Lesson 8 Flashcards
(147 cards)
1
Q
These are non-routine laboratory tests that may not only involve additional preparation and procedure but may require other specimens such as urine or feces. These can be applied for special cases such as blood donation.
A
Special collection procedures
2
Q
This is important in determining which blood product can be safely used for blood transfusion.
A
blood bank specimen
3
Q
In collecting blood bank specimen, use ____ tubes.
A
Lavender-top or pink-top EDTA tube
Or
A red-top non-additive glass as an alternative
4
Q
These follow strict specimen identification and labeling procedures to ensure that there are no errors that could lead in incompatible blood product causing fatal reaction to the recipient of the blood.
A
Blood banks
5
Q
Blood banks can use special identification systems such as: (3)
A
1) ID bracelet (self-carbon adhesive for specimen)
2) blood ID band (linear bar-code)
3) patient identification check-blood administration.
6
Q
Blood banks also conduct tests in the laboratory to ensure that the donated blood is safe for ____.
A
blood transfusion
7
Q
Blood banks also conduct tests in the laboratory to ensure that the donated blood is safe for blood transfusion. These include typing the blood for ____ and _____. The ______ are determined, too.
A
transfusion and screening for infectious diseases
blood type (ABO) and Rh factor (+ or -)
8
Q
There are cases when there is a need to conduct a ____ to eliminate blood-related compatibility issues that may arise between the patient and the donor.
A
cross-match test
9
Q
There are cases when there is a need to conduct a cross-match test to eliminate blood-related compatibility issues that may arise between the patient and the donor. The ____ or ____from the patient is mixed with the ____ of the donor to check for compatibility.
A
plasma or serum
RBC
10
Q
This is done mainly for the purpose of blood transfusion.
A
Blood donor collection
11
Q
Blood is donated by ___ in units.
A
volunteers
12
Q
Blood donors should be ___ to ____ years of age, with a minimum weight of __.
A
17 to 66
110 Ibs.
13
Q
They must have completed the physical exam and declared their medical history. Their medical history is recorded, and brief examination is conducted prior to the collection. All donor data are confidential and a written permission must be submitted by the donor for documentation purposes since all blood components of a unit mustb traceable as part of the look-back program.
A
Blood donors
14
Q
The unit of blood can be separated into ____,____, and ____ but these should still be traceable to the donor.
A
RBCs, plasma, and platelets
15
Q
Under the ____, blood reciplents need to be notifled when the donor has been diagnosed positive for disease. The blood components are then verified and retrieved.
A
look-back program
16
Q
There are also cases when there is an ____ in which the patients donate blood for their own use especially for elective surgeries.
A
autologous donation
17
Q
(1) This eliminates risks associated with blood transfusion. After securing a written permission from the ____, blood can be collected within a minimum of ____ from the surgery schedule.
A
Autologous donation
physician
72 hours
18
Q
This special scenario is in which the blood of the patient is salvaged (during surgical procedure), washed, and re-infused after testing for residual free hemoglobin.
A
cell salvaging
19
Q
The _____ needs to he tested prior to reinfusion because a ____ means that too many red cells were destroyed during the salvage process and reinfusion is not recommended because it will result in _____.
A
salvaged blood
high free hemoglobin level
renal dysfunction
20
Q
This is a test that checks the blood for pathogens for patients who have a fever of unknown origin (FUO). The test determines the existence of bacteria in the blood that results in ____ or the presence of microorganism and toxins in the blood that causes ____.
A
blood culture
bacteremia
septicemia
21
Q
What is the meaning of FUO?
A
fever of unknown origin (FUO)
22
Q
The physician orders blood culture only if there is a probability of _____.
A
bloodstream microorganism invasion
23
Q
Since blood culture identifies and determines the responsible organism and the extent of the infection, the best ____ could be prescribed.
A
antibiotic
24
Q
STERILE TECHNIQUE IN BLOOD CULTURE:
For optimum results, the collection should have ____ placed in special bottles–___ and ___ that were drawn ___ to ____ apart
A
2 to 4 blood culture sets
one aerobic (with air) and one anaerobic (without air)
30 to 60 minutes apart
25
This is crucial in the blood collection procedure because it prevents the contamination by ___ in the skin which can be introduced in blood culture bottles and affect the results.
Skin antisepsis
microbial flora
26
The sterile technique varies per laboratory but the following antiseptics can be used to sterilize the site: (5)
(1)betadine swab sticks
(2)chloroprep
(3)PVP ampule
(4)Frepp/Sepp II
(5)benzalkonium chloride.
