PMLS LEC Flashcards

1
Q

________________ is the ideal specimen for respiratory function evaluation due to the _________________________ and ______________________

A

ARTERIAL BLOOD GAS, consistency of its composition, high oxygen content

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2
Q

Information/s provided by the ABG test

A
  1. Oxygenation
  2. Ventilation
  3. ACID- BASE BALANCE
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3
Q

Patients with diabetes or other metabolic disorders use __________________________ to manage the electrolyte and acid-base tolerance

A

ARTERIAL BLOOD GAS

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4
Q

The accuracy of the test for ABG is easily affected by _______________________

A

Pre-analytical Errors

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5
Q

A calculation of non-respiratory part of acid-base balance

A

Base excess

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5
Q

A measure of acidity or alkalinity of blood

A

pH

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6
Q

Partial pressure of O2, dissolved in arterial blood

A

PaO2

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7
Q

Partial pressure of CO2, dissolved in arterial blood

A

PaCO2

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8
Q

A measure of bicarbonate in the blood

A

HCO2

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9
Q

Percent of O2 bound to hemoglobin

A

O2 Saturation

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10
Q

NORMAL RANGE FOR pH

A

7.35- 7.45

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11
Q

Normal range for PaO2

A

80-100 mmHg

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12
Q

Normal range for PaCO3

A

35-45 mmHg

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13
Q

Normal range for HCO2

A

22-26 mEq/L

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14
Q

Normal range for 02 saturation

A

97% - 100%

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15
Q

Normal range for Base excess

A

(-2)-(+2) mEq/L

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16
Q

The process in which the site gets blood supply from more than one artery

A

Collateral Circulation

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17
Q

Criteria used for selecting arterial puncture:

A
  1. There is collateral circulation (evaluated through portable ultrasound instrument or by modified Allen Test)
  2. Artery is large and accessible
  3. Surrounding tissue of puncture site have little risk of injury
  4. Area is free from inflammation, irritation, etc.
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18
Q

3 Main sites for arterial puncture

A
  1. Radial Artery
  2. Brachial Artery
  3. Femoral Artery
    (other sites include the dorsalis pedis and scalp for infants)
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19
Q

The most commonly used site located at the thumb site of the wrist

A

Radial Artery

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20
Q

Advantage of this Puncture Site includes:
- Good Collateral Circulation
- Easy to Palpate (Close to the skin)
- Less chance of Hematoma formation after collection

A

RADIAL ARTERY

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21
Q

Disadvantage of this Puncture Site includes:
- Necessitates considerable skill to puncture because it is small in size
- Difficult to locate in patients with hypovolemia or low cardiac output
- Arteries of the arm and hand

A

RADIAL ARTERY

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22
Q

Advantage of this Puncture Site includes:
- Relatively easy to puncture and palpate due to size
- Sometimes the preferred artery for a large volume of blood
- Adequate collateral circulation (not as good as radial)

A

BRACHIAL ARTERY

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23
Q

Located in the medial anterior of the antecubital fossa

A

Brachial Artery

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24
Q

Disadvantage of this Puncture Site includes:
- Deeper and can be harder to palpate than the radial artery
- Lies close to the basilic vein; risk of mistakenly puncturing it
- Lies close to median nerve; risk of pain and nerve damage
- Increased risk of hematoma formation

A

BRACHIAL ARTERY

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25
Q

Located in the Groin lateral to the pubic bone

A

FEMORAL ARTERY

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26
Q

Advantage of this Puncture Site includes:
- Large Easily palpated and punctured
- Sometimes only the site where Arterial Sampling is possible

A

Femoral Artery

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27
Q

Disadvantage of this Puncture Site includes:
- Poor collateral circulation
- Lies close to the femoral vein; increased risk of mistakes in puncturing
- Increased risk of infection because of location and pubic hair
- Risk of dislodging plaque build-up from inner artery walls
- Requires extended monitoring for hematoma formation

A

FEMORAL ARTERY

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28
Q

Necessary requisition information for ABG includes:

A
  • Body Temperature
  • Respiratory rate
  • Ventilation status
  • Fraction of inspired oxygen (FIO)
  • Prescribed flow rate in liters per minute
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29
Q

The Phlebotomist must wear the following before the ABG procedure:

A
  • Gloves
  • Masks
  • Lab gowns, coats, or aprons.
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30
Q

Volume of syringe used for ABG

A

1 to 5 ml self-filling syringe

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31
Q

Temperature ABG specimen is subjected after collection before analysis

A

4 Degrees Celsius

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32
Q

PATIENT PREPARATION INCLUDES:

