Chapter 11 Flashcards
What tubes are used for blood bank specimens?
- Lavender or pink top EDTA tubes
- Nonadditive glass red-top tube
ABO
Blood type
What is on an ID blood bank bracelet
- ABO and Rh factor (+ or -) and screen
- Cross match to determine compatibility between patient and donor
What should you compare before drawing blood from a blood bank donor?
You should compare the labeled blood bank tube with the blood bank ID bracelet
Blood Cultures
Determine presence and extent of infection
Why are blood cultures ordered?
- P has a condition in which bloodstream invasion is possible
- Or presence of fever of unknown origin (FUO)
Name 2 reasons why skin antisepsis is done for blood cultures
- Destroy skin microorganisms
- Prevent misinterpretation of microorganism as pathogenic
What are 2 antiseptics that can be used for blood cultures? How long do you have to disinfect the skin?
- Chlorhexidine gluconate
- Tincture of iodine or povidine
Requires 30 to 60 second friction scrub
Blood Culture collection procedure steps
- Follow normal ID protocol: explain collection procedure
- Identify venipuncture site and release tourniquet
- Aseptically select and assemble equipment
- Perform friction scrub
- Allow site to dry
- Remove flip off cap and inspect bottle for visible
defects - Cleanse culture bottle stoppers while site is drying
- Mark and max fill on culture bottles
- Reapply tourniquet and perform venipuncture
- Inoculate medium as requested
- Invert bottle several times
- Clean P’s skin of applicable
- Label specimen containers
- Disposed of used and contaminated materials
- Thank the P, remove gloves and sanitize hands
- Transport specimens to lab ASAP
Which tube must be filled completely for testing
The light blue tube
What must you remember to do for all coagulation tests except for PT or PTT
Use a ‘clear’ or light blue discard tube.
What is the most important thing to remember when drawing from an indwelling catheter?
Use a discard tube (red glass or clear tube) to discard 5mls of blood or 6x of dead space vol of catheter
Hyperglycemia
Increase blood glucose
Hypoglycemia
Decrease blood glucose
GTT
Glucose Tolerance Test
What is a GTT (glucose tolerance test) do and use for?
- To diagnose problems of the carbohydrate metabolism
- Monitors P’s tolerance to high levels of glucose
2 - Hour postprandial glucose
Done 2 hours after a meal since glucose significantly increases 2 hrs after a meal
GTT (Glucose Tolerance Test) Procedure
- Patient must finish glucose beverage in 5 minutes (if not test must be done another day)
- Note time P finishes, start timing, calculate collection times
OGCT
Oral glucose Challenge test (1 hour glucose screening test)
What are the procedures of the oral glucose challenge test (1 hour glucose screening test)?
- P is given drink containing containing 50g of glucose
- Blood specimen collected after 1 hour
- If glucose result is >140 mg/dL, then suggested that P complete follow up OGTT w/in 1 week
Therapeutic Drug Monitoring
Establishes and maintains drug dosage at therapeutic level and avoids drug toxicity
Toxicology specimens
Used to detect toxins and treatment of effects
Forensic blood alcohol (ethanol) specimens
Used to determine levels of alcohol in breath, urine and blood and collection must follow chain of custody
Clinical blood alcohol (ethanol) specimens
Required in connection to on the job injury, employee insurance programs and employee drug screening
What are the special skin preparations and specimen requirements related to collection of clinical blood alcohol specimens?
- Can’t use alcohol-based specimens for skin disinfection
- Must use gray top sodium fluoride tube
Trace elements - what does it test for and what tubes need to be used?
- Test for aluminum, arsenic, copper, lead, iron and zinc
- Special trace element - free tubes must be used (royal blue & contain EDTA, heparin, or no additive)
What does ‘standing order’ mean?
Good for a year - P is able to get the test done weekly for year
What tube do you use for monitored coagulation tests?
Light blue top tubes
Monitored coagulation tests
- Prothrombin time (PT)
- International normalized rate (INR)
- Activated partial thromboplastin time (APTT or PTT)
ABG
Artierial Blood Gases
POCT
Point of Care testing
