Chapter 53 & 54 Flashcards

1
Q

What is the portion of blood that is plasma ?

A

55%

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2
Q

What is the universal donor blood type and why?

A

Type O negative is referred as the universal blood donor.
Because there are no circulating antibodies to the ABO antigen, nor the RH antigens that might sensitize an Rh-negative recipient.

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3
Q

Define: hemoconcentration

A

A condition is which the concentration if blood cells is increased in proportion to the plasma .

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4
Q

Define: Hemolysis

A

The destruction or dissolution of red blood cells, with subsequent release of hemoglobin.

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5
Q

Define: syncope

A

Fainting.

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6
Q

What type of tube is used for hematology testing?

A

A lavender vacutainer

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7
Q

What tubes contain an anticoagulant?

A

Yellow, Red-grey (marbled), Light blue, Green, Lavender, Grey.

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8
Q

What tube is used for hematology testing?

A

Lavender

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9
Q

What tube is used for collecting GTT?

A

Glucose Tolerance Test. Grey tube

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10
Q

What tube is used for collecting plasma?

A

Green Grey Marbled

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11
Q

What is the density of thixotropic gel to RBCs?

A

This synthetic gel has density between that of red cells and plasma or serum, and it settles between the two during centrifugation, forming a barrier that facilitates retrieval of the liquid portion without cellular contamination.

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12
Q

What tube is used for collecting serum ?

A

Red-grey Marbled

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13
Q

Define Serum?

A

The liquid portion of whole blood that remains after the blood has clotted is serum.

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14
Q

What tube is used for coagulation studies?

A

Light blue

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15
Q

What is the procedure for mixing blood in tubes with an additive?

A

By inverting

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16
Q

What is the common needle size used for infants?

A

23 Gauge

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17
Q

What is the common size needle used on older adults?

A

23 Gauge

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18
Q

What is the common needle size used on adults?

A

20-21 gauge

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19
Q

What is the common needle size used for blood bank donations?

A

16 Gauge

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20
Q

Define Bevel?

A

Angled tip of a needle

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21
Q

Define hub?

A

the part of the venipuncture needle that fits into the syringe or Vacutainer adapter.

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22
Q

Define EDTA and its purpose ?

A

is an anticoagulant that prevents platelets from clumping and preserves the appearance of blood cells for microscope preparation.

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23
Q

Define Lancet?

A

Device used to perform a dermal puncture, which delivers a quick puncture to a predetermined depth.

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24
Q

Define Hematoma?

A

Is a large painful bruised area at the puncture site caused by blood leaking into the tissue, which causes the tissue around the puncture site to swell. Most common cause of hematoma formation during the draw are excessive probing with the needle to locate a vein, failure to insert the needle far enough into the vein and a needle that goes through the vein. Also can form after a draw if you fail to remove a tourniquet before removing the needle.

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25
Q

Define: Winged infusion set?

A

also known as a butterfly needle: Designed for use on small veins, such as those in the hand or in pediatric patients. Most common gauge 23.

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26
Q

What veins are used for routine venipuncture?

A

Medial or cephalon veins

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27
Q

What are the most common phlebotomy sites in adults?

A

veins in the antecubital space

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28
Q

What are the common sites for capillary puncture in adults?

A

Ring finger, or middle finger.

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29
Q

what are the common sites for capillary puncture in infants?

A

the medial or lateral side of the heel

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30
Q

Define: Butterfly needles?

A

are used for small veins, such as those in the hand or in a pediatric patient.

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31
Q

Define SESIP?

A

Sharp with engineered sharps injury protection. AKA safety needles.

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32
Q

Define syncope?

A

Fainting

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33
Q

Define Hemolysis?

A

The destruction or dissolution of red blood cells, with subsequent release of hemoglobin.

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34
Q

Define Antiseptic?

A

An agent that inhibits bacterial growth and that can be used on human tissue. should be applied to the skin 30 to 60 seconds before the blood draw to prevent infection at the puncture site.

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35
Q

Define Hemoconcentration?

A

a situation in which the concentration of blood cells is increased in -proportion to the plasma is hemoconcentration.
Leaving a tourniquet on longer that 1 minute greatly increases the chance of hemoconcentration.

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36
Q

Define Hemolysis?

