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STUDY CCMA for NHA2
Flashcards made for studying for CCMA exam through NHA
| Question | Answer |
|---|---|
| This is difficulty or inability to breath unless in an upright position | Orthopnea |
| State in which reduced amount of air enters the lungs resulting in decreased oxygen level in the blood | Hypoventilation |
| Abnormal increase in the depth and rate of breathing | Hyperpnea |
| State in which there is an increased amount of air entering the lungs | Hyperventilation |
| The amount of force exerted by the blood on the peripheral arterial walls | Blood Pressure |
| Common Errors in Blood Measurements: | Improper cuff size, The arm is not at heart level, Cuff is not completely deflated before use, Deflation of the cuff is fater than 2-3 mmHg per second,Improper cuff placement, Defective equipment |
| The four principles of physical exam are: | Inspection, Palpation, Percussion, Auscultation |
| The Medical Assistant's role in the physical exam | Room Preparation,Patient Preparation, Assisting the physician |
| To make diagnosis, the physician utilizes three sources: | The patient's health history, the physical exam, and lab tests |
| This patient position is used for most physical exams. The patient lies on his/her back with legs extended. | Horizontal Recumbent Position |
| This position is when the patient lays on their back with knees flexed and soles of feet flat on the bed. | Dorsal Recumbent Position |
| A sitting or semi-sitting position where the back of the examination table is elevated to either 45 degrees or 90 degrees. Used to promote drainage or to ease breathing | Fowler's Position |
| Position used for examination of pelvic organs.For example, delivery | Dorsal Lithotomy Position |
| This position is when the patient lies on his/her abdomen with head turned to one side for comfort, the arms may be above head or alongside the body | Prone Position |
| Position where patient is on his/her left side with the right knew flexed the abdomen and the left knee slightly flexed | Sim's Position |
| Used for rectal and vaginal examinations, the patient is on his/her knees with his/her chest resting on the bed arms above head | Knee-Chest Position |
| OSHA | Occupational Safety and Health Administration |
| Responsible for the identification of the various hazards present in the workplace and for the creation of rules and regulations to minimize exposure to such hazards | OSHA |
| When a safety incident arises you must.. | report it to your supervisor immediately |
| 3 major categories of safety hazards: | Physical hazards, Chemical hazards, Biological hazards |
| Electrical Safety Regulations: | Use only ground plugs that have been approved by Underwriter's Laboratory (UL), Never use extension cords, Avoid electrical circuit overloading, Use signs and/or labels to indicate high voltage |
| Chemical Safety Regualtions | If the skin or eyes come in contact with any chemicals, immediately wash area with water for atleast 5 mins, Store flammable or volatile chemicals in a well-ventilated are, After use, immediately recap all bottles containing toxic substance |
| Biological Hazards | Disinfect the laboratory work area before and after each use when dealing with biologicals, Never draw a specimen through a pippette by mouth,Always wear gloves,Sterilize specimens and any other contaminated materials andor dispose of them by incineration |
| Emergency situations: | External Hemorrhage, Cardiopumonary Resuscitation,Shock |
| Common symptoms of shock: | Pale,cold clammy skin/Rapid,weak pulse/Increased,shallow breathing rate/Expressionless face;staring eyes |
| First Aid for Shock | Maintain an open airway for the victim, Call for assistance, Keep the victim lying down with the head lower than the rest of the body, Attempt to control bleeding or cause of shock, Keep the victim warm until help arrives |
| Chain of Infection | Portal of exit=Agent=Mode of transmission=Suceptible host=Portal of entry |
| Agents | infectious microorganisms that can be classified into groups naemly: viruses,bacteria,fungi,and parasites |
| Portal of exit | The method which an infectious agent leaves its reservoir |
| Mode of transmission | Specific ways in which microorganisms travel from the reservoir to the susceptible host |
| 5 main types of mode of transmission | Contact direct and indirect/Droplet/Airborne/Common vehicle/Vectoreborne |
