Module 3D: Point of Care Testing and Laboratory Procedures Flashcards

Question

Helicobacter Pylori Test

Answer 1

A whole blood sample can screen for the presence of H. pylori antibodies.

Answer 2

Type of bacteria that infects the digestive tract.

Answer 3

This screening tool tests for the presence of the Epstein-Barr virus in a capillary blood sample.

Answer 4

Contagious virus that is spread through saliva, also known as mono, most commonly caused by the Epstein-Barr virus.

Answer 5

This screening is a qualitative test for multiple influenza antigens using a swab that is inserted into the nostril to obtain the sample specimen.

Answer 6

Identifying or measuring by the quality of something rather than its quantity.

Answer 7

Substances such as recreational drugs and medications can be detected in urine and blood samples. *These are considered legal specimens because they may be used in a court of law and must be handled carefully. - The specimen has to be placed into a specimen bag that is permanently sealed until it is opened for analysis. - The seal will ensure that there has been no tampering with the bag’s contents prior to reaching the lab for testing.

Answer 8

This test is performed to screen for hidden blood in the stool. This test is performed with a fecal occult blood testing kit using the patient’s stool specimen.

Answer 9

Ambulatory care centers typically perform CLIA-waived testing, which is the simplest form of testing of all laboratory procedures. - These tests could be performed in the home environment or easily conducted in the medical office with minimal risk of incorrect results. - They pose no reasonable risk of harm to the patient if the tests are performed incorrectly.

Answer 10

Moderate- and high-complexity tests are considered nonwaived. - Labs performing these tests must have a CLIA certificate and undergo inspections to ensure standards are being met. - These tests are typically performed in a reference or hospital laboratory.

Answer 11

Action is performed to ensure the reliability of test results by detecting and eliminating error.

Answer 12

Comprehensive and relates to policies and procedures that must be implemented for the reliability of test results. Maintenance of a desired level of quality related to a service or piece of equipment.

Answer 13

Quality control (QC) is included in quality assurance but is more specific; it is related to test reliability and accuracy while attempting to uncover errors and eliminate them. Ex: - reviewing the expiration date of urine reagent strips is a means of quality control, whereas policies related to rotating stock to put the newest containers in the back of the storage area is a quality assurance measure. - checking the temperature of the laboratory refrigerator and documenting it on a log is a quality control measure. The policy of checking the temperature and maintaining it between 2° C and 8° C (35° F and 46° F) is a quality assurance measure.

Answer 14

- Collect the specimen at the appropriate time. - Collect the specimen from the site of suspected infection. - Minimize transport time to a reference lab. - Collect the appropriate quantity. - Use the appropriate containers and label them accordingly.

Answer 15

Urine is the most commonly tested specimen in an ambulatory care setting. There are various means of collecting urine specimens: - Random Urine - First Morning Specimen - Clean-Catch Midstream - 24-Hour Sample - Catheterized Collection

Answer 16

This sample can be collected at any time of the day and is used for screening purposes. The patient urinates in a clean, nonsterile container.

Answer 17

The patient collects their first urine specimen of the morning in a clean container. This specimen is more concentrated and is often used for pregnancy testing or when other analytes (protein, nitrites) need to be evaluated.

Answer 18

This specimen is used for cultures or when a noncontaminated specimen is required. 1. The patient cleanses the genitalia area using three moist antiseptic wipes. - Females will cleanse each side and the middle of the urinary meatus from front to back using a separate wipe for each passage. (total of 3 wipes) - Males will cleanse each side of the glans penis and across the middle using a separate wipe for each passage. 2. The patient will begin by urinating in the toilet, then pause and collect the rest of the urine specimen in a sterile container or until it is adequately filled.

Answer 19

This type of collection is important in the quantitative analysis of components such as protein when analyzing kidney function. It is also used to analyze substances that are sporadically released into the urine over a 24-hour period. This method uses a large container with preservatives: - The patient discards their first morning urine specimen and collects all remaining urination specimens for the next 24 hr, including the first morning void of the second day.

Answer 20

This method is used when a sterile urine sample is needed or if patients are unable to provide a specimen on their own. It involves insertion of a sterile tube (catheter) through the urethra into the bladder. - The provider or nurse performs this procedure, with the medical assistant prepping the patient and assisting, if needed.

