1 Flashcards
1
Q
what is the purpose of the physician’s order sheet?
A
to communicate medical care for each patient
2
Q
all physician’s orders should contain what?
A
- date and time order was written
- orders
- doctors signature
3
Q
what are the classifications of a physician’s order?
A
- activity
- diagnostic
- dietary
- medication
- treatment
- miscellaneous
4
Q
what are activity orders referred too?
A
refer to the type of activity the patient is allowed
5
Q
what are examples of a diagnostic order?
A
- ECG
- lab work
- ultrasounds
6
Q
what are dietary orders referred too?
A
nourishment that will be given to the patinet
7
Q
what are medication orders, ordered for?
A
- ease pain
- treat disease
- prepare patients for diagnostic or surgical procedures
8
Q
what are examples of treatment orders?
A
- IV therapy
- dressing changes
- respiratory therapy
9
Q
what are miscellaneous orders?
A
orders that do not fall into the five classifications
10
Q
what are the 4 types of physicians orders?
A
- standing or counting orders
- standing or counting orders PRN
- one time orders or short orders series
- STAT orders
11
Q
what is a standing or continuing order?
A
orders stay in effect until they are discontinued or changed by a written doctor’s order
12
Q
what is a standing or continuing order PRN?
A
orders in effect until changed or discontinued by the physician. they are only in effect when the patient is in need
13
Q
what are one time or short order series orders?
A
orders a doctor may only want carried out once
14
Q
what are stat orders?
A
first order transcribed in a set of orders
15
Q
what does the symbol “k” mean?
A
the order has been transcribed onto the kardex
16
Q
what does the symbol “RMO or Req” mean?
A
requisition has been completed
17
Q
what does the symbol “LMO” mean?
A
label made out
18
Q
what does the symbol “EC” mean
A
entered in computer
19
Q
what does the symbol “aware” mean?
A
the correct department or medical staff have been notified of the order
20
Q
what does the symbol “DONE” mean?
A
the order has already been completed
21
Q
what is the laboratory department responsible for?
A
performing tests on body fluids to aid in the diagnosis and treatment of the patient
22
Q
what are the different laboratory departments?
A
- pathologist
- hematologist
- microbiologist or bacteriologist
- lab technologist
- phlebotomist or lab assistant
- lab clerk
23
Q
what are the hours of the lab?
A
24/7
24
Q
how can the lab department be contacted?
A
- phone
2. computer
25
BCCDC
British Columbia Centre for Disease Control
26
what is the pathologist?
department head
27
what is the hematologist?
specialist who deals with blood disorders
28
what is the microbiologist or bacteriologist?
specialist who deals with infectious diseases
29
what does the laboratory technologist do?
1. draws blood
2. tests blood
3. urine test
4. stool test
5. CSF
30
what does the phlebotomist or lab assistant do?
1. draws blood
| 2. routine lab procedures
31
what does the lab clerk do?
maintains records and reports
32
basic procedures for entering lab orders in the computer
1. open patient chart on meditech
2. select new order and tick the tests to be ordered
3. all tests ordered will be collected on the next routine draw.
4. indicate if test is STAT, urgent, or routine
5. record the diagnosis if the lab test requires one
6. double check physician's order, and orders you have selected in meditech
7. only call lab to draw blood if
a) STAT order
b) scheduled lab draws have ended for the day
33
steps for processing physicians orders?
1. check previous order for completion
2. read over all orders
3. scan to pharmacy
4. collect all necessary requisitions and forms that will be needed
5. read order before completing any requisitions or entering into the computer
6. transcribe lab orders onto kardex
7. MAR any necessary items
8. look over orders one last time
9. add blank physician's order to the patient chart prn
10. flag order for nurse to check
34
what are the steps to insure transcription accuracy?
1. complete concentration
2. all labels are on correct patient
3. re-read orders
4. double check patients name
5. always ask if unsure
6. you must transcribe from the doctor's order sheet
7. symbolize after each completed order
8. re-read the forms
35
VBG - Venous Blood Gas is taken by?
Lab Tech
36
Gastric washing's, sputum, stool, swabs are taken by?
Nurse (sputum is sometimes taken by the respiratory technologist)
37
ABG - Arterial Blood Gas is taken by?
