Blue Packet 2 Flashcards
1
Q
what gloves should be worn if a pt has a latex allergy
A
vinyl or nitrile
2
Q
what should be used to clean the skin before inserting the needle
A
isopropyl swabs
3
Q
what is the capacity of blood collection tubes
A
6-10 mL
4
Q
what are the most common blood tubes
A
blue, lavendar, red
5
Q
what are the measurements of blood collection tubes
A
3 in long & 0.5-0.75 in wide
6
Q
what is the technical term for the inside of the needle
A
lumen
7
Q
why should adult collection ubes not be used for children
A
can collapse veins
8
Q
t/f: vacutainer is a brand name
A
true
9
Q
when are winged infusion sets useful
A
drawing blood from vein in hand or foot
10
Q
what angle should a needle be when inserting blood
A
15-30 degrees
11
Q
what should you always tell the pt when drawing blood
A
tell pt when about to insert needle
12
Q
tourniquets should gen not be on longer than
A
1 min
13
Q
what are 3 complications of prolonged tourniquet use
A
hemolysis, petechiae, hemoconcentration
14
Q
why is hemolysis bad when drawing blood
A
can lead to inaccurate test results
15
Q
define PETECHIAE
A
tiny hemorrhages appearing as small red or purple spots
16
Q
what are petechiae a sign of when drawing blood
A
tourniquet was on too long & blood may be hemolyzed
17
Q
why is hemoconcentration a problem when drawing blood
A
ratio of cells to liquid in blood altered that may affect result
18
Q
what is the most amount of blood taken in a blood draw at a time
A
6 tsp
19
Q
how long does each tube take to fill
A
about 5 seconds
20
Q
how many inversions do blue top blood tubes require
A
3-4 inversions
21
Q
how many inversions do SST (red top) tubes and serum (red top w/o separating gel) require
A
5 inversions
22
Q
how many inversions do EDTA and heparin containing tubes (lavender/pink & green) require
A
8-10 inversions
23
Q
list widely used anticoagulants
A
- sodium citrate (light blue tube)
- EDTA (lavender/pink tube)
- Heparin (green tube)
- ACD (light yellow tube)
- SPS (yellow stopper tube)
- Potassium oxalate (gray tube)
24
Q
which tube is best at preserving the coagulation factors
A
sodium citrate (light blue)
25
what color is the tube for sodium citrate
light blue
26
what color is the tube for EDTA tubes
lavender or pink
27
what color is the tube for ACD tubes
light yellow
28
what color is the tube for Potassium oxalate
gray
29
what color is the SPS tube
yellow stopper
30
what are sodium citrate tubes used for
coagulation test
31
what are EDTA tubes used for
hematology, some blood banking test, checking CBC
32
what are Heparin tubes used for
chemistry tests requiring plasma/whole blood & STAT chemistry tests
33
what are ACD tubes used for
DNA testing
34
what are the SPS tubes used for
draw cultures for micro-organisms
35
what are potassium oxalate tubes used for
testing blood glucose
36
what are red stopper plastic tubes used for
tests requiring blood to clot before being centrifuged, used for draws needing serums, chemistry & immunuology tests
37
what do red stopper plastic tubes have
clot activator
38
what are gold or black & red mottled stopper tubes
tubes with gel and clot activator
39
what are gold or black & red mottled stopper tubes used for
chemistry & immunology tests
40
what should always be deployed immediately following withdrawal of needle
safety devices
41
what needles should be disposed into a sharps container
any needle expired, broken seal, damaged bevel, one without safety device
42
define a BLOOD CULTURE
lab test used to check for bacteria/other micro-organnism in blood sample often used to help diagnose pt w/fever of unknown cause
43
how should the area be cleaned when obtaining blood for blood culture
clean with alcohol first then with povidone-iodine
44
if the blood culture set includes an aerobic and anaerobic, what should be collected first
aerobic
45
what disorders are screened in newborns
cystic fibrosis, hypothyroidism, PKU, galactosemia
46
describe how to do newborn (blood) testing
1. puncture heel no deeper than 2 mm w/lancet
2. saturate circles
3. airdry blood spots for 3 hours at room temp
47
what tests are Clinical Laboratory Improvement Act (CLIA) tests
blood glucose, fecal occult blood, hematocrit, urine chemical screening, pregnancy testing, rapid strep test
48
quick transport is essential for which specimens
microbiological
49
give examples of microbiological specimens
blood/throat cultures, sputum, semen, stool, urine
50
define CHAIN OF CUSTODY
process that maintains control of and accountability for each specimen from time of collection to time of disposal
51
what is required on chain of custody
- name & identifying info of pt/subject from whom specimen collected
- name of person who got specimen
- date, location, & signature of person attesting specimen is correct & matches document
- signature & date from every person who possessed specimen
52
can you give police blood alcohol levels if pt refuses
no
53
what is an appropriate antiseptic to use when testing blood alcohol levels
chlorhexidine
54
why should iodine and alcohol not be used when cleaning the site when testing blood alcohol levels
can lead to false positive
55
urine specimen should be between...
