CPT-1 FINAL EXAM
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| What is ASPT | American society of Phlebotomy Technicians (national certifying organization)
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| What is AMT | American Medical Technologist (national certifying organization)
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| What is ASCP | American Society of Clinical Pathologist (national certifying organization)
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| What is NPA | National Phlebotomy Association (national certifying oranization)
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| What is NCCT | National Center for Competency Testing (National certifying organization)
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| What is NHA | National Healthcareer Association (national certifying organization)
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| How many CEU units do you need every two years to renew your state phlebotomy license? | 6 Continuing education units
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| Define Certification | Issuance by an official body of a certificate to a person indicating that he/she has met certain requirements
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| define Licensure | legal permission grated by the state to engage in an occupation or activity
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| define Reciprocity | One state recognizes the licensure granted by another state
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| Define integrity | Dedicated to maintaining high standards
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| define empathy | ability to understand another's feelings
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| define discretion | use of good judgement and prudence
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| define diplomacy | use of tact and understanding
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| define confidentiality | ability to safeguard patient privacy
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| define ethics | moral duty to determine the difference between right and wrong
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| define honesty | always telling the truth regardless of the situation
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| communication skills | verbal, non verbal, and active listening
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| define compassion | a gentle caring attitude
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| define dependability | being punctual and completing tasks in a timely manner
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| define accountability | being responsible for your actions
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| what does the LABORATORY DIRECTOR do | interprets results to diagnose disease...can be a pathologist or bioanalyst
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| what does the LABORATORY ADMINISTRATOR or AKA MANAGER do | Day to day operations of lab... liaison between director and lab staff
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| What do TECHNICAL SUPERVISORS do | daily work schedules and staffing ...
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| Define CLS | Clinical laboratory scientist
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| What does CLS do | Directs work of other lab staff...MAINTAIN QA standards ...
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| How do you become a CLS | 4year med tech program, 1yr. internship, board exam
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| What is MLT | Medical laboratory technicians
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| What are CLT | Clinical Laboratory tecnicians
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| What do MLT/CLT do | test BLOOD, URINE, LYMPH...report abnormal test values, train new employees..2YR trainins in medical lab program, certification for approved agency
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| What do Blood bank technologist do | Test for BLOOD GROUPS, ANTIGENS, and ANTIBODY IDENTIFICATION AND COMPATIBILITY
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| What are the major divisions within laboratory departments | Clinical analysis...Surgical/anatomical pathology
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| What is the purpose of the chemistry dept. | Makes test more efficient and quality assurance testing more accurate ...(ITS THE LARGEST DEPARTMENT)
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| What is the purpose of microbiology dept. | Analyzes for presence of microorganisms
Ex. of tests C&S , GRAM STAIN TEST
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| What is the purpose of the immunology/serology dept. | Determines the antigen-antibody reaction of the body (identifies bacterial growth in blood culture bottles)
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| What is the purpose of the blood bank dept. | Blood typing and antibody tests..Blood from donors is tested here before being used for transfusions ..THE MAKE NO MISTAKES
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| what is the purpose of the Urinalysis dept | cam be performed in sevaral areas of the lab
3parts..PHYSICAL, CHEMICAL, MICROSCOPIC
ex. of test....CLEAN CATCH SPECIMEN TEST
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| CLSI use to be called what | NCCLS National Committee For Clinical Laboratory Standards
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| What is CLSI | Clinical Laboratory Standards Institute
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| What does CLSI do | Establishes prcedural guidelines for all areas of the lab(GOLD STANDARD)
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| What is CAP | College of AMerican Pathologists
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| What does CAP do | Sets standards for phlebotomy ...Proficiency testing/lab testing by pathologist and CLSs.....Compares results to labs across country
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| Define JCAHO | Joint Commission on Accreditation Of Health care organization
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| What is the purpose of JCAHO | Accrediting agency for hospitals and nursing homes ..inspects every two years ..ENFORCE STANDARDS ESABLISHED BY CLSI ..WORKS WITH CAP to provide lab accreditation
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| Define CLIA | Clinical Laboratory Improvement Act of 1988
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| What is the purpose of CLIA | Enacted by congress to regulate all labs..Include guidelines ...QUALITY CONTROL..QUALITY ASSURANCE...RECORD KEEPING,,PERSONAL QUALIFICATIONS
NO AN ORGANIZATION
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| What is the objective of CLIA program | ENSURE QUALITY LAB TESTING
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| What is an Infection | Invasion of the body with pathogenic(diease causing) bacteria, fungi,viruses, protozoa or parasites
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| What is the primary goal of infection control program | Reduce the risk of endemic and epidemic infections in patients personnel and visitors
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| Define Bloodborne Pathogen | Pathogenic Organisms in blood that cause disease
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| define parenteral | Piercing mucous membranes or skin barriers
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| What is the CHAIN OF INFECTION | Infectious Agent...Reservoir..Exit Pathway..Means of Transmission...Entry Pathway..Susceptible Host
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| Define Pathogen | disease causing organism
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| give ex. of an infectious agent | Becteria, fungus, protozoon, rickettsia, virus
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| give ex. of RESERVOIR | animal, human, equiment, food, soil, water
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| give ex. of EXIT PATHWAY | Blood,exudates, excretions, secretions
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| give ex. of MEANS OF TRANSMISSION | airborne, contact, droplet, vector, vehicle
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| give ex. of ENTRY PATHWAY | body orficies, mucous membranes, broken skin
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| give ex. of susceptible host | elderly, newborn, acute/chronically ill patients, immune suppressed unvaccinated
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| What is a NOSOCOMIAL INFECTION | infection acquired AFTER a person has enetered a hospital, clinic, nursing home, or rehab faciility
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| What is a common nosocomial infection | UTI ..Urinary tract infections
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| Standard/Universal precautions is enforced by | OSHA and established by CDC .center of disease control
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| you should change your gloves every | 30min
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| to disinfect equipment and surfaces use | 1:10 bleach solution
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| What are the body's natural barriers | Skin and mucous membranes
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| define STRICT ISOLATION | for HIGHLY contagious disease.EX. HIV.
