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Phlebotomy > Module 6: Processing > Flashcards

Module 6: Processing Flashcards

1
Q

steps required for tests to be accurate

A
  • correct specimen collection
  • preparation for transport
  • handling
  • quality control
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2
Q

turnaround time

A

time it takes for the entire process including ordering, specimen collection, transportation, processing, analysis, and reporting

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3
Q

reference laboratory

A
  • lab outside of the patient care facility
  • perform more types of testing than those available at the average hospital lab
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4
Q

point of care (POC) tests

A

at or near the patient or at the patient’s bedside

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5
Q

steps of handling and transporting

A
  • mixing the sample
  • creating aliquots
  • adding diluents
  • centrifuging
  • packaging the labeled specimen in a biohazard bag
  • following thermal and light sensitivity procedures
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6
Q

aliquot

A

divide specimen into smaller portions

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7
Q

how to mix additives into blood sample

A
  • gently invert as soon as possible after collection
  • do not shake: hemolysis
  • not mixing enough: formation of clots
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8
Q

thermolabile specimens

A
  • sensitive to high temperatures
  • use heat source or heat blocks to regulate temperature
  • use ice slurries, refrigerators, or freezers for chilling purposes
  • do not use cold or ice packs
  • avoid fluctuating temperatures
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9
Q

photosensitive specimens

A
  • abnormal reaction to or change resulting from exposure to light
  • protect from light
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10
Q

special handling of ammonia

A

let blood tube sit in an ice slurry immediately after collection

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11
Q

special handling for lactic acid

A

let blood tube sit in an ice slurry immediately after collection

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12
Q

ice slurry

A

thick mix of water and ice

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13
Q

special handling for cold agglutinins

A

sample remains at body temp (37 C or 98.6 F)

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14
Q

special handling for bilirubin

A

wrap the blood tube in foil

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15
Q

special handling for vitamin A

A

amber bag

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16
Q

special handling for folate

A

wrap the blood tube in foil

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17
Q

special handling for blood gas tests

A
  • store at room temperature for 15 to 30 minutes or in an ice slurry for up to 1 hr
  • speedy delivery to prevent loss of gases from the blood prior to analysis
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18
Q

special handling for coagulation tests (other than PT)

A
  • analysis takes place within 1 hr of collection
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19
Q

special handling for prothrombin time (PT)

A
  • coagulation tests should be analyzed within 1 hr of collection
  • a delay of up to 24 hrs at room temp will not affect the results (22 C or 71.6 F)
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20
Q

what specimens require centrifuging

A

specimens requiring separating the serum or plasma from the cells

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21
Q

two types of centrifuge rotors and what tests they are best for

A
  • flat gel barrier: immunoassay and chemistry tests
  • angled gel barrier: problematic for some chemistry tests
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22
Q

steps of centrifuging

A
  • pre-centrifugation: handling and processing of specimens after collection and before centrifugation
  • centrifugation: processing of specimens by spinning at high speeds in a centrifuge
  • post-centrifugation: handling and processing of specimens once centrifugation process is complete and removal of serum or plasma is necessary
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23
Q

delay in separating plasma from cells should not exceed

A

2 hrs

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24
Q

what should a specimen with no anticoagulant added do before centrifugation

A

clot

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25
Q

how long does clotting take at room temperature

A

30 to 60 minutes

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26
Q

does chilling a specimen make clotting go faster or slower

A

slower

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27
Q

how is a blood sample separated when centrifuging

A
  • heavy components (blood cells) move to the bottom
  • lighter components (serum, plasma) move to the top
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28
Q

how do you know the speed and time to centrifuge a specimen

A

check manufacturers guidelines

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29
Q

affects of inadequate centrifugation

A
  • portions of blood cells can remain in the plasma and serum
  • incomplete formation of the barrier gel
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30
Q

how to place tubes in the centrifuge

A
  • with stoppers and caps on
  • balanced to prevent breaking
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31
Q

when is it best to remove serum or plasma from a blood sample

A
  • immediately after centrifugation
  • no longer than 2 hrs later
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32
Q

generally, how long should plasma and serum remain at room temp before testing

A
  • no longer than 8 hrs
  • otherwise, it needs refrigeration
  • testing after 48 hrs requires freezing
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33
Q

when should you aliquot a specimen

A

right after completing the centrifugation process

34
Q

how to aliquot a sample

A
  • hold the empty tube adjacent to the specimen tube
  • use a disposable pipette to transfer the serum (without cells) from the specimen tube to the aliquot tube
  • label the specimen
35
Q

how to package specimens

A
  • in original specimen tubes or plastic screw-cap transfer tubes
  • absorbent materials
  • watertight primary containers
  • watertight secondary containers (resealable bags, plastic canisters, foam boxes)
  • strong outer packaging (fiberboard boxes or mailing tubes, wooden boxes, rigid plastic containers)
  • coolants (ice packs, dry ice) if necessary
36
Q

what should you do before placing a specimen in a biohazard bag

A

label the specimen with the pts full name, date and time of collection, and the source and type of specimen

37
Q

timed blood tests

A
  • glucose tolerance test
  • 2 hr postprandial blood glucose level
  • peak and trough values, often for antibiotics
38
Q

how long after refrigeration should you process a urine specimen

A

1 hour

39
Q

how to transport a urine specimen to a reference lab

A
  • use evacuated tubes containing preservatives
  • use disposable pipette or pour into tube
40
Q

how long to keep urine at room temp for urinalysis with chemical reagent strip testing

A

no longer than 72 hours

41
Q

how long to keep tubes at room temp for culture and sensitive tests

A
  • up to 72 hours
  • refrigerate if there is any delay
42
Q

what should be completed on the lab requisition form for transportation to other sites for analysis

