Module 5: Special Collections Flashcards
(68 cards)
1
Q
blood smear
A
- thin film of blood spread into a microscopic glass slide
- used to microscopically examine blood
- venous blood or capillary blood
2
Q
when must peripheral blood smear be prepared when collected in an EDTA tube
A
within 1 hr of collection
3
Q
wedge method of preparing blood smears
A
- touching two slides at an angle of 30 to 35 degrees
- place edge of spreader slide in front of the drop of blood
- pull back the slide until it touches the blood
- let blood spread almost to the edges of the spreader slide
- push spreader slide toward clear end of the slide in one smooth motion
4
Q
ways to collect blood for blood smear
A
- dermal puncture
- venipuncture using tube of uncoagulated blood, usually containing EDTA
5
Q
how to get blood on slide if collecting with dermal puncture
A
- perform finger stick
- wipe away first drop of blood
- apply pressure to finger to obtain a free-flowing drop of blood
- allow blood to fall onto glass slide toward one end
6
Q
how to get blood on slide if collecting with venipuncture
A
- use a safety device to access the blood or carefully uncap the tube behind a safety shield
- use disposable pipette or plastic dropper to remove the blood
- use applicator sticks or a capillary tube to place the drop on the slide
7
Q
where should you place the drop of blood on a microscope slide
A
- 1/2 to 1 inch from the end of the slide
- do not place directly on the frosted end
8
Q
should the frosted side of the microscope slide be facing up or down when using slides that have a frosted end
A
- up
- it is used to write pt information or to affix aliquot label
9
Q
how should blood be distributed on a slide
A
- thicker at the drop point
- thinner on the opposite end
- tail with a feathered end that is slightly rounded
- should not touch the edges of the microscopic glass slide
- smooth without irregularities or holes
10
Q
how to dry blood smear
A
- let it air dry before staining
- do not blow on it
11
Q
blood cultures
A
- lab tests used to check for microbes in a blood sample
- assist in diagnosing conditions in a pt who has a fever of unknown origin (FUO)
12
Q
how do you know how much blood to collect for blood cultures
A
- review the medical requisition form
- mark the bottle with the level of blood required
13
Q
how to uncap and clean the blood culture bottle
A
- remove the protective cap, not the entire cap
- cleanse the top of the bottles with an antiseptic (alcohol)
14
Q
how to cleanse the skin prior to venipuncture for a blood culture
A
- clean for 60 seconds using alcohol or chlorhexidine gluconate
- light friction using outward spiral technique
- clean around site to a diameter of 2 to 2.5 inches
- allow area to dry
- clean the area again using the same technique but with povidone-iodine for 30 to 60 seconds
- allow area to dry
15
Q
which blood culture bottle should you collect first when using a butterfly needle
A
- aerobic
- anaerobic for other collection methods
16
Q
when should the pt clench and unclench their fist
A
- clench: after the tourniquet is applied, before needle insertion
- unclench: as blood enters the tube or bottle
17
Q
how long should you observe the venipuncture site for bleeding after releasing pressure
A
10 seconds
18
Q
inborn errors of metabolism
A
- newborns screened for various metabolic and genetic disorders by analyzing blood on special filter paper
- assist in early detection
19
Q
when is blood testing for newborn screenings performed
A
- before newborn is 72 hours old
- if it is obtained before the newborn is 24 hr old, a second specimen should be screened by 2 weeks of age
20
Q
what conditions does newborn screening help detect
A
- cystic fibrosis
- hypothyroidism
- phenylketonuria (PKU)
- galactosemia
- other genetic disorders (biotinidase deficiency, sickle cell disease)
- infectious diseases (HIV, toxoplasmosis)
21
Q
cystic fibrosis
A
mucous secretions that accumulate in various organs
22
Q
hypothyroidism
A
decreased thyroid function
23
Q
phenylketonuria (PKU)
A
- metabolic genetic disorder
- deficiency in hepatic enzyme phenylalanine hydroxylase
- causes permanent intellectual disability, seizures, delayed development, behavioral/psychiatric problems, mousy body odor, lightening of hair/skin, eczema
24
Q
galactosemia
A
- lack of enzyme that breaks down galactose (a milk sugar)
- infant can slowly starve if left untreated
25
biotinidase deficiency
deficiency of enzyme that breaks down biotin
26
sickle cell disease
abnormal hemoglobin structure
27
what should you check newborn screening forms for
- expiration dates: substances within absorbent areas of filter paper can expire
- guardians phone number: in case any tests yield positive results
28
how do you collect blood for newborn screenings
- capillary puncture on infants heel
- allow large blood droplet to form
- touch the filter paper to the drop of blood to soak through completely in each circle
- circles must be totally saturated
29
how long should filter paper dry for newborn screenings
- air dry
- 3 hr
- room temperature
- away from direct sunlight and heat
30
how not to get blood on filter paper for newborn screenings
- avoid touching the skin with the card
- avid blotting or attempting to color in the circle with several blood drops: causes serum rings
- do not use capillary tubes: make filter paper rough and cause overabsorption
31
why might specimens for newborn screenings be rejected
- a circle is oversaturated
- all circles are not completely filled
- expired form is used
- form not received within 14 days of collection
- specimen is contaminated with foreign substance
- specimen not allowed to dry thoroughly
- circles have serum rings
32
autologous transfusion
pt donates their own blood for use for a transfusion or upcoming surgery
33
blood banks
- handle blood used in blood donations
