Exam 3: Chap 30-32 Flashcards
Urine is composed of
95% water and 5% waste products
Organic waste products of urine
urea, uric acid, ammonia, and creatinine
Polyuria
excessive urine
Causes of polyuria
excessive intake of caffeinated fluids, certain drugs (diruetics), DM, DI, and renal disease
Oliguria
decreased urine output
Urine collection for pregnancy test
first-morning voided specimen
Urine collection for UTI testing
clean-catch midstream
Why would you want a first-voided morning specimen?
it has the greatest concentration of dissolved substances and could easily detect presence of abnormal substance
Why would you want a clean-catch midstream specimen?
to remove and examine bacteria
Urine collection for chlamydia and gonorrhea testing
first-catch specimen with a nucleic acid amplification test
Prep for a first-catch specimen
pt should not urinate for at least 1 hr prior to collection
Amount of specimen for a first-catch collection
15-30 mL
____ contains the greatest concentration of chlamydia and/or gonorrhea bacteria, if present
first 15-30 mL
Urinalysis consists of what exams
physical, chemical, and microscopic
Time frame urinalysis needs to be preformed
within 1 hr of fresh or preserved specimen; if not then put closed container in fridge
Signs of a jeopardized urine sample
alkaline, cloudy, broken down blood cells, and decomposed casts
physical examination of urine
color, appearance, odor, and specific gravity
chemical examination of urine
pH, glucose, protein, ketone, bilirubin, urobilinogen, blood, nitrite, and leukocytes
Glucose in urine may indicate
diabetes
Protein in urine may indicate
strenuous exercise (temp), filtration problems, renal disease, and bacterial infection of urinary tract
Ketones in urine may indicate
DM, starvation, and keto diet
Ketones are products of
fat metabolism
Bilirubin is normally excreted into
bile
Bilirubin in urine may indicate
gallstones, hepatitis, and cirrhosis
Nitrite in urine may indicate
presence of a pathogen; UTI
Leukocytes in urine accompanies
inflammation of the kidneys and lower urinary tract
Storage of reagent strips
cool, dry area away from direct sunlight, with the cap tightly closed to maintain reactivity of the reagent
Pregnancy tests rely on which hormone
human chorionic gonadotropin
How do we identify the pt
name and DOB
If the pt is prone to fainting during venipuncture, what position should they be placed in?
semi-fowlers
Purpose of a tourniquet?
make the veins easier to palpate
How long do we leave the tourniquet on for?
less than 1 min
Where do we place the tourniquet?
3-4 inches above the site
First vein of choice to draw blood
median cubital
What do we never use to palpate the vein?
thumb
Why are hands the last resort for drawing blood?
veins roll and are likely to collapse due to the thin walls
anticoagulant will separate into what layers
plasma, buffy coat, and blood cells
no anticoagulant is
serum
what results when blood is centrifuged without anticoagulants
serum
what results when blood is centrifuged with anticoagulants
plasma
What color tube do we use when we need whole blood?
lavender because it as anticoagulant
What do we do after we use the needle?
put on safety device
What needle gauge is commonly used
21
Tube size depends on
specimen
What additives are in the lavender tube?
EDTA
What additives are in the red tube?
nothing
What additives are in the grey tube?
sodium fluoride and sodium oxalate
What additives are in the blue tube?
sodium citrate
What tube is used for a CBC panel?
lavender
What tube is used for a PTT exam?
blue
Why shouldn’t we use an expired tube?
it loses its vacuum
Why do we invert the tube but never shake it?
shaking may cause hemolysis
Butterfly technique is aka
winged infusion method
Needle insertion at more than 15 degrees may cause
needle to go through vein; no blood
How do we prevent the needle from moving?
anchor the vein
What needle do we use for a pt w/ a collapsed vein
butterfly
What do we do when the site of the needle begins to swell?
remove the needle
If we do not remove the tourniquet before removing the needle
blood will gush out
What do we do if the pt faints during venipuncture?
stop procedure and lay them on floor
Serum is plasma with what component removed
fibrinogen
The SST tube stands for how long before centrifuged
45 mins
What happens if you do not let enough time pass before centrifuging the SST tube?
may not get enough serum
The SST tube contains what additive?
clot activator
What do we do after drawing the SST tube?
invert 5x
How do we anchor a vein?
pulling to the side underneath
Order of the draw
yellow, blue, red/marble, green, lavender, gray
Serum appearance
clear and yellow
Dissolved substances in serum
glucose, cholesterol, sodium, potassium, chloride, antibodies, hormones, and enzymes
Purpose of hematocrit
measure the percentage volume of packed RBCs in whole blood
What type of test is done on pts undergoing long-term warfarin therapy?
PT/INR
Warfarin
anticoagulant; inhibits formation of blood clots, makes it longer for blood to clot
plasma vs serum
plasma has anticoagulant
serum has clotting factors