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| Define Enteric Isolation | For patients with intestinal infections
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| define Contact Isolation | for patients with diseases that can be spread by direct contact ..ex MRSA,VRE, and C. Difficile
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| define Protective/reverse/neutropenic isolation | for non infectious patiets who may be susceptible to infection..ex..Geriatric patients.. newborns
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| define Airborne isolation | for patients with diseases spread by droplets that are smaller than 5micrometers example of diseases (TB) Varicela zoster (chicken pox) and measels (SPECIAL REQUIRMENT.NEGATIVE PRESSURE ROOM)
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| define droplet isolation | for patients with diseases spread droplets that are larger than 5 micrometers (example PERTUSSIS..meningitis, German measles
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| What is OSHA | occupational Safety and health administration
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| What is the purpose of OSHA | Assures every person safe and healthful working conditions (FEDERAL AGENCY)
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| If a glass is broken you should remove it with a | DUST PAN
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| Sharp containers should be replaced when they are | 2/3 full
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| what is the function of the Adrenal Glands | Prodeuce hormones .EPINEPHRINE and NOR EPINEPHRINE...located on top of each kidney
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| what is the function of the ALVEOLAR SACS | Aloow for diffusion between air and blood
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| What is Amoiotic fluid | Fluid from the AMONIOTIC SAC
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| what is the AORTA | Largest artery in the body
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| what are ARTERIES | Blood vessels that carry blood away from the heart
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| what are the ARTERIOLES | Smaller branches of the arteries
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| What is the ATRIA | Upper chambers of the heart
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| What are Blood vessels | The transport blood ..Include ARTERIES ARTERIOULES CAPILLARIES VENULES and VEINS
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| What are capollaries | Microscopic, Unicellular blood Vessels linking arteriols to venules
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| What does the INFERIOR VENA CAVA do? | Brings deoxygenated blood to the heart from lower parts of the body
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| What does the lymphatic system do | Maintains fluid balance, defends against disease, absorption of fats from blood stream
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| what is PERITONEAL FLUID | fluid from the abdominal cavity
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| What is PLEURAL FLUID | fluid from the lung cavity
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| What is the function of the superior vena cava | Brings deoxygenated blood from the head, neck, chest region of the heart
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| What is SYNOVIAL FLUID | fluid from joints
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| what do veins do | carry deoxygenated blood towards the heart
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| what are venules | smaller branches of veins
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| what are ventricles | they are the lower chambers of the heart
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| what is BLEEDING TIME | test to assess PLATELET PLUG formation in CAPILLARIES (pre surgical)
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| What is BUFFY COAT | after centrifuation of a specimen mixed with an anticoagulant, the layer between the plasma and erythrocytes..CONTAINS WBC and PLATELETS
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| what is a DIFFERENTIAL TEST | a test that categorizes blood cells and abnormalities present
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| what does EDTA do | prevents blood from clotting by binding calcium
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| Hematocrit is also known as | PCV ..Packed cell volume
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| what are LYMPHOCYTES | non-granulocytic WBCs( ASSIST IN IMMUNITY and PRODUCTION OF ANTIBODIES
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| what are MONOCYTES | Largest Leukocyte...Assist in IMMUNE SYSTEM
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| What is plasma | it is the liquid portion of whole blood
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| what is platelets | blood cells that aid in blood clot formation
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| what is serum | it is the liquid portion of CLOTTED blood
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| Define Hematoma | Localized leakage of blood into tissues (most common complication of phlebotomoy)
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| define OCCLUDED VEIN | Closed or constricted vein
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| Define Sclerosed Vein | Vein that becomes hardened (possible due to fatty deposits)
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| Define Bactermia | Presence of bacteria in the blood
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| What is the purpose of C&S test | a test to identify the microorganism and the antibiotic most effective for treamtent
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| define O&P | ova and parasites
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| define Septicemia | Presence of bacterial toxins
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| define ACIDOSIS | condition when blood pH is below 7.35
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| define ALKALOSIS | condition when blood is pH is above 7.45
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| What is a BUN TEST | test to determine amount of urea in blood
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| define LIPEMIC | Cloudy/milky appearance of serum due to excessive lipid content
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| what is POST PRANDIAL GLUCOST TEST | glucose test performed after ingestion of a meal
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| what is the PREANALYTICAL PHASE | when tests are ordered and specimens are collected and prepared for testing
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| define TDM | therapeutic drug monitoring
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| what is the purpose of Citrate | keeps blood from clotting by binding calcium
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| define fibrin | substance that makes up a clot
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| what is the purpose of heparin the green tubes | prevents blood clotting by inactivating thrombin and prothrombin
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| what is BASAL STATE | patients condition early in the morning.. 12hour after last ingestion of food (fasting)
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| define DHS | department of Health Services
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| What is a Fistula | an artificial shunt or passage(vein and artery fused together)
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| define Hemolysis | rupture of erthrocytes
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| define metabolic acidosis | condition when the kidneys cannot eliminate acid substances (can cause renal failure)
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| define metabolic alkalosis | condition resulting from excessive vomiting or an abnormal secretion of certain homrmones that cause excess elimination of hydtogen ions (too much base and not enough acid)
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| what is the purpose of OSHA | Ensures a safe working environment
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| what is the purpose of QC quality control | daily control used in analytic testing to determine accurace in precision
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| define QNS | quantity not sufficient
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| If you leave a tourniquet for more than one minute it can cause | Hemoconcentration
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| define ANATOMY | study of the structure of an organism
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| define Physiology | Study of how the body functions
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| define Pathophysiology | Study of disease and how it affects the body
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| Why do we need to draw blood | provided information about vital bodily function
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| Blood is the primary means of transport for | Nutrients, waste, oxygen, carbon dioxide, and hormones
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| What should a blood draw ALWAYS start with | a REQUISITION
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| a requisition can be written in what ways | Hand written, preprinted or computer generated
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| what information may not be found on a requisition | patient diagnosis ...patients gender...patients billing information ..
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| If any doubts at any time of a tube what should you do | DISCARD
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| what are the 3primary methods for venipuncture | Evacuated tube method (straight needle)....Butterfly Method...Syringe Method
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| Additives are usually either ..? | anticoagulant or preservative
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| Light Blue Tube | ANTICOAGULANT: sodium citrate
Prevents coagulation by binding Ca+
ex. of test....PT, PTT
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| RED TUBE (Serum Tube) | No additive ..Commonly Requested tube ..
