PMLS LEC Flashcards
(154 cards)
1
Q
________________ is the ideal specimen for respiratory function evaluation due to the _________________________ and ______________________
A
ARTERIAL BLOOD GAS, consistency of its composition, high oxygen content
2
Q
Information/s provided by the ABG test
A
- Oxygenation
- Ventilation
- ACID- BASE BALANCE
3
Q
Patients with diabetes or other metabolic disorders use __________________________ to manage the electrolyte and acid-base tolerance
A
ARTERIAL BLOOD GAS
4
Q
The accuracy of the test for ABG is easily affected by _______________________
A
Pre-analytical Errors
5
Q
A calculation of non-respiratory part of acid-base balance
A
Base excess
5
Q
A measure of acidity or alkalinity of blood
A
pH
6
Q
Partial pressure of O2, dissolved in arterial blood
A
PaO2
7
Q
Partial pressure of CO2, dissolved in arterial blood
A
PaCO2
8
Q
A measure of bicarbonate in the blood
A
HCO2
9
Q
Percent of O2 bound to hemoglobin
A
O2 Saturation
10
Q
NORMAL RANGE FOR pH
A
7.35- 7.45
11
Q
Normal range for PaO2
A
80-100 mmHg
12
Q
Normal range for PaCO3
A
35-45 mmHg
13
Q
Normal range for HCO2
A
22-26 mEq/L
14
Q
Normal range for 02 saturation
A
97% - 100%
15
Q
Normal range for Base excess
A
(-2)-(+2) mEq/L
16
Q
The process in which the site gets blood supply from more than one artery
A
Collateral Circulation
17
Q
Criteria used for selecting arterial puncture:
A
- There is collateral circulation (evaluated through portable ultrasound instrument or by modified Allen Test)
- Artery is large and accessible
- Surrounding tissue of puncture site have little risk of injury
- Area is free from inflammation, irritation, etc.
18
Q
3 Main sites for arterial puncture
A
- Radial Artery
- Brachial Artery
- Femoral Artery
(other sites include the dorsalis pedis and scalp for infants)
19
Q
The most commonly used site located at the thumb site of the wrist
A
Radial Artery
20
Q
Advantage of this Puncture Site includes:
- Good Collateral Circulation
- Easy to Palpate (Close to the skin)
- Less chance of Hematoma formation after collection
A
RADIAL ARTERY
21
Q
Disadvantage of this Puncture Site includes:
- Necessitates considerable skill to puncture because it is small in size
- Difficult to locate in patients with hypovolemia or low cardiac output
- Arteries of the arm and hand
A
RADIAL ARTERY
22
Q
Advantage of this Puncture Site includes:
- Relatively easy to puncture and palpate due to size
- Sometimes the preferred artery for a large volume of blood
- Adequate collateral circulation (not as good as radial)
A
BRACHIAL ARTERY
23
Q
Located in the medial anterior of the antecubital fossa
A
Brachial Artery
24
Disadvantage of this Puncture Site includes:
- Deeper and can be harder to palpate than the radial artery
- Lies close to the basilic vein; risk of mistakenly puncturing it
- Lies close to median nerve; risk of pain and nerve damage
- Increased risk of hematoma formation
BRACHIAL ARTERY
25
Located in the Groin lateral to the pubic bone
FEMORAL ARTERY
26
Advantage of this Puncture Site includes:
- Large Easily palpated and punctured
- Sometimes only the site where Arterial Sampling is possible
Femoral Artery
27
Disadvantage of this Puncture Site includes:
- Poor collateral circulation
- Lies close to the femoral vein; increased risk of mistakes in puncturing
- Increased risk of infection because of location and pubic hair
- Risk of dislodging plaque build-up from inner artery walls
- Requires extended monitoring for hematoma formation
FEMORAL ARTERY
28
Necessary requisition information for ABG includes:
- Body Temperature
- Respiratory rate
- Ventilation status
- Fraction of inspired oxygen (FIO)
- Prescribed flow rate in liters per minute
29
The Phlebotomist must wear the following before the ABG procedure:
- Gloves
- Masks
- Lab gowns, coats, or aprons.