27
To minimize the risk, friction rub of the collection sites is performed for about ___ to ___ using: (3) combination
30 to 60 seconds
(1)tincture of iodine
(2)chlorhexidine gluconate
(3) povidone/70% ethyl alcohol combination.
28
Any detected microorganism in the laboratory should be ____ so that the physician could evaluate if it is clinically significant.
reported
29
It is important to note that ____ take first priority in the order of draw to prevent contamination.
blood culture collection
30
Blood Culture Collection Procedure:
identify the ___ properly and explain the collection
clearly.
patient
31
Blood Culture Collection Procedure:
Select the venipuncture site and release the tourniquet within ___.
60 seconds
32
Blood Culture Collection Procedure:
Assemble the equipment and make sure to follow the proper __.
aseptic technique
33
Blood Culture Collection Procedure:
Perform the friction rub for about ___.
60 seconds.
34
Blood Culture Collection Procedure:
Wait for ___ to allow the site to dry.
30 seconds
35
Blood Culture Collection Procedure:
Open the culture bottle by removing the ___ while checking it for defects. Bottle should draw at least ___
flip-off cap
8 cc
36
Blood Culture Collection Procedure:
Clean the ___ while waiting for the site to dry.
bottle stopper
37
Blood Culture Collection Procedure:
Check the ___ on the bottle to determine the minimum and maximum levels of the bottle.
fill lines
38
Blood Culture Collection Procedure:
Reapply the ___ and perform the venipuncture. Make sure that the site is not touched.
tourniquet
39
Blood Culture Collection Procedure:
___ the medium.
Inoculate
40
Blood Culture Collection Procedure:
To mix the blood with the medium, ___ the bottle a couple of times.
invert
41
Blood Culture Collection Procedure:
If ___ is used in the arm, clean the patient's skin.
iodine
42
Blood Culture Collection Procedure:
Observe proper ___. Make sure to include information about the site where the blood has been collected.
labeling procedures
43
Blood Culture Collection Procedure:
____ used and contaminated materials properly.
Discard
44
Blood Culture Collection Procedure:
Thank the patient courteously. Remove the gloves and decontaminate the hands with ___.
hand sanitizer
45
Blood Culture Collection Procedure:
Transport the specimen promptly to the laboratory for ___ and ___.
analysis and processing
46
There are three ways to inoculate the medium:
(1) directly into the bottle (during collection)
(2) collected in a syringe (after collection)
(3) through an intermediate collection tube (in the laboratory).
47
In ____, a butterfly and a specially designed holder are used.
direct inoculation
48
DIRECT INOCULATION:
The holder is connected to the ___ of the butterfly collection set. The ___ is filled first and each container is mixed after removal from the holder. The ___ is removed after completing the collection and the ___ is activated as pressure is applied over the site.
Luer connector
aerobic vial
needle
safety device
49
When utilizing the ____, blood is transferred to the culture bottles after completing the draw using a ______, which is activated as soon as the needle is removed from the site.
The safety transfer device is attached to the ___. The bottle is pushed into the device until it reaches the ____. The blood will be drawn from the syringe filling the vacuum in the container. The bottle should be placed on a solid surface or in a rack.
syringe method
safety transfer device
syringe
stopper
50
The use of the _____ is performed in the laboratory rather than at the patient's bedside. Nonetheless, this is not recommended because the ____ in collection tubes increases its concentration when added to the blood culture bottles. Moreover, the _____ increases the risk of contamination and the exposure of laboratory staff. However, if it could not be avoided, the ____ is acceptable for collection purposes.
intermediate collection tube
sodium polyanethole sulfonate (SPS)
transfer of blood
yellow-top SPS tube
51
A physician requests _____ to assess the blood clotting functions especially if the patient has an unexplained bleeding. This test could be: ___,____, and ___ which is a close approximation of the hemostatic system.
coagulation tests
prothrombin time (PT)
activated partial thromboplastin time (aPTT)
thrombin time (TT)
52
The integrity of the blood specimen during collection and transportation has a __ on the test result, thus, special care should be taken to ensure that it is done properly.
direct effect
53
If only the coagulation specimen is drawn, draw a "____" tube with _____ which is discarded prior to collection. The blood specimen is then collected using a:
clear
1-2 mL
light blue top with 3.2% citrate tube with the correct (9:1) blood to coagulant ratio.
54
COAGULATION SPECIMEN:
To ensure proper mixing, invert the tubes gently _____ immediately after collection.