| Portal of Entry | Allows the infectious agent access to the susceptible host. |
| Susceptible Host | The infectious agent enters a person who is not resistant or immune. |
| Medical Asepsis | The destruction of pathogenic microorganisms after they leave the body |
| Methods of medical asepsis: | Standard Precautions and Transmission-Based Precautions |
| The least expensive and most readily available disinfectant for surfaces such as countertops is: | 1:10 solution of household bleach |
| Another form of disinfection is boiling water at what temperature: | 212 F |
| Four methods of sterilization | Gas Sterilization, Dry Sterilization, Chemical Sterilization, and Steam Sterilization(autoclave) |
| Gas Sterilization | Often used for wheelchairs and hospitals. Useful in hospitals, but costly for office. |
| Dry Heat Sterilization | Requires higher temperature that steam sterilization but longer exposure times. Used for instruments that easily corrodes |
| Steam Sterilization Sterilization(autoclave) | Uses steam under prssure to obtain high temperature of 250-254 F with exposure times 20-40 minutes depending on the item being sterilized. |
| PPE includes: | Masks, Goggles, Face Shields, and Respirator |
| Standard Precautions are used when there is a possibility of contact with any of the following: | Blood, All body fluids, Nonintact skin, Mucous membranes designed to reduce the risk of transmission of microorganisms from both, Recognized and unrecognized sources of infections |
| Standard Precautions are: | Wear gloves when collecting and handling blood, body fluids, or tissue specimen, Wear face shields when there is a danger for splashing on mucous membranes, Dispose of all needles and sharp objects in puncture-proof containers without recapping |
| Name all of the different parts of a prescription | 1)patient's name&info2)Todays date3)Name of med4)Dosage of med5)How many doses taken at once6)Route7)How often med should be taken&how to take it8)Number of doses being dispensed9)#of Refills10)DEA#11)Doctor's Sig |
| PO | By mouth or orally |
| PR | Per rectum or "by way of the rectum" by suppository |
| SL | Sublingual(under the tongue) |
| IV | Intravenous |
| IM | Intramuscular |
| SQ | Subcutaneous(meaning under the skin) |
| qd | every day |
| bid | twice a day |
| tid | three times a day |
| qid | four times a day |
| pc | after meals or not on an empty stomach |
| qhs | each night |
| prn | as need |
| Where is the heart located? | In the thoracic cavity between the lungs just behind the sternum. |
| The innermost layer of the heart.It forms the lining and folds back onto itself to form the four valves. It is in this layer that conduction system is found. | Endocardium |
| The middle and contractile layer of the heart. It is made up of striated muscle fibers interspersed with interspersed disks. | Myocardium |
| The outermost layer of the heart. It is actually the inner (visceral) layer of pericardium | Epicardium |
| A sac in which the heart is contained | Pericardium |
| Right Atrium | Receives deoxygenated blood returning to the heart from the body via the superior vena cava which carries blood from the upper body and the inferior vena cava which carries blood from the lower body |
| Right Ventricle | Receives deoxygenated blood from the right |
| Pulmonary Arteries | The only arteries in the body that carry deoxygenated blood |
| Left Atrium | Receives oxygenated blood returning from the lungs via the right and left pulmonary veins |
| Pulmonary veins | The only veins in the body that carry oxygenated blood |
| Left Ventricle | Receives the oxygenated blood from the left atrium and pumps it to the body through the aorta, the largest artery of the body |
| What is the purpose of the heart valves? | To prevent backflow of blood thereby assuring uni-directional flow through the heart |
| AV | Atrioventricular Valve |
| Tricuspid Valve | located between the right atrium and the right ventricle. As the name connotes, it has three cusps |
| Mitral Valve | Located between the left atrium and the left ventricle. It has two cusps and it is also called the bicuspid valve |
| Pulmonic Valve | Located between the right ventricle and the pulmonary trunk |
| Aortic Valve | Located between the left ventricle and aorta |
| How are murmurs caused? | By diseases of the valves or other structural abnormalities |
| S1 | First sound is due to the closure of the mitral and tricuspid valves |
| S2 | Second heart sound is due to the closure of the aortic and pulmonic valves. |