12-50 mL
56
what is the most commonly analyzed non blood specimen
urine
57
what info should be labeled on the urine specimen container
pt name, date, time of collection
58
t/f: menstruating women shouldn't undergo urine tests until their cycle is complete
true
59
what is the most common form of urine testing
random specimen
60
when is the clean catch midstream specimen collection ordered
to diagnose UTI or evaluate medication effectiveness & culture & sensitvity test
61
define TIMED SPECIMEN
specimen collected over predetermined time period to obtain additional health info
62
t/f: pt should not discard the first specimen when doing a timed specimen
false
63
what test are timed specimens collected for
glucose tolerance test
64
define 24-HOUR SPECIMEN
specimen collected to measure urine output over 24 hr period
65
describe the procedure for 24-hour specimens
urinate into small collection container which is pouured into larger collection container, small container should be cleaned with soap and warm water
66
define FIRST-VOIDED MORNING SPECIMEN
specimens collected in morning after sleeping
67
what are FIRST-VOIDED MORNING SPECIMEN used for
pregnancy testing, culturing & microscopic examination
68
aka: first-voided morning specimen
8 hour specimen
69
why is catheterization not routinely used when obtaining urine sample
can cause infection
70
describe SUPRAPUBIC SPECIMEN procedure
sterile syringe w/needle inserted directly into urinary bladder to asiprate urine
71
when are suprapubic specimens done
microbial analysis or cytology studies
72
why are fecal specimens collected
detect parasites, occult blood, and colorectal cancer
73
fecal samples should be kept at what temp
body temp
74
what is required if a fecal fat analysis is performed
72 hour refrigerated stool sepcimen
75
semen samples must reach the lab in less than ____ hours
2
76
semen specimens should not be exposed to
light or extreme temperatuers
77
how should semen specimens be collected
container or condom free of spermicides
78
TB test containers have what, requiring caution from you and your pt
poisonous preservative
79
what kind of container should sputum specimens be collected in
sterile container
80
what happens to urine if it stands at room temp
urine components change
81
urine specimens should be refrigerated within ___ hour of collection
1
82
tubes needed for culture and sensitivity tests may be kept at room temperature for up to ____ hours
72
83
what should be used when sending specimen to labs
plastic biohazard bags
84
what is required for all specimen shipped to a reference lab
watertight secondary container
85
define POINT OF CARE
lab testing conducted close to site of pt care
86
define CRITICAL VALUE
test result significantly higher/lower than normal and indicate potential life-threatening situation for pt
87
define the 1500 METHOD
count # of small boxes between P-P interval and between R-R interval then divide that number by 1500
88
define the P-P INTERVAL
amount of time between atrial depolarization cycles
89
define the R-R INTERVAL
amount of time between ventricular depolarization cycles
90
aka: sequence method
300 method
91
the sequence method uses what pattern
300, 150, 100, 75, 60, 50
92
define the SEQUENCE METHOD
calculate by dividing 300 by # of large boxes between QRS complexes
93
describe the 6-SECOND RULE
gold standard for estimating rate of irregular rhythm; count # of QRS complexes in 2 of sections and multiply by 10
94
what do small hash marks at the top of an EKG tracing indicate
3 second intervals
95
what are the most common reasons for artifact of the EKG
movement of pt, seizure, trembling, fast breathing, dry/wet skin, shivering
96
when do wondering baselines occur on an EKG
when contact between electrode and skin is impacted
97
t/f: seizures will cause artifact on an EKG
true
98
what should be done when doing an EKG on a pt who is trembling
try to move the electrodes to place with minimal tremors
99
t/f: electrodes with dry gel should be used
false
100
what helps with electrode adhesion (when doing EKGs) if a pt has dry skin
abrading skin & using tincture of benzoin
101
what helps w/electrode adhesion (when doing EKGs) if a pt has wet skin
wipe off pt and apply tincture of benzoin
102
how does cell phone interference appear on an EKG
flutter of P waves on tracing at rate of 300/min
103
when seeing an interference on an EKG, what should be considered the source first
nonmedical devices
104
list certain conditions that require a right-sided 12 lead EKG
- inferior wall ST segment elevation
- myocardial infarction
- pts younger than 8 yrs
105
define POSITIVE DEFLECTION
wave that exists above isoelectric line
106
define NEGATIVE WAVE
wave existing below isoelectric line
107
define T WAVE SYMMETRY
T wave left and right sides are symmetrical
108
P wave symmetry is symmetry w/respect to which axis
y axis
109
how do you find the amplitude of wave on EKG
count number of small boxes between lowest and highest points of wave
110
what is 1 small box on EKG
1 mm
111
define P WAVE
atrial depolarization
112
define R WAVE
ventricular depolarization
113
define T WAVE
ventricular repolarization
114
define PR INTERVAL
