Fresenius ~ Water Treatment Study Guide
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