| What arteries supply the heart? | The right and left coronary from the aorta. |
| ANS | Autonomic Nervous System |
| Sympathetic Nervous System | affects both the atria and the ventricles by increasing heart rate conduction and irritability |
| Parasympathetic Nervous system | affects the atria only by decreasing heart rate,conduction and irritability |
| Automaticity | The ability of the cardiac pacemaker cells to spontaneously initiate their own electical impulse without being stimulated from another source |
| Excitability | Also referred to as irritability. Is shared by all cardiac cells and it is the ability to respond to external stimlulus: electrical, chemical, and mechanical. |
| Conductivity | The cardiac cells to receive an electrical stimulus and transmit the stimulus to the other cardiac cells |
| Contractility | The ability of the cardiac cells to shorten and cause cardiac muscle contraction in response to an electrical stimulus |
| Primary pacemaker of the heart and has a normal firing rate of 60-100 bpm | SA Node |
| Where is the SA Node found? | Found in the upper posterior portion of the right atrial wall just below the opening of the superior vena cava |
| AV Node | A 1/10 of a second delay of electrical activity at this level to allow blood to flow from the atria to the ventricles |
| Bundle of His | Has an ability to initiate electrical impulses with an intrinsic firing rate of 40-60 bpm |
| Where are the Purkinje Fibers found? | Within the ventricular endocardium |
| Purkinje Fibers | Consists of a network of small conduction fibers that delivers the electrical impulses to the ventricular myocardium, Firing rate is 20-40 bpm |
| EKG consists of | Placing 10 electrodes on the patient producing 12 Leads I,II,III,aVR,aVF,aVL,V1-V6 |
| Limb Leads | Consist of three bipolar leads and three augmented leads. These leads record electrical potentials in the frontal plane. |
| Where are Limb Leads placed? | Electrodes are usually applied just above the wrists or upper arms and ankles |
| Where are Bipolar Leads placed? | Electrodes are applied to the left arm(LA),the right arm(RA), and the left leg(LL) |
| Lead I | =Left arm is positive and the right arm is negative(LA-RA) |
| Lead II | =Left leg is positive and the right arm is negative (LL=RA) |
| Lead III | =Left leg is positive and the arm is negative(LL-LA) |
| Augmented Unipolar Lead | aVR,aVL, and aVF. |
| Lead aVR | =Right arm is positive and the other limbs are negative |
| Lead aVL | =Left arm is positive and the other limbs are negative |
| Lead aVF | =Left leg(or foot) is positive and the other limbs are negative |
| V1 | Fourth intercostal space, right sternal border |
| V2 | Fourth intercostal space, left sternal border |
| V3 | Equidistant between V2 and V4 |
| V4 | Fifth intercostal space, left midclavicular line |
| V5 | Fifth intercostal space, anterior axillary line |
| V6 | Fifth intercostal space midaxillary line |
| Waveform | Refers to movement away from the isoelectric line either upward(positive) or downward(negative) deflection |
| Segment | Line between two waveforms |
| Interval | Waveform plus a segment |
| Complex | Several waveforms |
| (Atrial Activation)P wave | The deflection produced by atrial depolarization. |
| The normal P wave in standard,limb, and precordial leads does not exceed: | 0.11s in duration or 2.5mm in height |
| (Ventricular Repolarization) | T Wave and U wave |
| T wave | The deflection produced by ventricular repolarization |
| U wave | The deflection seen following the T wave but preceding the next P wave |
| QRS Complex | Represents centricular depolariation (activation) |
| Where is the ventricle depolarized from? | The ventricle is depolarized from the endocardium to the myocardium, to the epicardium. |
| Q Wave | The initial negative deflectioin produced by ventricular depolarization |
| R Wave | The first positive deflection produced by ventricular depolarization |
| S Wave | The first negative deflection produced by the ventricular depolarization that follows the first positive deflection,(R)wave |
| RR interval | The interval between two R waves |
| PR Interval | P wave plus the PR segment. |
| Normal interval for PR | 0.12-0.2 |
| QRS Interval | Represents vetnricular depolarization time, should not be more than 0.1 sec |
| PR segment | Line from the end of the P wave to the onset of the QRS complex |
| J(RST) junction | Point at which QRS complex ends and ST segment begins |
