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CCMA Cards > Blue Packet 2 > Flashcards

Blue Packet 2 Flashcards

1
Q

what gloves should be worn if a pt has a latex allergy

A

vinyl or nitrile

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2
Q

what should be used to clean the skin before inserting the needle

A

isopropyl swabs

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3
Q

what is the capacity of blood collection tubes

A

6-10 mL

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4
Q

what are the most common blood tubes

A

blue, lavendar, red

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5
Q

what are the measurements of blood collection tubes

A

3 in long & 0.5-0.75 in wide

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6
Q

what is the technical term for the inside of the needle

A

lumen

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7
Q

why should adult collection ubes not be used for children

A

can collapse veins

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8
Q

t/f: vacutainer is a brand name

A

true

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9
Q

when are winged infusion sets useful

A

drawing blood from vein in hand or foot

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10
Q

what angle should a needle be when inserting blood

A

15-30 degrees

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11
Q

what should you always tell the pt when drawing blood

A

tell pt when about to insert needle

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12
Q

tourniquets should gen not be on longer than

A

1 min

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13
Q

what are 3 complications of prolonged tourniquet use

A

hemolysis, petechiae, hemoconcentration

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14
Q

why is hemolysis bad when drawing blood

A

can lead to inaccurate test results

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15
Q

define PETECHIAE

A

tiny hemorrhages appearing as small red or purple spots

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16
Q

what are petechiae a sign of when drawing blood

A

tourniquet was on too long & blood may be hemolyzed

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17
Q

why is hemoconcentration a problem when drawing blood

A

ratio of cells to liquid in blood altered that may affect result

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18
Q

what is the most amount of blood taken in a blood draw at a time

A

6 tsp

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19
Q

how long does each tube take to fill

A

about 5 seconds

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20
Q

how many inversions do blue top blood tubes require

A

3-4 inversions

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21
Q

how many inversions do SST (red top) tubes and serum (red top w/o separating gel) require

A

5 inversions

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22
Q

how many inversions do EDTA and heparin containing tubes (lavender/pink & green) require

A

8-10 inversions

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23
Q

list widely used anticoagulants

A
  • sodium citrate (light blue tube)
  • EDTA (lavender/pink tube)
  • Heparin (green tube)
  • ACD (light yellow tube)
  • SPS (yellow stopper tube)
  • Potassium oxalate (gray tube)
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24
Q

which tube is best at preserving the coagulation factors

A

sodium citrate (light blue)

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25
Q

what color is the tube for sodium citrate

A

light blue

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26
Q

what color is the tube for EDTA tubes

A

lavender or pink

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27
Q

what color is the tube for ACD tubes

A

light yellow

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28
Q

what color is the tube for Potassium oxalate

A

gray

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29
Q

what color is the SPS tube

A

yellow stopper

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30
Q

what are sodium citrate tubes used for

A

coagulation test

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31
Q

what are EDTA tubes used for

A

hematology, some blood banking test, checking CBC

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32
Q

what are Heparin tubes used for

A

chemistry tests requiring plasma/whole blood & STAT chemistry tests

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33
Q

what are ACD tubes used for

A

DNA testing

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34
Q

what are the SPS tubes used for

A

draw cultures for micro-organisms

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35
Q

what are potassium oxalate tubes used for

A

testing blood glucose

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36
Q

what are red stopper plastic tubes used for

A

tests requiring blood to clot before being centrifuged, used for draws needing serums, chemistry & immunuology tests

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37
Q

what do red stopper plastic tubes have

A

clot activator

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38
Q

what are gold or black & red mottled stopper tubes

A

tubes with gel and clot activator

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39
Q

what are gold or black & red mottled stopper tubes used for

A

chemistry & immunology tests

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40
Q

what should always be deployed immediately following withdrawal of needle

A

safety devices

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41
Q

what needles should be disposed into a sharps container

A

any needle expired, broken seal, damaged bevel, one without safety device

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42
Q

define a BLOOD CULTURE

A

lab test used to check for bacteria/other micro-organnism in blood sample often used to help diagnose pt w/fever of unknown cause

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43
Q

how should the area be cleaned when obtaining blood for blood culture

A

clean with alcohol first then with povidone-iodine

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44
Q

if the blood culture set includes an aerobic and anaerobic, what should be collected first

