Steps Involved in Processing and Handling Different Types of Specimens

Question 1

The result of a test is compromised when the _______ are not followed in the pre-
analytical phase.

Answer 1

proper collection procedures,
storage, processing, and transporting protocol

Question 2

TRUE OR FALSE
Phlebotomists should have the knowledge and skills to perform routine
venipuncture.

Answer 2

TRUE

Question 2

Studies show that approximately _____ of laboratory errors
occur prior to analysis.

Answer 2

46% to 68%

Question 2

They should be careful in mixing tubes and preparing specimen
for transport to the laboratory.

Answer 2

PHLEBOTOMISTS

Question 2

It is the responsibility of __________ to follow all the
appropriate steps required for each test that they are scheduled to perform.

Answer 2

phlebotomists

Question 3

Routine Handling

Answer 3

Mixing Tubes by Inversion

Transporting Specimens

Question 3

They should adhere to time limits set for delivery of
specimen to the laboratory except for cases such as ___ or ______

Answer 3

emergency specimen OR other
conditions mentioned in the time limit exceptions.

Question 3

Mixing Tubes by Inversion

The number of inversion depends on the type of ___, but it is usually
between ___

Answer 3

additive ; 3 to 10 gentle inversions.

Question 3

Mixing Tubes by Inversion

Some tests require ___ of the specimen tube to evenly distribute the
additive.

Answer 3

gentle inversion

Question 3

(3) aid clot formation for serum tubes. The tubes are placed in __ with a visible ___ and a slip pocket for the
appropriate paperwork or documentation.

Answer 3

liquid-tight
closure plastic bags ; biohazard logo

Question 4

The specimen will precipitate or agglutinate if allowed to cool below body
temperature; it should be transported at ___

Answer 4

near body temperature of 37C

Question 4

Transporting Specimens

Handling specimens for transport to the laboratory should be done properly because
rough handling can lead to ____ which might ____ the
specimens, activate platelets, affect the coagulation, and even break the glass tube.

Answer 4

undesirable conditions ;

hemolyze the specimens

activate platelets

affect the coagulation,

break the glass tube.

Question 4

Blood Specimen Processing and Reasons for Specimen
Rejection

Answer 4

They are
(1) identified;
(2) logged or accessioned;
(3) sorted by department and
type of processing;
(3) evaluated for specimen suitability which is necessary to get accurate results.

Question 4

Transporting Specimens

The specimen tubes should be transported with the stopper to

Answer 4

(1) avoid contact
between contents and the stopper,

(2) minimize agitation of the specimen,

(3) aid clot formation for serum tubes. The tubes are placed in liquid-tight
closure plastic bags with a visible biohazard logo and a slip pocket for the
appropriate paperwork or documentation.

Question 4

The tubes
should also be pre-warmed at ___ and ___ are used during
transport, which could hold the temperature for ___ from removal from the
incubator.

Answer 4

37 C ; portable heat blocks ; 15 minutes

Question 4

A ___ can be used for specimens that can withstand a temperature
slightly ____

Answer 4

heel warmer ; higher than 37C.

Question 5

Special Handling

Answer 5

Body Temperature

Chilled Specimen

Light-sensitive Specimen

Question 6

examples of body temperature

Answer 6

Cold agglutinin

cyrofibrinogen

cyroglobulins

Question 6

Specimen is exposed to light.

Answer 6

Light sensitive specimen

Question 7

Light-sensitive Specimen examples (8)

Answer 7

Bilirubin,

carotene,

red cell folate,

serum folate,

Vitamin B2, B6, B12

Vitamin C,

urine porphyrins,

urine porphobilinogen

Question 7

Chilled Specimen example (12)

Answer 7

Adrenocorticotropic hormone (ACTH),

acetone,
angiotensin-converting
enzyme (ACE),

ammonia,

catecholamines,

free fatty acids,

gastrin,

glucagon,

homocysteine,

lactic acid,

parathyroid hormone (PTH),

ph/blood gas (if
indicated),

pyruvate, and renin

Question 7

Chilled Specimen

Chilling slows the ____, which could affect the results for some
specimens. The specimen tube should be completely submerged in __________ and immediately tested or refrigerated, if necessary.

Answer 7

metabolic process, ; crushed ice and
water slurry during transport

Question 7

Light-sensitive Specimen

There are cases when exposure to light can affect the result of a specimen, like
___

Answer 7

bilirubin.

Question 7

Light-sensitive Specimen

The phlebotomist should wrap the tube with ___

Answer 7

aluminum foil or use

light-blocking

amber-colored container.

Question 8

Blood Specimen Processing and Reasons for Specimen Rejection The collected specimens are transported to the ___ .

Answer 8

central processing or triage for screening and prioritizing

Question 8

There is a delay or error in processing.

Answer 8

Any specimen will be rejected for the following reasons:

Question 9

Procedure did not follow testing time limits.

Answer 9

Any specimen will be rejected for the following reasons:

Question 10

Collection time is incorrect.

Answer 10

Any specimen will be rejected for the following reasons:

Question 11

Specimen is insufficient or "quality not sufficient" (QNS).

Answer 11

Any specimen will be rejected for the following reasons:

Question 11

The specimen is contaminated.

Answer 11

Any specimen will be rejected for the following reasons:

Question 12

There is improper handling (improper mixing).