| ST segment | From J point to onset of the T wave |
| Somatic Tremors | Patient's tremors or shaking the wires can produce jittery patterns on the EKG tracing |
| Wandering Baseline | Sweat or lotion on the patient's skin or tension on the electrode wires can interfere with the signal going to to EKG apparatus causing the baseline of the tracing to move up and down on the EKG paper |
| 60-cycle interference | can produce deflections occurring at a rapid rate that may mimic atrial flutter |
| Broken recording | the stylus goes up and down trying to find the signal |
| Arrythmias of sinus origin | Where electrical flow follows the usual conduction pathway but is too fast, too slow, or irregular. Normal sinus rate is 60-100 bpm |
| Ectopic Rhythms | Electrical impulses originate from somewhere else other than the sinus node |
| Conduction Blocks | Electrical impulses go down the usual pathway but encounter blocks and delays |
| Pre-excitation Syndromes | The electrical impulses bypass the normal pathway and, instead, go down an accessory shortcut |
| Ischemia | Occurs when there is a decrease in the amount of blood flow to a section of the heart. This is usually experienced as chest pain and discomfort and is called angina |
| Myoccardial Infarction | Infarction refers to the actual death of the myocardial cells |
| Holter Monitor | An ambulatory EKG done to rule out intermittent arrhythmias or ischemia that cold be missed on a routine EKG |
| Recording Artifact can result from the following | Incomplete tape erasure, Tape drag within the apparatus, Battery depletion, Loose connection, and Movement of electrodes |
| Pharmacological Therapy | One of the essentials of quality care of a patient who is having an acute myocardial infarction |
| Common Pharmacological Agents used for Myocardial Infarction patients: | Oxygen, Epinephrine, Isoproterenol(Isuprel),Dopamine(Intropin), Beta Blockers,Lidocaine, Verapamil, Digitalis,Morphine Sulfate, Nitroglycerin |
| Oxygen | Oxygen should be given to all patients with acute chest pain that may be due to cardiac ischemia, suspected hypoxemia of any cause, and cardiopulmary arrest |
| Epinephrine | is indicated in the management of cardiac arrest. The chance of successful defibrillation is enhanced by administration of epinephrine and proper oxygenation |
| Isoproterenol(Isuprel) | Produces an overall increase in heart rate and myocardial contractility, but newer agents have replaced it in most clinical settings. |
| Dopamine(Intropin) | is indicated for significant hypotension in the absence of hypovolemia |
| Beta Blockers: Propranolol, Metoprolol, Atenolol, and Esmolol | Reduce heart rate, blood pressure, myocardial contractility, and myocardial oxygen consumption which make them effective in the treatment of angina pectoris and hypertension. |
| Lidocaine | is the drug of choice for the suppression of ventricular ectopy, including ventricular tachycardia and ventricular flutter. Excessive doses can produce neurological changes, myocardial depression, and circulatory depression |
| Verapamil | used in treatment of paroxysmal supraventricular tachycardia(PSVT), effective in terminating more than 90% of episodes of PSVT in adults and infants. Also useful in slowing ventricular response to atrial futter and fibrillation |
| Digitalis | increases the force of cardiac contraction as well as cardiac output. |
| Morphine Sulfate | the traditional drug of choice for the pain and anxiety associated with acute myocardial infarction. In high doses, morphine sulfate may cause respiratory depression. It is a controlled substance and has a tendency for abuse and addiction |
| Nitroglycerin | is a powerful smooth muscle relaxant effective in relieving angina pectoris. |
| Circulatory System | this system is to deliver oxygen, nutrients, horomones, and enzymes to the cells and to transport cellular waste such as carbon dioxide and urea to the organs where they can be expelled from the body. |
| Blood Vessels are: | Aorta, arteries, arterioles, capillaries, venules, veins, superior and inferior vena cavae |
| All blood vessels, except for the capillaries are composed of these three layers: | The outer connective tissue layer(tunica adventitia). The middle smooth muscle layer(tunica media) and the Inner endothelial layer(tunica intima) |
| What do the aorta, arteries, and arterioles do? | Carry oxygenated blood from the heart to the various parts of the body |
