CCHT Water Treatment and Quality 2

Question 1

What is the primary purpose of the softener in the dialysis water treatment system?

Accepted Answer

To remove calcium and magnesium ions to prevent scaling and protect the reverse osmosis membrane

Answer

To remove chlorine and chloramines from the water supply

Answer

To eliminate bacteria and endotoxins from the water

Answer

To adjust the pH of the water to dialysate range

Question 2

What is the maximum allowable bacterial count in dialysis water per AAMI standards?

Accepted Answer

200 CFU/mL (action level 50 CFU/mL)

Answer

1,000 CFU/mL (action level 500 CFU/mL)

Answer

100 CFU/mL (action level 10 CFU/mL)

Answer

10 CFU/mL (no action level)

Question 3

Chloramine is particularly dangerous in dialysis water because it can cause which serious complication?

Accepted Answer

Hemolytic anemia from oxidative damage to red blood cell membranes

Answer

Hypercalcemia from displacement of calcium by chlorine

Answer

Hyperphosphatemia from chlorine interference with phosphate binders

Answer

Aluminum toxicity from chloramine-aluminum complexes

Question 4

What does the conductivity test of dialysate measure, and why is it important?

Accepted Answer

The total dissolved solute concentration of the dialysate, confirming correct electrolyte mixing

Answer

The temperature of the dialysate to ensure patient comfort

Answer

The pH of the dialysate to prevent acid-base disturbances in patients

Answer

The bacterial load of the dialysate to detect contamination

Question 5

How often should activated carbon filters in the dialysis water treatment system be tested for chlorine/chloramine removal efficacy?

Accepted Answer

Before the first patient treatment of each day and after each shift

Answer

Monthly, with daily visual inspection of filter condition

Answer

Weekly, or after any water utility maintenance in the area

Answer

Only when the reverse osmosis membrane is being serviced

Question 6

What is the role of the reverse osmosis (RO) unit in the dialysis water treatment system?

Accepted Answer

To remove the majority of dissolved solutes, bacteria, and endotoxins from the pretreated water

Answer

To add necessary minerals and electrolytes to the purified water for dialysate preparation

Answer

To neutralize chloramines that were not removed by the activated carbon tanks

Answer

To sterilize the water by ultraviolet irradiation before distribution to dialysis machines