Answer 21

A fecal occult blood test requires a stool specimen collection to screen for the presence of hidden blood, which can indicate the presence of disease or gastrointestinal bleeding. Correct patient instructions are imperative to ensure that false positives do not occur: - Instruct the patient on medications and foods to avoid for three days prior to obtaining the specimen - Patients should avoid red meats or dyes, aspirin or aspirin products, vitamin C, and iron supplements because these could create false-positive fecal occult blood tests (FOBT).

Answer 22

Specimens for cultures are always collected in sterile containers. - Take precautions to avoid touching the insides of lids, swabs, or containers, which could contaminate the specimen. If the specimen is not properly collected, the identification of the causative agent might not occur, and proper treatment cannot be started.

Answer 23

- Name - Assigned identification number (e.g., medical record number) - Date of birth - Phone number - Address

Answer 24

Each (individual) specimen must have a clear plastic bag with a zip closure and dual pockets, which allows for the separation of the specimen and lab requisition. The requisition form should be placed in the outside pocket of the bag. Whenever specimens are transported via mail, biohazard identification on the outside of the package alerts handlers of a potentially infectious agent within the package. *If the container has the potential to break or crack, padding and protection from leakage must occur. - Wrapping the container in absorbent material and placing the item in a biohazard bag are added safety measures to ensure that the outside of the package does not get contaminated.

Answer 25

A chain of custody must be established to document the handling of the specimen. Everyone who handles the specimen, including the patient being tested, must sign the chain of custody form. The chain of custody form will indicate the source of the specimen. The patient’s signature on the consent form states, officially, that they are the same person that provided the sealed specimen to send for laboratory analysis.

Answer 26

These are considered legal specimens because they may be used in a court of law and must be handled carefully. - The specimen has to be placed into a specimen bag that is permanently sealed until it is opened for analysis. - The seal will ensure that there has been no tampering with the bag’s contents prior to reaching the lab for testing.

Answer 27

Always follow proper office procedure and reference the lab manual for proper handling of specimens. A urine sample that requires testing for bilirubin needs special handling to protect the specimen from light, which would affect the accuracy of the testing. For this situation, a dark container is required for the specimen.

Answer 28

Urine samples also need to be tested within one hour of collection, and if not tested, the specimen must be refrigerated. When urine is left sitting out longer than an hour, it can allow bacteria to grow and cause the test to have inaccurate results. Refrigerating helps prevent the bacteria from growing.

Answer 29

Iron-containing oxygen-transport in red blood cells that is responsible for carrying oxygen from the respiratory organs to the rest of the body.

Answer 30

Volume percentage of red blood cells in blood.

Answer 31

Laboratory results at such variance to the normal value range that a potentially life-threatening, pathophysiologic state is occurring. Action must be taken as soon as possible.

Answer 32

Male: 13.5 to 17.5 g/dL Female: 12 to 16 g/dL

Answer 33

Male: 41% to 53% Female: 36% to 46%

Answer 34

White blood cell count: 4,500 to 11,000/mm3 Red blood cell count: - Male: 4.5 to 5.9 million/mm3 - Female: 4 to 5.5 million/mm3 Platelet count: 150,000 to 400,000/mm3 Granulocyte ratio: 50% to 70% (of all white blood cells) Hemoglobin (Hgb): - Male: 13.5 to 17.5 g/dL - Female: 12 to 16 g/dL Hematocrit (Hct): - Male: 41% to 53% - Female: 36% to 46% Mean corpuscular volume (MCV): A value score of 80 to 95

Answer 35

70 to 100 mg/dL (fasting)

Answer 36

Below 5.7%

Answer 37

Total Cholesterol: 130 to 200 mg/dL Low-density lipoprotein (LDL): Less than 100 mg/dL High-density lipoprotein (HDL): Greater than 60 mg/dL Triglycerides: 40 to 150 mg/dL

Answer 38

A blood test that measures the number and types of cells in your blood to assess your overall health. A CBC can help diagnose and monitor a variety of conditions, including: anemia, infection, leukemia, inflammation, blood disorders, and bone marrow and spleen function. Specimen type: - Hematology - Blood specimen Tests Included: - White blood cell count - Red blood cell count - Platelet count - Granulocyte ratio - Hemoglobin (Hgb) - Hematocrit (Hct) - MCV

Answer 39

Blood test measures the average size of red blood cells. Part of a complete blood count (CBC)

Answer 40

- Mislabeled specimens - Improper instructions for clean-catch urine samples: This could alter the results of the test due to excessive bacteria presence and may result in the need for the patient to provide a new sample. - Lack of patient adherence: A patient who has not completed proper testing preparation may need to delay their testing, such as when a patient has not fasted for bloodwork requiring fasting.