A
  • Identification and explanation of Procedure
  • Patient Preparation and Assessment
  • Steady State
  • Modified Allen Test
  • Administration of local anesthetic (Optional)
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33
Q

The patient should be resting in a comfortable position for __________________ or ____________________________

A

5 minutes, until breathing of the patient become stable

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34
Q

The patient should be stable or in stable state for __________________ before the Allen test is performed

A

20 to 30 minutes

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35
Q

Why is isopropyl alcohol used for disinfection for ABG procedure

A
  • Isopropyl Alcohol does not affect certain analytes tested for ABG
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36
Q

Angle of needle for application of Local Anesthetics

A

10 Degrees

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37
Q

After the application of anesthetics wait _________________ before continuing to the ABG procedure

A

2 Minutes

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38
Q

In radial artery puncture, position the arm, palm up, and wrist extended to approximately __________________ angle

A

30 Degree

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39
Q

In radial artery puncture insert the needle at a ____________ angle

A

30 to 45 Degree

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40
Q

Hazards and Complications of ABG procedure includes:

A
  • Arteriospasm
  • Artery Damage
  • Discomfort
  • Infection
  • Hematoma
  • Numbness
  • Thrombus Formation
  • Vasovagal response
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41
Q

involuntary contraction of artery.

A

Arteriospasm

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42
Q

results from repeated punctures.

A

Artery Damage

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43
Q

can be avoided by using local anesthesia

A

Discomfort

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44
Q

observe proper preparation in the pre-analytical
phase.

A

Infection

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45
Q

avoid multiple punctures

A

Hematoma

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46
Q

should be addressed and reported

A

Numbness

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47
Q

must be reported to the nurse/physician

A

Thrombus formation

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48
Q

remove the needle, activate the safety device,
maintain pressure over the site, and follow the syncope procedure

A

Vasovagal response

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49
Q

SAMPLE ERROS INCLUDE

A
  1. Air bubbles were not expelled from the sample
    2.Processing exceeded optimal time
    3.Sample was not mixed properly or immediately
    4.Syringe was used improperly
    5.Venous blood was obtained by mistake
    6.Improper anticoagulant was used
    7.Incorrect volume of heparin used
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50
Q

CRITERIA FOR REJECTION

A
  1. Air bubbles are found in specimen
    2.Specimen has clotted
    3.Specimen has hemolyzed
    4.Submitted specimen did not comply with proper labeling
    5.Prescribed transportation temperature was not met
    6.Specimen did not meet the required volume or QNS
    7.It took so much time to reach the laboratory
    8.Wrong type of syringe was used
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51
Q
  • Considered the most efficient system for collecting blood sample
  • A closed collection system in which blood flows through a needle inserted into a vein and directly into a collection tube
  • Prevents exposure to air or outside contaminants
  • Allows numerous tubes to be collected in a single venipuncture
A

Evacuated tube system

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52
Q

Consists of a double-pointed needle
multisample needle, needle safety
device, a holder, and color-coded
evacuated tubes

A

Evacuated Tube System

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53
Q

Routine venipuncture: _____ or ___-gauge with ____ or
____ inch length

A

21, 22, 1, 1.5

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54
Q

Children and patients with small veins: ___ or ____
gauge with ___ inch length

A

22, 23, 3/4

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55
Q

Types of safety devices in ETS

A
  • Safety Shield
  • Blunting Devices
  • In-vein retraction device
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56
Q

The air pressure inside the tube is _______, ____________ the
normal environment, which creates the vacuum in the tube

A

negative, less than

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57
Q

ETS Order of Draw

A

1.Sterile tube (blood culture)
2. Blue-top coagulation tube
3.Serum tube w. or w/o. clot activator or gel
4.Heparin tube tube w. or w/o. gel plasma
separator
5.EDTA tube
6.Glycolytic inhibitor tube

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58
Q

Special Handling Procedures for ammonia, lactic acid, blood gases samples

A

Put on Crushed Ice

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59
Q

Special Handling procedures for cold agglutinin, cryoglobulin

A

Keeping it warm

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60
Q

Special Handling Procedure for Bilirubin

A

Protect from light

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61
Q

it is the collection, testing, preparation, and storage
of blood from donors who are usually volunteers.

A

Blood Donation

62
Q

The Blood donation process usually takes _________ minutes and it safe, simple, and rewarding procedure

A

45-60

63
Q

Donors should be at least ____ years
old weighing ____________ at the
minimum and should be generally
healthy.