Answer 12

Any specimen will be rejected for the following reasons:

Question 13

Tube used is outdated.

Answer 13

Any specimen will be rejected for the following reasons:

Question 14

Wrong tube for collection isused.

Answer 14

Any specimen will be rejected for the following reasons:

Question 15

It has inadequate volume to complete the test.

Answer 15

Any specimen will be rejected for the following reasons:

Question 16

There is hemolysis.

Answer 16

Any specimen will be rejected for the following reasons:

Question 17

Specimen is not identified properly.

Answer 17

Any specimen will be rejected for the following reasons:

Question 18

Delivery Time Limits and Exceptions for Delivery and Processing Specimens

Answer 18

Delivery Time Limits Time Limit Exceptions

Question 19

The specimen should be transported to the laboratory immediately after collection.

Answer 19

Delivery Time Limits

Question 20

Delivery Time Limits Centrifugation needed by the specimen should be done in ______

Answer 20

1 hour.

Question 21

Delivery Time Limits Routine blood specimen is expected to reach the laboratory within ________

Answer 21

45 minutes.

Question 22

The delivery time limit has some exceptions. For instance, a specimen that is marked as "STAT" or "emergency" takes priority over all other specimens in terms of transportation, processing, and testing.

Answer 22

Time Limit Exceptions

Question 23

Delivery Time Limits However, hematology specimens with ___ , which are placed in tubes with lavender or purple stopper, should ______

Answer 23

EDTA; not be centrifuged.

Question 24

Exceptions to time limit rule

Answer 24

Blood smear from EDTA specimen EDTA specimen for CBC EDTA specimen for erythrocyte sedimentation rate (ESR) EDTA specimen for reticulocyte counts Glucose test drawn in sodium fluoride tubes Prothrombin time (PT)

Question 24

stable for 24 hours and partial thromboplastin time (PTT) should be analyzed within 4 hours from collection.

Answer 24

Prothrombin time (PT)

Question 25

tubes-stable for 24 hours (room temperature) but stable for up to 48 hours when refrigerated at 2℃ to 8C.

Answer 25

Glucose test drawn in sodium fluoride tubes

Question 26

stable for 6 hours (room temperature) and 72 hours if refrigerated.

Answer 26

EDTA specimen for reticulocyte counts

Question 27

tested 4 hours (room temperature) and 12hours (refrigerated).

Answer 27

EDTA specimen for erythrocyte sedimentation rate (ESR)

Question 27

analyzed within 6 hours but is stable 24 hours from collection if stored at room temperature.

Answer 27

EDTA specimen for CBC

Question 28

prepared 1 hour from collection.

Answer 28

Blood smear from EDTA specimen

Question 29

an apparatus that is used to separate cells, plasma, or serum of blood specimens.

Answer 29

centrifuge

Question 29

Centrifugation is achieved by ______ inside the vessel at a ______ such that the centrifugal force will cause the separation of the specimens.

Answer 29

spinning the blood tubes ; high speed

Question 30

It must be noted that the tubes should be ___ in a centrifuge; tubes of the ___ of specimen should be placed ___ one another. The process of centrifugation should _______.

Answer 30

balanced ; same size and volume ; opposite ; not be repeated

Question 30

It is important to _________ to avoid contamination, evaporation, aerosol formation, and pH changes, which will affect the accuracy of the results.

Answer 30

leave the stoppers on the tube before and during centrifugation

Question 31

Removal can be done using ___

Answer 31

devices or robotics

Question 31

The plasma specimen collected in tubes with anticoagulants should be _________

Answer 31

centrifuged immediately and without delay.

Question 32

On the other hand, the serum specimen needs to be completely ___ prior to centrifugation. Normally, complete clotting takes around ______

Answer 32

clotted ; 30 to 60 minutes at room temperature.

Question 33

An aliquot of specimen refers to a portion of a sample specimen taken for chemical analysis or testing.

Answer 33

Aliquot Preparation

Question 34

It is prepared when multiple tests are ordered on a single specimen.

Answer 34

Aliquot Preparation

Question 35

The preparation is done by transferring a portion of the specimen into one or more tubes that are labeled with the same information as the original specimen tube using a disposable transfer pipette.

Answer 35

Aliquot Preparation

Question 36

Specimens with different anticoagulants should not be put in the same aliquot tube. The phlebotomist must see to it that the tube is covered as soon as it is filled.

Answer 36

Aliquot Preparation

Question 37

When processing specimens in the laboratory, the health worker is exposed to blood and other potentially infectious materials.

Answer 37

OSHA Act (RA 11058)-Required Protective Equipment Worn When Processing Specimen

Question 38

healthcare institutions should comply with the appropriate protective equipment set by the _____ . The protective equipment includes gloves, laboratory gowns/coats, and masks.

Answer 38

Occupational Safety and Health Standards Act (RA 11058)

Question 39

TRUE OR FALSE Although there are machines that test sample specimens directly through the stopper, most of the processes require the stopper to be removed to obtain the serum or plasma

Answer 39

TRUE

Question 40

if there is a need to remove the tubes manually, a _______ should be used to protect the technician from any risk of contamination.

Answer 40

face shield or splash shield

Question 41

A _______ is used to cover the stopper to catch drops of blood that may leak or to prevent the aerosol that may be released during the process. The tube stopper should be removed by pulling it _____ and off the tube.

Answer 41

gauze or tissue ; straight up