30
Volume of syringe used for ABG
1 to 5 ml self-filling syringe
31
Temperature ABG specimen is subjected after collection before analysis
4 Degrees Celsius
32
PATIENT PREPARATION INCLUDES:
- Identification and explanation of Procedure
- Patient Preparation and Assessment
- Steady State
- Modified Allen Test
- Administration of local anesthetic (Optional)
33
The patient should be resting in a comfortable position for __________________ or ____________________________
5 minutes, until breathing of the patient become stable
34
The patient should be stable or in stable state for __________________ before the Allen test is performed
20 to 30 minutes
35
Why is isopropyl alcohol used for disinfection for ABG procedure
- Isopropyl Alcohol does not affect certain analytes tested for ABG
36
Angle of needle for application of Local Anesthetics
10 Degrees
37
After the application of anesthetics wait _________________ before continuing to the ABG procedure
2 Minutes
38
In radial artery puncture, position the arm, palm up, and wrist extended to approximately __________________ angle
30 Degree
39
In radial artery puncture insert the needle at a ____________ angle
30 to 45 Degree
40
Hazards and Complications of ABG procedure includes:
- Arteriospasm
- Artery Damage
- Discomfort
- Infection
- Hematoma
- Numbness
- Thrombus Formation
- Vasovagal response
41
involuntary contraction of artery.
Arteriospasm
42
results from repeated punctures.
Artery Damage
43
can be avoided by using local anesthesia
Discomfort
44
observe proper preparation in the pre-analytical
phase.
Infection
45
avoid multiple punctures
Hematoma
46
should be addressed and reported
Numbness
47
must be reported to the nurse/physician
Thrombus formation
48
remove the needle, activate the safety device,
maintain pressure over the site, and follow the syncope procedure
Vasovagal response
49
SAMPLE ERROS INCLUDE
1. Air bubbles were not expelled from the sample
2.Processing exceeded optimal time
3.Sample was not mixed properly or immediately
4.Syringe was used improperly
5.Venous blood was obtained by mistake
6.Improper anticoagulant was used
7.Incorrect volume of heparin used
50
CRITERIA FOR REJECTION
1. Air bubbles are found in specimen
2.Specimen has clotted
3.Specimen has hemolyzed
4.Submitted specimen did not comply with proper labeling
5.Prescribed transportation temperature was not met
6.Specimen did not meet the required volume or QNS
7.It took so much time to reach the laboratory
8.Wrong type of syringe was used
51
- Considered the most efficient system for collecting blood sample
- A closed collection system in which blood flows through a needle inserted into a vein and directly into a collection tube
- Prevents exposure to air or outside contaminants
- Allows numerous tubes to be collected in a single venipuncture
Evacuated tube system
52
Consists of a double-pointed needle
multisample needle, needle safety
device, a holder, and color-coded
evacuated tubes
Evacuated Tube System
53
Routine venipuncture: _____ or ___-gauge with ____ or
____ inch length
21, 22, 1, 1.5
54
Children and patients with small veins: ___ or ____
gauge with ___ inch length
22, 23, 3/4
55
Types of safety devices in ETS
- Safety Shield
- Blunting Devices
- In-vein retraction device
56
The air pressure inside the tube is _______, ____________ the
normal environment, which creates the vacuum in the tube
negative, less than
57
ETS Order of Draw
1.Sterile tube (blood culture)
2. Blue-top coagulation tube
3.Serum tube w. or w/o. clot activator or gel
4.Heparin tube tube w. or w/o. gel plasma
separator
5.EDTA tube
6.Glycolytic inhibitor tube
58
Special Handling Procedures for ammonia, lactic acid, blood gases samples
Put on Crushed Ice
59
Special Handling procedures for cold agglutinin, cryoglobulin
Keeping it warm
60
Special Handling Procedure for Bilirubin
Protect from light
61
it is the collection, testing, preparation, and storage
of blood from donors who are usually volunteers.
Blood Donation
62
The Blood donation process usually takes _________ minutes and it safe, simple, and rewarding procedure
45-60
63
Donors should be at least ____ years
old weighing ____________ at the
minimum and should be generally
healthy.
16, 110 pounds
64
Blood donation Process
Donor Screening
Donor Registration
Medical History
Donor Interview
Physical Examination
Guidance on Venipuncture for Blood Donation
Preparing the Venipuncture Site
Collecting the Unit
Adverse events in Blood Donation
Donor Care Post Phlebotomy
Donor Blood Processing
Donated Blood Labelling
65
The donor is asked about his/her
health, lifestyle, and disease risk
factors. All the details provided
are confidential.
Donor Screening
66
The donor needs to complete a
donor registration form which
includes his/her name, address,
and other demographic
information.
Donor
registration
67
the donor will have to confirm if
he/she has any healthy issues and
disease risk factors.
Medical
history
68
the donor will have a brief
interview with the healthcare
personnel to ensure that the
donor has met general donor
requirements.
Donor
interview
69
a short health exam (pulse,
temperature, and blood pressure) will
be conducted and a drop of blood from
the donor’s finger will be tested to
ensure that his/her blood iron level is
suitable for blood donation.
Physical
examination
70
a short briefing on the procedure will
be given by the health personnel.