(SEROLOGY, SERUM CHEMISTRY TESTS)
ex. of test Cholesterol
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| Tiger Top (SST) | Clot Activator ...Gel Separator -SST=Serum separator tube ..(SEROLOGY, SERUM CHEMISTRY
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| Gold (SST) | Clot Activator..Gel Separator
(SEROLOGY, SERUM CHEMISTRY TESTS)
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| Green Tube | Anticoagulant: Sodium Heparin, Lithium heparin, or Ammonia heparin ...Prevents coagulation by inhibiting the action of THROMBIN(a clotting factor)
(PLASMA CHEMISTRY TEST)
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| Lavender Tube | Anticoagulant: Sodium or K+ EDTA
..Prevents clotting by binding Ca2+
..Prevents platelet aggregation (clumping)
..Preserves the shape of the cells
..CANNOT be used for coagulation studies
Tests: CBC (HEMATOLOGY STUDIES) "preserves glucose up to 5d
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| Gray Tube | Contains an anticoagulant and a preservative ..
Anticoagulant=POTASSIUM OXALATE
Binds Ca2+..Preservative: SODIUM FLOURIDE
..Ihibits the glycolytic activity in cells ..
Tests collected EX. Glucose, ETOH (CHEMISTRY TEST)
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| Pink Tube | Additive: anticoagulant EDTA
(USED FOR BLOOD BANK)
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| Black Tube | Additive: Anticoagulant Sodium Citrate..
Used for:WESTERGREN SEDIMENTATION RATE
"4:1 Ratio"
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| Dark Blue Tube | Additive: either no additive, sodium heparin, or EDTA ...
Used for trace metal assays
"TOXICOLOGY STUDIES"
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| Brown Tube | Additive: anticoagulant Heparin
Used for: Lead Testing
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| Yellow Tube | additive: anticoagulant SPS..
Used for Blood Cultures
MUST BE STERILE
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| what is HEMATOLOGY | study of blood and blood forming tissues (includes are of hemostasis)
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| average person has how many liters of blood | 5.5-6 liters
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| Blood has to part ..which is ? | liquid portion-plasma .....Cellular portion-RBC ,WBC, Platelets(thrombocytes)
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| what is a routine hematology test? | CBC complete blood count
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| What is Erthrocyte Sedimentation Rate ESR | they measure the rate that RBCs fall to the bottom of a tube (also monitor inflammation and tissue injury)
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| what are the 4 main tests to determine hemostasis? | Platelet count test...Bleeding time test...PT test (PROTHROMBIN TIME)...aPTT/PTT test
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| What are some specialized Chemistry Areas | Toxicology (TDM and OD)..ABG..Serology ..
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| Random specimen is collected when ? | any time of the day
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| First Voided specimen is collected when? | in the morning as soon as the patient wakes up
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| Timed specimen must be collected when? | usually 8-24hrs ..
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| Clean-catch midstream specimen | patients are required to cleanse the urethral area with castile soap and towelette..first portion of urine ..urinate in tiolet then after in cup ..
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| A 24hr urine specimen must be collected in ? | a 2000mL graduated cylinder
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| What are RARE complications of venipuncture | Cardiac arrest...Hemorrhage ...Reflex arteriospasm...infection
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| taking 10ml of blood from a PREMATURE infant leads to a decrease percentage of what blood volume | 5-10%
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| What is the reason for a dermal puncture on an adult | Suitable vein cannot be found
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| When is skin puncture inappropriate | when patient is ..severly dehydrated ..has bad circulation
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| Most common size for adults on a skin puncture is | 2.4mm
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| skin puncture size on premature infants are | 0.85 to 3.0mm
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| Swollen areas are avoided for a venipuncture because | due to accumulation of tissue (interstitial) fluid
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| If a bone is punctured what may occur | Osteomyelitis (inflammation of bone or bone marrow, usually due to infection)
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| what are the two most commonly used finger sites on adults for a fingerstick | 3rd and 4th fingers towards tip of finger
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| Why is the index finger not used for a finger stick | causes calluses and discomfort
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| What is the CAPILLARY ORDER OF DRAW | Blood gases, EDTA tubes, Other additive tubes, Serum tubes
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| What is the appropriate depth lancet for this size of infant: 1-2kg(2.2-4.4 lbs.) | 0.75-1.0mm
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| What is the appropriate depth lancet for this size of infant: 2-3 kg (4.4-6.6 lbs.) | 1.0-2.0mm
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| What is the appropriate depth lancet for this size of infant: 3 kg (6.6 lbs.) or greater | 2.0-2.4mm "GREATER THAN 2.4mm MAY CAUSE OSTEOMYELITIS AND PERMANENT DAMAGE TO THE INFANTS FOOT"
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| What is the use of EMLA | Eutectuc Mixture of local Anesthetic, is used to relieve pain
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| Hematomas occur when | blood leaks from vein or
capillaries and collects in tissues around
puncture site
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| Removal of tourniquet AFTER removal of needle can cause | a Hematoma
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| What is PETECHIAE | Tiny red spots that appear under the skine and sign of platelet defects or week capillary walls (can be an indication of broken/bruised capillaries)
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| the cause of Petechiae can be sign of what kind of allergy | Possible latex allergy