A

The destruction or dissolution of red blood cells, with subsequent release of hemoglobin is hemolysis.

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37
Q

Mastectomy?

A

Do not draw blood from the side of the mastectomy, because mastectomy surgery causes lymphostasis, which may produce false results.

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38
Q

What would be the intervention for slow blood flow into a vacutainer tube?

A

Withdraw the needle slightly to center it within the vein.

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39
Q

What would be the intervention for a patient that complaints during a phlebotomy procedure ?

A

Limit yourself to two attempts to obtain blood from any one patient. If you continue to fail, ask the patient whether he would prefer if someone else try. Oe better to come back at another time. Perform the procedure quickly, efficiently and effectively.

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40
Q

What would be the intervention for a patient complains of collapsed veins?

A

Butterfly units also can be used to draw blood from the hands of adults, the tubing also minimizes the strength of the vacuum, this preventing the collapse of fragile veins. Syringes are used when there is concern that the stopper vacuum in a stopper tube might collapse the vein. Vacutainer blood transfer device.

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41
Q

What would be the intervention for a hematoma forming during a draw?

A

Adjust the depth of the needle or remove the needle and apply pressure. Discontinue the procedure stat, apply pressure to the area for a minimum of 3 minutes, and then apply an ice pack to the area. Notify the physician to determine if the site has stopped bleeding.

42
Q

What would be the intervention for a patient fainting?

A

Position the patients head between the knees, check and record the patients pulse, blood pressure and respiration rate, and continue to observe the patient. Secure the patient in the blood collection chair prevents bodily injury if the person faints. Constant conversation with the patient during the procedure can help identify an impending episode, as can observing the patients face and breathing rate.

43
Q

What are the OSHA guidelines regarding use of needles?

A

Do not use needles when safe, effective alternatives are available. Help your employer select and evaluate devices with safer features. Use devices with safety features provided by your employer. Never recap a contaminated needle. Plan for safe handling and disposal before beginning any procedure using needles. Dispose of needles promptly. Report all needlestick and other related injuries. Tell your employer of hazards from needles that you observe in your work environment. Participate in blood borne pathogen training.

44
Q

What is the procedure for capillary collection ?

A

Put on gloves, cleanse the finer with alcohol prep pad. If jams are soiled, ask person to wash them before the procedure. If the patients hands are cold, warm them in warm water or ask the pt. to rub them together. Have your supplies ready. Puncture skin. do not milk the finger to get more blood. After it is punctured wipe away the first drop of blood, and restart the flow. Collect sample. Place cotton ball with pressure to stop bleeding. once it stops, apply band aid.

45
Q

What % of physician decisions based on lab test results?

A

%80

46
Q

What portion of blood that is plasma?

A

55%

47
Q

What is the universal donor blood type, and why?

A

universal donor, No antigens, A and B antibodies, compatible with only O blood types.

48
Q

Define: HDL

A

High Density Lipoproteins

49
Q

What are the normal ranger for HDL?

A

35mg/dL considered normal
Values below 35 mg/dL place a person at a high risk category. In general total cholesterol under 200 md/dL are considered normal.

50
Q

Define: LDL:

A

Low Density Lipoprotein

51
Q

Define: AST/ALT

A

Two liver enzymes, that can be useful for monitoring homeostasis during drug therapy. AST/ALT is a,sk Cholestech ALT/AST test, which is performed on the cholestech LDX system.
AST : Aspartate aminotransferase
ALT: Alanine aminotransferase

52
Q

Define: Glucose

A

Is used as a fuel by many body cells, under normal circumstances it is the only substance used to nourish brain cells. Maintenance of blood glucose levels within a normal range is vital to homeostasis of the human body.

53
Q

What are the normal ranger for Glucose?

A

GTT- Fasting- If the glucose level does not exceed 100g/dL at the onset of the testing period, or 180 g/dL 1 hour after ingestion of the glucose drink, the patient is believed to have normal glucose. If the blood glucse level exceeds 200 g/dL, glucose escapes into the urine bevause the tubules no longer are able to absorb.

54
Q

What are some indications Glucose is out of normal range? Too high, and too low?

A

Elevated glucose levels most often are associated with diabetes mellitus, but they also may indicate pancreatitis, endocrine disorders or chronic renal failure.

55
Q

Define: RBCs?

