What are two types of water sources? - correct answer Ground Water and Surface Water
Ground Water - correct answer Comes from wells and springs. It is
... [Show More] often higher in ions (e.g.,iron, calcium, magnesium), but lower in microorganisms (e.g.,bacteria, viruses, endotoxins).
Surface Water - correct answer Comes from lakes, ponds, rivers, and reservoirs. Surface water may be high in pesticides, industrial waste, sewage, and microorganisms.
Who regulates drinking water? - correct answer The Environmental Protection Agency (EPA).
** EPA passed the Safe Drinking Water Act in 1974**
What is the typical amount of water most pt's are exposed to in a week? - correct answer 270 - 576 liters a week.
** People with working kidneys may drink 10 - 14 liters of
water per week.**
What is the purpose of water tx for dialysis? - correct answer To prevent harm to the pt and to the water tx equipment. Many of the substances added to make drinking water safe for healthy people are harmful to people on dialysis.
Water for dialysis should be treated to meet standards set by who? - correct answer Association for the Advancement of Medical Instrumentation (AAMI)
AAMI standards for water tx include: - correct answer - Bacteria - Endotoxins - Metals - Salts
- Trace elements and other substances
What do AAMI standards cover? - correct answer All water and water - related equipment used for reprocessing dialyzers, mixing concentrates, and making dialysate.
Who adopted the AAMI standars as part of the Conditions for Coverage for dailysis centers? - correct answer Centers for Medicare and Medicaid Services (CMS)
Why must water always be kept moving in a water tx system? - correct answer Because still water allows bacteria to grow.
**A return loop carries the water back through the system,
preventing stagnant spots and reduces the amount of feed
water a center needs. **
Feed Water Components include: - correct answer - Backflow Prevention Device
- Temperature Blending Valve
- Booster Pump
Backflow Prevention Device - correct answer Stops water from a center's water tx system from flowing back into the feed water, keeping contaminants taken out by the water tx system from getting into the feed water.
Temperature Blending Valve - correct answer Mixes hot and cold water to a standard 77*F.
- This level prevents harm to pt's and damage to the RO
membranes.
- There is a 1.5% decrease in efficiency for every 1*F
drop in temperature.
Booster Pump - correct answer A water tx system needs constant water flow and pressure. If flow or pressure drop from a center's water source, a booster pump may be used to increase them.
Pretreatment Components include: - correct answer - Chemical Injection System
- Sediment Filters
- Water Softener
- Carbon Tanks
Chemical Injection System - correct answer May be used to monitor pH and Chloramine levels. It has a reservoir to hold the chemicals, a metering pump, and a mixing chamber in the feed water line.
What is the ideal pH of the feed water? - correct answer 5.0 - 8.5
- If higher, a small amount of hydrochloric or sulfuric acid
needs to be injected into the feed water.
Sediment Filters - correct answer Strain out particles, solutes, and other substances of a given size.
What is the most common sediment filter? - correct answer Multimedia Filter
- Has layers of different-sized rocks. Water can pass
through the filter, but most particles above a certain size
are trapped.
- Each layer is finer than the one before, to trap smaller and
smaller particles.
What is 'backwashing'? - correct answer When a sediment filter is not in use, water should be sent from the bottom of the filter to the top to clean and remix the media. This flushes particles out of the filter.
Water Softener - correct answer Used in water tx to reduce the concentration of calcium and magnesium that form scale. Water softeners work by ion exchange. Ions of calcium and magnesium are removed from the water by a bed of electrically charged resin beads and traded for sodum ions, which form sodium cholride.
Ion Exchange - correct answer Occurs inside a deionizer for water tx. Unwanted ions are traded for hydrogen and hydroxyl ions to create pure water.
Where does ion exchange take place? - correct answer In a 'bed' of tiny round beads made of polystyrene resin. The resin beads are coated with sodium chloride ions. The resin attracts positively charged ions of calcium and magnesium from the hard water. It gives up sodium ions of equal charge.
How does regeneration of a water softener occur? - correct answer By flushing the resin bed with water and then with brine (very concentrated saline). The resin beads exchange their calcium, magnesium, and other positively charged ions, and are again coated with sodium ions. The unwanted positive ions are then rinsed to the drain.
How often and when should regeneration take place? - correct answer - Regeneration should be done every day or every other
day.
- It is vital to prevent your water softener from regenerating
during dialysis. *If this were to happen, high levels of
sodium could cause the RO system to alarm because it
could not handle that much sodium.*
Carbon Tanks - correct answer Are water tx devices that contain granular, activated carbon that adsorbs low molecular weight particles from water. Carbon tanks are mainly used to remove chlorine, chloramines, pesticides, industrial solvents, and some trace organic substances from water used for dialysis.
How many carbon tanks are needed in a series? - correct answer Two, the 1st is called the Worker and the second is called the Polisher.
What is GAC? - correct answer Granular activated charcoal
- the best tanks use GAC
- it is very porous; it's large surface area helps remove
contaminants from water. [Show Less]