Physician
RT
RN
38
Biopsies, bone marrow, cerebral spine fluid(CSF), cervical swab, thoracic fluid, peritoneal fluid are taken by?
the doctor
39
steps for communicating with the lab
1. doctor will write order for lab test
2. NUA will process the order
3. lab or nurse will come to collect
4. test are preformed in the hospital lab or necessary tests are sent out to provincial lab prn
5. lab results are sent to the nursing station via printer
6. results are filed into patients chart when we have time
7. doctor sees results and may order more test prn
40
what does a CBC (complete blood count) test include?
1. white blood count (WBC)
2. red blood cell count (RBC)
3. hemoglobin (Hgb)
4. hematocrit (Hct.)
5. peripheral smear
41
if the doctor orders a CBC+diff what do NUA's order?
CBC and in the comments to lab we say "CBC+Diff"
42
what is a ESR (erythrocyte sedimentation) test for?
to look for inflammatory activity in a patient
43
what is a Plt. Count (platelet count) test for?
to test a patients platelet levels
44
what is a RBC morph (red blood cell morphology) test used for?
to look for the size and shape of RBC's
45
what is Retic. Count (reticulocyte count) test for?
used for diagnostic purposes only
46
what are the hematology basic tests?
1. CBC
2. Diff
3. ESR
4. Plt. Count
5. RBC Morph
6. Rectic. Count
47
what are hematology special tests?
1. Activated partial thromboplastin time - (PTT)
2. Prothrombin Time/INR - (PT, INR)
3. Fibrin Degradation Products - (FDP)
4. Fibrinogen
48
what does the NUA do when ordering a anticoagulant test?
note to the lab if patient is on anti-coagulants
49
what is an Activated partial thromboplastin time test?
anti-coagulant test
50
what is an Prothrombin Time/INR test?
anti-coagulant test
51
do you need to notify the lab if an Prothrombin test is ordered?
no
52
what test is a Fibrin Degradation Products?
blood clotting test
53
what test is a fibrinogen test?
blood clotting test
54
NUA's responsibilities for processing routine hematology blood work
1. Enter blood work into med-tech
2. Kardex - record into blood work section
3. symbolize on the doctors order sheet "K" & "EC"
55
what do you do if medi-tech crashes?
downtime requisitions
56
what are the steps of downtime requisitions ?
1. label requisition with correct patient
2. record date, doctor that's ordering, patient diagnosis
3. check off correct ordered test
4. scan to lab
57
steps to enter coagulation test: PTT
1. enter into med-tech - if patient is on a anti-coagulant
2. kardex under lab work
3. symbolize on order sheet
58
what does the hematology department do?
test on blood
tests on bone marrow
cerebrospinal fluid
59
what can the hematology department determine
1. number, size, shape and appearance of blood cells
2. clotting and bleeding disorders
3. coagulation studies
60
what is the most common method of obtaining bone marrow?
inserting a large bore needle, under local or general anesthesia into the bone
61
once bone marrow is aspirated where is it sent?
sent to the lab for anaylsis
62
what are bone marrow aspirations used for?
to diagnosis blood disorders and malignant diseases
63
does a legal consent need to be filled out when getting a bone marrow aspiration?
yes
64
when tests require patients to be fasting how long of fasting do they need?
8-12 hours
65
if fasting blood work is ordered on a patient when will it be done?
following day - unless patient is already NPO that day
66
where do you record the lab test on the kardex?
under lab work
67
what does "fasting" mean?
without food
68
what is fasting blood sugar?
the level of glucose in the blood without eating for a certain period of time
69
why is a FBS test performed?
to determine how much glucose that is ingested daily is used by the body
70
what are some problem solving techniques for illegible/unfamiliar lab orders?
1. check with RN/PCC
2. check with doctor if still around
3. check lab manual
4. call the lab or ask another clerk
71
what do you do if a lab test is not done at your hospital?
1. inform the doctor
| 2. write in red pen beside the lab order the lab order is not available at your hospital
72
what does the chemistry department do?
analyze specimens of body fluids for chemical components
73
what are common specimens that may be analyzed for chemical components?