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| Who should you contact if bleeding does not stop after 5min | Contact physician or nursing staff
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| Excessive bleeding can be due to what type of anticoagulants | Coumadin, Heparin (patient can have excessive bleeding as well due to clotting disorders)
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| Mastectomy patients are highly susceptible to ..? | INFECTIONS
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| In Mastectomy patients, due to edema some tests may be | Altered
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| If a patient has double mastectomy (each on one arm) ..what site would you perform a venipuncture | back of hands, legs, or a fingerstick (consult physician first)
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| Edema | Abnormal accumulation of fluid in the
intracellular spaces of the body
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| The heart is the size of a ..... ?? | Mans fist
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| What is the normal heart rate of an adult | 60-80 times/min
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| What is the SEPTUM | Wall the separates the heart into right and left sides
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| what is the Pericardium | outer double walled sac to prevent friction
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| Right atrium fills with blood from ...? | the Superior and Inferior Vena Cava
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| the LEFT ATRIUM filles with blood from the | Pulmonary vein
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| Contraction of he heart pushes blood into the...? | Ventricles
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| the left and right atria are separated by | Interatrial septum
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| Ventricles receive blood from | ATRIA
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| Contracitons of the heart pushes what out | Blood
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| The right ventricle pushes blood through the | Pulmonary artery
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| The left and right ventricles are separated by | the interventricular septum
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| Sinoatrial (SA)node "pacemaker" causes ? | wave of impulses through muscle of atria (where heart begins)
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| What is the function of the ATRIOVENTRICULAR (AV)Node | sends impulses goes down the bundle of his-> R & L bundle branches ->Purkinje fibers-> Ventricles
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| Define Diastole | Relaxation phase of the cardiac cycle (VENTRICLES ARE FILLING WITH BLOOD FROM THE ATRIA)
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| define Systole | Contraction phase of cardiac cycle (VENTRICLES CONTRACT AND PUSH BLOOD THROUGH PULMONARY VALVE AND AORTIC VALVE TO DISTRIBUTE BLOOD TO LUNGS AND BODY)
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| The heart is controlled by | The autonomic nervous system
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| Bradycardia is considered at what heart rate | BELOW 60
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| Tachycardia is considered at what heart rate | Above 100
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| Tunica Adventitia is | Thick outer layer, mostly connective tissue (prevents rupture or bursting due to increased pressure)
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| Tunica Media is | Middle layer, smooth muscle and elastic fibers (helps maintain normal blood pressure;able to contrict)
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| Tunica Intima is | Inner layer, single later of endothelial cells, connetive tissue, and elastic fibers (smoothness prevents abnormal blood clotting)
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| Adult men have about how much blood | 5-6 liters of blood
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| how much blood does an adult women have | 4-5 liters of blood
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| whole blood is composed of approximately....? | 2.8(55%) of plasma and 1.9 liters (45%) of cells
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| Plasma is composed of | 90% water and 10% solid materials
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| Serum is composed of | same components as plasma EXCEPT FIBRINOGEN
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| What color is ICTERIC (liquid component) | Dark green/yellow
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| What color is HEMOLYZED (liquid component) | Pink/Red
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| What color is LIPEMIC )liquid component) | Milky/creamy/cloudy
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| Erthrocytes have a life spam of | 120days (circulating RBC have no nucleus)
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| Neutrophils are | PHAGOCYTES..they are the first responders to infection and have 3-5 lobed nucleus (fine light blue cytoplasmic granules) "45-70% in the body"
🗑
|
||||
| Eosinophils are | Bright RED/ORANGE cytoplasmic granules with a BILOBED NUCLEUS.. they INCREASE IN ALLERGIC REACTIONS AND PARASITIC INFECTIONS "0-5% percentage in the body"
🗑
|
||||
| Basophils are | DARK PURPLE-BLUE cytoplasmic granules..they have irregular S-shaped nucleus and dduring inflammation it releases histamine to dialte blood vessls(granules contain heparin and histamine) "0-1% in the body"
🗑
|
||||
| Lymphocytes are | Non-granular blue cytoplasm...LIGHT BRIGHT PURPLE NUCLEUS..2types T-destroy foreign material..B-produce antibodies to fight infection "20-40% in the body"
🗑
|
||||
| Monocytes are | Non-granular cytoplasm...KIDNEY BEANED SHAPED..PURPLE NUCLEUS ....phagocyte and becomes macrophage ...it is the LARGEST WBC ..."4-10% in the body"
🗑
|
||||
| What is the function of a THROMBOCYTE | it retracts after blood clot has formed ..transports needed chemical for clotting ...it has a life span of 9-12days
🗑
|
||||
| what is an antibody | A substance that is produced by the body in response to an antigen
🗑
|
||||
| RBCs with A antigen = | Type A ...plasma has antibodies to B antigen
40%common
🗑
|
||||
| RBCs with B antigen = | Type B... plasma has antibodies to A antigen
10% common
🗑
|
||||
| RBCs with A and B antigen = | Type AB ... plasma has NO antibodies to A or B antigens .. 4% common
🗑
|
||||
| RBCs without A or B antigen = | Type O... Plasma CONTAINS antibodies to A and B antigens ..46% common
🗑
|
||||
| PRESENCE of D antigens designatedd as | Rh+
🗑
