L3: Special Collection and POCT Flashcards
are non-routinelaboratory test that may not only involve additionalpreparation and procedure but may require other specimensuch as urine or feces. These can be applied for specialcases such as blood donation.
SPECIAL COLLECTION PROCEDURES
determines the blood type nd Rh factor
Blood Bank: Blood Type and Screening
check the compatibility of the blood between the donor and paient
Blood Bank: Cross-match test\
determines the presence of infection, extent of infection, and the type of microorganism involved
blood culture
evaluates the blood clotting function
coagulation test
screening for diabetes and other metabolic disorders
2 hour postprandial glucose
diagnose problem in carbohydrate metabolism and checks the ability to metabolize glucose thru the tolerance level test
Glucose Tolerance Test & Oral Glucose Tolerance Test
Determine the lack of mucosal lactasewhich is responsible for conversion oflactose into glucose.
Lactose Tolerance Test
is responsible for conversion of lactose into glucose.
mucosal lactase
Verifies the probability that the patientfathered a particular child.
Paternity/ Parenting testing
Tests the drug levels at specific interval toestablish proper drug dosage and avoid toxicity.
Therapeutic Drug Monitoring
Used as treatment to polycythemia and hemochromatosis
Therapeutic Phlebotomy
Checks the presence of toxins in the blood, hair, urine, and other substance
toxicology test
Checks for presence of aluminum, arsenic,copper, lead, iron, and zinc
trace elements
TRace Elements Checks for presence of ? (6)
aluminum, arsenic,copper, lead, iron, and zinc
Blood Bank: Cross-match test’s special requirement
patient’s serum/ plasma, donor’s rbc
Blood Culture’s special requirement
blood volume should be 20-30 mL for each culture
If >80 lbs, should be minimum of 10 per draw
for infants, it should be only 1% to 4% of total blood volume
______ are avoided by gently inverting ______ tubes three or four times from collection
Microclots; anticoagulants
special requirement for 2-hour postprandial glucose
must be obtained 2hrs after the meal
special requirement for GTT and OGTT
1 hour for gestational diabetes and 3 hours for other glucose metabolism evaluation.
special requirement for Lactose Tolerance Test
Same procedure as 2-hour GTT but anequal amount of lactose is substituted for glucose.
special requirement for paternity testing
Follows the chain-of custody protocol andspecific identification procedures.
special requirement for Therapeutic Drug Monitoring
Collection timing should include the peak and trough level.
special requirement for Therapeutic Phlebotomy
Involves withdrawal of approximately 500mL as part of the treatment.
special requirement for Toxcology test
Toxins usually exist in very small amounts
special requirement for Trace Minerals
Measured in small amounts
infos required for blood bank tests
1.Full name including middle initial
2.Hospital ID Number
3.Social Security Number for outpatients
4.Date of Birth
5.Date & time of collection
6.Initials of the phlebotomist.
can use special identification systems suchas ID bracelet (self-carbon adhesive for specimen), BloodID band (linear bar-code), and Siemens PatientIdentification check-blood administration.
blood banks
______ includes typing the blood for _____ and ______ for infectious diseases. The blood type (ABO)and Rh factor (+ or -) are determined.
screening
transfusion and screening
this test is necessary in orde to eliminate blood related compatibility issues that may arise between the patient and the donor.
cross-match test
Blood donor collection is done mainly for the purposes of _____
blood transfusion
blood donors should be
___ to ___ years of age
minimum weight of ____ lbs
completed the __ exam and declared their _____
18-65
110
physical exam and medical history
the patient donates blood for his use especially for elective surgeries.
autologous donation
blood of the patient is salvaged (during surgical procedure),washed and re-infused after testing for residual free hemoglobin.
cell salvaging
A blood culture is a test that checks the blood forpathogens for patients who have a ____
Fever of Unknown Origin (FUO)
PRESENCE OF BACTERIA IN THE BLOOD CAUSES _____
PRESENCE OF MICROORGANISM AND TOXINS IN THE BLOOD THAT CAUSES _______
BACTEREMIA
SEPTICEMIA
The physician orders this test only if there is a probabilityof bloodstream invasion.
BLOOD CULTURE
BLOOD CULTURE
For optimum results, the collection should have 2-4 blood culture sets placed in special bottles, one _____ (with air) and one _____ (without air), that were drawn __ to __ minutes apart.
aerobic; anaerobic
30-60
prevents the contamination by microbial flora in the skin which can be introduced in blood culture bottles and affect the results
Skin antisepsis
3 Media Inoculation Methods
(1) directly into the bottle (during collection),
(2) collected in a syringe (after collection)
(3) through an intermediate collection tube (in the laboratory).
is performed in thelaboratory rather than the patient’s bedside.
Intermediate Collection Tube
When using the _____ method, blood is transferred to the ____ bottles after completing the draw using a safety transfer device which is activated as soon as the needle is removed from the site.
syringe, culture
The blood specimen is then collected using a light bluetop with ______ with the correct (9:1) blood to coagulant ratio
3.2% citrate tube
in coagulation test, if the colected specimen is unable to reach the lab within ___ hours, it should be ____ and the plasma ____
4; centrifuge;frozen
this blood test is used to monitor insulin therapy
2-hour Postprandrial Glucose
The principles of 2-hour PP specimen collection are:
1. A ______ diet was introduced 2 to 3 earlier.
2. The patient should fast at least ____ hours prior to the test.
3. _____ _____ specimen maybe be collected before the start of the procedure.
4. A special breakfast containing an equivalent of ____ glucose or a glucose beverage will be given on the day of the test.
