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ascpi > Laboratory Operations Review > Flashcards

Laboratory Operations Review Flashcards

1
Q

It is a recognition granted by non-governmental agency to institutions that meet certain standards. Voluntary.

A

Accreditation

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2
Q

It is a recognition granted by non-governmental agency to individuals who meet education requirements & demonstrate entry-level competency by passing exam. Voluntary.

A

Certification

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3
Q

Permission granted by state to individuals/organizations to engage in certain professions/businesses. Mandatory.

A

Licensure

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4
Q

What agency is the technical standards & accreditation of blood banks?

A

AABB (formerly American Association of Blood Banks)

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5
Q

What Agency issues standards & guidelines primarily related to infection control & safe work practices?

A

Centers for Disease Control & Prevention (CDC)

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6
Q

What Agency issues standards on all aspects of lab practice developed through voluntary consensus?

A

Clinical Laboratory & Standards Institute (CLSI)

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7
Q

What Agency issues standards to facilitate international exchange of goods & servicees. Developed through voluntary worldwide concensus?

A

International Organization for Standardization (ISO)

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8
Q

What Agency writes regulations for & enforces Clinical Laboratory Improvement Amendments of 1988?

A

Centers for Medicare & Medicaid Services (CMS)

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9
Q

What Agency interprets & implements federal regulations related to health care? It oversees CDC, CMS, FDA, SAMSHA.

A

Department of Health & Human Services (HHS)

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10
Q

What Agency regulates packaging, labeling, & transportation of biological wastes?

A

Department of Transportation (DOT)

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11
Q

What Agency regulated disposal of toxic chemical & biohazard outs wastes?

A

Environmental Protection Agency (EPA)

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12
Q

What Agency regulates market entry of instruments/reagents & production of donor blood & components. Licenses blood banks.

A

Food & Drugs Administration (FDA)

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13
Q

What Agency licenses labs that use radionucleotides?

A

Nuclear Regulatory Commission (NRC)

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14
Q

What Agency regulates employee safety in the workplace?

A

Occupational safety & Health Administration (OSHA)

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15
Q

What Agency certifies laboratories to conduct forensic drug testing for federal agencies?

A

Substance abuse and Mental Health Services Administration (SAMSHA)

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16
Q

What Federal regulation requires employers to inform employees about hazardous substances in workplace & educate them in safe handling?

A

Hazard Communication Standard (OSHA 1983) - “Right to know Law”

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17
Q

What Federal regulation regulates all lab testing (except research) performed on humans in U.S Requirements for personnel & quality assurance determined by test compelixty. Administered by CMS.

A

Clinical Laboratory Improvements Amendments of 1988 “CLIA ‘88”

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18
Q

What Federal regulation requires chemical hygiene plan to minimize personnel exposure to hazardous chemicals in labs?

A

Occupational Exposure to Hazardous Chemicals in Laboratories (OSHA 1990) “Laboratory Standard”

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19
Q

What Federal regulation mandates work practices & procedures to minimize worker exposure to bloodborne pathogens?

A

Bloodborne Pathogens Standard (OSHA 1991)

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20
Q

What Federal regulation requires monitoring of formaldehyde exposure?

A

Formaldehyde Standard (OSHA 1992)

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21
Q

What Federal regulation regulates the use & disclosure of protected health information (PHI)?

A

Health Insurance Portability and Accountability Act of 1996 “HIPAA”

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22
Q

What specimens are potentially infectious? (11 total)

A
  1. Blood
  2. Tissues
  3. Semen
  4. Vaginal secretions
  5. Cerebrospinal fluid
  6. Synovial fluid
  7. Pleural fluid
  8. Peritoneal fluid
  9. Pericardial fluid
  10. Amniotic fluid
  11. Saliva in dental procedures
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23
Q

What specimens are not USUALLY infectious (unless visibly bloody) (7 total)

A
  1. Feces
  2. Nasal secretions
  3. Sputum
  4. Sweat
  5. Tears
  6. Urine
  7. Vomitus
24
Q

What classification of hazard chemical shows visible destruction of human tissue on contact. It can also cause injury on inhalation or contact?

A

Corrosive

(e.g. Glacial acetic acid, Hydrocholic acid, Sodium hydroxide)

25
Q

What classification of hazard chemical interferes with metabolic processes when ingested, inhaled or absorbed though skin?

A

Toxic substances

(e.g. Cyanides, Sulfides)

26
Q

What classification of hazard chemical is capable of causing cancer?