3 to 4 times
55
When an evacuated tube system is used, collect the _____ secondarily.
coagulation sample
56
If the specimen is collected using an _____, drew and discard ____ of blood before collecting the specimen. When heparin is introduced to the line, flush with ____ saline before drawing the discard blood and collect the specimen.
indwelling catheter
5 mL
5 mL
57
Adjust the concentration of the sodium citrate for patients with:
above 55% hematocrit values
58
COAGULATION SPECIMEN:
Transport the collected specimen to the laboratory immediate, Should the specimen be unable to reach the laboratory within four hours, it should be:
centrifuged and the plasma frozen
59
What are these called?
There are three ways to inoculate the medium: (1) directly into the bottle (during collection), (2) collected in a syringe (affer collection) and
(3) through an intermediate collection tube (in the laboratory).
Media Inoculation Methods
60
This blood test is done to check if the patient is suffering from diabetes. It is also used to monitor insulin therapy.
2-hour Postprandrial Glucose (2-hour PP)
61
The principles of 2-hour PP specimen collection are as follows:
1. The patient is on a high-carbohydrate diet _____ prior to the test.
2. The patient should fast for at least ____ before the test.
3. ____ may be collected before the start of the procedure.
4. A special breakfast containing an equivalent of _______ is given on the day of the test.
5, Blood glucose specimen is collected ____ after the meal.
2 to 3 days
10 hours
Fasting glucose specimen
100 g glucose or a glucose beverage
2 hours
62
A patient who could be suffering from carbohydrate metabolism problems is subjected to the:
glucose tolerance test (GT'T), which is also called oral glucose tolerance test (OGT'T).
63
This is to evaluate the ability of the body to metabolize glucose by measuring the tolerance level to high glucose level.
Glucose Tolerance Test (GTT)
64
_____ to a measured dose of glucose is recorded by specimen collection at given intervals.
Insulin response
65
The GTT length is ___ for gestational diabetes while it is ____ for other evaluations.
1 hour
3 hours
66
Before the procedure, the patient must eat a balanced meal containing approximately ____ of carbohydrates for ___ and must fast for ____ hours before the scheduled test.
150 grams
3 days
12 to 16
67
Is drinking water allowed in GTT procedure?
Yes, to avoid dehydration and to collect urine specimen
68
GTT PROCEDURE:
Begin with the_____. Explain the procedure and advise the patient that only ____ is allowed during the whole test period.
normal identification protocol
water
69
GTT PROCEDURE:
Draw the fasting specimen and check the glucose level. It should not be over ____ for the test to proceed.
200 mg/dL
70
GTT PROCEDURE:
Let the patient collect the ____ if ordered.
fasting urine specimen
71
GTT PROCEDURE:
Give the patient the glucose beverage dose. Adult dose is ____ while children are given ___ glucose per kilogram of weight. For gestational diabetes, the dose should be between _____
75 g
1 g
50 g to 75 g.
72
GTT PROCEDURE:
Let the patient ingest the beverage within ____
5 minutes.
73
GTT PROCEDURE:
____ when the drink was finished, then start timing the test which is collected within 30 minutes, 1 hour, 2 hours, and so forth.
Record the time
74
GTT PROCEDURE:
Provide the patient with a copy of the:
collection time.
75
GTT PROCEDURE:
If applicable, make the collection time for other specimens such as urine ____ with the computed collection time.
coincide
76
GTT PROCEDURE:
Write the exact collection time and the time interval on the:
label along with the patient identification information
77
GTT PROCEDURE:
Transport the specimen ______ to the laboratory for accurate results.
immediately or within 2 hours
78
A ____ measures the ability of the body to process lactose and determines if the patient lacks mucosal lactase, which is an enzyme that converts lactose into glucose or galactose.
lactose tolerance test
79
These follow after ingestion of milk or food containing lactose for those who lack the lactase enzyme.
Gastrointestinal distress and diarrhea
80
This test is similar to the procedure of the GTT, but the difference is that lactose is substituted for glucose.
Lactose tolerance test
81
The principles for the lactose tolerance testing include:
1. It is recommended that a ____ be administered at least a day before the lactose tolerance test.
2. ____ amount of lactose is substituted to glucose but the test will be performed following the manner of GTT.
3. ____ is drawn at the same time as the previous GT procedure.
4. The GTT curve and the glucose curve will be similar if the patient has ____.
5. If the patient is ____, the result will yield a "flat” curve where glucose levels just slightly rise over the fasting level.
6. Patients with slow gastric emptying, Crohn's disease and cystic fibrosis can show ____
2-hour GTT test
Equal
Glucose specimen
mucosal lactase
lactose intolerant
false-positive results.
82
This is performed to exclude the possibility of paternity of a particular child.
