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Phlebotomy 115
Phlebotomy 115 wk 7 Ch. 15
Question | Answer |
---|---|
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 |