1. Blood
2. urine
3. sweat
4. stool
5. CSF
6. amniotic fluid
7. synovial fluid ( from the joint)
74
who draws a blood chemistry test (venous blood)
lab tech
75
how is a venous blood test obtained?
direct puncture into the vein
76
who draws arterial blood gas (ABG)
1. doctor
2. RT
3. RN
77
T/F - you may be asked to indicate wether a patient is on 02?
Ture
78
who draws therapeutic drug level tests? (venous blood)
lab tech
79
who draws miscellaneous lab tests?
lab tech
80
who draws urine/misc - urine/stool tests?
nursing staff
81
LFT's
liver function tests
82
what test are included in a liver function test? (LFT)
1. ALT
2. ALK PHOS
3. Total Bili
4. AST
5. GGT
6. Total protein
7. ALB
83
what are the unit clerk responsibilities for processing chemistry orders?
1. enter test into the computer
2. kardex test under lab work section
3. symbolize the order with "EC", "K" + initials
84
what are the unit check responsibilities for miscellaneous orders?
1. enter test into the computer
2. kardex under lab work section
3. symbolize orders with "EC" and "K"
85
what is the definition of therapeutic drug levels?
drug levels can assist the doctor in determining the appropriate dosage to make sure the required therapeutic response with minimal risk of toxicity to the patient
86
therapeutic tests can also be referred to as?
trough test
87
what type of test would go under therapeutic tests?
1. digoxin level
2. dilantin/phenytoin level
3. theophylline level
4. antibiotic levels
88
T/F - (therapeutic drug) the NUA may be asked to enter the last time the patient took the drug
Ture
89
unit clerk responsibilities for therapeutic drug levels?
1. enter into computer
2. MAR the order
3. kardex under lab work
4. symbolize "EC" and "K" on order sheet
90
how long after you enter a STAT order will you receive the results?
within 1 hour
91
when you place an "urgent" order when will you receive the results?
within 3 hours
92
what lab order will you receive results the same day ASAP?
routine order
93
what does the pathology department analyze ?
tissues and cells for evidence of disease
94
what does the blood bank do?
1. orders and receives blood from red cross
| 2. gives blood to patients in the hospital
95
who collects venous blood gas?
lab tech
96
name 4 specimens that nurses collect?
1. gastric washings
2. sputum
3. stool
4. swabs
97
who collects arterial blood gases?
respiratory technologist
98
name 4 specimens that the doctor will collect?
1. biopsy
2. bone marrow
3. cerebrospinal fluid (CSF)
4. cervical swab
5. thoracic fluid
6. peritoneal fluid
99
a urinalysis is performed by?
chemistry department
100
what does a routine urinalysis include?
1. PH
2. protein
3. glucose
4. ketones
5. specific gravity
101
what does a microscopic urine include?
1. RBC
2. WBC
3. pus cells
4. epithelial cells
5. hyaline casts abd crystals
102
unit clerk responsibilities for urinalysis
1. enter test into computer
2. kardex under lab work section
3. print label for correct patient
4. symbolize on order sheet "LMO, EC, K" in red ink
5. go back into med-tech and change "uncollected" to "collected" once nurse brings you specimen
103
name 6 chemistry tests for urine and miscellaneous body fluids:
1. amylase
2. barbiturate
3. calcium
4. chloride
5. creatinine
6. creatinine clearance
104
steps to print a label in med-tech?
1. open medi-tech (first screen)
2. go to reports
3. click forms/labels
4. put in correct patient name
5. choose correct printer & number of labels
6. print
105
unit clerk responsibilities for processing random urine chemistry tests:
1. enter order into med-tech
2. print label
3. kardex under lab work
4. symbolize with "LMO, EC, K"
5. once specimen has been collected go back into med-tech and change it to "collected"
106
unit clerk responsibilities for occult blood tests / stool OB
1. print 3 labels and write "stool OBx1, OBx2, OBx3" and out onto kardex
2. enter these into med-tech one at a time
3. in the comments you indicate which stool OB it is
107
when do you draw a blood specimen before a trough test ?
half hour before
108
what lab tests are included in a lytes panel ?
1. sodium
2. potassium
3. chloride
4. anion gap
5. C02
109
what lab tests are included in a lipid panel?
1. cholesterol
2. triglycerides
3. high density lipoprotein
4. low density lipoprotein
