L4: Specimen Handling and Processing Flashcards
approximately ___% to ___% of lab errors occur prior to analysis
46% to 68%
gentle inversion of the specimen tube evenly distribute the ___
it is usually between __ to __ gentle inversions
additive
3-10
rough handling of specimen results to ? (4)
- hemolyze specimens
- activate platelets
- affect coagulation
- break the test tube
the specimens should be transported with the ___
stoppers
the specimens should be placed in a liquid-tight closure plastic bags with a visible ___ logo and a slip pocket for paperworks
biohazard
the specimen will ___ or ____ if allowed to cool below body temp
precipitate, agglutinate
specimens should be transported at a near ___ temp
37 degrees or body temperature
what to use when transporting specimens?
how many mins can it hold from removal from the incubator?
portable heat blocks
15 mins
this can be used for specimens that can withstand a temperatureslightly higher than 37 degree celsius
heel warmer
when dealing with chilled specimens, the specimen tube should be completely submerged in crushed __ amd __ slurry during transport an immediately ___ or ___ , if necessary
ice, water
tested, refrigerated
it slows the metabolc process
chilling
exposure to light can affect the result of a specimen
light-sensitive specimen
when dealing with light-sensitive specimen, the phlebotomist should wrap the tube with _______ or use _____, _____-colored container
aluminum
light-blocking
amber
the routine blood specimen is expected to reach the lab within? centrifugation needed by the specimen should be done in ____?
45 mins
1hour
hematology specimens with ___ should not be centrifuged
EDTA
this specimen is marked as ___ or ___ which takes priority over all other specimens
STAT or emergency
- Blood smear from EDTA specimen - prepared ___ from collection
- EDTA specimen for CBC - analyzed wihin ___ but is stable ___ from collection if stored at room temperature
- EDTA specimen for erythrocyte sedimentation rate (ESR) determination - tested ___ (room temp) and ___ (refrigerated)
- EDTA specimen for reticulocyte counts - stable for ___ (room temp) and ___ if refrigerated
- glucose test drawn in sodium fluoride tubes - stable for ___ (room temp) but stable for up to ___ when refrigerated at 2 - 8 degrees celc
- Prothrombin time (PT) - stable for ___ and partial thromboplastin time (PTT) should be analyzed within ___ from collection
- 1hour
- 6 hours, 24 hours
- 4 hours, 12 hours
- 6 hours, 72 hours
- 24 hours, 48 hours
- 24 hours, 4 hours
used to separate cells, plasma, or serum of blood specimens
centrifuge
____ is achieved by spinning the blood tubes inside the vessel at a high speed such that the ____ force will cause the separation of the specimens
centrifugation, centrifugal
it is important to leave the stoppers on the tube before and during centrifuge to ? (4)
- contamination
- evap
- aerosol formation
- pH changes
true or false. the process of centrufugation should not be repeated
true
the plasma specimen collected in tubes with ____ should be centrifuged immediately without delay
serum specimen needts to be completely ___ prior to centrifugation
anticoagulants
clotted
complete clotting takes around __ to __ minutes at room temp
30 - 60
used to cover the stopper to catch drops of blood that may leak or to prevent the aerosol that may be released during the process
gauze/ tissue
________ refers to a portion of a sample specimen taken for chemical analysis or testing. It is prepared when multiple tests are ordered on a single specimen
________ method of dividing or separating specimens into separate containers
aliquot
aliquoting
RA 11058
Occupational Safety and Health Standards Act (OSHA)
What law states about required protective equipment worn when processing specimen
OSHA / RA 11058
Hemolyzed specimens can affect ____, _____ and most ___ tests
potassium, magnesium, enzyme
inadequate mixing of anticoagulated tubes results to? (2)
micro clot formation, erroneous test results
inadequate mixing of gel seperation tubes results to?
clotting may be incomplete
TRUE OR FALSE: if non-additive tube, then do not mix
true
in transporting specimens, the primary container must have 2 compartmenets:
with ___ logo
sample and requisition form
biohazard
- system that propels cylindrical containers through networks of tubes by compressed air or by partial vacuum
- more traumatic
- faster delivery
Pneumatic Tube System / Pneumatic Tube Transport (PTT)
Extreme temperature results to rupture of ____
RBCs
documentation of proper sample identification from the time of collection to the receipt of laboratory results
chain of custody
needed when handling blood specimens to protect its condition and quality
special care
specimens ___ at cold temperature
precipitate
these are proteins that precipitate at cold temperature
cold agglutinins, cryoglobulin, cryofibrinogen
Tests that require chilling of specimen
Adrenocorticotropic hormone (ACTH)
Acetone
Ammonia
Acid Phosphatase
Catecholamines
Lactic acid
Parathyroid hormone
pH/blood gases
chilling of uncentrifuged blood will elevate __?
