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M3 Test 4
Army Dialysis School
Question | Answer |
---|---|
How is dialysate bath defined? | A fluid that helps remove uremic waste products and excessive electrolytes (urea, creatinine, sodium, potassium, etc.) from patients’ blood |
What is the normal Serum level of Sodium? | 135-145 meq/L |
Drinking water is regulated by what department of the government? | EPA - Water Safety Act 1974 and 1994 |
Who sets the standards on water quality for dialysis? | AAMI |
What chemicals are used to purify drinking water? | Chloramine - bacteria Alum - Heavy metals |
What does a water softener do? | ion exchange device that exchanges calcium and magnesium for sodium |
When is a water softener regenerated? | When it runs out of sodium. |
What is the process of a water softener regereation? | The dirty resin is washed by the brine tank to reattach Sodium to the resin. |
When must a water softener never be regenerated? | During dialysis treatments |
How often should a water softener be regenerated? | Daily or alternating days |
For each calcium ion removed what is added? | 2 sodium ions |
What is tested in the water softener to test it's "hardness"? | Calcium Carbonate |
What are the types of filters used in a dialysis water system? | Sediment Filter, Carbon filter, and Ultrafilter |
What removes electrolytes from city water? | Water Softener |
What removes chloramine and chlorine from city water? | Carbon Filter Tank |
What is the average amount of carbon filter tanks in a water room? | 2 |
What are the name of the 2 tanks? | Worker and polisher |
What are the disadvantage of a water softener? | Potential for acterial growth and potential hypernatremia |
What is a disadvantage of carbon tank removing chlorine? | Removes chlorine causing increased bacterical growth potential downstream |
What is the most effective way to filter endotoxins? | Ultrafiltration |
What does a deionizer do? | Removes all cations and anions |
What is the disadvantage to a deionizer? | Doesn't remove organisms, Resin beds when exhausted release their particulates |
What does RO stand for? | Reverse Osmosis |
Which process removes 90-99% of electrolytes, bacteria, organic particles, viruses, pyrogens, particles and endotoxins? | Reverse Osmosis (RO) |
How does an RO work? | Increases Hydrostatic pressure forcing Osmosis |
What are disadvantages to an RO? | Requires pretreatment, sensitive membranes, Expendsive, 8.0 PH required, Membrane must be wet at all times. |
What is the maximum acceptable limit of bacteria in a RO Product water according to AAMI? | 200 colony forming units per milliter (200 cfu/ml) |
What is the maximum acceptable limit of bacteris in a Dialysis machine according to AAMI? | 2000 colony forming units per milliter (2000 cfu/ml) |
How long must the machine be running before taking test samples? | 10-30 minutes |
True or False You test before and after disinfection? | True - This is to prove the disinfectant process is working |
Can vinegar be used for an acid clean? | Yes vinegar is an acceptable substitue for Acid |
What is used to check the wuality of an RO? | Conductivity Test |
What does a Residual Test test for? | It tests for any remaining disinfectant? |
What is the order of a water room? | City water, Softener and Brine, Worker Carbon Tank, Polisher Carbon Tank, RO, Holding Tank, UV Light, Dialysis Machine Loop |
What are your Daily cleans? | Acid/Vinegar, Heat and Rinse |
What are your weekly cleans? | Bleach and rinse |
What is the monthly clean? | Renalin (mincare) and rinse |