A

RBCs = Erythrocytes : Transport oxygen from the lungs to the body cells and cary carbon dioxide away from cells, back to the lungs to be exhaled. Shape: biconcave disk that is thicker at the rim than the middle, formed in the red bone barrow. lifespan 120 days.

56
Q

What are the normal ranger for RBCs?

A

Women 4.5-5 Million / mm3

Men 4.5-6 Million/mm3

57
Q

What are some indications RBCs is out of normal range? Too high, and too low?

A

Decreased RBC in anemia. Increase are found in people with dehydration, polycythemia vera or severe burns and in those who live at high altitudes in whom reflects adaptation to lower oxygen content of the air.

58
Q

Define: WBCs?

A

WBCs = Leukocytes
have a nucleous and larger than erythrocytes. Prime function is to protect the body againts infection and disease. 5 types of leukocytes.

59
Q

What are the normal ranger for WBCs?

A

Normal range: 4000-11000/mm3

60
Q

What are some indications WBCs is out of normal range? Too high, and too low?

A

INCREASE in the number of normal WBCs is a condition called Leukocytosis.
Physiologic increases int eh WBC count are seen with pregnancy, stress, anesthesia, exercise, and exposure to temperature extremes.
Payhologic causes of leukocytosis include bacterial infections, leukemia, appendictis and pneumonis.
A DECREASE is called Leukopenia. May be caused by viral infection or by exposure to radiation and certain chemicals and drugs.

61
Q

Define: HgbA1c

A

Hemoglobin A1C

Test gives information about the average blood glucose level during the past 2 or 3 months.

62
Q

What are the normal ranger for HgbA1c?

A

Patient without diabetes: 4-6%
Patient with diabetes: Goal is to maintain glycosylated hemoglobin below
7-8% are considered good, and those blow 7% demonstrate excellent blood glucose control.

63
Q

What are some indications HgbA1c is out of normal range? Too high, and too low?

A

If the HBA1C levels are at 9% or higher, the patients treatment should be reassesed, or we might question the the pts compliance.

64
Q

HgbA1c and significance in control of DM?

A

Diabetes control : Because the test results give feedback on the previous 2 to 3 months an HgbA1c test every 3 months provides data on the patients average blood glucose. If the numbers are too high, treatment might need to be reassessed or the phycisian may question the patients compliance with treatment.

65
Q

High eosinophil?

A

The granular leukocytes are called polymorphonuclear leukocytes and include the neutrophils, eosinophils, and basophils. They engulf invading bacteria and viruses.

66
Q

High phagocytic count?

A

granular leukocytes are phagocytic, which means that they, engulf invading bacteria and viruses, they function in the tissues

67
Q

Define: platelet?

A

thrombocytes, platelets responsible for

clot formation. They are the smallest formed elements of the blood. Discoid shape.

68
Q

Abnormal platelet count, might have?

A

People with a mutation in one of the clotting factor genes can have Hemophilia.

69
Q

Define: CPK?

A

Creatine phosphokinase (CPK) Purpose: To assess source of muscle damage (myocardial infarct)

70
Q

Define Creatinine:

A

CREAT= Test used to screen for renal function.

71
Q

What are the normal ranger for Creatinine?

A

0.2-0.8mg/dL

72
Q

Define: ESR?

A

Erythrocyte sedimentation Rate: Laboratory test that measures the rate at which erythrocytes gradually separate from plasma and settle to the bottom of a specially calibrated tube in an hour. Used for general indication of inflammation. Increases are found in such conditions as acute and chronic infections, rheumatoid arthritis, tuberculosis, hepatitis, cancer, multiple myeloma, rheumatic fever, and lupus erythematosus.
the rate at which red blood cells settle out in a tube of blood under standardized conditions, erythrocyte sedimentation rate

73
Q

What are the normal ranger for ESR?

A

MEN: Westergren method :
50 yrs. 0-20
Women:Westergren Method:
50 yrs. 0-30

74
Q

What are some indications ESR is out of normal range? Too high, and too low?

A

Only increased levels are significant. Increases are found in such conditions as acute and chronic infections, rheumatoid arthritis, tuberculosis, hepatitis, cancer, multiple myeloma, rheumatic fever, and lupus erythematosus.

75
Q

What is ESR procedure?