| What do the venules, veins and superior and inferior vena cavae do? | Carry deoxygenated blood back to the heart |
| Capillary blood is a mixture of: | Aterial and Venous blood |
| The average adult has how many liters of blood? | 5-6 Liters |
| What is the liquid portion of blood called? | 'plasma' |
| What is the cellular portion of blood called? | 'formed elements' |
| What does plasma consist of? | is 55% of the blood and it contains proteins, amino acids, gases electrolytes,sugars,hormones,minerals,vitamins, and water 92%. Also waste products such as urea that are destined for excretion |
| what do the formed elements consist of? | the remaining 45% of the blood. They are erythrocytes(RBCs) which comprise 99% of the formed elements, the leukocytes(WBCs) and the thrombocytes(platelets). All blood cells normally originate from stem cells in the bone marrow |
| Erythrocytes(RBCs) | Contain hemoglobin, the oxygen-carrying protein. |
| Reticulocyte | An immature RBC, that after 1-2 days, it matures into an erythrocyte. |
| How many RBCs are there per microliter of blood? | 4.2 to 6.2 million |
| What is the normal life span of an RBC? | 120 days |
| Thrombocytes(Platelets) | Small irregularly shaped packets of cytoplasm formed in the bone marrow from megakaryocytes. Essential for blood coagulation |
| What is the average number of platelets is | 140,000 to 440,000 per micro liter of blood |
| What is the life span of Thrombocytes(platelets) | 9 to 12 days |
| Leukocytes(WBCs) | Function is to provide the body protection against infection |
| What is the normal amount of WBCs for an adult? | 5,000 to 10,000 per microliter |
| Leukocytosis | An increase in WBCs which is seen in cases of infection and leukemia |
| Leukopenia | A decrease in WBCs which is seen with viral infection or chemotherapy |
| The 5 types of WBCs in the blood | Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophilis |
| Hemostasis | Is the process by which blood vessels are repaired after injury |
| How does the process of Hemostasis start? | From Vascular contraction as an initial reaction to injury, then to clot formation, and finally removal of the clot when the repair to injury is done |
| What are the four stages of Hemostasis? | Stage 1: Vascular Phase, Stage 2: Platelet Phase, Stage 3: Coagulation Phase, Stage 4: Fibrinolysis |
| The Medical Assistant uses three skills when contacting patients for phlebotomy: | Social, Clerical, Technical |
| Blood request forms should include: | Patient's name and age from ID plate or wristband/ID number/Date and time the specimen is obtained/Name or initials of person who obtains the specimen/Accessioning number/Department for which work is being done/Other info |
| Venipuncture | The process of obtaining blood from a patient's vein |
| Factors to consider prior to performing the procedure: | Fasting/Edema/Fistula |
| Fasting | some tests such as those for glucose, cholesterol, and triglycerides require that the patient abstain from eating for at least 12 hours |
| Edema | The accumulation of fluid in the tissues. Collection from edematous tissue alters test results |
| Fistula | The permanent surgical connection between an artery and a vein. Fistulas are used for dialysis procedures and must never be used for venipunctures due to the possibility of infection |
| Necessary supplies for performing venipuncture? | Laboratory requisition slip&pen/antiseptic/vacutainer tubes/vacutainer needles/needle adapters/winged infusion sets/ sterile syringes and needles/tourniquets/chux/specimen labels/gloves/needle disposal container |
| What is the preferred site for venipuncture? | The antecubital fossa of the upper extremities. |
| What are the 3 major veins located in the antecubital fossa? | Median cubital vein/Cephalic vein/Basilic vein |
| Median cubital vein | The vein of choice because it is large and does not tend to move when the needle is inserted |
| Cephalic vein | The second choice. It is usually difficult to locate and has a tendency to move, however, it is often the only vein that can be palpated in the obese patien |
| Basilic vein | The third choice. It is the least firmly anchored and located near the brachial artery. If the needle is inserted too deep, this artery may be punctured |
| Unsuitable veins for venipuncture are: | Sclerosed veins/Thrombotic veins/Tortuous veins |
| Sclerosed Veins | These veins feel hard or cordlike. Can be caused by disease,infammation,chemotherapy or repeated venipunctures |