A
  • pt name
  • date
  • type of test
  • order provider’s name
  • ICD-10-CM code for diagnosis
  • provider signature
43
Q

what tests can have altered results due to delays between collection and processing

A
  • phosphorus
  • glucose
  • aldosterone
  • calcitonin
  • enzymes
44
Q

hand delivery

A
  • directly to reference lab
  • use necessary carrying devices (trays, carts, tube racks, leakproof containers)
45
Q

pneumatic tube systems

A
  • usually in an inpatient setting
  • efficient
  • used to send and receive specimens, pt records, medications, and bills in a hospital
46
Q

what tests are particularly affected by hemolysis

A
  • potassium
  • plasma hemoglobin
  • lactate dehydrogenase
  • acid phosphatase
  • coagulation
47
Q

automated carrier delivery

A

transport vehicle within facility

48
Q

chain of custody

A

process that maintains control of and accountability for each specimen from the time of collection to the time of disposal

49
Q

things required on the chain of custody form

A
  • name of pt, body, subject, or object the specimen came from
  • name of person who obtained and processed the specimen
  • date, location, and signature of the person attesting that the specimen is the correct one and matches the documentation
  • signature and date from every person who has possesion of the specimen for any amount of time
50
Q

situations requiring the chain of custody process

A
  • forensic analysis
  • drug testing
  • blood alcohol content testing
  • occasionally: DNA analysis, rape test kits, parentage testing
51
Q

forensic specimens

A
  • rape, crime scenes, autopsies
  • toxicology testing of substances after poisoning or substance abuse
  • can be in any condition
52
Q

Federal Drug Testing Custody and Control Form (CCF)

A
  • for drug testing
  • documents handling and storage information for specimens from the time they are obtained to their final disposal
53
Q

what can urine drug tests usually detect

A
  • marijuana use within the past week
  • use of cocaine, heroin, an other illegal drugs within the past 2 days
  • do not measure degree of impairment or frequency of use
54
Q

types of drug testing

A
  • workplace
  • sports-related
  • neonatal
55
Q

workplace drug testing

A
  • ensures compliance with federal regulations and company policy
  • improves health an safety of employees
56
Q

sports-related drug testing

A
  • detects use of stimulants that enhance athletic performance
  • analyzes blood and urine to detect blood doping (injections of blood cells to increase endurance) or use of erythropoietin (med for chemo pts, boost RBC production)
57
Q

neonatal drug testing

A
  • detects cocaine, opiates, amphetamines, methamphetamines, and phencyclidine which cause prenatal drug exposure and neonatal abstinence syndrome (withdrawal)
  • specimen within 24 hours after birth to detect recent drug use
  • specimen 24-72 hours after birth to confirm maternal drug use
58
Q

most accurate method to identify alcohol level

A

blood specimen

59
Q

what is lab information systems software used for

A
  • transmitting test requisitions
  • creating specimen labels, collection lists, and schedules
  • monitoring and updating specimen records
  • storing, reporting, and sending results
  • submitting charges on pt account
  • maintaining records of procedures, policies, and inventory
60
Q

manual systems

A

require human interaction during pre-examination, examination, and post-examination steps in the testing process

61
Q

semi-automated systems

A

parts of the testing process require little to no human input

62
Q

automated systems

A

require human intervention only when errors occur

63
Q

advantages of automated computer systems

A
  • fewer clinical or documentation errors
  • timely and accurate reports
  • overall higher quality of patient care
64
Q

information to input in semi-automated and automated methods of lab processing

A
  • pt identification data (name, sex, date of birth)
  • order provider’s info
  • tests ordered
  • date, time, and source of specimen collection
  • special notes, other clinical data
  • insurance or billing info
65
Q

examples of informatics used in practice

A
  • bar codes
  • quick response (QR) codes
  • radio frequency identification (RFID)
66
Q

critical value

A
  • test result that is significantly above or below the expected reference range
  • could indicate a life-threatening situation
  • requires an immediate response to the ordering provider
67
Q

POC and CLIA waived tests that can be inserted into automated clinical analyzers for fast and accurate results

A
  • electrolytes (sodium, potassium, chloride, calcium, magnesium)
  • hematology (WBCs, RBCs, Hct, Hgb)
  • glucose, hemoglobin A1c
  • cholesterol (HDL, LDL, total cholesterol, triglycerides)
  • blood coagulation (PT, INR)
68
Q

rapid antigen detection test

A

identifies streptococcal pharyngitis

69
Q

when to complete quality controls on a glucometer

A
  • opening new package of test strips
  • several tests have been significantly out of range
  • changing batteries
70
Q

what should you look at on a glucometer before testing every pt

A

compare the code on the glucometer with the code on the strips

71
Q

how to provide results to clinical staff for POC testing

A

directly or by logging the data in the EHR

72
Q

what information should you document when sharing verbal results

A
  • pt name
  • pt ID number
  • name of the person receiving the report
  • date and time
  • detailed result information
  • orgination of the report or results
73
Q

most common and secure means for transmitting lab test results to providers

A

electronic reports

74
Q

temperature for cryoglobulin specimen

A

37 C or 98.6 F

75
Q

what info should be used to access a pts medical records

A

pt identification number

76
Q

what symptom can low blood glucose cause

A

rapid heartbeat

77
Q

example of information in the laboratory information system

A

previous lab results

78
Q

does stat or asap have a higher priority

A

stat

79
Q

what to do if you receive an unlabeled specimen

A
  • recollect the specimen
  • treated as a rejected specimen
80
Q

tests required for reproductive testing on a female pt

A

FSH and LH

Phlebotomy (9 decks)

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