Lab and Diagnostic Studies Flashcards
3 Phases
- Pre-testing
- Testing
- Post-testing
Blood Samples
- Standard precautions
- Never recap need and dispose of sharps immediately.
- Obtained from venous or arterial
- Tubes are vacuum sealed and color coded based on test ordered
- Can be ordered STAT
Arterial Blood Gas (ABG)
- Obtained from artery not vein
- Done by respiratory therapist
- Usually radial artery, apply pressure to the site
- Place on ice and immediately take to blood gas analyzer
What do ALL blood samples have to be labeled with?
-Pt name, DOB, acct #
-Date & time of when it was drawn
-Initials of who drew it
-Site course for some specimens
Complete Blood Count (CBC); CBC w/ differential
-The CBC consists of a series of tests that determine the number, variety, percentage, concentrations and the quality of red and white blood cells. The differential measures the different amount of the WBC cell types.
-(Cellular component of blood):WBC (elevated with infection), [RBC, Hgb, Hct]- (low oxygen), Platelets (blood clotting increases if low), Leukocytes and monocytes formation.
Normally Venous
What are the two chemistry Panels?
- Basic metabolic panel/ profile (BMP) or Chem 7- Glucose, BUN, Creatinine, Sodium , Potassium, Chloride, Carbon Dioxide. (Glucose level may be elevated if non fasting/ diabetic)
-
Complete Metabolic panel/ profile (CMP) or Chem 14-
Includes the BMP plus calcium, albumin, total protein,
And liver enzymes
How many hours should a patient fast if a lipid panel is ordered?
12 hours
Electrolyte Reference Range
- Sodium (135-145mEq/L)
- Potassium (3.5-5mEq/L)
- Magnesium (2.6-2.2 mEq/L)
- Calcium (8.2-10.2)
- Chloride (97-107 mEq/L)
- Phosphate (2.5-4.5 mEq/L)
Coagulation Tests
Intrinsic system of blood clot formation
1. Partial Thromboplastin Time(aPTT)
Used to evaluate Heparin therapy
2. Anti-Xa- preferred
Used to evaluate plasma heparin levels
Extrinsic system of blood clotting
1. Prothrombin Time (PT)
2. International Normalization Ratio INR
Used to evaluate Coumadin/Warfarin therapy
Blood Cultures
(testing for infection)
- Draw when temp is rising
- Collect before starting antibiotics
- Clean skin
- Draw 2 cultures 40-60 minutes apart and from seperate sites
- Do NOT draw culture from IV catheter
- Draw 10-15ml of blood
Cardiac Enzymes
- CPK- “Creatine Phosphokinase”- muscle enzyme/protein
-
CK-MB- specific to myocardial cells
-After MI elevates to 4-6, peaks 24 hrs after, and remains for 3-4 days
3.Troponin- protein thats released into circulation 4-10 hrs after MI
-peaks at 12-48 hrs, remains for 10 days
-found in muscles of heart and released to blood stream when heart muscles are damaged.
Barium Swallow
-Indicated for pts with dysphagia, GERD, severe indigestion
-Assists in the diagnosis of strictures or tumors
-Requires consent, no jewlery, NPO 8 HOURS
Contraindicated in pregnancy
Post- laxatives, increase fluids, asses for GI bleeding
Computerized Axial Tomography
(CT Scans)
Abdominal and Pelvic CT Scans may require radiopaque contrast medium by mouth/ intravenous and require a period of NPO (4-12 hrs.)
Assess for seafood and iodine allergies
-Warm flushing sensation with IV contrast (feels like they are peeing)
Magnetic Resonance imaging
(MRI)
Especially useful to visualize cross-sectional images of organs, tissues and skeleton
No metal objects in the MRI room
May use intravenous contrast Gadolinium to help imaging
Magnetic Resonance Angiography
(MRA)
-MRI technology that takes images of the blood flow in blood vessels
-used to visualize vascular abnormalities
-USED INSTEAD OF ANGIOGRAPHY W/ PTS ALLERGIC TO IODINE