Guidance on
venipuncture
site
71
donor will be led to the donor area where the arm
is cleaned with antiseptic and the vein for
venipuncture is selected.
Preparing the venipuncture site
72
the unit of blood will be collected by the health
personnel.
A blood donation kit will be used to draw blood
from the vein in the donor's arm.
Collecting the unit
73
One unit of blood takes about ___ minutes to
complete.
6-10
74
Healthcare personnel must monitor the donor for
adverse effects during and after blood collection.
Donors should remain seated for a few minutes
before leaving to ensure they aren't dizzy from the
procedure.
Adverse events
in blood
donation
75
the venipuncture site should be inspected and
refreshments should be offered to the donor
before he/she leaves the area.
Donor care post phlebotomy
76
the collected blood unit is prepared and placed in
the proper container for transport to the
processing area.
Donor blood
processing
77
the information indicated on the label found in
the blood unit must be double-checked. It should
be complete and accurate.
Donated blood labeling
78
Blood Donation Areas must be made of cleanable surfaces such as ________, and kept clean and disinfected by ____________________________ solutions.
Vinyl, sodium hypochlorite bleach
79
used to minimize contaminations
from skin flora and to obtain the first 20mL of blood.
Diversion pouches
80
a sterilized lancet (single used) is utilized, and the collected blood should immediately be placed in a safety box.
Hemoglobin testing
81
Remove the tourniquet in Blood Donation after __________________________ or after ____________________
the blood flow is established, two (2) minutes
82
Mix collected blood with anticoagulant gently either
manually or by continuous mechanical mixing during
the donation procedure observing approximately a ______ seconds interval
30
83
Determines the blood type and Rh Factor
Blood Bank: Blood Type and Screen
84
Checks the Compatibility between the donor's and the recipient's blood
Blood Bank: Cross-Match Test
85
Determines the presence of infection, identifies the type of organism involved, and measures the extent of infection
Blood Culture
86
Evaluates the blood clotting function
Coagulation Studies
87
Screens for diabetes and other metabolic disorders
2-hours Postprandial Glucose
88
Diagnoses problems in carbohydrate metabolism and checks the ability to metabolize glucose through the tolerance level
Glucose Tolerance Test (GTT) and Oral Glucose Tolerance Test (OGTT)
89
Determines the lack of mucosal lactase which is responsible for conversion of lactose into glucose
Lactose Tolerance Test
90
Verifies the probability that the patient fathered a particular child
Paternity/ Parentage Test
91
Tests the drug levels at specific intervals to establish proper drug dosage and avoid toxicity
Therapeutic Drug Testing
92
Treats polycythemia and hemochromatosis
Therapeutic Phlebotomy
93
Checks the presence of toxins in the blood, hair, urine. and other substances
Toxicology Test
94
Checks the presence of aluminum, arsenic, copper, lead, iron, and zinc
Trace Elements
95
in collecting blood bank specimen, use _______ tube or _______ tube as altermative
EDTA, Red-top
96
Blood donors should be __ to ___ in age, while also weighing at least ______ pounds
17 to 66, 110 lbs.
97
patients donate their own blood to themselves
Autologous Donation
98
test that checks the blood for pathogens for patients who have a fever of unknown origin (FUO)
Blood Culture
99
blood culture requires ___ to ____ blood culture sets placed in 2 bottles: one with _________ and one without _____________
2 to 4, with air or aerobic, without air or anaerobic
100
Coagulation Specimen tests include the following:
PT- Prothrombin Time
aPTT- Activated Partial Thromboplastin Time
TT- Thrombin Time
101
If coagulation specimen is drawn, draw a clear tube with ______ ml to discarded prior to collection
1-2
102
This Blood Test is done to check if the patient is suffering from diabetes
2-Hour Postprandial Glucose (2 hour PP)
103
a P/x suffering from carbohydrate metabolism problems is subjected to ______________________________
glucose tolerance test
104
in GTT procedure the Patient must eat a balanced diet meal containing appx. ______ grams of carbohydrates for ______ days, and must fast for ______________ hours before testing
150g, 3 days, 12 to 16 hours
105
Glucose Beverage dose for Adults
75g
106
Glucose Beverage dose for children
1g per kg of weight
107
Glucose Beverage dose for Gestational Diabetes
50g to 70g
108
measures the ability of the body to process lactose and determines if the patient lacks mucosal lactase
Lactose Tolerance Test
109
an enzyme that converts lactose into glucose or galactose
Mucosal Lactase
110
Consequence of consuming milk or food containing lactose for those who lack the lactase enzyme
gastrointestinal distress and diarrhea
111
is performed by drawing a large volume of blood about 500ml from the patient as part of the treatment procedure for polycythemia and hemochromatosis