Parentage testing or paternity testing
83
Before the advent of DNA parenting testing, testing for parentage involves:
ABO and Rh typing and basic red cell antigen testing.
84
If the result does not exclude alleged parent, further test is performed which involves: (6)
extended red cell antigens
red cell enzymes
serum proteins testing
white cell enzymes
white cell antigen
human leukocyte antigen (HLA).
85
This uses genetic fingerprinting or DNA profiling to establish parentage by providing genetic proof.
DNA paternity testing
86
These are the other two methods used today although the older techniques still exist. (Paternity testing)
Polymerase chain reaction (PCR)
restriction fragment length polymorphism (RFLP)
87
The following are the principles of DNA paternity testing:
1. All involved parties need to submit a government issued photo identification along with the completed _____.
The photos of all tested parties are also taken.
2. ____ are collected using a swab that was rubbed inside the cheek where loose cheek skin cells can be gathered.
3. ___ is used to hold the specimen during transport to the laboratory.
4. The test results are ready after ___ and are usually sent
via mail.
chain-of-custody form
Buccal samples
Sealed and tamper-evident package
48 hours
88
This measures drug levels at designated intervals so that the appropriate dosage can be established and maintained for the patient, thus avoiding toxicity.
Therapeutic drug monitoring (TDM)
89
This begins with prescription of the initial dosage appropriate for the patient’s clinical condition.
TDM
90
The amount in the bloodstream is expected to ___
Rise
91
This is performed by drawing a large volume of blood about ___ from the patient as part of the treatment procedure for polycythemia and hemochromatosis.
Therapeutic phlebotomy
500 mL
92
This is the overproduction of red blood cells that is harmful to the patient.
A ____ is used to check the RBC level. The removal of blood is done when hematocrit exceeds certain levels. It is done with the goal of returning the levels to normal range.
Polycythemia
hematocrit test
93
This is characterized by excess iron deposits in the tissues which could be due to problems with iron metabolism caused by multiple blood transfusions or excessive intake of iron. The procedure is done through the periodic removal of single units of blood which will gradually deplete the excess iron in
the body.
Hemochromatosis
94
A ____ plays a role in both clinical toxicology (detection of toxins and treatment) and forensic toxicology (legal consequences of toxin exposure).
phlebotomist
95
detection of toxins and treatment
toxicology
96
legal consequences of toxin exposure
forensic toxicology
97
Apparently, any ____ involves the collection of blood, hair, urine, and other substances from the body for the purpose of determining the presence of toxins which could be in very small amounts.
toxicology test
98
These are ordered by the law -enforcement agencies for legal or forensic purposes. The most common specimens are ____. Others request ___ for drug screening and ____ for drugs and DNA analysis. For forensic specimen, there is a need to track the specimen from the time of collection until the time that the results are released using a special protocol called _____
Toxicology specimens
breath and blood for alcohol
urine
blood specimen
chain of custody
99
These are usually ordered for purposes related to treatment, but could also be for industrial of job-related reasons such as insurance claims or programs and employe drug screening.
Blood alcohol (ethanol (ETOH)) tests
100
The law enforcement department orders ___ for individuals involved in traffic-related accidents
blood alcohol concentration (BAC)
101
The ___ for treatment purposes does not require the chain of custody to be accomplished but the results of such a test can become evidence in court. However, BAC test for industrial and legal samples should follow the chain-of-custody protocol.
ETOH test
102
The ETOH specimen collection uses:
aqueous povidone-iodine and aqueous benzalkonium chloride (BZK).
103
Using isopropyl alcohol and tincture of iodine as antiseptic should be ___ because these might affect the results.
avoided
104
ETOH specimen collection tube
Use gray-top sodium fluoride glass tubes for specimen collection.
105
Drug screening specimen used is
Urine
106
This checks for the presence of aluminum, arsenic, copper, lead, iron, and zinc.
Trace element/mineral testing
107
Trace elements tubes used
special element free tubes colored royal blue
108
The ____ is any analytical test that is done outside the centralized laboratory and near the site where the patient receives treatment.
point-of-care testing (POCT)
109
POCT other name(s)
alternate site testing (AST)
bedside testing
near patient testing
remote testing
satellite testing
rapid diagnostics.
110
The testing ranges from a simple procedure such as a dipstick or a glucose meter which is handheld to an automated molecular test using portable analyzers and imaging systems. These tests are not only convenient, but also shorten the turnaround time (TAT).
POCT
111
This should be followed during the conduct of POCT to maintain the accuracy of results.