Answer 41

Errors That Affect the Results: - Inappropriate test request - Order entry error - Misidentification of the patient - Inappropriate container - Improperly labeling of specimen - Inadequate sample collection - Inadequate sample/anticoagulation ratio

Answer 42

1. The provider orders a test to screen, monitor, or diagnose a patient’s condition. 2. A written or electronic requestion is filled out, showing the requested tests to be ordered, the specimen required, and where the specimen will be tested. 3. The specimen is collected, labeled, and processed. 4. The specimen is transported to the laboratory or properly prepared for offsite laboratory pickup.

Answer 43

1. Instruments are maintained and calibrated. 2. Controls are run and analyzed for each testing method. 3. The specimen is tested, and the results are compared with reference ranges. 4. The test results are logged and documented in the patient’s health record.

Answer 44

Errors That Affect the Results: - Equipment malfunctions (Personnel are required to perform calibration on laboratory equipment. - Preventive maintenance schedules must be followed and documented.) - Sample mix-up - Unindicated failure of quality controls - Procedures not properly followed

Answer 45

1. Specimens are properly discarded. 2. Analyses of control results are compared over time. 3. Patient reports from outside laboratories are logged or documented. 4. The provider interprets and signs all lab reports. 5. The patient is notified of the results in the office or is contacted by laboratory personnel. 6. The final report and all communication with the patient are documented in the patient’s health record.

Answer 46

Errors That Affect the Results: - Failure to report - Improper data entry (Accurate recording is a key responsibility of the medical assistant.) - Excessive turnaround time

Answer 47

1. Preanalytical Phase 2. Analytic Phase 3. Postanalytical Phase These three stages must be applied to each test or procedure that is performed in the laboratory. *If any of these steps are missed or not performed correctly, quality assurance is broken.

Answer 48

Tests performed in the medical office that do not fall under point-of-care testing or CLIA-waived tests are considered specialty tests. Ex: - hearing and vision screening tests - respiratory or peak flow testing - allergy testing *Specialty exams and procedures vary based on the provider and the medical specialty in which they practice.

Answer 49

Performed as a noninvasive screening to detect visual abnormalities of the eye. - Distance vision is easily tested by using a Snellen chart to evaluate for myopia (nearsightedness). - Near vision testing screens for presbyopia (a refractive disorder that occurs with the aging eye) or hyperopia (farsightedness) by using the Jaeger eye chart.

Answer 50

Each eye is tested individually, and then both are tested together. - Adult patients stand 20 feet and identify letters on the Snellen chart, with each row of letters getting progressively smaller in size. - Children stand 10 feet away from a chart at eye level and identify letters, shapes, or the direction an “E” is pointing. *Patients are allowed to wear corrective lenses during the test (which should be documented in the patient’s EHR). Result: - The last line at which the patient can clearly read the letters or pictures with accuracy is their screening result. - Most facilities state that a patient can miss one item and still pass that line. Once the patient misses two items in a single line, the test is complete, using the previous line read without error as the final result.

Answer 51

Vision is recorded as a fraction. - The numerator in the fraction represents the distance at which the test is performed (20 feet away from the chart). - The denominator represents the distance at which patients with typical vision can read the line. Ex: a patient with 20/20 vision represents typical vision.

Answer 52

Using the Jaeger eye chart, the patient is asked to read words from various-sized prints on cards that are held 14 to 16 inches away from the eyes (*without corrective lenses). Each eye is tested individually, and then both are tested together. Result: - The level at which the patient can read the smallest printing clearly and accurately is the final result.

Answer 53

Vision test to assess for color deficiency. The most common type of color deficiency is a red-green deficiency. Procedure: - Screening is done by testing the patient using 11 color plates within an Ishihara test color-plate book. - If the patient misses four or more plates, there might be a color deficiency, and further testing is warranted.