A

aerobic

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45
Q

what disorders are screened in newborns

A

cystic fibrosis, hypothyroidism, PKU, galactosemia

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46
Q

describe how to do newborn (blood) testing

A
  1. puncture heel no deeper than 2 mm w/lancet
  2. saturate circles
  3. airdry blood spots for 3 hours at room temp
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47
Q

what tests are Clinical Laboratory Improvement Act (CLIA) tests

A

blood glucose, fecal occult blood, hematocrit, urine chemical screening, pregnancy testing, rapid strep test

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48
Q

quick transport is essential for which specimens

A

microbiological

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49
Q

give examples of microbiological specimens

A

blood/throat cultures, sputum, semen, stool, urine

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50
Q

define CHAIN OF CUSTODY

A

process that maintains control of and accountability for each specimen from time of collection to time of disposal

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51
Q

what is required on chain of custody

A
  • name & identifying info of pt/subject from whom specimen collected
  • name of person who got specimen
  • date, location, & signature of person attesting specimen is correct & matches document
  • signature & date from every person who possessed specimen
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52
Q

can you give police blood alcohol levels if pt refuses

A

no

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53
Q

what is an appropriate antiseptic to use when testing blood alcohol levels

A

chlorhexidine

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54
Q

why should iodine and alcohol not be used when cleaning the site when testing blood alcohol levels

A

can lead to false positive

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55
Q

urine specimen should be between…

A

12-50 mL

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56
Q

what is the most commonly analyzed non blood specimen

A

urine

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57
Q

what info should be labeled on the urine specimen container

A

pt name, date, time of collection

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58
Q

t/f: menstruating women shouldn’t undergo urine tests until their cycle is complete

A

true

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59
Q

what is the most common form of urine testing

A

random specimen

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60
Q

when is the clean catch midstream specimen collection ordered

A

to diagnose UTI or evaluate medication effectiveness & culture & sensitvity test

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61
Q

define TIMED SPECIMEN

A

specimen collected over predetermined time period to obtain additional health info

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62
Q

t/f: pt should not discard the first specimen when doing a timed specimen

A

false

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63
Q

what test are timed specimens collected for

A

glucose tolerance test

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64
Q

define 24-HOUR SPECIMEN

A

specimen collected to measure urine output over 24 hr period

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65
Q

describe the procedure for 24-hour specimens

A

urinate into small collection container which is pouured into larger collection container, small container should be cleaned with soap and warm water

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66
Q

define FIRST-VOIDED MORNING SPECIMEN

A

specimens collected in morning after sleeping

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67
Q

what are FIRST-VOIDED MORNING SPECIMEN used for

A

pregnancy testing, culturing & microscopic examination

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68
Q

aka: first-voided morning specimen

A

8 hour specimen

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69
Q

why is catheterization not routinely used when obtaining urine sample

A

can cause infection

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70
Q

describe SUPRAPUBIC SPECIMEN procedure

A

sterile syringe w/needle inserted directly into urinary bladder to asiprate urine

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71
Q

when are suprapubic specimens done

A

microbial analysis or cytology studies

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72
Q

why are fecal specimens collected

A

detect parasites, occult blood, and colorectal cancer

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73
Q

fecal samples should be kept at what temp

A

body temp

74
Q

what is required if a fecal fat analysis is performed

A

72 hour refrigerated stool sepcimen

75
Q

semen samples must reach the lab in less than ____ hours

A

2

76
Q

semen specimens should not be exposed to

A

light or extreme temperatuers

77
Q

how should semen specimens be collected

A

container or condom free of spermicides

78
Q

TB test containers have what, requiring caution from you and your pt

A

poisonous preservative

79
Q

what kind of container should sputum specimens be collected in

A

sterile container

80
Q

what happens to urine if it stands at room temp

A

urine components change

81
Q

urine specimens should be refrigerated within ___ hour of collection

A

1

82
Q

tubes needed for culture and sensitivity tests may be kept at room temperature for up to ____ hours

A

72

83
Q

what should be used when sending specimen to labs

A

plastic biohazard bags

84
Q

what is required for all specimen shipped to a reference lab

A

watertight secondary container

85
Q

define POINT OF CARE

A

lab testing conducted close to site of pt care

86
Q

define CRITICAL VALUE

A

test result significantly higher/lower than normal and indicate potential life-threatening situation for pt