|
||||
| ABSENCE of D antigeens designate as | Rh-
🗑
|
||||
| Define break of duty | neglect or failure to perform an obligation
🗑
|
||||
| Define patients bill of rights | Rights that every patients has while undergoing treatment
🗑
|
||||
| define Stature of limitation | the period after the incident that a patient has to file a lawsuit (may begin after the problem is discovered)
🗑
|
||||
| define TORT | wrongful act(other than breach of contract) .."committed against another person or property"
🗑
|
||||
| define standard of care | The ordinary skill and care that medical practitioners
such as physicians, nurses and phlebotomists must
use that is commonly used by other medical
practitioners when caring for patients
🗑
|
||||
| define Negligence | Failure to perform professional duties in accepted
standard of care
🗑
|
||||
| deinfe Proximate cause | Natural continuous sequences of events, without an
intervening cause, that produces an injury
• Also referred to as direct cause
🗑
|
||||
| define Res ipsa loquitur | Latin phrase that means “the thing speaks for
itself”
• This is a doctrine of negligence law
🗑
|
||||
| define Respondeat superior | Latin phrase that means “let the master answer”
• This means that the physician or employer is
responsible for the acts of the employee
🗑
|
||||
| what are the three branches of government | Legislative, executive, and judicial
🗑
|
||||
| what are the three levels of law | – Federal
– State
– Local
🗑
|
||||
| what is negligence | • Violation of duty to not exercise
reasonable skill and care when
performing a task
• Failure to perform professional duties in
an accepted standard of care
🗑
|
||||
| what is MALPRACTICE | BAD PRACTICE ...Professional negligence, improper or unskillful
care of a patient
🗑
|
||||
| What are the 4D's if Negligence | – Duty
– Derelict
– Direct Cause
– Damage
🗑
|
||||
| If a phlebotomist becomes infected with HIV during employment, he/she will be covered by | Worker’s Compensation Benefits
🗑
|
||||
| What is HIPPA | • Health Insurance Portability and Accountability • Protects the privacy and security of a person’s health information when that information
🗑
|
||||
| In order for a provider to use or disclose PHI, the hospital/lab must give each patient a | “Notice of Privacy Practices” ..Describes how the hospital/lab may use and disclose the
patient’s PHI
🗑
|
||||
| what are the 3 catergories that CLIA divides lab into: | Waived (level I)....Moderate (level II)...High (level III)
🗑
|
||||
| What is WAIVED (level I) | • Simple testing that requires minimum
judgment or interpretation
• Incorrect test results pose little risk for
the patient
• Examples
– Dipstick urinalysis
– Pregnancy testing
🗑
|
||||
| What is MODERATE (level II) | • Moderate complexity of testing
• 75% of all lab tests
• Certified by approved accrediting agency
• Requires MLT or higher discipline
• Must meet quality assurance standards
🗑
|
||||
| What is HIGH (level III) | • High complexity of testing
• Highly sophisticated tests
• High risk to patient if there is an incorrect
test result
• Certified by approved accrediting agency
• Requires CLS or higher discipline
• Must meet quality assurance standards
🗑
|
||||
| Most frequent reason for rejection in hematology is | Improperly mixed tubes causing clots in EDTA microtubes
🗑
|
||||
| a specimen for sedimentation rate is only stable for...? | 4hrs at room temperature and 12hrs refrigerated
🗑
|
||||
| What is MINOR MISLABELING | Truncated (cut
off/shortened/abbreviated) name or medical record number,
misspelled name, missing information as date and signature
🗑
|
||||
| what is MAJOR MISLABELING | Unlabeled specimens; mismatched
information on specimens and requisitions; ABO/Rh results
on current specimen not matching historical record on file
• This category is known as Wrong Blood in Tube (WBIT)
🗑
|
||||
| 56% of lab errors occur during what phase | During the Pre-Analytical Phase of testing
🗑
|
||||
| What is the most potentially fatal pre-analytical error | Improper patient identification
🗑
|
||||
| An impatient should be asked to state his/her name, address, DOB and or unique ID number according to whos standards | CLSI (Clinical Laboratory Standards Institute)
🗑
|
||||
| Fasting specimens should be collected around how many hours? | 10-12 hours of complete fasting
🗑
|
||||
| How long do you pre-warm a site for capillary collection | 3-5minutes (can cause increased blood flow to the area SEVENFOLD
🗑
|
||||
| The ORDER OF DRAW is suggested by | CLSI
🗑
|
||||
| What happens if you under-fill a EDTA TUBE? | you result with RBC SHRINKAGE
🗑
|
||||
| What happens if you under-fill blue top tubes | You result with ELEVATED PT
🗑
|
||||
| What two analytes must be protected from the light? | -BILIRUBIN
-CAROTENE
🗑
|
||||
| aPTT should be tested within...? | 4 HOURS
🗑
|
||||
| PT can remain stable for up to...? | 48 HOURS (at room temperature)
🗑
|
||||
| Blood cultures are essential in the diagnosis of .. | ENDOCARDITIS
🗑
|
||||
| Why are blood cultures done? | To detect the presence of bacteria or yeast
🗑
|
||||
| What happens if a patient comes back with a positive blood culture? | Physician might put the patient on broad-spectrum antibiotics, OFTEN I.V.
🗑
|
||||
| Septicemia may cause...? | Fever, chills, shock, tachycardia, hypertension
🗑
|
||||
| 50% of all positive blood cultures may be positive due to the process of | CONTAMINANTS
🗑
|
||||
| Intravascular | Organisms come from infected organs, cavities, fluids (CSF, synovial fluid, pericardial fluid), untreated superficial wounds, abscesses, U.T.I., or Respiratory infections
🗑
|
||||
| Extravascular | Vascualr access devides(atrial lines, central venous catheters, etc.) urinary catheters, needles, etc
🗑
|
||||
| Define TRANSIENT BACTEREMIA | Bacteria that exist momentarily in the bloodstream and then are engulfed by the cellular immune response
🗑
|
||||
| High risk contamination rates are an example of | Vascular access devices, arterial lines, central venous catheters, and heparin locks
🗑
|
||||
| Define edema | Swelling ...an accumuation of fluid in the intercellular spaces of the body (FLUID IS INTRACELLULAR)
🗑
|
||||
| Hematoma | (Bruise)
..Caused by the leakage of blood from veins and capillaries that collects the tissues (Blood accumulation)
🗑
|
||||
| Masectomies are usually accompanied by ... | REMOVAL OF LYMPH NODES (high susceptibility to infections)
🗑
|
||||
| Sclerosed Veins | Hardened Veins...due to inflammation, Disease, Repeated punctures (may be difficult to push the needle though)
🗑
|
||||
| If both arms have an IV, obtain the blood specimen ....? | BELOW the insertion point ofthe IV LINE
🗑
|
||||
| PKU tests are done to..? | rule out a hereditary metabolic disorder
🗑
|
||||