Quality control (QC) and maintenance procedures
112
In the effort to continuously improve the healthcare service provided to the patients, manufacturers have enhanced their instruments to include ____, which can detect specimen-related problems.
electronic quality controls (EQCs)
113
These are also in place to gauge the functionality status of the instrument.
Internal checks
114
For non-instrumented tests, daily ___ make sure that there is adherence to the use of required techniques and the generated results are accurate.
external liquid QC checks
115
____ can be evaluated using a ____.
Warfarin and heparin therapy
coagulation POCT analyzer
116
The common coagulation tests checked are prothrombin time (PT) and international normalized ratio (INR), activated partial thromboplastin time (APTT or PTI), activated clotting time (ACT), and platelet function. Listed are the available POCT instruments available:
•Cascade POC - ACT, APTI, PI/INR
• CoaguChek XS Plus -PT/INR
• GEM Premier 4000 - ACT, APTI, PT/INR
• I-STAT - ACT, PT/INR
• Verify Now -platelet function
117
This is a non-instrumented test ordered by the physician to evaluate the capillaries for platelet plug formation, which is indicative of disorder in the platelet function or problems in the capillary integrity
Bleeding Time (BT) Test
118
BLEEDING TIME:
Choose a site in the ___ of the forearm and ___ distal to the antecubital area
volar lateral
5 cm
119
BLEEDING TIME:
Inflate the blood pressure cuff to
40 mm Hg.
120
Record the bleeding time and round it to the nearest 30 second,
Normal results are between ___
2 to 8 minutes.
121
Many healthcare institutions have supported the use of POCT for ____ in selected settings such as the emergency department, pulmonary unit, and neonatal intensive care unit.
arterial blood gases (ABGs) and electrolytes
122
The ____ measures the level of oxygen, carbon dioxide, and acid-base (pH) in the blood, which gives the physician an idea about the status of the function of the patient's lungs, heart, and kidneys.
arterial blood gas (ABG) test
123
The ___ refers to the concentration of hydrogen ions in a solution.
The ____ checks the balance of the acid-base level, which shows the metabolic and respiratory status of the patient. Normal range is from ____
pH
arterial pH test
7.35 to 7.45 only.
124
A normal person exhibis ___ oxygen saturation.
98%
125
This aids in moving nutrients in the body and remove wastes in the cells of the body
Electrolytes
126
This helps keep the normal balance of fluids in the body as well and plays a role in transmitting nerve impulses.
Sodium
127
An elevated amount of sodium is called
Hypernatremia
128
Reduced level of sodium
Hyponatremia
129
This is an electrolyte that helps in nerve conduction and muscle function and regulates the acid-base balance and osmotic pressure
Potassium
130
Increased and decreased blood potassium
Hyperkalemia
Hypokalemia
131
The ____ is composed of small, portable testing devices that measure analytes such as sodium, potassium, chloride, and bicarbonate ion as well as blood gas values for potential hydrogen, partial pressure of carbon dioxide, partial pressure of oxygen, oxygen saturation, BUN, glucose, hemoglobin, hematocrit, ACT, lactate, and troponin.
multiple-test panel monitoring
132
Pregnancy could be detected as early as ____ from conception by checking the presence of B-subunit of human chorionic gonadotropin (ACG) in the urine or serum.
10 days
133
This gauge the effectiveness of the thrombolytic therapy being administered to patients who have suffered from heart attacks.
Cardiac Troponin T (InT) and Troponin I (ThI)
134
This measures the alanine transferase (ALT) of patients under lipid-lowering medication.
Lipid Testing
135
This differentiates chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF).
B-Type Natriuretic Peptide (BNP)
136
This detects and evaluates infection, tissue injury, and other inflammation orders.
C-Reactive Protein (CRP)
137
This monitors glucose level of patients with diabetes mellitus.
Glucose
138
This is a diagnostic tool for diabetes therapy monitoring.
Glycosylated Hemoglobin
139
This measures the volume of the red blood cells.
Hematocrit
140
This checks the hemoglobin level to manage patients suffering from anemia.
Hemoglobin
141
This evaluates the severity of the lactic acid disorder and the stress response of the patient
Lactate
142
This detects gastrointestinal (GIT) bleeding
Occult Blood (Guaiac)
143
This detects the presence of the human chorionic gonadotropin (hCG)
Pregnancy test
144
This checks contact with allergens and determines if the body has developed anti-bodies
Skin test
145
Skin test could be:
Tuberculin test (TB)
Aspergillus
Coccidioidomycosis (cocci)
Histoplasmosis
146
This detects the presence of group A streptococci
Strep testing
147
This involves physical, chemical, and microscopic analyses of the urine specimen.
Urinalysis