Answer 54

Hearing screenings can be a valuable tool in detecting hearing loss. These tests use an audiometer to measure hearing acuity at different frequencies: - Tympanometry - Speech, Tone, and Word Recognition Information Sound amplitude is measured in decibels (dB), and sound frequency is measured in hertz (Hz).

Answer 55

Records movement of the tympanic membrane, which can be affected by increased pressure in the middle ear. Using a small earbud, eardrum movement can be measured by changing the amount of air pressure applied. This test is valuable for determining the presence of fluid and potential infections in the middle ear. A normal tympanogram produces a peak on the graph, whereas an abnormal tympanogram will produce a flat line.

Answer 56

Medical assistants can perform audiometry if patients (especially children) can respond to directions. 1. The patient will wear a set of headphones, and various tones will be played. 2. The patient will be directed to push a button or raise their hand to indicate they hear the tone. The level of hearing is documented in decibels and the frequency in hertz. An adult who has normal hearing should be able to hear tones below 25 decibels, and a child should be able to hear below 15 decibels.

Answer 57

Instruct the patient to discontinue the use of antihistamines three days prior to allergy skin testing. - Antihistamines block histamine's response time, inhibiting skin testing reactions and possibly producing a false-negative result.

Answer 58

A diluted allergen is applied to a scratch or prick that has been made on the surface of the patient’s skin. - The testing is usually conducted on the forearm or upper back. If a wheal occurs in the first 15 minutes, the allergist can identify the substance as a possible allergen and consider further allergy testing to be conducted intradermally. *Generally, the larger the wheal, the more significant the allergy. If a wheal is evaluated less than 15 minutes from time of application, it may not have had enough time to develop a reaction.

Answer 59

A diluted allergen is injected intradermally, and the patient is observed. An initial wheal is expected. If the wheal becomes inflamed with induration (raised, hard area), the substance can be identified and confirmed as an allergen. *Generally, the larger the wheal, the more significant the allergy. If a wheal is evaluated less than 15 minutes from time of application, it may not have had enough time to develop a reaction.

Answer 60

aka pulmonary function test, is a noninvasive test that detects the lung's ability to function will help assist in the detection and evaluation of pulmonary disease. It is an automated test that produces a graphic result by measuring how “fast” a patient can move air into and out of the lungs and how “much” air is moved into and out of the lungs.

Answer 61

The patient’s demographic factors (age, gender, weight, and height) are used to calculate the predicted respiratory values for a healthy patient. These values are then compared to three measured values that are obtained while the patient is performing the test.

Answer 62

This prep includes the following. - No large meals 2 hours before the test - No smoking 1 hour before the test - Discontinuation of the use of bronchodilators or other breathing therapies (inhalers, nebulizers) for at least 6 hours before the test

Answer 63

1. The patient should wear loose clothing, be in an upright sitting or standing position, and breathe through the mouth, pursing the lips around the mouthpiece. 2. The medical assistant will likely apply a clip to the patient’s nose to avoid nose-breathing during the procedure. 3. The patient should lift the chin slightly and extend the neck a little during the test to reduce breathing resistance. 4. Instruct the patient to “Take the deepest breath possible. Seal your lips around the mouthpiece. Blow as hard and as fast as you can, blowing until you empty the air from your lungs.” The procedure is repeated until there are three acceptable maneuvers or attempts. *Proper coaching is essential for yielding the best results from the patient.

Answer 64

Expected Value (95% confidence interval) FEV1: 80% to 120% FVC: 80% to 120% Absolute FEV1/FVC ratio: Within 5% of the predicted ratio TLC: 80% to 120% FRC: 75% to 120% RV: 75% to 120%

Answer 65

This test can be used to monitor lung function at home by the patient. This is especially helpful for patients who have chronic respiratory diseases such as asthma or chronic obstructive pulmonary disease (COPD). A peak flow rating of 80% or better is considered well-controlled and does not require treatment.

Answer 66

Device that measures the forced expiratory volume, which indicates the effectiveness of airflow out of the lungs.

Answer 67

1. Wear nonrestrictive clothing. 2. Begin with the marker at the bottom of the scale on the meter. 3. In an upright sitting or standing position, take a deep breath and forcefully blow out of the mouth, which is secure around the mouthpiece of the machine. 4. Record the number where the marker is located at the end of the test. 5. Repeat the test two to three times and record the results.

Module 3D: Point of Care Testing and Laboratory Procedures Flashcards

(91 cards)