exam Flashcards
how much blood volume should be collected in a short amount of time for infants? And how do you calculate?
- 10%
- multiply kg by 100 then multiply by the percent
how to clean site for blood cultures? which bottle first?
- clean with alcohol or chlorhexidine gluconate for 60 secs allow to dry completely then clean again with povidine iodine
- aerobic
how are routine screenings for newborns collected? how do you collect it?
- specific forms/cards that contain filter paper
- avoid touching the filter paper; puncture no deeper than 2mm; wipe off 1st drop of blood; touch; has to soak through completely in each circle
what urine test requires fasting?
glucose tolerance test
what urine test has you void and then eat?
postprandial
what urine test has you discard 1st morning urine then collect the rest?
24-hour
what urine test uses clean catch midstream?
culture and sensitivity
what immunization is available to all employees?
hep B
1st order of draw
additive: sodium polyanethol sulfonate(SPS)
color: yellow or bottles
inversions: 8-10
lab: blood cultures
2nd order of draw
additive: sodium citrate
color: light blue
inversions: 3-5
lab: PT, PTT, D-dimer, fibrinogen, factor assay
what do blood cultures test for?
bacterial infections etc
3rd order of draw
no additive
clot activator in plastic
color: red
inversions: 3-5 plastic none:glass
labs: Chemistry dept.
bilirubin, hepatitis, thyroid panel, vitamins, Cryoglobulins, cold agglutinins, troponins
4th order of draw
additive: serum separator gel (SST)
color: gold/mottled red
inversions: 3-5
lab: Chemistry dept(same as red tube) plus the following:
basic metabolic, electrolytes, hcg, comprehensive metabolic panel, renal/ kidney function, creatine
5th order of draw
additive: rapid serum separator
color: orange
inversions: 3-5
Same as SST tubes but for stat order
6th order of draw:
additive: heparin (prevents thrombin)
color: green
inversions: 8-10
lab: routine chemistry, chromosome, genetic studies
7th order of draw
additive: EDTA with or without separator gel
color: lavender/ pearly white
inversions: 8-10
lab: CBC, hemoglobin, hematocrit, platelet, estimated sedimentation rate, factor v, HBA1c, ammonia
8th order of draw
additive: EDTA
color: pink
lab: blood bank collections
9th order of draw:
additive: EDTA free of trace elements
color: royal blue
lab: trace element, toxicology, nutrition
10th order of draw
additive: EDTA lead free
color: tan
lab: lead levels
11th order of draw
additive: sodium fluoride, potassium oxalate (anticoagulant) (prevents deterioration of glucose)
color: grey
inversions: 8-10
lab: glucose, blood alcohol level, lactic acid
12th order of draw
additive: acid citrate dextrose(acd)
color: yellow
inversions: 8-10
lab: DNA analysis, paternal testing
what are standard precautions? what are some of them?
- precautions taken with all patient encounters
- washing hands, wearing gloves
what are transmission based precautions? what are some?
- additional precautions taken when a patient is sick
- wearing additional ppe
what are droplet precautions? what are some diseases? what additional precautions should you take?
- additional precautions taken when patients have infections that spread via droplets larger than 5 microns
- meningitis, rubella, diphtheria, mumps, pertussis(whooping cough), flu, kneumonia
- wear a mask
what are contact precautions? what are some diseases? what additional precautions should you take?
- required for patients with infections that spread via contact
- diptheria, herpes, scabies, hep a, would/skin infection, MRSA, c diff
- wear gown
what are airborne precautions? what are some diseases? what additional precautions should you take?
- required for patients with infections that spread via droplets smaller than 5 micron
- chickenpox, tuberculosis, measles
- wear N95/N99 respirator
what do you cleanse with when doing a blood alcohol test?
povidone iodine unless allergic
what sites aren’t used for venipuncture?
- above IV
- arm with arteriovenous shunt
- arm with central venous access device
- same side as mastectomy
- with edema
- site with scarring
- sitee with hematoma
what does requisition include?
