booster Pump

Maintains sufficient pressure to the RO from the water supply

Aluminum in product water put the patient at risk for

Neurological Deterioration

piping within the water treatment distribution loop is made of what

PVC

Steps taken to ensure PT safety if Chlorine breakthrough occurs post GAC (Carbon) filter #1

Pause treatment, measure after tank 2, TCL log, report to Med Officer

Ion Exchange

Processes of removing hardness from the water

Hemolysis

Pt complication due to the exposure of blood to chloride & Chloramines

Function of the Carbon (GAC) Filter/Tank

Remove total chlorine from water

If Total Chlorine Testing after 2nd carbon tank (post GAC Filter 2) shows results above the acton limits what action is immediately taken

STOP TREATMENT

Hemolysis

Serious side effect if chlorine crosses dialyzer membrane

UV light is a form of

Sterilization

RO performance is measured by

TDS (Total Dissolved Solids)

What does a Phoenix Meter measure

Temperature, Conductivity, pH

Function of Back Flow Preventer

To prevent water from flowing back into water system

What causes a Pyrogenic Reaction in PTs

Toxins coming from dead bacteria

Example of ground water source

Wells & Springs

Where does water Pathway of water start in the dialysis facility

Where is enters the facility

where are the UltraFilters located in the water treatment system

after the holding tank

Empty Bed Contact Time (EBCT)

amount of time water must be n contact with carbon

When is Phoenix Meter Calibrated

any verification fails or receiving inaccurate readings

the low level alarm on the holding atnk must be set (or on)

continuously

When is routine total chlorine testing performed Per FMS policy

every 4 hrs

Characteristics of bacteria and/ or viruses

fever, chills, low BP, vomiting

Function of the Sediment Filters

filters water of particulate water

Back flow Preventer

first piece of equipment that water goes thruin the dialysis facility

At what Frequency is routine total chlorine tested

less than .10ppm

the FMC acceptable limit for water hardness port softener

less than 10 ppm (parts per million)

Function of the Captive Air (expansion/bladder) Tank

maintains minimum system pressure while the booster pump cycles

Routine testing for bacteria and endotoxin should take place

monthly

What is the frequency of routin holding tank and water distribution loop disinfections

monthly

Endotoxin

remains of dead bacteria

Function of the Mutimedia Filter

removes particles to 10 microns

The purpose of Residual Chlorine strips is

test for residual bleach

Chlorine and Chloramines are added o City water

to kill bacteria

Product Water

water that has been through RO membrane

The full Calibration of the TDS meter is required

weekly


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