| If BILIRUBIN levels are too high babies are placed on...? | UV LIGHT
🗑
|
||||
| EACH newborn is kept in an | ISOLETTE
🗑
|
||||
| Newborns are extremely susceptible to ...? | INFECTIONS
🗑
|
||||
| Always remove supplies from the isolette, ESPECIALLY ..? | LANCETS
🗑
|
||||
| For children under two, ______puncture is the method of choice | DERMAL
🗑
|
||||
| Heel Punctures are considered for | Children under 1year/20pounds
🗑
|
||||
| Finger punctures are considered for | Children from 1-2years
🗑
|
||||
| Children over 2 may have what type of puncture | VENIPUNCTURE
🗑
|
||||
| Most elderly develop what type of anemia due to continuous phlebotomy | LATROGENIC ANEMIA
🗑
|
||||
| EPA (environmental protective agency) recommends noise level in hospitals not to exceed ...? | 40dB
🗑
|
||||
| Dialysis is performed on patients with | END STAGE RENAL DISEASE
🗑
|
||||
| What happens during dialysis | Waste products are removed from the blood
🗑
|
||||
| Venipunctures are prohibited from dialysis patients therefore you must perform..? | a FINGER STICK
🗑
|
||||
| How many identifiers is recommended for an outpatient? | 2 Identifiers
🗑
|
||||
| Its against "______regulations" to palpate a vein without gloves | OSHA
🗑
|
||||
| Tourniquet must be applied how many inches apart from the antecubital fossa | 3-4inches (restricts bloods flow, causes veins to distend)
🗑
|
||||
| Why should you allow chlorhexidine to dry completely before beginning a venipuncture | To prevent Hemolysis
🗑
|
||||
| You should insert a needle at what angle | 15-30 Degree angle (BEVEL UP)
🗑
|
||||
| All tubes with additives must be properly mixed as quickly as possible to prevent...? | PLATELET CLUMPING AND COAGULATION
🗑
|
||||
| Examples of special handeling regarding "KEPT COLD SPECIMEN" include: | Blood gases..ammonia
🗑
|
||||
| Examples of special handeling regarding "KEPT WARM SPECIMEN" include: | Cold Agglutinins
🗑
|
||||
| Examples of special handeling regarding "KEPT IN THE DARK SPECIMEN" include | Bilirubin...Carotene
🗑
|
||||
| What are some examples of Adverse Reaction | Syncope...Nausea...Vomiting
🗑
|
||||
| If bleeding continues for more than 5minutes call | PHYSICIAN
🗑
|
||||
| What are some communication strategies | Verbal communication
Nonverbal communication
Active Listening
🗑
|
||||
| What are the "Four Components Of Communication" | -THE SENDER(Person sending the message)
-MESSAGE SENT(What the sender wants to convey) -SYMBOLS(How the sender communicates the message)
-MESSAGE RECEIVED(How the message is perceived)
🗑
|
||||
| What is the measurement considered for "PERSONAL SPACE" | 18in.-4ft. (Interactions with friends and some patients)
🗑
|
||||
| What is the measurement considered for "SOCIAL SPACE" | 4ft.-12ft. (Most interactions of daily life)
🗑
|
||||
| What is the measurement considered for "PUBLIC SPACE" | >12ft. (lectures, speeches)
🗑
|
||||
| What is the "Zone of Comfort" | Area around patient that is private territory(CHILDREN may feel uncomfortable if you get to close)
🗑
|
||||
| What is the "GOLDEN RULE" | Treat patient as you would want yourself or a family member treated in a health care setting
🗑
|
||||
| What is "Culture Sensitivity" | System of values, beliefs and practices that stem from a person's concept to reality
🗑
|
||||
| Physical Impact of Stress can cause? | -Hypertension
-Hyperglycemia
-Stroke
-Myocardial Infarction
-Diabetes
-Ulcers
-Neck and back pain
🗑
|
||||
| What are the early signs of stress | Headaches/fatigue (due to burnout and overload)
🗑
|
||||
| Immediate physical signs of stress are? | -Cold
-Nervousness
-Tense
-Sweaty Hands
🗑
|
||||
| What are some coping strategies for stress | -keep caffeine to a minimum
-try not to use alcohol/nicotine(may increase level of stress)
-exercise regularly
-set aside time to relax each day
🗑
|
||||
| define ethics | Morales duty to determine right and wrong
🗑
|
||||
| define accountability | You are responsible for your actions
🗑
|
||||
| Define Hemophilia | Tendency to bleed
🗑
|
||||
| define Thrombophilia | tendency to clot
🗑
|
||||
| Define Hemostasis | Process of blood clotting and then the subsequent dissolution of the clot following repair of injured tissue
🗑
|
||||
| What are the 5 Steps of the hemostatic process | Platelet Phase ..
Coagulation Phase..
Clot Reaction..
Fibrinolysis
🗑
|
||||
| What is Primary Hemostasis | -Process of forming a platelet plug at the sit of vessel injury
-Consists of a vasoconstriction of platelet adhesion
🗑
|
||||
| Define Vasoconstriction(Vascular Phase) | "tightening" of blood vessels to divert blood flow around the damaged vessel
-enhances contact activation of platelets and coagulation factors
🗑
|
||||
| Define Platelet Adhesion( Platelet Phase) | Platelets become activated and aggregate at the site of injury, forming a temporary loose, platelet plug
🗑
|
||||
| What happens in Secondary Hemostasis | Stabilizes the initially loose platelet plug, a sequence of enzymatic reaction is initiated which culminates in fibrin strands forming at the platelet plug
🗑
|
||||
| What happens in the "Coagulation Phase" | -Coagulation factors interact with each other to form a fibrin clot
(reinforces the platelet plug...ADP, thromboxon, PFB) "FIBRIN FORMING SYSTEM
🗑
|
||||
| What are "Coagulation Factors" | Proteins normally presented in the blood
(most are produced by the liver) ...normally "turned off" (inactive)..."A" signals the factor in its "active" form of coagulation cascade
🗑
|
||||
| What happens in the "Extrinsic Pathway" | Activated when endothelial cells are injured and tissue factor is released
-activated factor VII and tissue factor bind to form a complex.(this complex, plus calcium, activates factor XTissue Factor)
🗑
|
||||
| What happens in the "Intrinsic Pathway" | Initiation occurs when factor XII is exposed to a negatively charged surface(termed the contact phase) "REQUIRES CLOTTING FACTORS VIII-XII
🗑
|
||||
| What is the "COMMON PATHWAY" | When factor Xa bigs to the platelet surface, a complex is formed composed of platelet phospholipid, calcium and factor Va...-Complex converts prothrombin to thrombin which in turn converts fibrinogen to fibrin
🗑
|
||||
| Explain Fibrinolysis | Bodys ways of keeping coagulation from becoming excessive and occluding the blood vessels
🗑
|
||||
| Thromboplastin activates what factor? | FACTOR 7
🗑
|
||||
| define the REGULATION STAGE | Balance between coagulation and fibrinolyctic process must be maintained otherwise excess clotting or fibrinolysis will occur
🗑
|
||||
| Thrombophilia causes what | D.V.T. (Deep Venouse Thrombosis) or P.E. (Pulmonary Embolism)
🗑
|
||||
| define THROMBOPHILIA | Hypercoagulable state due to inherited(heriditary/genetic) defects or acquired defects in one or several factors of the coagulation cascade
🗑
|
||||