potassium
routine blood specimens should arrive at the laboratory within _______ of collection
Specimens that require separation of the serum or plasma from the cells should be centrifuged within ______
45 mins
1 hour
maximum time limit for separating serum and plasma from the cells is ______ from time of collection
2 hours
Serum tubes that have not been spun within 2 hours or refrigeration of serum tubes before centrifugation will : (2)
increase potassium, increase glucose
Non-additive and gel-barrier serum tubes (SSTs): completely ____ before centrifugation
Heparin gel-barrier tubes (PSTs) : can be ______ right away
clotted
centrifuged
Specimens in gel-barrier tubes do not require ______ separation
manual
_________: after specimen collection and beforecentrifugation
_________: when the specimen is in the centrifuge
_________: after centrifugation and before removal of serum or plasma
Precentrifugation
Centrifugation
Postcentrifugation
Allow blood in nonadditive, clot activator, and gel-containing tubes used for serum tests (e.g., SSTs) to clot for the serum to separate from the cells
precentrifugation
specimens taht may take longer to clot (3)
◦ patients on anticoagulant medications, heparin or warfarin (e.g., Coumadin)
◦from patients with high WBC counts
◦ chilled specimens◦from patients with coagulopathies (bleeding disorders)
tubes with clot activators clots within ____
tubes with thrombin clots in ______
30 minutes
5 minutes
complete clotting can be determined by ____ or ____ the tube gently
tilting/ inverting
Rimming the tube with an applicator stick to release the clot from the walls of the tube is a potential source of ______ and ______
hemolysis/ contamination
specimens that require separation of the serum and plasma from the cells should be ____ within ____
centrifuged; 1 hour
maximum time limit for separating serum and plasma from the cells is __ hours from time of collection
2
Serum tubes that have not been spun within 2 hours or refrigeration of serum tubes before centrifugation will : (2)
increase potassium, decrease glucose
prevents glycolysis
sodium fluoride
SST: completely ___ before _____
PST: can be _____ right away
clotted; centrifugation
centrifuged
_________: after specimen collection and before centrifugation
_________: when the specimen is in the centrifuge
_________: after centrifugation and before removal of serum or plasma
precentrifugation
centrifugation
postcentrifugation
Allow blood in nonadditive, clot activator, and gel-containing tubes used for serum tests (e.g., SSTs) to clot for the serum to separate from the cells
precentrifugation
________ is a process in which centrifugal force is used to separate solid matter from a liquid suspension
________ machine that spins blood and other specimens at a high number of revolutions per minute (rpm) or centrifugal force
centrifugation
centrifuge
centrifugation:
___ minutes at 750 g to 1000g
___ minutes at 1000 g
15
10
in centrifugation, removing the stopper will result to: (4)
Aerosol formation
pH changes (loss of CO2 which can increase pH)
Evaporation (leads to concentration of analytes)
Contamination
drop of sweat, interferes with _______ results
electrolyte
powder from gloves, interferes with _____ determinations
calcium
TRUE OR FALSE: specimen can be centrifuged more than once
FALSE. specimen should never be centrifuged more than once
Repeated centrifugation can cause: (3)
- hemolysis
- analyte deterioration
- alter test results
check the speed using a strobe light or a ______, an instrument designed for measuring rpm
tachometer
STAT chemistry tests - _________ tubes to save time; reduce turn-around time (TAT)
green top heparin
serum on gel barriers can be stored up to ___ hours at 4°C
48
after centrifugation, the normal color is?
yellow
Icterus
- descp:
- increased:
Lipemia
- descp:
- increased:
Hemolysis:
- descp:
- indication:
- increased:
Icterus
- descp: dark yellow
- increased: bilirubin
Lipemia
- descp: cloudy, turbid
- increased: lipids
Hemolysis:
- descp: pink/ red
- indication: underlying condition, error in collection
- increased: K+, ammonia, phosphate, enzymes
TRUE OR FALSE: Pouring the serum or plasma into aliquot tubes is recommeded
FALSE. not recommended because it increases the possibility of aerosol formation or splashing