5. Blood glucose specimen will then be collected ___ hours after the meal.
high-carbohydrate
10
Fasting glucose
100g
2
GTT procedures
Before the procedure the patient must eat balanced meal containing approximately ____ of _________ for __ days and must fast for __ to __ hours before the scheduled test. Drinking water is allowed to avoid dehydration and because urine specimen is also collected as part of the test.
150g
carbohydrates
3
12-16
for GTT procedure, The fasting specimen is drawn and the glucose level is checked and should be over ____ mg/dL for the test to proceed.
200
glucose beverage dose:
adults? children? gestational diabetes?
should be ingested within?
adults - 75g
child - 1g per kg of weight
gestational diabetes - 50-75 g
5 mins
GTT Procedure
Record the time when the drink was finished then start timing the test whichis collected within ___ minutes, 1 hour, 2 hours and so forth
transfer specimen within?
30
2hrs
_________ and __________follows after ingestion of milk or food containing lactose for those who lack the lactase enzyme.
Gastrointestinal distress and diarrhea
lactose tolerance test is administered at least __ day bef lactose tolerance test
1
If the patient is lactose intolerant, the result will yield a “___” curve where glucose levels just slightly rise over the fasting level
flat
for paternity testing, Should the result does not exclude alleged parent further test is performed which include ___ (6)
extended red cell antigens, red cell enzymes, serum proteins testing, white cell enzymes, white cells antigen, and human leukocyte antigen (HLA).
most advanced technology to date.
DNA paternity testing
principles of DNA paternity testing are:
1. All involved parties need to submit a government issued photoidentification along with the completed ________ form. The photos of all tested parties are also taken.
2. The _____ samples as collected by using a swab that was rubbed inside the cheek and the loose cheek cells adhere to the swab.
3. Sealed and tamper-evident package are used to hold the specimen during transportation to the laboratory.
4. The test results are ready after __ hours which are usually sent viamail.
Chain of Custody
Buccal
48
legal consequences oftoxin exposure
orensic toxicology
______ test involves collection of blood, hair,urine and other substances from the body for the purpose of determiningthe presence of toxins which could be in very small amounts.
toxicology
most common specimen for toxicology tests are _____ and ____ for alcohol.
breath; blood
For forensic specimen, there is a need to track the specimen from the time of collection until the time that the results are released using aspecial protocol called __________
chain of custody
characterized by excess iron deposits in the tissues which could be due to problems with iron metabolism as are sult of multiple blood transfusions or excessive intake of iron.
hemochromatosis
the overproduction of red blood cells which is harmful to the patient. A hematocrit test is used to check the RBC level and removal of blood is done when level exceeds a certain level with the goal of returning the levels to normal range
polycythemia
______ (ethanol [ETOH]) tests are usually ordered forpurposes related to treatment but could also be for industrial or jobrelated purposes such as insurance claims or programs andemployee drug screening.
Blood alcohol
The law enforcement department orders _______ for individuals involved in traffic related accidents.
blood alcohol concentration(BAC)
The ETOH test requires chain of custody. true or false?
false
for blood alcohol speciments, Use _______ glass tubes for specimen collection.These tubes could be with anticoagulant but it depends on the need of the required specimen for a specific test.
gray-top sodium fluoride
Companies, healthcare organizations and sports associations subject their potential employee to drug screening as part of their preemployment requirement
drug screening
in drug screening, the specimen used is?
what protocol is strictly implemented?
urine; chain of custody protocol
any analytical test that is done outside the centralized laboratory and near the site where the patient receives treatment.
Point-of-Care Testing (POCT)
The testing ranges from a simple procedure as a dipstick, ______ which is handheld, and up to automated molecular test using analyzers and imaging systems that are portable. These tests are notonly convenient, but it also shortens the turnaround time (TAT).
glucometer
Warfarin and heparin therapy can be evaluated using a ______
Coagulation POCT analyzer
POCT instruments available
Cascade POC —ACT, APTT, PT/INR
CoaguChek XS Plus —PT/INR
GEM Premier 4000 —ACT, APTT, PT/INR
i-STAT —ACT, PT/INR
Verify Now —platelet function
a non-instrumented test ordered by the physician to evaluate the capillaries for platelet plug formation whichis indicative of disorder in the platelet function or problems incapillary integrity.
bleeding time
This test is also used for pre-surgical screening and detection of problems involving hemostasis. Although platelet function assays (coagulation test) has been mostly ordered in place of BT, it is still requested in some occasion.
bleeding time
measures the level of oxygen,carbon dioxide and acid-base (pH) in the patient’s blood which givesthe physician an idea about the status of the function of your lungs,heart and kidneys.
arterial blood gas (ABG)
pH refers to the concentration of hydrogen ions in a solution. The _______ test checks the balance of the acid-base level which shows the metabolic and respiratory status of the patient.
arterial pH
normal range in arterial blood gases
7.35 to 7.45
an indicator on how well air is exchanged between the blood and lungs. The test shows the measure of pressure exerted by dissolved CO2in the blood plasma in proportion to the PO2in thealveoli.
PCO2
when the PCO2level increased to an abnormallevel while hyperventilation is when it decreases.
Hypoventilation
representative of the pressure exerted by the dissolved O2 and the ability of the lungs to diffuse oxygen through the alveoli which isusually used to measure the effectiveness of an oxygen therapy. Anormal person exhibits 98% oxygen saturation.
PO2
The _______ in the body mainly aid in moving nutrients in thebody and removes wastes in the cells of the body.
electrolytes
in electrolytes, ______ helps keep the normal balance of fluids in the body and also plays a role in transmitting nerve impulses. An elevated level of sodium is called ______ while reduced level is known as _______.
sodium ; Hypernatremia ; hyponatremia