| FACTOR 1(fibrinogen) ...define .AFIBRINOGENEMIA | Total absense of measurable fibrinogen (RARE CONGENITAL DISORDER)
🗑
|
||||
| FACTOR 1(fibrinogen)...define HYPOFIRINOGENEMIA | Below normal levels of fibrinogen
-treated by cryoprecipitate or FFP
🗑
|
||||
| FACTOR 1(fibrinogen)...define DYSFIBRINOGENEMIA | altered structure of the fibrinogen molecule
-usually asymptomatic but has been associated with both bleeding and thrombotic events
🗑
|
||||
| explain ...FACTOR V (proaccelerin)GENE DEFECT | (MOST COMMON CAUSE OF THROMBOPHILIA)
coafactor in coagulation cascade..defieceny causes bleeding but factor V mutation causes thrombotic events due to impaired degradation of factor V resulting in continued thrombin generation
🗑
|
||||
| what does MTHFR do ? | Breaks down homo cysteine
🗑
|
||||
| deficiency of MTHFR causes ? | increase of homocysteine leading to thrombosis
🗑
|
||||
| Acquired Homo cysteine is due to | deficiency of vitamin B6 and B12
🗑
|
||||
| What happens if Prothrombin does not break down | keeps on activating thrombin to convert fibrinogen into a fibrin clot
🗑
|
||||
| deficiency in vWF causes (FACTOR VIII) | vonWillebrand's Disease
🗑
|
||||
| Defect or absense of coagulant portion causes | Classic Hemophilia A
🗑
|
||||
| Acute Phase Reactant | Increase in inflammation, stress, pregnancy and infectin which can lead to clot formation
🗑
|
||||
| What is the purpose of Quality Assurance | Gathering/evaluating information and data about services/tests provided
🗑
|
||||
| Quality Assurance is also known for | QUALITY IMPROVEMENT
QUALITY ASSESSMENT
PROFICIENCY IMPROVEMENT
PERFORMANCE IMPROVEMENT
🗑
|
||||
| define T.A.T. | TURN AROUND TIME
🗑
|
||||
| What is the purpose of P.I. | Implement an interdisciplinary approach to collection, analysis and reporting of performance measures
🗑
|
||||
| What is the overall goal of P.I. | Effect quality improvement including accuracy and precision
🗑
|
||||
| Where does P.I. begin in a hospital setting | Begins in the lab before specimen is collected
🗑
|
||||
| What are Logbooks | Logs examined in quality assurance meeting to determine problem areas (also document problem areas with incident reports)
🗑
|
||||
| Define INCIDENT REPORTS | a formal written description of an incident/unusual occurrence
🗑
|
||||
| What is the purpose of incident reports | To objectively document exactly what happened (GOAL is to prevent another episode)
🗑
|
||||
| Define DELTA TEST | comparison between current results of the lab test and previous test results for same patient (CLS)
🗑
|
||||
| What are FLOOR BOOKS | Containcs information that lists the name of each test/procedure (useful to aid in consistency of testing for quality control purposes "AKA PROCEDURE, REFERENCE or TEST MANUAL)
🗑
|
||||
| what does JCAHO stand for | Joint commission on accrediation of healthcare organization (PRIVATE NON-GOVERNMENT AGENCY)
🗑
|
||||
| What does JCAHO do | Establishes guidelines for healthcare agencies regarding quality of care
🗑
|
||||
| What is CQI | Continuous Quality Improvement
🗑
|
||||
| What does CQI do ? | Framework and management commitment to improve healthcare structure, processes, outcomes, and customer satisfaction
🗑
|
||||
| What is the ultimate goal for CQI | IMPROVE PATIENT OUTCOMES
🗑
|
||||
| what are the "Poor patient outcomes (5 D's)" | -DEATH
-DISEASE
-DISABILITY
-DISCOMFORT
-DISSATISFACTION
🗑
|
||||
| Define P.D.C.A. | Plan-Do-Check-Act
🗑
|
||||
| What is the purpose of PDCA | Cycle for assessing, making changes, then reassessing and putting in action
🗑
|
||||
| What is the primary goal during a specimen collection | obtain accurate samples for analysis
🗑
|
||||
| Occupational Safety and Health Administration (OSHA) was established when ? | 1970 by US Congress
🗑
|
||||
| What is the goal of OSHA | Assures every working person in the nation a safe and healthful working condition
🗑
|
||||
| Center of Disease Control establishes ? | Universal Precautions (OSHA enforces them)
🗑
|
||||
| What are Bloodborne Pathogens | Microorganisms that cause disease in humans and are transmitted only through contact with infectious body fluids (NOT urine or feces..unless blood is visible) examples:HIV/AID, malaria, syphilis, ebola virus
🗑
|
||||
| What is the main symptom for Hepatitis B | Jaundice (other symptoms may be ..fatigue abdominal pain, anorexia, nausea and vomiting)
🗑
|
||||
| How many vaccines are required for Hep. B? | 3 shots over 6month period
🗑
|
||||
| What disease is the leading cause for liver transplants | Hepatitis C
🗑
|
||||
| What are the symptoms for Hepatitis C | Fatigue and Abdominal Pain
🗑
|
||||
| What are some symptoms for Human Immunodeficiency Virus | Swollen lymph nodes, weight loss, night sweats, opportunist infections, skin lesions (can eventually lead to AIDS)
🗑
|
||||
| Define Prophylaxis | The prevention of disease
🗑
|
||||
| Highest number of phlebotomy injuries occur with ? | Butterflies
🗑
|
||||
| What does the bacteriology dept. do | deals with identification, study, and cultivation of bacteria and their application in medicine, agriculture, industry, and biotechnology
🗑
|
||||
| What is Mycology | The study of FUNGI (fungi break down dead organic material and continue the cycle of nutrients through ecosystems)
🗑
|
||||
| What is Virology | The study of biological viruses
🗑
|
||||
| What is Serology | The study antigens and antibodies in serum (red top tubes, may base use as well for the detection of an antigen-antibody reaction)
🗑
|
||||
| What is Immunology | The study of immune process and immunity (immunology lab IDs antibodies that are produced due to a disease state)
🗑
|
||||
| What is the purpose of the infection control system | Meant to break chain of infection
🗑
|
||||
| define asepsis | destruction of organisms after they leave the body (hand washing, disposable equipment, gloves)
🗑
|
||||
| What does fire need in order to start | Needs Oxygen, heat, and fuel
🗑
|
||||
| What are the four categories of fires | Class A,B,C,D
🗑
|
||||
| What is Class A based on the "category of fires" | Paper, wood, cloth and plastics
🗑
|
||||
| What is Class B based on the "category of fires" | Flammable solvents such as gases, oils, paints, and grease and an interaction with air and vapors
🗑
|
||||
| What is Class C based on the "category of fires" | In or near electrical equipment
🗑
|
||||
| What is Class D based on the "category of fires" | Combustible metals such as lithium and magnesium
🗑
|
||||
| What is the use of Class A FIRE EXTINGUISHERS | For ordinary combustible fires (contains soda and H2o)
🗑
|
||||
| What is the use of Class B FIRE EXTINGUISHERS | For fires from solvents and air-vapor mixtures (contains foam, dry chemical, or CO2)
🗑
|
||||
