Chapter 11

Question 1

Septicemia

Answer 1

Presence of pathogens and toxins in the circulating bloodstream, sometimes called “blood poisoning.”

Question 2

Blood ________ are often collected from patients who have fevers of _______ ______ (FUO).

Answer 2

Cultures; unknown origin.

Question 3

What percent of people with severe sepsis die?

Answer 3

Between 28 and 50 percent.

Question 4

Blood cultures aid in identifying the specific _________ organism causing infections.

Answer 4

Bacterial

Question 5

When taking a blood culture specimen, after you find the vein, scrub the site of the venipuncture with 70% isopropyl alcohol for __ seconds, and then scrub with the ______ ________ for at least 30 seconds.

Answer 5

60; iodine tincture.

Question 6

What should you use if the patient is sensitive to iodine tincture or if the patient is an infant older than two months?

Answer 6

Chlorhexidine gluconate.

Question 7

How should you clean the site with iodine tincture when prepping for blood culture collection?

Answer 7

The iodine swab should be placed at the venipuncture site and moved outward in concentric circles to a diameter of approximately 2.5 inches for a total of about 30 seconds. Scrub with friction.

Question 8

Collect the blood culture by vacuum tube, syringe, or ______ _________ assembly.

Answer 8

Safety butterfly

Question 9

True or False: You can go back over an area that has been prepped for blood culture collection.

Answer 9

False. This could potentially cause contamination. It should not be touched and should be allowed to dry for 1 to 1.5 minutes.

Question 10

SPS stands for:

Answer 10

Sodium polyanethole sulfonate

Question 11

It is recommended to take __ mL for a safety sterile syringe collection (blood cultures). What should then be done with this volume of fluids?

Answer 11

20mL. 10mL should be transferred to the anaerobic bottle and the remaining 10mL to the aerobic bottle.

Question 12

What needle gauge can be used for blood culture collection?

Answer 12

21- or 23-gauge.

Question 13

Cannula

Answer 13

A tubular instrument used to gain access to venous blood.

Question 14

How much blood can usually be collected from infants and small children? What does the CLSI say about collection in reference to a patient’s total blood volume?

Answer 14

Between 1 and 5 mL. The CLSI states that no more than 1% of a patient’s total blood volume can be collected.

Question 15

It can be helpful to place a strip of ____ over the butterfly wings to keep the needle in place as the blood culture bottles are filled with the blood.

Answer 15

Tape.

Question 16

What do you do if only 3mL of blood are collected when drawing for blood cultures?

Answer 16

Place the entirety of the specimen in the aerobic bottle.

Question 17

SPS is an additive in what colored tube? What are these tubes used for?

Answer 17

Yellow-topped evacuated tube. Blood cultures.

Question 18

GTT stand for?

Answer 18

Glucose Tolerance Test

Question 19

Diabetes Mellitus

Answer 19

Patient has problems with carbohydrate (i.e., sugar) metabolism.

Question 20

What is hemoglobin A1c (HbA1c) used for?

Answer 20

Screening and diagnosis of diabetes.

Question 21

What is the purpose of a GTT test?

Answer 21

Test the efficiency of your body’s insulin-releasing mechanism and glucose-disposing system.

Question 22

What are the 5 requirements to receive the best test results before a GTT test?

Answer 22

1) Eat normal, balanced meals for at least 3 days before the test.
2) Fast for 8-12 hours before the test.
3) Drink water.
4) Do NOT drink unsweetened tea, coffee, or any other beverage during fasting or during the procedure.
5) Do NOT smoke, chew tobacco, or chew gum during fasting or during the procedure.

Question 23

A dose of __ grams of glucose is recommended for the diagnosis of gestational diabetes.

Answer 23

75.

Question 24

Gestational Diabetes

Answer 24

Diabetes occurs during pregnancy, usually during the second or third trimester.

Question 25

Postprandial

Answer 25

After a meal

Question 26

The 2-hour postprandial glucose test can be used to screen patients for diabetes (including gestational diabetes) because?

Answer 26

Glucose levels in serum specimens collected 2 hours after a meal are rarely elevated in normal patients.

Question 27

Point-of-Care Testing (POCT) may also be called:

Answer 27

Decentralized laboratory testing
On-site testing
Bedside testing
Near-patient testing
Patient-focused testing

Question 28

Hemoglobin A1c, hemoglobin, Influenza A and B, and cholesterol are all examples of common _____-__-____ _____.

Answer 28

Point-of-care tests.

Question 29

How should you proceed with glucose testing when using a skin puncture method?

Answer 29

Clean the site (the finger) with antiseptic and then an alcohol wipe and allow it to dry. Massage the finger a few times from base to tip to aid in blood flow and decide on where to make an incision. Remove the safety lancet from its protective paper and make a swift, deep puncture. Wipe the first 3 drops of blood away with a clean gauze and gently massage (not squeeze) the finger again. Apply the microcuvette to the drop of blood; the correct volume is drawn into the cuvette by capillary action. Wipe any excess blood from the cuvette, place it in the microcuvette holder, and insert it into the photometer, which will automatically display the laboratory test result.

Question 30

What do HbA1c levels determine?

Answer 30

The average circulating glucose concentration over the life span of red blood cells (about 3 months).

Question 31

Quality Control Material

Answer 31

Used to monitor glucose-monitoring instruments and instruments that measure other analytes on a daily basis.

Question 32

What is the glucose control material? Why?

Answer 32

Whole blood, because this type of body fluid is used for measurements with point-of-care glucose-monitoring instruments.

Question 33

What does EQC stand for? What is its purpose?

Answer 33

Electronic Quality Control; to test the electronics (the internal and analyte circuits) of the instrument.

Question 34

Routine cleaning of the point-of-care testing instruments is needed to avoid the transmission of __________ __________.

Answer 34

Nosocomial infections.