87
Q

define the 1500 METHOD

A

count # of small boxes between P-P interval and between R-R interval then divide that number by 1500

88
Q

define the P-P INTERVAL

A

amount of time between atrial depolarization cycles

89
Q

define the R-R INTERVAL

A

amount of time between ventricular depolarization cycles

90
Q

aka: sequence method

A

300 method

91
Q

the sequence method uses what pattern

A

300, 150, 100, 75, 60, 50

92
Q

define the SEQUENCE METHOD

A

calculate by dividing 300 by # of large boxes between QRS complexes

93
Q

describe the 6-SECOND RULE

A

gold standard for estimating rate of irregular rhythm; count # of QRS complexes in 2 of sections and multiply by 10

94
Q

what do small hash marks at the top of an EKG tracing indicate

A

3 second intervals

95
Q

what are the most common reasons for artifact of the EKG

A

movement of pt, seizure, trembling, fast breathing, dry/wet skin, shivering

96
Q

when do wondering baselines occur on an EKG

A

when contact between electrode and skin is impacted

97
Q

t/f: seizures will cause artifact on an EKG

A

true

98
Q

what should be done when doing an EKG on a pt who is trembling

A

try to move the electrodes to place with minimal tremors

99
Q

t/f: electrodes with dry gel should be used

A

false

100
Q

what helps with electrode adhesion (when doing EKGs) if a pt has dry skin

A

abrading skin & using tincture of benzoin

101
Q

what helps w/electrode adhesion (when doing EKGs) if a pt has wet skin

A

wipe off pt and apply tincture of benzoin

102
Q

how does cell phone interference appear on an EKG

A

flutter of P waves on tracing at rate of 300/min

103
Q

when seeing an interference on an EKG, what should be considered the source first

A

nonmedical devices

104
Q

list certain conditions that require a right-sided 12 lead EKG

A
  • inferior wall ST segment elevation
  • myocardial infarction
  • pts younger than 8 yrs
105
Q

define POSITIVE DEFLECTION

A

wave that exists above isoelectric line

106
Q

define NEGATIVE WAVE

A

wave existing below isoelectric line

107
Q

define T WAVE SYMMETRY

A

T wave left and right sides are symmetrical

108
Q

P wave symmetry is symmetry w/respect to which axis

A

y axis

109
Q

how do you find the amplitude of wave on EKG

A

count number of small boxes between lowest and highest points of wave

110
Q

what is 1 small box on EKG

A

1 mm

111
Q

define P WAVE

A

atrial depolarization

112
Q

define R WAVE

A

ventricular depolarization

113
Q

define T WAVE

A

ventricular repolarization

114
Q

define PR INTERVAL

A

represents time it takes for SA node to fire, atria to depolarize, and electricity to travel through AV node

115
Q

define QRS COMPLEX

A

time it takes for ventricles to depolarize

116
Q

define ST SEGMENT

A

represents early phase of ventricular repolarization

117
Q

define J POINT

A

represents exact point in time where ventricular depolarization stops and ventricular repolarization starts

118
Q

when do J points occur

A

at end of QRS complex or where ST segment begins

119
Q

define QT interval

A

one complete cycle of ventricular depolarization and repolariztation

120
Q

when do QT intervals begin

A

at Q wave to end of T wave

121
Q

define PREMATURE VENTRICULAR COMPLEXES (PVCs)

A

ventricular depolarization occurring early in cardiac cycle

122
Q

define HEART BLOCKS

A

special set of arrhythmias indicating difficulty/no communication between atria and ventricles

123
Q

heart blocks are often described in these stages

A
  • first degree
  • second degree type 1
  • second degree type 2
  • third degree
124
Q

define a first-degree heart block

A

slow/delayed conduction through AV node causing prolonged PR interval

125
Q

define third degree heart block

A

complete lack of association between atria and ventricles

126
Q

what should the MA do if a pt is experiencing V-fib

A

call for help, start CPR, retrieve AED

127
Q

list causes of asystole

A
  • large pulmonary embolism
  • large Myocardial infarction
  • respiratory arrest (hypoxia)
  • overdose
  • hypothermia
  • acidosis
  • electrolyte abnormalities
  • tension pneumothorax
  • trauma
128
Q

what is the most common paper speed

A

25 mm

129
Q

at what speed on EKG enables certain waves to become visible on the tracking

A

50 mm

130
Q

what does 1 small square on EKG stand for

A

0.04 seconds

131
Q

what does 1 large 5 mm square on EKG stand for

A

0.2 seconds

132
Q

what do 5 large squares on EKG stand for

A

1 sec

133
Q

what is the P-P interval

A

atrial rate

134
Q

what is the R-R interval

A

ventricular rate

135
Q

range of PR?