| What is the use of Class C FIRE EXTINGUISHERS | Used for electrical fires (contains dry chemicals)
🗑
|
||||
| What is the use of "Halon" FIRE EXTINGUISHERS | For computer fires
🗑
|
||||
| What does R.A.C.E. stand for | Remove the patient, activate the alarm and alert other staff, contain or confine the fire by closing all doors, extinguish the fire if its safe to do so
🗑
|
||||
| What does P.A.S.S. stand for | PULL the pin, AIM the nozzle just above the base of the fire, SQUEEZE the trigger of the extinguisher, SWEEP the nozzle over the fire
🗑
|
||||
| Any chemical that comes into contact with the skin or eyes must be treated | STAT
🗑
|
||||
| What is the use for Material Safety Dada Sheets (MSDS) | Detailed information about identity of chemical, physical characteristics, physical hazards and how to handle them, reactivity and dangerous reactions, health hazards, handling precautions and control measure (MUST BE KEPT IN A PROMINENT PLACE)
🗑
|
||||
| What does CHP stand for | Chemical Hygiene Plan
🗑
|
||||
| What are the four types of biological hazards and waste | Solid, Chemical, Radioactive, Infectious
🗑
|
||||
| Alcohol can become what type of hazard | flammable, poisonous
🗑
|
||||
| Cytotoxic drugs can be what type of hazard | Carcinogenic
🗑
|
||||
| Nitrous Oxide can be what type of hazard | Oxidizer and irritant
🗑
|
||||
| Formalin can be what type of hazard | Carcinogenic irritant
🗑
|
||||
| Bleach can be what type of hazard | Skin irritant, can compromise the respiratory tract
🗑
|
||||
| Betadine is what type of hazard | Thyroid/renal disturbance
🗑
|
||||
| Mercury can be what type of hazard | poisonous, corrosive
🗑
|
||||
| Glutaraldehyde can be what type of hazard | Skin irritant, can be harmful to asthma patients (can cause deterioration of latex gloves)
🗑
|
||||
| White out can be become what type of hazard | Flammable, and can lead to tumors
🗑
|
||||
| What blood levels are HIGH in the morning ? | Hormones: testosterone, cortisol, adrenocorticotropic hormone (ACTH, iron and insulin
🗑
|
||||
| What blood levels are LOW in the morning | Eosinophil count, creatine, glucose, triglycerides
🗑
|
||||
| What are some specimens that have to be kept cold during transport | Blood gases, gastrin, amoonia, lactic acid, renin
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| What color will plasma or serum be if there is a leakage of hemoglobin | Pink or red
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| Rupture of RBC membrane causes a leakage of hemoglobin which imparts a pink or red color to the serum/plasma and may affect values of certain tests like? | CBC..LD..AST..K+..Fe..T4
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| Additive-containing tubes must be inverted gently how many times ? | 8-10times
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| What is the Analytic phase | Takes place during testing the specimen
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| What is post analytic phase | reporting results and follow up
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| What are the most common fasting specimens | Triglycerides, cholesterol, and glucose
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| what is the purpost of Two-Hour Postprandial Glucose Test | Screens for Diabetes
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| What is the purpose of a Glucose Tolerance Test | Diagnoses diabetes mellitus and hypoglycemia (similar to epinephrine tolerance test but glucagon is INJECTED INSTEAD)
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| What is the purpose of a Lactose Tolerance Test | Diagnoses lactose intolerance
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| what is the purpose of epinephrine tolerance test | determines the amount of GLYCOGEN stored in the liver (epinephrine helps break down glycogen stores and are used for energy when needed)
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| What is the purpose of Therapeutic Drug Monitoring (TDM) | Measures amount of specific medication in a patient's system
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| Why are blood cultures performed | Aids in the diagnosis of SEPTICEMIA
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| When is it best to draw a blood culture | When FEVER SPIKES
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| What is the purpose of a Bleeding time Test | Assesses status of patient's hemostasis (detects platelet function disorders "PART OF STANDARD PRE-SURGICAL WORK UP"
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| Blood smears can be performed using what type of blood? | Capillary blood or blood from lavendar tube within 1hr or being drawn into tube (part of CBC)
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| What is Neonatal Screening? ... | a state that requires infants to be tested for phenylketonuria (PKU) and congenital hypothyroidism (should be tested 24-72 hours after birth)
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| What is the purpose of ABG | Monitors patients respiration status (obtaines for measuring Po2, PCO2, and pH of blood..which tells the degree of oxygenation and acid base balance of blood.
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| What are the most common specimens collected in legal cases | ETOH, Drug screening, DNA analysis
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| POINT OF CARE TESTING is performed where | at patients bed side (falls under CLIA)
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| What is the most common test done for POINT OF CARE TESTING | Glucose level, PT, aPTT/PTT,cardiac enzymes (reduces TAT)
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| What are the common tests for common pathologies | Troponin, Amylase, lipase, ABG, BUN, Creatinine , Hct, Hgb, RBC Count
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| What is the duty of College of American Pathologist (CAP) | Sets standards for phlebotomy ...profeciency testing lab testing by pathologist and CLSs REGULATION OF CLINICAL LABORATORIES
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| What is the duty of CLSI | Establishes procedural guidelines for all areas of the lab
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| What is the duty of JCAHO | Accredits agency for hospitals and nursing homes ..inspects every 2 years ..enforces standards established by CLSI ..works with CAP to provide lab accreditation
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| What is the purpose of CLIA | Ensure quality lab testing
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| What is the duty of Survey and certification group(SCG) | has responsibiliyu of implementing CLIA program
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