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
Positron Emission Tomography
(PET)
-Radioactive tracer injected via IV with glucose molecule & gamma ray emissions are detected to plot images
Used to detect cancer, cancer metastasis, neurological disorders, and mycardial perfusion exams to determine lack of blood flow to heart muscles
DO NOT HAVE CONTACT WITH KIDS OR PREGNANT WOMEN FOR 24 HOURS
Ultrasound
Examples: echocardiogram, sonogram, doppler studies
Electrocargiogram
(ECG/EKG)
Records electrical activity of the heart
Detects conduction problems such as arrhythmias and areas of damage or ischemia
NO hair on chest
patient must lay down with minial activity
Echocardiogram
(2 Types)
- Transthoracic (Ultrasound type)
- Transesophageal echocardiogram
-transesophageal echo (TEE)uses a long, thin, tube (endoscope) to guide the ultrasound transducer down the esophagus (“food pipe” that goes from the mouth to the stomach)
-allows for pictures without lungs and ribs in the way
Cardiac Stress Tests
(3 Types)
-
Stress EKG
* Most common type
* Resting EKG is done followed by EKG monitoring while on a stationary bike or treadmill
* Blood pressure, cardiac arrythmias and symptoms like chest pain or difficulty breathing are assessed -
Nuclear stress test
* A radioactive tracer is injected intravenously
* An image of the heart is taken at rest and again after the heart is stressed either by exercise or medication induced -
Stress Echo testing
* Like the nuclear stress test but uses ultrasound technology to capture images of the heart pre and post cardiac stress.
Angiography
An imagingtestthat uses X-rays to view the body’s blood vessels and to study narrow, blocked, enlarged, or malformed arteries or veins in many parts of your body, including the brain, heart, abdomen, and legs
Sterile procedure, NPO after midnight, done in a surgical setting
A long, narrow catheter is inserted into an artery located in the arm, upper thigh, or groin
Contrast dye (which improves visualization) is injected into the catheter and X-rays images of the blood vessels are taken. (Assess for allergies to Iodine)
A mild sedative helps the person relax.
Vital signs are monitored during the procedure and post-op. Assess the site for bleeding
Endoscopic Procedures
- Done in a surgical setting
- NPO after midnight
- General Anesthesia is used in most cases
- No driving for 24 hours following the procedure
- May require special preoperative preparation (colonoscopy)
Examples: endoscopy (GERD/Nausea), colonoscopy(blood in stool/abdominal pain), bronchoscopy (Chronic Pneumonia), cystoscopy (UTI’s/Cysts,Bladder)
