chapter 5

Question 1

who submits a laboratory test requisition to lab

Answer 1

nurse or physician, either computer based or written order

Question 2

What information should the lab order have

Answer 2

patient id, gender, dob, doctors name, lab tests to be done, date of order date to be done

Question 3

Label specimens accurately, and include

Answer 3

patients name, dob, phleb. initials, the date of collection, time of collection

Question 4

Where should Bar codes be places

Answer 4

upper left hand corner of the specimen tubes

Question 5

what do bar codes help reduce

Answer 5

TAT- turn around time

Question 6

Radio Frequency Identification

Answer 6

Tiny silicon chips that transmit data to a wireless receiver

Question 7

How many times do u need to invert tubes to make sure additives are mixed in properly

Answer 7

5-10 times at patients bedside

Question 8

what time limit should all lab specimens be taken to the lab

Answer 8

no more than 45 minutes

Question 9

what specimens require centrifugation right away

Answer 9

specimens that have blood thinner or anti coagulant

Question 10

what do anticoagulant specimens turn into once centrifuged

Answer 10

turn into plasma

Question 11

how long does it take for blood to clot

Answer 11

30 minutes

Question 12

after centrifugation what should immediately be separated

Answer 12

plasma or serum

Question 13

3 processes of centrifugation

Answer 13

Pre-centrifugation, centrifugation, post-centrifugation

Question 14

when should handling and processing be done (pre centrifugation)

Answer 14

should be done asap

Question 15

How long can u not exceed to separate plasma

Answer 15

do not exceed more than 2 hours

Question 16

how do u protect photosensitive items

Answer 16

wrapping them in foil or placing them in amber specimen container

Question 17

What is centrifugation

Answer 17

process of specimen by spinning at high speed

Question 18

where do heavy items move when centrifuged

Answer 18

(RBCs) move to bottom

Question 19

where do light items move when centrifuged

Answer 19

(plasma, serum) move to top

Question 20

How should u balance tubes when centrifuging

Answer 20

tubes should be same size and volume and placed opposite to each other

Question 21

Never do what when centrifuging

Answer 21

open the lid while centrifuging is still happen

Question 22

what’s the max amount of times u can centrifuge

Answer 22

1

Question 23

What happens during post centrifugation

Answer 23

serum is removed from plasma

Question 24

when is removal of serum and plasma advised

Answer 24

immediately after centrifugation (no longer than 2 hours)

Question 25

testing conditions may affect the

Answer 25

conditions serums might require

Question 26

how long should serum and plasm remain under room temp

Answer 26

no longer than 8 hours, if not refrigerate

Question 27

Chilled specimens

Answer 27

ammonia, lactic acid, pth

Question 28

how are chilled specimens chilled

Answer 28

slurry bath, ice bag, frozen tube holder ready

Question 29

Light sensitive (photosensitive) specimens

Answer 29

Bilirubin, Beta-carotene, B6, semen

Question 30

Warmed specimens

Answer 30

Cryofibrinogen

Question 31

What samples are heat sensitive

Answer 31

blood samples (keep at 2-8 degrees Celsius)

Question 32

Preparation of warmed species

Answer 32

prepare with special heat packs, transport at 36-38 degrees celsius, protect from bright light

Question 33

what temp should semen be transported at

Answer 33

body temp (37 C)

Question 34

Why should blood sputum and urine be transported to lab asap

Answer 34

to prevent growth of bacteria

Question 35

How to make sure u dont have false positives for urine analysis and cultures

Answer 35

• 12 ml of specimen needed to perform test
• Tell patients to clean genital area with cleansing wipe
• Women need to clean from front to back
• Void some into the toilet and catch urine midstream (called clean catch)

Question 36

how to make sure u dont have false positive for sputum cultures

Answer 36

• Have patient collect mucus into sterile cup
• Best specimen is to be collected morning before the patient eats
• When collecting tuberculosis specimens the patient be really careful

Question 37

How to make sure u dont have false positive for blood cultures

Answer 37

• Explain process in depth to the patient
• The puncture site must be decontaminated, so it’s sterile
• Type of collection tubes used must contain culture media that enable bacteria to grow under laboratory conditions
• Timing and number of cultures obstained must be indicated, as well as location of venipuncture
• Anaerobic bottle must be collected first
• Aerobic bottle second

Question 38

what could interfere with blood cultures

Answer 38

o If other tests are ordered along with other lab tests, blood culture specimens must be collected first
o Do not scrape needle across skin
o Anaerobic method must be first in all, except in butterfly method
o Gently mix resin beads
o Sometimes two sets of blood cultured are ordered: same manner as the first except the second set needs to be obtained at the second site or at a different time, about 60 minutes
o Butterfly system to prevent backflow into vein. If using vacutainer system, make sure to have patient lower the rest of their body
o Blood cultures are often collected from patients who have fever of unknown origin (FUO). Bacteremia (presence of bacteria in the blood) or septicemia (presence of pathogens in the circulating bloodstream), also sometimes called blood poisoning, can occur

Question 39

specimen handling is part of what

Answer 39

pre-analytical phase

Question 40

why would specimens be rejected

Answer 40

o Short samples, hemolyzed (broken rbcs)
o Label and test request don’t match
o Label isillegible
o Anticoagulated tube contains blood clots
o Excessive delays in processing the specimen
o Hemolyzed blood specimens
o Impromper specimen transport or storage
o Incorrect blood volume (too little or too much
o Lipemic (cloudy or milky blood specimen)
o Non fasting blood specimen
o Use of outdated supplies to collect the specimen
o Timed specimens drawn at the wrong time
o Unlabeled specimens
o Contaminated urine specimens