A

beginning of P wave to beginning of QRS complex

136
Q

range of QRS complex?

A

beginning of Q to end of S wave

137
Q

range of QT complex

A

beginning of Q to end of T wave

138
Q

what is the conduction layer of the heart

A

endocardium

139
Q

what side of the heart carries low pressure deoxygenated blood

A

right side

140
Q

what is the only artery that carries deoxygenated blood

A

pulmonary artery

141
Q

what is the only vein that carries oxygenated blood

A

pulmonary vein

142
Q

aka: mitral valve

A

bicuspid

143
Q

where is the mitral valve

A

between left ventricle and left atrium

144
Q

what valve is on the right side of the heart

A

tricuspid

145
Q

what happens in the relaxation/diastole phase

A

cardiac chambers fill w/blood

146
Q

define stroke volume

A

blood volume ejected outside ventricle after each contraction

147
Q

define cardiac output

A

amount of blood ejected outside heart per minute

148
Q

define peripheral vascular resistance

A

force exerted against blood flow and determined by diameter of vessels

149
Q

determine blood pressure

A

force exerted by circulating blood volume on walls of artery during circulation

150
Q

formula for cardiac output?

A

stroke volume x HR per/min

151
Q

formula for blood pressure?

A

cardiac output x vascular resistance

152
Q

what is an EKG

A

graphical presentation of heart electricity

153
Q

define automaticity

A

ability to spontaneously trigger electrical impulses w/o being stimulated by another source

154
Q

define excitability

A

ability to respond and react to stimulus

155
Q

aka: excitability

A

irritability

156
Q

define CONDUCTIVITY

A

ability to receive and transmit electrical impulses to adjacent cells

157
Q

define DEPOLARIZATION

A

electrical event expected to result in contraction

158
Q

define REPOLARIZATION

A

strictly an electrochemical event

159
Q

describe SA NODE

A

primary pacemaker of the heart delivering electrical impulses at the top of the right atrium

160
Q

what is the normal firing rate of the SA Node?

A

60-100 bpm

161
Q

define PURKINJE FIBERS

A

network of small conduction fibers that deliver electrical impulses

162
Q

what does PKU cause

A

mental retardation and brain damage

163
Q

what is the red top tube used for

A

cold agglutinin tests

164
Q

is a blood specimen placed in ice or ice water considered a chilled specimen?

A

yes

165
Q

what should be used to protect blood specimens from exposure to light

A

aluminum foil

166
Q

aka: dermal puncture

A

skin puncture

167
Q

t/f: order of capillary specimen is lavender, tube w/additive, tube w/o additive

A

true

168
Q

what should never be used for dermal puncture

A

hypodermic needle

169
Q

what can deep penetration into skin cause

A

osteomyelitis

170
Q

how can the speed of a centrifuge in RPMs be checked

A

tachometer

171
Q

what is the life space of an average RBC

A

120 days

172
Q

when a glucose meter is cleaned for its battery changed, what is crucial to do

A

double check the first 3 tests run afterward

173
Q

define GLUCOSURIA

A

sugar in urine

174
Q

what is an example of a time dependent lab test

A

glucose tolerance

175
Q

define PROTHROMBIN TIME

A

lab test that evaluates extrinsic coagulation function

176
Q

what is the most common reason for blood accumulation at site of venipuncture

A

hematoma

177
Q

how long does a pt fast for before a blood draw in basal state

A

12 hours

178
Q

what is a 2 hour postprandial test used to evaluate

A

DM

179
Q

blood cultures are ordered to detect what

A

microorganisms

180
Q

what are 3 types of venipunctures

A

fasting, timed, and blood cultures

181
Q

what does OGTT stand for

A

oral glucose tolerance test

CCMA Cards (9 decks)

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