A

Carcinogens

(e.g. Benzidine, Formaldehyde)

27
Q

What classification of hazard chemical induces genetic mutations and may cause defects in embryo?

A

Mutagens & teratogens (respectively)

(e.g. Benzene, Lead, Mercury, Radioactive materials, Toluene)

28
Q

What classification of hazard chemical causes fire?

A

Ingitables

(e.g. Acetone, Alcohol, Ether, Xylene)

29
Q

What classification of hazard chemical may cause explosion?

A

Reactives

(e.g. Ether, Perchloric acid, Picric acid, Sodium azide)

30
Q

How should you store acids?

A

Store below counter level or in acid cabinets.

a. Separate flammable & combustible.
b. Separate bases & active materials
c. Separate organic and inorganic acids.
d. Separate oxidizing from organic acids.

31
Q

How should you store bases?

A

Separate from acids, store inorganic hydroxide in polyethylene containers.

32
Q

How should you store flammables?

A

Limit amount in work area. Store in approved safety cans or cabinets.

33
Q

How should you store oxidizers?

A

Separate from reducing agents, flammable & combustible materials.

34
Q

How should you store water-reactive chemicals?

A

Keep away from water. Store in a dry, cool place.

35
Q

CLASSES OF FIRE

Give examples for Class A fire.

A

Cloth, wood, and paper

36
Q

CLASSES OF FIRE

Give examples for Class B fire.

A

Flammable or combustible liquids

37
Q

CLASSES OF FIRE

Give examples for Class C fire.

A

Electrical equipment

38
Q

CLASSES OF FIRE

Give examples for Class D fire.

A

Combustible metals

39
Q

CLASSES OF FIRE

Give extinguishers to use for Class A fire.

A

Pressurized water & Dry chemical

40
Q

CLASSES OF FIRE

Give extinguishers to use for Class B fire.

A

Dry chemical & CO2

41
Q

CLASSES OF FIRE

Give extinguishers to use for Class C fire.

A

Dry chemical & CO2

42
Q

CLASSES OF FIRE

Give extinguishers to use for Class D fire.

A

Leave to professional firefighters

43
Q

Give the stopper color and mode of action of EDTA

A

Lavander

Prevents clotting by cheating Ca2+ (calcium)

44
Q

Give the stopper color and mode of action of Heparin.

A

Green

Prevents clotting by neutralizing thrombin.

45
Q

Give the stopper color and mode of action of Sodium Citrate.

A

Light Blue

Prevents clotting by binding Ca2+ (calcium)

46
Q

Give the stopper color and mode of action of Sodium Flouride.

A

Gray

Inhibits glycolysis (not an anticoagulant)

47
Q

What is the recommended order of draw for venipuncture?

A

Blood culture (yellow)&raquo_space;> Citrate (Light Blue)&raquo_space;> Serum (Red/Gold)&raquo_space;> Heparin (Green)&raquo_space;> EDTA&raquo_space;> (Lavander)&raquo_space;> Sodium Flouride (Gray)

Rationale:
1. Blood Culture - Prevents bacterial contamination from needle that has pierced other stoppers.
2. Citrate - avoids contamination with additives that can affect coag results.
3. Serum - prevents alteration of results.
4. Heparin - prevents contamination from EDTA (decreased Ca2+)
5. EDTA - drawing before gray prevents contamination with oxalate, which alters cellular morphology
6. Gray

48
Q

Phlebotomy

What should you do if patient has an IV line.

A

Use opposite arm or perform fingerstick, if possible; otherwise, have the nurse staff turn off IV for 2 min, apply tourniquet below the IV line.

Document location of IV & Venipuncture.

49
Q

Phlebotomy

What should you do if there is a fistula?

A

Draw blood from the opposite arm.

50
Q

Phlebotomy

This is not usually performed by lab staff but what should be the proper collection from Indwelling lines & catheters, Heparin locks, cannulas?

A

First 5 ml drawn should be discarded. Lab may draw below Heparin lock if nothing is being infused.

51
Q

If the patient has sclerosed veins, how should phlebotomy be performed?

A

Select another site

52
Q

If the patient has hematoma, how should phlebotomy be performed?

A

select another site

53
Q

If the patient underwent mastectomy, how should phlebotomy be performed?

A

Draw from the opposite arm

54
Q

If the patient refuses, how should phlebotomy be performed?

A

Try to persuade. If unsuccessful, notify nurse. Never draw without consent; it could lead to charges of assault & battery.

55
Q

If the patient is an unidentified patient, how should phlebotomy be performed?

A

Ask nurse to ID before drawing

ascpi (3 decks)

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