- responsible for collection, processing, storing
- usually part of the lab
- work closely with regional blood centers that provide blood and blood products to hospitals
34
therapeutic phlebotomy
- intentional removal of blood to lower RBC or iron levels
- polycythemia vera: high RBC count
- hemochromatosis: high iron count
- performed by blood banks
35
how to hang bags during blood donation collection
- lower than pts arm
- gravity helps fill the bag
36
what to do and what not to do if blood donation bag only fills partially
- do: restart blood collection
- don't: combine two bags
37
apheresis
- removal of blood plasma from pts body without withdrawing the blood itself
- separates blood into plasma and cells
- returns cells to pt body
- aka power red
38
plasmapheresis
removal of blood plasma from whole blood
39
requirements for blood donation
- at least 17 y/o (16 with parent permission in some states)
- weigh at least 110 pounds
- pulse: 50-100 bpm
- diastolic pressure: less than 100 mmHg
- temperature: less than 99.5 F
- hematocrit: over 38%
- donations at least 56 days apart (8 wks)
40
apheresis requirements for males
- age 17+ y/o
- weight 130+ lbs
- height 61+ in
41
apheresis requirements for females
- age 17+ y/o
- weight 150+ lbs
- height 65+ in
42
what is done before someone can donate blood
- get complete medical history
- mini-physical exam: temp, pulse, BP
- hemoglobin or hematocrit levels measured
- blood tested for HIV, AIDS, and hepatitis
43
what is done before someone can donate blood
- get complete medical history
- mini-physical exam: temp, pulse, BP
- hemoglobin or hematocrit levels measured
- blood tested for HIV, AIDS, and hepatitis
44
what questions are included in the medical history for pts wishing to donate blood
- sexual activity
- recent out-of-country travel
- use of medications
45
what must a pts hemoglobin be before they can do an autologous blood donation
at least 11 g/dL
46
when must a pts surgical procedure be scheduled for a pt to do an autologous blood donation
more than 72 hrs after the donation
47
iatrogenic anemia
- blood loss due to repeated venipunctures in a short period of time
- older pts, pediatric pts, pts who are underweight
48
why are older pts at risk of iatrogenic anemia
- medications may suppress bone marrow production
- decreases in nutritional intake
- significant amount of blood collected from different doctors
49
max amount of blood that can be taken from infants
- 1-5% of blood volume within 24 hrs
- 10% of blood volume over 8 wk period
50
max amount of blood that can be taken from adults
- 100 mL
- over that can cause decreased hemoglobin or hematocrit
51
how to calculate infant blood volume
- convert weight in lbs to kg: divide by 2.2
- convert kg to mL: multiply by 100
- convert mL to L: divide by 1000
52
what can iatrogenic anemia lead to
- shortness of breath
- fatigue
- need for blood transfusions
53
random urine collection
- most commonly performed urine test
- no preparations or time restrictions
- use a sterile specimen container
54
glucose tolerance test
- confirm pt is fasting, usually for 12 hr
- blood and urine tests should be performed at the same time
- collections every 1 to 2 hrs after finishing glucose solution
- drink glucose solution within five minutes
- document time specimen was collected
- if not collected on time, document reason and actual time it was collected
55
postprandial test
- void and then eat a meal
- specimen collection 2 hr after pt eats prescribed amount of carbs or glucose
- monitors effects of insulin dosage for those with diabetes
- screening tool
56
24-hour urine collection
- container that holds 3-4 L
- discard first-morning specimen and collection and specimens after that for 24 hrs
57
urine drug testing
- accuracy and privacy
- chain of custody form: everyone who handles the specimen must sign and date the form
58
clean-catch midstream urine collection
- use antiseptic that won't damage genitals
- void small amount into toilet
- begin collection
- stop collection before urine flow stops completely
- finish voiding into the toilet
- used for culture and sensitivity testing
59
reagent strip for urine
- chemical analysis
- strip dipped into urine and analyzed
- use analysis chart to determine level of substance in the urine
- dispose of used strip in biohazard bag
60
saliva specimens
test for hormone, alcohol, and drug levels
61
sputum specimens
- collected from lungs, trachea, and bronchi
- pt takes deep breath and expectorates by coughing deeply into specimen container
- best to collect before or several hours after eating to prevent vomiting
- larger volume is available in the morning
62
fecal specimens
- determines bacterial infections, parasites, and occult blood
- dietary restrictions may be required
- keep sample at 98.6 F
63
semen specimens
- sperm count to assess fertility, DNA to prove identity in rape cases
- pt may need to refrain from ejaculation prior to specimen collection
- collect in sterile container, condoms contain spermicides
- keep specimen warm, protect from light
- return in 2 hr, 1 hr preferred
64
throat swab
- culture specimen, tests for strep throat
- wipe both tonsils, the throat, and all areas that look inflamed or infected
- wear a mask to protect yourself from airborne contanimation
65
buccal swab
- collected from inside of the cheek in the mouth
- collects pt DNA
- gently rub swab against inside of pts cheek
66
what should you verify on the requisition form when receiving a forensic specimen
- type of specimen
- case number
- name, age, and sex of person it was taken from
67
what color tube is used to test testosterone levels
red
68
where to collect two sets of blood cultures from
- if both must be taken from the same site: wait 1 hr
- draw from two separate sites to get most accurate results: two sites on pt left arm