| Tortuous Veins | These are sinding or crooked veins. These veins are susceptible to infection, and since blood flow is impaired, the specimen collected may produce erroneous test results |
| Order to Draw: | 1:Blood Cultures/2:Light Blue top tubes/3:Serum or non-additive tube(Red or Red/Gray top)/4:Green top tubes/5:Lavender top tubes/6:Gray top tubes |
| Simple way to remember order of draw: "BeCause Better Specimens Generate Perfect Goals" | BeCause=Blood Cultures,Better=Blue,Specimens=Serum(Red),Generate=Green,Perfect=Purple(Lavender),Goals=Gray |
| Analytic Errors that can be made BEFORE blood collection: | Patient misidentification,Improper time of collection,Inadequate fast,Exercise, Patient posture, Poor coordination with other treatments,Improper site preparation,Medication interference |
| Analytical Errors that can be made DURING blood collection: | Extended tourniquet time, Hemolysis, Wrong order of draw, Failure to invert tubes, Faulty technique, Under filling tubes |
| Analytical Errors that can be made AFTER blood collection: | Failure to seperate serum from cell, Improper use of serum separator, Processing delays, Exposure to light, Improper storage conditions, Rimming clots |
| What not to do when collecting blood specimen: | DO NOT: label the tubes prior to the venipuncture,leave the patient's room before labeling the tubes,dismiss an outpatient before labeling the tubes, label tubes using a pencil, leave the patient until you checked&ensure that bleeding stopped |
| Hematoma | Most common of phlebotomy procedure.This indicates that blood has accumulated in the tissue surrounding the ven. The two most common causes are the needle going through the vein, and/or failure to apply enough pressure on the site after needle withdrawal |
| Hemoconcentration | The increase in proportion of formed elements to plasma caused by the tourniquet being left on too long.(More than 2 mins) |
| Petechiae | These are tiny non-raised red spots that appear on the skin from rupturing of the capillaries due to the tourniquet being left on too long or too tight |
| Phlebitis | Infammation of a vein as a result of repeated venipuncture on that vein |
| Thrombus | This is a blood clot usually a consequence of insufficient pressure applied after the withdrawal of the needle |
| Thrombophlebitis | Inflammation of a vein with formation of a clot |
| Septicemia | This is a systemic infection associated with the presence of pathogenic organism introduced during a venipuncture |
| Trauma | This is an injury to underlying tissues caused by probing of the needle |
| Some of the common causes of FAILURE TO OBTAIN BLOOD: | A manufacturing defect,Expired tube,A very fine crack in the tube,Improperly positioned needle,The bevel of the needle is resting against the wall of the vein,The needle has passed through the vein,The vein was missed completely,Collapsed vein |
| Timed specimens | Often used to monitor the level of a specific substance or condition in the patient ` |
| Blood is drawn at specific times for different reasons: | To measure blood levels of substances exhibiting diurnal variation,To determine blood levels of medications,To monitor changes in a patient's condition |
| Two-Hour Postprandial Test | Test is used to evaluate diabetes mellitus.Fasting glucose level is compared with the level 2 hours after eating a full meal or ingesting a measured amount of glucose |
| Oral Glucose Tolerance Test(OGTT) | This test is used to diagnose diabetes mellitus and evaluate patients with frequent low blood sugar. 3-hour OGTT is used to test hyperglycemia and diagnose diabetes mellitus. |
| Hyperglycemia | Abnormally high blood sugar level |
| Hypoglycemia | Abnormally low blood sugar level |
| Therapeutic Drug Monitoring | Test is used to monitor the blood levels of certain medication to ensure patient safety and also maintain a plasma level |
| Blood Cultures(BC) | Ordered to detect presence of microorganisms in the patient's blood |
| PKU(phenylketonuria) | Ordered for infants to detect phenylketonuria, a genetic disease that causes mental retardation and brain damage. |
| Cold Agglutinins | Antibodies produced in response to Mycoplasma pneumoniae infection(atypical pneumonia). The antibodies formed may attach to red blood cells at temp below body temp, and the specimen must be kept warm until the serum is seperated from cells. |
| Blood is collected in red-topped tubes pre-warmed in the incubator at what temp and for how long? | 37 degrees Celsius for 30 minutes |