represents time it takes for SA node to fire, atria to depolarize, and electricity to travel through AV node
115
define QRS COMPLEX
time it takes for ventricles to depolarize
116
define ST SEGMENT
represents early phase of ventricular repolarization
117
define J POINT
represents exact point in time where ventricular depolarization stops and ventricular repolarization starts
118
when do J points occur
at end of QRS complex or where ST segment begins
119
define QT interval
one complete cycle of ventricular depolarization and repolariztation
120
when do QT intervals begin
at Q wave to end of T wave
121
define PREMATURE VENTRICULAR COMPLEXES (PVCs)
ventricular depolarization occurring early in cardiac cycle
122
define HEART BLOCKS
special set of arrhythmias indicating difficulty/no communication between atria and ventricles
123
heart blocks are often described in these stages
- first degree
- second degree type 1
- second degree type 2
- third degree
124
define a first-degree heart block
slow/delayed conduction through AV node causing prolonged PR interval
125
define third degree heart block
complete lack of association between atria and ventricles
126
what should the MA do if a pt is experiencing V-fib
call for help, start CPR, retrieve AED
127
list causes of asystole
- large pulmonary embolism
- large Myocardial infarction
- respiratory arrest (hypoxia)
- overdose
- hypothermia
- acidosis
- electrolyte abnormalities
- tension pneumothorax
- trauma
128
what is the most common paper speed
25 mm
129
at what speed on EKG enables certain waves to become visible on the tracking
50 mm
130
what does 1 small square on EKG stand for
0.04 seconds
131
what does 1 large 5 mm square on EKG stand for
0.2 seconds
132
what do 5 large squares on EKG stand for
1 sec
133
what is the P-P interval
atrial rate
134
what is the R-R interval
ventricular rate
135
range of PR?
beginning of P wave to beginning of QRS complex
136
range of QRS complex?
beginning of Q to end of S wave
137
range of QT complex
beginning of Q to end of T wave
138
what is the conduction layer of the heart
endocardium
139
what side of the heart carries low pressure deoxygenated blood
right side
140
what is the only artery that carries deoxygenated blood
pulmonary artery
141
what is the only vein that carries oxygenated blood
pulmonary vein
142
aka: mitral valve
bicuspid
143
where is the mitral valve
between left ventricle and left atrium
144
what valve is on the right side of the heart
tricuspid
145
what happens in the relaxation/diastole phase
cardiac chambers fill w/blood
146
define stroke volume
blood volume ejected outside ventricle after each contraction
147
define cardiac output
amount of blood ejected outside heart per minute
148
define peripheral vascular resistance
force exerted against blood flow and determined by diameter of vessels
149
determine blood pressure
force exerted by circulating blood volume on walls of artery during circulation
150
formula for cardiac output?
stroke volume x HR per/min
151
formula for blood pressure?
cardiac output x vascular resistance
152
what is an EKG
graphical presentation of heart electricity
153
define automaticity
ability to spontaneously trigger electrical impulses w/o being stimulated by another source
154
define excitability
ability to respond and react to stimulus
155
aka: excitability
irritability
156
define CONDUCTIVITY
ability to receive and transmit electrical impulses to adjacent cells
157
define DEPOLARIZATION
electrical event expected to result in contraction
158
define REPOLARIZATION
strictly an electrochemical event
159
describe SA NODE
primary pacemaker of the heart delivering electrical impulses at the top of the right atrium
160
what is the normal firing rate of the SA Node?
60-100 bpm
161
define PURKINJE FIBERS
network of small conduction fibers that deliver electrical impulses
162
what does PKU cause
mental retardation and brain damage
163
what is the red top tube used for
cold agglutinin tests
164
is a blood specimen placed in ice or ice water considered a chilled specimen?
yes
165
what should be used to protect blood specimens from exposure to light
aluminum foil
166
aka: dermal puncture
skin puncture
167
t/f: order of capillary specimen is lavender, tube w/additive, tube w/o additive
true
168
what should never be used for dermal puncture
hypodermic needle
169
what can deep penetration into skin cause
osteomyelitis
170
how can the speed of a centrifuge in RPMs be checked
tachometer
171
what is the life space of an average RBC
120 days
172
when a glucose meter is cleaned for its battery changed, what is crucial to do
double check the first 3 tests run afterward
173
define GLUCOSURIA
sugar in urine
174
what is an example of a time dependent lab test
glucose tolerance
175
define PROTHROMBIN TIME
lab test that evaluates extrinsic coagulation function
176
what is the most common reason for blood accumulation at site of venipuncture
hematoma
177
how long does a pt fast for before a blood draw in basal state
12 hours
178
what is a 2 hour postprandial test used to evaluate
DM
179
blood cultures are ordered to detect what
microorganisms
180
what are 3 types of venipunctures
fasting, timed, and blood cultures
181
what does OGTT stand for
oral glucose tolerance test
