Mod 3 - Pt Preparation Flashcards by Samantha Lee

what should be on the lab requisition form

pt full name
pt DOB
pt sex
specific identification/medical record number
tests ordered

How well did you know this?

Not at all

Perfectly

in addition to the most basic info, what may be on the lab requisition form

specific precautions/concerns
date & time of collection
billing info
diagnostic coding
specific preparations/restrictions prior collection
priority

How well did you know this?

Not at all

Perfectly

define FASTING

not eating or drinking anything except water for generally 8-12 hours

How well did you know this?

Not at all

Perfectly

define BASAL STATE

condition of rest and fasting for at least 12 hours and typically in the morning upon waking

How well did you know this?

Not at all

Perfectly

if a facility does not use pt labels, what should be recorded on the blood tubes

date & time of collection
your initials
pt full name & DOB
other specific indicators

How well did you know this?

Not at all

Perfectly

the timing of an individual’s basal state is based on when they

wake up

How well did you know this?

Not at all

Perfectly

what questions should be asked before venipuncture

any allergies (specifically latex)
have you eaten/drinken anything
have you taken any medications
do you faint at the sight of blood
arm preference

How well did you know this?

Not at all

Perfectly

what should be done when a pt feels faint

stop procedure
have pt lower head & take deep breaths
loosen any tight clothing around the enck
apply a cold compress on forehead or back of neck

How well did you know this?

Not at all

Perfectly

how long should be a pt be observed for if they faint/feel faint

15 min

How well did you know this?

Not at all

Perfectly

what can be done when anticipating for a fainting episode

lock arm of phlebotomy chair

How well did you know this?

Not at all

Perfectly

acetaminophen can falsely

elevate levels of liver enzymes

How well did you know this?

Not at all

Perfectly

some blood pressure meds can affect

glucose, sodium, and potassium levels

How well did you know this?

Not at all

Perfectly

how can alcohol affect blood results

affect coagulation activation and platelet reactivity

How well did you know this?

Not at all

Perfectly

alcohol can affect coagulation activation and platelet reactivity especially in pts with

diabetes mellitus

How well did you know this?

Not at all

Perfectly

t/f: chewing gum can affect fasting blood results

true

How well did you know this?

Not at all

Perfectly

the effects of smoking on blood are

elevation of several coagulation factors

How well did you know this?

Not at all

Perfectly

vigorous exercise can cause

coagulation activation

How well did you know this?

Not at all

Perfectly

how long should a pt rest before venipuncture if they exercised recently

15-30 min

How well did you know this?

Not at all

Perfectly

what are some complications of venipunctures

excessive bleeding/bruising
hematoma
severe pain/lack of sensation
infection

How well did you know this?

Not at all

Perfectly

what should be done if gauze becomes soaked with blood after venipuncture

apply pressure and ice until pt further evaluated by provider

How well did you know this?

Not at all

Perfectly

if a pt experiences severe pain, numbness, or tingling in the venipuncture arm, this may indicate

nerve damage

How well did you know this?

Not at all

Perfectly

what may be used when the nerve was accidentally hit during a venipuncture but depends on facility policy

ice

How well did you know this?

Not at all

Perfectly

t/f: hematomas can evolve info infections

true

How well did you know this?

Not at all

Perfectly

hematomas may be referred to as

bruises

How well did you know this?

Not at all

Perfectly

which vein has a higher incidence of nerve involvement

basilic vein

why are ankle and foot veins the last choice veins

difficult to access, easy to injure, often painful

blood should never be collected from the ankle/foot if the pt has

diabetes mellitus or peripheral vascular disease

what should be done if a vein cannot be palpated

have them place the arm below the heart

when an IV is involved, where should the blood be drawn

above catheter insertion site

blood should not be drawn from an arm that has ____ bc it can compromise circulation and damage it

arteriovenous fistula/shunt for hemodialysis

blood should not be drawn from an arm that has ___ bc it can be damaged

central venous access device

blood should not be drawn from arm on the same side as a recent ____ bc it can cause swelling, injury, or infection

mastectomy

blood should not be drawn from a site that has ___ bc it can alter test results and be painful

edema

blood should not be drawn from a site with ___ bc it will be difficult and painful