| Chilled Specimens: Some tests require that the specimen collected be chilled immediately after collection in crushed ic or ice and water mixture. Some of these tests are: | Arterial blood gases, ammonia, lactic acid, pyruvate, ACTH, gastrin, parathyroid hormone |
| Light-Sensitive Specimens:Specimens are protected from light by wrapping the tubes in aluminum foil immediately after they are drawn. Exposure to light could alter the test results for: | Bilirubin, beta-carotene, Vitamins A&B6, and porphyrins |
| Where is a dermal puncture done on an infant less than 1 year of age? | One the heel, in the medial and lateral areas of the plantar surface of the foot. |
| Where is the recommended site for dermal puncture for older children and adults? | The distal segment of the third or fourth finger of the non-dominant hand.Puncture is made in the fleshy portion of the finger slightly to the side of the center perpendicular to the lines of the fingerprint. |
| Order of draw for capillary specimens: | 1)Lavender tube 2)Tubes with other additives 3)Tubes without additives |
| Lavender Top Tube | Contains the anticoagulant ethylenediaminetetraacetic acid (EDTA). EDTA inhibits coagulation by binding to calcium present in the specimen. |
| How many times are Lavender Top Tubes inverted? | 8 times |
| What kind of tests are done with Lavender Top Tubes? | CBC(Complete Blood Count),Includes:RBC Count, WBC count and Platelet count; WBC diferential count, Hemoglobin and Gematocrit determinations;Sickle Cell Screening |
| Light-Blue Top Tube | Contains the anticoagulant Sodium Citrate, which also prevents coagulation to calcium in the specimen. Inverted 3-4 times |
| Common tests done with Light-Blue Top tube | Prothrombin Time(PT),Activated Partial THromboplastin Time(APTT,PTT),Fibrinogin Degradation Products(FDP),Thrombin Time(TT);Bleeding Time(BT |
| Green Top Tube | Contains the anticoagulant Heparin combined with sodium,lithium, or ammonium ion. Heparin works by inhibiting thrombin in the coagulation cascade.Inverted 8 times |
| Common tests done with Green Top Tube | Chemistry tests:performed on plasma such as Ammonia, carboxyhemoglobin and STAT electrolytes |
| Yellow Top Tube | Sterile. Used to collect specimens to be cultured for the presence of microorganisms |
| QC | Quality Control |
| Quality Control(QC) | Purpose is to provide reliable data about the patient's health status by ensuring the accuracy of test results while detecting and eliminating errors |
| Standards | A substance of known value essentially free of impurities and have close to a "true" value. |
| Four sections of a Clinical Laboratory | Clinical Chemistry/Hematology/Microbiology/and Blood Bank |
| Functions of the Hematology Section of the Lab | This department deals with various components of blood:WBCs/RBCs/Platelets. CBC is the most common test performed. |
| Coagulation Tests | These tests are done to determine discrepancies in the clotting mechanism, the most common of which are prothombin time and activated partial thromboplastin time |
| Chemistry Section of the Lab is divided into these areas | Electrophoresis/Toxicology/Immunochemistry |
| Electrophoresis | Analyzes chemical component of blood such as hemoglobin and serum, urine and cerebrospinal fluid, based on the differences in electrical charge |
| Toxicology | Analyzes plasma levels of drugs and poisons |
| Immunochemistry | This section uses techniques such as radio immunoassay(RIA) and enzyme immunoassay to detect and measure substances such as hormones, enzymes, and drugs |
| Some tests in the Chemistry Section are ordered by Profiles;Examples of these are: | Liver Profile, Coronary Risk Profile |
| Liver Profile | Tests may include ALP,AST,ALT,GGT Biliruben |
| Coronary Risk Profile | Tests may include Cholesterol, Triglycerides,HDL,LDL |
| Blood Bank Section of the Lab | This is where blood is collected, stored, and prepared for transfusion |
| Tests done in the Blood Bank require a red top tube or a lavender or pink top tube. Specimens must have the following info: | Patients full name and date of birth/Patient's hospital ID Number/Date and time of collection/MA's Initials |
| What is the most common testing done in the Blood Bank? | ABO and Rh typing, the antibody screen and crossmatch. |
| What is an RH Blood Group System? | The presence or absence of the "D" antigen on the RBC membrane determines whether a person is RH positive or negative. |