- dob
- full name
- sex
- specific identification numbers
can include space to document, billing info, and diagnostic coding
peak of medication
2 hrs after administered
ask nurse when administered
through of medication
test 15 mins before next dose
ask nurse when administered
fasting
usually 8-12 hrs with nothing to eat or drink besides water
capillary order of draw
- blood gas
- EDTA
- heparin
- additive specimens
- serum
glucose levels
70-110
wbc levels
4.4-11
cholesterol levels
140-200
troponins t levels
0-0.2
urine temp
32C- 38C
warming technique
encase warm towel in plastic bag
what do you do with arterial blood gas?
place in an ice bath
what can cause hemolysis?
- not inverting tubes
- using too small of a needle
- oull to forceful on syringe
- handling roughly
- overtight tourniquet or leaving it longer than one min
6.
what can cause hemoconcentration?
- not removing tourniquet when blood flow is established
- if patient just sat up straight from supine position
- pumping fist during venipuncture
how to doff ppe
gloves, goggles,gown, mask
how to don ppe
gown, mask, goggles, gloves
what are sclerotic veins?
hard, inflexible, narrow
what are tortuous veins? varicose
twisted and lack elasticity
what are thrombotic veins?
hard, inflexible, blood clot
what are phlebitic veins?
tender warm and red area around it
what does nerve damage feel like?
numbness, pins/needled, pain shooting down arm
what’s phlebitis?
inflammation of blood vessel
what’s thrombosis?
blood clot
what’s petechiae?
small red dots below tourniquet
symptoms of shock?
cold, clammy, pale skin, rapid pulse, shallow breathing
how long do serum tubes need to clot before centrifugation?
30 mins
how long do rapid serum tubes need to clot?
5mins
what does heparin prevents?
clotting
when your using a butterfly needle for light blue tubes…
you have to use a non additive tube to start blood flow
how do you label every type of collection container immediately after collection?
- patients name
- date and time of collection
- specimens type
what do you send specimens to the lab in?
plastic biohazard bags with seals
how to use filter paper?
- apply blood to printed side
- don’t add a second drop
- wipe off 1st drop of blood
- don’t touch puncture site to paper
- allow to dry for at least 4 hrs
is a medical record number an acceptable identifier?
yes
when do you centrifuge serum tubes?
before transportation
where do you drop blood for peripheral blood smear?
1mm of blood one half inch from edge of slide
why is capillary order of draw different?
blood clots more quickly
procedure for fecal occult?
- avoid taking ibuprofen
- collect for 3 days
- consume high fiber diet
- keep cards at room temp
how much urine for a drug test?
45ml
what do you do if a person is donating blood and bag fills halfway and vein collapses?
use a new collection bag to draw a new unit
syncope
pale diaphoretic
seizure
involuntary movement before hand
what is a safety data sheet?
where chemicals must be clearly labeled and all possible hazards are clearly communicated
what are the 4 categories of hazards in lab environment?
- chemical (flammable)
- biological (Bloodborne)
- physical (ergonomics)
- safety
ergonomics definition
science of designing equipment, areas, and work tasks to make them safer
how can hazards in the workplace be controlled?
- safety devices
- setting rules
- work practices
- ppe
guidelines dealing with chemical hazrds
- don’t use chemicals you aren’t trained to use
- wear appropriate gloves when using disenfectant
- don’t store food/drink near chemicals are used/stored
- dont eat or drink anything you don’t know origin of
- don’t keep food/drink in lab/drawing station
- ## know where eyewash stations, sinks, showers etc are
guidelines for physical hazrads
- pay attention to ergonomics
- standard precautions
- pay attention to signs, lights, for xray/radiation exposure
- use ear protection when working with loud machines
how do you respond to a fire?
PASS
- pull pin
- aim at base of fire
- squeeze handle
- sweep back and forth at base
RACE
- remove anyone from danger
- activate alarm or call 911
- contain fire if possible by closing all doors/windows
- extinguish fire