Therapeutic Phlebotomy
112
overproduction of blood cells that is harmful to the patient
Polycythemia
113
characterized by excess iron deposits in the tissues which could be due to problems with iron metabolism cause by multiple blood transfusions or excessive iron intake
Hemochromatosis
114
Detection of toxins and treatment
Clinical Toxicology
115
legal consequences of toxin exposure
Forensic Toxicology
116
any analytical test that is done outside the centralized laboratory and near the site where the patient receives treatment
POCT - Point of Care Treatment
117
Non instrumentalized 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 capillary intergrity
Bleeding TIme
118
________________ helps keep the balance of fluids in the body as well as plays a role in transmitting nerve impulses
Sodium
119
elevated levels of sodium in the body
Hypernatremia
120
reduced levels of sodium in the body
Hyponatremia
121
an electrolyte that helps in nerve conduction and muscle function
Potassium
122
Increased levels of potassium in the blood
hyperkalemia
123
Decrease levels of potassium in the blood
hypokalemia
124
maintains the integrity of the cells by helping balance the osmotic pressure as well as the acid-base balance of the body
Chloride
125
Checking the presence of human chorionic gonadotropin in the urine or serum
Pregnancy Test
126
Gauge the effectiveness of the thrombolytic therapy being administered to patients who have suffered from heart attacks
Cardiac Troponin T (TnT) and Troponin I (TnI)
127
measures the alanine transferase (ALT) of patients under lipid-lowering medication
Lipid Testing
128
Measures the volume of the red blood cells
Hematocrit
129
checks the hemoglobin level to manage patients suffering from anemia
Hemoglobin
130
Test for the Intrinsic Pathway
Activated Partial Thromboplastin Time
131
Test for the Extrinsic Pathway
Prothrombin Time
132
also known as skin puncture is a method that uses a lancet to make a small incision into the capillary bed of the skin to obtain a small volume of blood specimen
Capillary Puncture
133
These are sterile, sharp instruments
ONLY intended for one-time use
Designed for use in making cuts in the skin for finger or heel puncture.
Lancet
134
Produces a small hole in the skin by vaporizing the water in the skin
Eliminates the risk of sharp injury
Used in 2 types of Capillary Puncture: (1) Finger Puncture Lancet & (2) Heel Puncture Lancet.
Laser Lancet
135
Also known as microtubes, container is a small plastic tube
HOLDS the blood specimen collected in the capillary puncture
MARKINGS to show minimum and maximum levels
Occasionally comes with a narrow capillary tube
Microcollection Tubes
136
Narrow bore tubes that are made of either plastic or glass
Typically used for hematocrit determination
Can hold 50 to 75 µL to be filled with a capillary system
One end is usually sealed with sealants made of clay or plastic
Hematocrit Tubes
137
Used for blood films for hematology determinations
Microscope Slides
138
Used to increase the blood flow seven-fold by warming the puncture site.
Warming Devices
139
bright red blood found in the pulmonary vein, left chamber of the heart and the arteries
oxygenated blood in the circulatory system
Arterial Blood
140
blood that travels from the peripheral veins passing through the venous system then through the right chamber of the heart
deoxygenated blood in the circulatory system and dark red in color
Venous Blood
141
prefered specimen for infants, young children, elderly patients, and patients with severe burns
extracted from the venules and arterioles found in the capillary bed
Capillary Blood
142
fills the spaces around the cells, filtered from the blood capillaries, drained away as lymph
Interstitial Fluid
143
found inside the cells, facilitates the movement of fluid in the membrane, blocks the entrance of unwanted materials
Intracellular Fluid
144
Capillary Blood concentration of the glucose in the blood is ________ while protein (TP), calcium (Ca4+), potassium (K+) concentrations are _______
higher, lower
145
Order of Draw for Capillary Puncture
Blood Gas
Microscope Slides
EDTA
Other Anticoagulated Tubes
Serum Tubes
Newborn Blood Spot Card
146
is a blood test that is used to check abnormalities in the blood cells
Routine blood film/smear preparation
147
is used to determine if the patient has malaria, which is diagnosed by its presence in the peripheral blood smear.
Thick Blood Smear
148
Newborn screening blood spot collection is done ________ hours after the baby is born
24 to 48
149
The site for capillary puncture should be warmed for _________ minutes
3 to 5 Minutes
150
detects gastrointestinal bleeding
Occult Blood
151
check contact with allergens and determines if the body has developed antibodies
Skin Test
152
detects and evaluates infection, tissue injury, and other inflammation orders
C Reactive Protein
153
Ionized Calcium comprises _____ of our blood calcium
45%