A

Check the leveling bubble of the sediplast rack. Bring the blood sample to room temperature if it was in refridgeration. EDTA blood specimen. Mix well with inversion, so bubbles. Fill the vile to the indicated line. Tube is placed vertically and after an hour ESR is measured in mm. Tube must be completely filled with blood, no air bubbles, must be allowed to sit undisturbed.

76
Q

Define: HCT?

A

Hematocrit: Is a measurement of the percentage of packed RBCs in a volume of blood.

77
Q

What are the normal ranger for HCT?

A

Women 36%-45%

Men 42%-52%

78
Q

What are some indications HCT is out of normal range? Too high, and too low?

A

Low microhematocrit values can indicate anemia or the presence of bleeding,
High values may be caused by dehydration or by a condition : Polycythemia Vera.

79
Q

Define: Hgb?

A

Hemoglobin : Rough measure of the oxygen-carrying capacity of blood.

80
Q

What are the normal ranges for Hgb?

A

High at birth, decline during childhood, increase at teens until adult level is reached.
Women 12-16 g/dL Men 15-17 g/dL

81
Q

What can affect hbg?

A

Age, gender, diet, altitude and disease.

82
Q

Define: H&H?

A

Hemoglobin and hematocrit tests. Often performed together reffered to as H&H.

83
Q

What is the quick calculation formula for Hgb to Hct values?

A

HGB X 3 = HCT

HCT / 3 = HGB plus & ;negative 3 for range.

84
Q

Define: Leukocytes?

A

White blood cells. Function: Protect the body againts infection and disease.

85
Q

Define: ALP?

A

Alkaline phosphatase: Test used to detect liver and bone disease.

86
Q

What are the normal ranger for ALP?

A

20-70 U/L

87
Q

Define: TSH

A

Thyroid-Stimulating hormone (thyrotropin) : Test used to assess thyroid and pituitary gland function.

88
Q

What are the normal ranger for TSH?

A

5-6 mU/L

89
Q

Define: Thyroid Panel?

A

Components:
Thyroid Stimulating Hormone (TSH)
Thyroxine (T4)
Triiodothyronine (T3)

90
Q

Define: Erythrocyte

A

RBCs: Transport oxygen from the lungs to the body cells and carry carbon dioxide away from cells, back to the lungs to be exhaled.

91
Q

Erythrocyte shape is?

A

Biconcave disk that is thicker at the rim than in the middle.

92
Q

Erythrocyte life span?

A

120 days.

93
Q

Define buffy coat?

A

Top portion of cellular/formed element fraction
WBCs and Platelets
Hematocrit does not include Buffy Coat (just RBCS component)

94
Q

Define: Thrombocytopenia?

A

Decrease in platelet count is called Thrombocytopenia.

95
Q

Define : Granular Leukocytes?

A

Granular Leukocytes = Polymorphonuclear leukocytes.
include the following:
Neutrophils segmented (mature)
Neutrophil band (immature)
Eosinophils
Basophils
Granual leukocytes are phagocytic, that is they engulf invading bacteria and viruses.

96
Q

Define: Hematocrit ?

A

HCT: is a measurement of the percentage of packed RBCs in a volume of blood

97
Q

What is the significance of a Hematocrit?

A

The Hemocrit serves as a baseline for determining the body’s ability to carry oxygen.
Although the hemocrit value varies with age and gender, a low hemocrit value for the patient’s age and gender may indicate anemia or bleeding, and a high hemocrit value for the patient’s age and gender may indicate dehydration and or polycythemia vera. A microhematocrit test is a simple procedure and requires very little blood to determine the hematocrit, so it is performed often as part of a CBC.

98
Q

Define: Leukocytes?

A

WBCs = Leukocytes

have a nucleus and larger than erythrocytes. Prime function is to protect the body against infection and disease.

99
Q

Define: Fasting Specimens in LDL/HDL testing?

A

Fasting for 12 hours before cholesterol levels are checked. If elevated, might order a lipid profile. Which checks total cholesterol, triglycerides and HDL and LDL cholesterol levels.

100
Q

What is protime?

A

System measures PT according to the time it takes the blood to form a fibrin clot. PT test rests are reported as the number of seconds the blood takes to clot when mixed with a thromboplastin reagent.

101
Q

Tests for liver damage?

A

ALT, ALP, AST,