| How present is the D antigen in the population? | 85% of the population |
| People who lack the D antigen are: | Rh negative |
| Serology(Immunology) Section of the Lab | Performs tests to evaluate the patient's immune response through the production of antibodies.This section uses serum to analyze presence of antibodies to bacteria,viruses,fungi,parasites |
| Microbiology Section of the Lab have subsections;these sections consist of: | Bacteriology/Parasitology/Mycology/Virology |
| Bacteriology | the study of bacteria |
| Parasitology | the study of parasites |
| Mycology | the study of fungi |
| Virology | the study of viruses |
| Urinalysis Section of the Lab | Performs physical,chemical,and microscopic examination of urine. |
| What is assessed when physically examing urine? | Color, clarity, and specific gravity |
| Arterial Blood Gas Studies(ABGs) | ABGs help assess a patient's ventilation,oxygenation,and acid-base balance. |
| Gram Stain Classification | Gram-positive bacteria/Gram-negative bacteria |
| Gram-positive bacteria | bacteria that take up and retain the crystal violet and resist alcohol decoloration. They appear blue to black |
| Gram-negative bacteria | Bacteria that are decolorized completely by ethanol and take up safranin counterstain. They appear red |
| Urinary System consists of: | 2 Kidneys, 2 Ureters, Urinary Bladder, and a Urethra |
| What is the primary organ of the urinary system? | The Kidney |
| What are the kidney's functions? | To remove metabolic waste from the blood stream, maintain the body's acid-based balance and regulate body hydration |
| Urea | A nitrogenous product of protein metabolism, that is the major waste product removed by the kidney |
| Anuria | The absence of urine |
| Hematuria | Presence of blood in urine |
| Proteinuria | Presence of excess proteins in urine |
| General Instructions for Urine Collection: | 1.Carefully label all specimens. 2.If a bacterial culture is ordered, make sure a sterile container is available. 3.Advise patients,with the consent of the physician avoided during their menstrual cycle. 4.If the testing has been delayed,add preservatives |
| First morning urine sample | This is the most commonly used for routine urinalysis. Because the concentration of urine varies throughout the day, it is usually easiest to identify abnormalities in a concentrated specimen. |
| Mid-Stream Specimen | Collected not at the beginning or end of voiding, but in the middle of urination. |
| Clean-Catch Specimen | Requires cleaning of the external genitalia, and is to be used to test for bacteria or antibiotic sensetivity |
| Most labs prefer what kind of urine collection? | Clean-catch and Mid-stream because they provide most clearest and accurate results |
| Urine formed by a healthy kidney consist of | Approximately 96% water and 4% dissolved substances consisting mainly of urea,sodium chloride,sulfates and phosphates. |
| The normal urine output averages: | 1200-1500ml every 24 hours |
| Oliguria | Decreased urinary output |
| Polyuria | Increased urinary output |
| The routine urinalysis procedure is composed of three parts: | Physical Examination,Chemical Examination,Microscopic Examination |
| What could the presence of increased numbers of leukocytes(WBCs) in urine indicate? | Bacteriuria or Urinary Tract Infection(UTI) |
| Informed Consent | Consent given by the patient who is made aware of any procedure to be performed,its risks, expected outcomes, and alternatives |
| HIPAA | All patients have a right to privacy and all info should remain privileged. Discuss patient info only with the patient's physician or office personnel that need certain info to do their job |
| Negligence | The failure to exercise the standard care that a reasonable person would give under similar circumstances |
| The 4 D's of negligence: | Duty-duty of care Derelict-breach of duty of care Direct cause-legally recognizable injury occurs as a result of the breach of duty of care Damage-wrongful activity must have caused the injury or harm that occurred |
| Tort | A wrongful act that results in injury to one person by another |
| Defamation of character | Injury to another person's reputation,name,or character through spoken or written words |
| The Patient Care Partnership | replaced the Patient's Bill of Rights, is a statement establishing the rights and responsibilities guaranteed by federal law to all health care patients |
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