scarring

blood should not be drawn from a site that has __ bc it can alter test results, be painful, increase risk of nerve damage, or cause permanent damage to circulation

hematoma

what veins are poor candidates for venipuncture

sclerotic, thrombotic, phlebitic, fragile, tortuous

define SCLEROTIC VEINS

hard, inflexible, and narrow veins

why are sclerotic veins poor candidates

difficult to puncture and painful

cause of sclerotic veins

aging and constant blood draws on same site

aka TORTUOUS VEINS

varicose veins

why are tortuous veins poor candidates

easy to push needle completely through vein wall

why are fragile veins poor candidates

painful and generally needs multiple sticks to collect enough blood

define FRAGILE VEINS

thin, weak, and difficult to puncture; they collapse easily on palpation and don't refill quickly

fragile veins are common in

elderly, newborn, and peds pts

define PHLEBITIC VEINS

tender and warm veins with red area and may have clots

why are phlebitic veins poor candidates

difficult to puncture and painful

infants younger than ___ should have a capillary heel stick

12 months

when doing an infant heel stick, never use a lancet that punctures deeper than

2 mm

generally how much urine is enough for a random urine testing

30-60 mL

urine begins to deteriorate within ___ of collection

30 min

what are instructions for clean-catch urine for men

- don't let anything besides urine tough the lid/inside of cup - wash hands - retract foreskin and clean meatus in a circular outward motion - pee a little in toilet then into the cup and then finish in the toilet

what are the instructions for a clean-catch urine for women

- don't let anything besides pee touch the inside of cup or lid - wash hands - separate labia and wipe with towelettes front to back - pee a little in toilet, then cup, then in toilet while still holding labia separated

how does a 24 hour urine collection start

begins at specific time by peeing into toilet then recording start time

what may make the 24 hour urine collection invalid

pt pees into toilet at any time during 24 hour period

how should the urine be kept during a 24 hour urine collection

in the refrigerator/on ice

what is the normal range for urine pH

5.5-8

bacteria grows better in

alkaline environments

unrefrigerated urine becomes more

alkaline

specific gravity of urine is usually

1.010-1.025

highly concentrated urine can be a sign of

dehydration

WBC and nitrates in urine indicate

infection

hemoglobin in urine can indicate

bleeding, infection, cancer, kidney disease, chemical poisoning, and other pathology

define KETONES

products of fat metabolism

ketones in urine can signify

diabetes mellitus, starvation, vomiting

bilirubin in urine may signify

liver disease or RBC destruction

protein in urine can signify

inflammation, infection, kidney disease, or chemical poisoning

glucose in urine can signify

diabetes mellitus

stool samples should not be refrigerated if they are being tested for

parasites

what should be avoided when doing a stool sample

contaminating feces with urine or toilet water

what are some pre-testing instructions for fecal occult blood test

- do not eat red meat, citrus, or raw veggies 3 days before collection - do not take vitamin C or aspirin 3 days before collection

FOBT stands for

fecal occult blood test

when should sputum be collected

in the morning before eating or drinking anything or doing any oral hygiene

what are the instructions for collecting a sputum sample

- take a deep breath - cough forcefully and deeply and cough up the sputum into the container - do not spit saliva into the container - close the lid, clean the outside of the container, put the label on

how much sputum should be in a sample

generally 1-2 teaspoons

semen samples must reach the lab within

1-2 hour of collection

t/f: the pt should avoid mixing or inverting the container after collecting specimen while doing a 24 hour urine collection

false: the container should be gently mixed and inverted after each sample is added

U R COLLECTIG A SPECIMEN TO TEST PT'S LITHIUM LEVEL AFTER RECENT DOSE OF MEDS. WHICH LEVEL SHOULD BE COLLECTED a) random b) trough c) fasting d) peak

d) peak

what types of urine specimen should be collected for a pregnancy test

first-morning

U R DOING A VENIPUNCTURE ON A PT WITH AN IV IN BOTH ARMS. WHAT SHOULD U DO a) ask the nurse to turn the IVs off for 1 min b) apply tourniquet above IV site c) ask nurse to turn IVs off for 2 min d) ask nurse to remove 1 IV

c) ask nurse to turn IVs off for 2 min

what statement should the CPT say when prepping to collect a blood sample for a cholesterol test

sit for at least 5 min before the test