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Phlebotomy 115

Phlebotomy 115 wk 7 Ch. 15

QuestionAnswer
urine specimen label should be placed on the container, NOT the lid
urinalysis (UA) one of the most frequently requested laboratory procedures
UA first morning-most concentrated
UA fasting-used for glucose level determinations for diabetes
UA first morning-used for protein, nitrate, & microscopic analysis
UA random-most convenient to obtain
UA random-used for routine urinalysis
UA clean catch/midstream-free of contamination
UA clean catch-culture for bacteria &/or microscopic analysis
UA Timed (e.g., 2, 4, 24 hour)-the excretion rate of the analyte can be determined
UA timed-creatinine clearance test, urobilinogen determinations, hormone studies
UA tolerance test-timed blood & urine specimens, are obtained to detect metabolic abnormalities
UA tolerance test-glucose tolerance test (GTT) & other tolerance test
abnormal UA presence of protein in urine (proteinuria); associated w/ kidney disease, prolonged excerise, or chemical poisoning
abnormal UA presence of hemoglobin (indicates blood destruction); associated w/ kidney disease, malaria, severe burns, or chemical poisoning
abnormal UA presence of bilirubin; associated w/ liver disease or obstructive jaundice
abnormal UA presence of glucose (glycosuria); diabetes mellitus
abnormal UA presence of leukocytes (WBC); infection in the kidney, urinary bladder or the urethra
abnormal UA presence of ketone bodies; diabetes mellitus or starvation
routine UA includes a physical, chemical, & sometimes microscopic analysis of the urine sample
UA physical properties include: color, transparency vs. cloudiness, odor, & concentration as directed through a specific gravity measurement
chemical analysis abnormal constituents is determined by using plastic reagent strips impregnated w/ color-reaction substances
reagent strips test for the presence of glucose, protein, blood (RBC) & hemoglobin
reagent strips test for the presence of WBC, ketones, bacteria, bilirubin, & other constituents
urine specimen the preferred for most analyses is the 1st voided urine of the morning
specimen should be transported to lab w/in 1 hour after the patient voids
specimen should be refrigerated if unable to reach lab w/in said time frame
urine culture & sensitivity (C&S) requires a clean-catch midstream collection
clean-catch midstream used to detect the presence or absence of infecting organisms
urine specimen transported to the microbiology department
timed collections incorrect collection & improper preservation of this type of specimen are the 2 most common errors affecting the results
CSF cerebrospinal fluid
CSF obtained by a physician through a spinal tap or lumbar puncture
CSF collected in 3 sterile containers numbered in order that they were collected
CSF 1st tube usually contaminated w/ blood or tissue debris
CSF 1st tube usually transported to the clinical chemistry or serological testing area
CSF 2nd tube is used for clinical microbiology testing
CSF 3rd tube usually used for cytological & microscopic analysis
CSF commonly test protein level, glucose level, cell count
CSF other test include microbiological, chloride level, & cryptococcal antigen determinations
CSF immediately transport @ room temp. to the clinical lab for STAT analysis
CSF maintained @room temp. NOT an icy slur
fecal specimens commonly collected to detect parasites
fecal specimens can detect enteric disease
enteric disease Salmonella (produces mild gastoenteritis to severe & often fatal food poisoning)
enteric disease Shigella (causes digestive distrubances from mild diarrhea to severe & often fatal dysentery)
enteric disease Staphylococcus aureus (can cause common food poisoning)
fecal specimens also collected to detect invisible (occult) quantities of blood that do not alter the appearance of stool
occult blood assists in confirming the presence of black stool
occult blood can detect gastrointestinal (GI) tract lesions & colorectal cancer
ColoScreen-ES a card used for occult blood test
ColoScreen-ES feces is collected on a special card and either mailed or brought into the lab for testing
occult blood test factors that may lead to a false-negative or false positive test-patient ingests aspirin, corticosteroids, ibuprofen, anticoagulants, &/or rare meats
seminal fluid examined in the clinical lab
seminal fluid used to determine the effectiveness of a vasectomy, investigate the possibility of sexual criminal charges or to assess fertility
seminal fluid must not be exposed to extremes of temperature or light prior to submission to the clinical lab
seminal fluid should be transported w/in 30 minutes of collection
amniotic fluid fluid that bathes the fetus w/in the amniotic sac
amniotic fluid can be collected by a physician when the pregnant patient is approximately 16 weeks gestation
amniotic fluid test fetal abnormalities through chromosomal analysis & chemical tests such as the alpha-fetoprotein (AFP)
amniotic fluid sometimes collected in last trimester to determing the lung maturity of fetus
amniotic fluid must be protected from light & should be transported to lab immediately
other body fluids synovial fluid-extraced aseptically from joint cavities
other body fluids pleural fluid-obtained from the lung cavity
other body fluids pericardial fluid-from the heart cavity
other body fluids peritoneal fluid-from the abdominal cavity
other specimens sputum (fluid from the lungs containing pus) is transported to the clinical lab
other specimens throat & sinus drainage cultures
other specimens wound cultures, ear or eye cultures, & skin cultures
other specimens should be handled extremely careful due to easy contamination and possible biohazard concerns
Nasopharyngeal cultures detect carrier states of neisseria meningitidis & Staphylococcu aureus
Nasopharyngeal cultures corynebacterium diphtheriae, streptococcus pyogenes, & haemophilus influenza
Nasopharyngeal cultures may be used to determine whooping cough, croup, & pneumonia in children
throat cultures most commonly obtained to determine the presence of streptococcal infections
skin tests range from detection of ragweed & milk allergies in hypersensitive individuals
skin tests can be used to detect tuberculosis (TB) & fungal infections
neisseria gonorrhea temperature & oxygen sensitive
viral cultures special viral transport media & calcium alginate swabs
throat cultures MUST stay moist in transport as Streptococcal are very delicate & fastidious
specimen labeling it is important to label properly & document the source of specimen (e.g. urine, blood, synovial fluid, etc)
routine UA done on virtually every patient in the hospital
1st part of UA physical analysis (color, transparency vs. cloudiness, odor, concentration
2nd part of UA chemical analysis (using the plastic reagent strip)
3rd part of UA not a CLIA waived test
3rd part of UA Microscopic analysis-cellular material e.g. WBC, RBC, & cast, Bacteria, trichomonas vaginalis (a parasite), sperm, renal & epithelial cells, various crystals, & yeast
3rd part of UA spun down in centrifuge
urine specimen bacteria increases by 16 times in 1 hour
Clean catch-mid stream preferred tests for UTI's, goes to microbiology
gastric analysis determines how much acid is produced in an individual's stomach
gastric analysis stomach (gastric) contents are emptied through a gastric tube
gastric analysis after emptying stomach contents, histamine (a stimulant) is injeted into the patiesn
gastric analysis 5 minutes after injection, stomach contents are emptied & tested for acidity
breath analysis used for peptic ulcers
helicobacter pylori a bacteria that damages the stomach lining & causes peptic ulcers
sweat chloride test used in the diagnosis of cystic fybrosis
cystic fybrosis a disorder of the exocrine glands, generally thought to be enzymatic in nature
cystic fybrosis causes changes in mucus-producing glands in the body
cystic fybrosis primarily affects the lungs, upper respiratory tract, liver, and pancreas
cystic fybrosis produce chloride in the sweat @ 2-5 times the level produced by a healthy individual
Created by: smkit03
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