A

16, 110 pounds

64
Q

Blood donation Process

A

Donor Screening
Donor Registration
Medical History
Donor Interview
Physical Examination
Guidance on Venipuncture for Blood Donation
Preparing the Venipuncture Site
Collecting the Unit
Adverse events in Blood Donation
Donor Care Post Phlebotomy
Donor Blood Processing
Donated Blood Labelling

65
Q

The donor is asked about his/her
health, lifestyle, and disease risk
factors. All the details provided
are confidential.

A

Donor Screening

66
Q

The donor needs to complete a
donor registration form which
includes his/her name, address,
and other demographic
information.

A

Donor
registration

67
Q

the donor will have to confirm if
he/she has any healthy issues and
disease risk factors.

A

Medical
history

68
Q

the donor will have a brief
interview with the healthcare
personnel to ensure that the
donor has met general donor
requirements.

A

Donor
interview

69
Q

a short health exam (pulse,
temperature, and blood pressure) will
be conducted and a drop of blood from
the donor’s finger will be tested to
ensure that his/her blood iron level is
suitable for blood donation.

A

Physical
examination

70
Q

a short briefing on the procedure will
be given by the health personnel.

A

Guidance on
venipuncture
site

71
Q

donor will be led to the donor area where the arm
is cleaned with antiseptic and the vein for
venipuncture is selected.

A

Preparing the venipuncture site

72
Q

the unit of blood will be collected by the health
personnel.
A blood donation kit will be used to draw blood
from the vein in the donor’s arm.

A

Collecting the unit

73
Q

One unit of blood takes about ___ minutes to
complete.

A

6-10

74
Q

Healthcare personnel must monitor the donor for
adverse effects during and after blood collection.
Donors should remain seated for a few minutes
before leaving to ensure they aren’t dizzy from the
procedure.

A

Adverse events
in blood
donation

75
Q

the venipuncture site should be inspected and
refreshments should be offered to the donor
before he/she leaves the area.

A

Donor care post phlebotomy

76
Q

the collected blood unit is prepared and placed in
the proper container for transport to the
processing area.

A

Donor blood
processing

77
Q

the information indicated on the label found in
the blood unit must be double-checked. It should
be complete and accurate.

A

Donated blood labeling

78
Q

Blood Donation Areas must be made of cleanable surfaces such as ________, and kept clean and disinfected by ____________________________ solutions.

A

Vinyl, sodium hypochlorite bleach

79
Q

used to minimize contaminations
from skin flora and to obtain the first 20mL of blood.

A

Diversion pouches

80
Q

a sterilized lancet (single used) is utilized, and the collected blood should immediately be placed in a safety box.

A

Hemoglobin testing

81
Q

Remove the tourniquet in Blood Donation after __________________________ or after ____________________

A

the blood flow is established, two (2) minutes

82
Q

Mix collected blood with anticoagulant gently either
manually or by continuous mechanical mixing during
the donation procedure observing approximately a ______ seconds interval

A

30

83
Q

Determines the blood type and Rh Factor

A

Blood Bank: Blood Type and Screen

84
Q

Checks the Compatibility between the donor’s and the recipient’s blood

A

Blood Bank: Cross-Match Test

85
Q

Determines the presence of infection, identifies the type of organism involved, and measures the extent of infection

A

Blood Culture

86
Q

Evaluates the blood clotting function

A

Coagulation Studies

87
Q

Screens for diabetes and other metabolic disorders

A

2-hours Postprandial Glucose

88
Q

Diagnoses problems in carbohydrate metabolism and checks the ability to metabolize glucose through the tolerance level

A

Glucose Tolerance Test (GTT) and Oral Glucose Tolerance Test (OGTT)

89
Q

Determines the lack of mucosal lactase which is responsible for conversion of lactose into glucose

A

Lactose Tolerance Test

90
Q

Verifies the probability that the patient fathered a particular child

A

Paternity/ Parentage Test

91
Q

Tests the drug levels at specific intervals to establish proper drug dosage and avoid toxicity

A

Therapeutic Drug Testing

92
Q

Treats polycythemia and hemochromatosis

A

Therapeutic Phlebotomy

93
Q

Checks the presence of toxins in the blood, hair, urine. and other substances

A

Toxicology Test

94
Q

Checks the presence of aluminum, arsenic, copper, lead, iron, and zinc

A

Trace Elements

95
Q

in collecting blood bank specimen, use _______ tube or _______ tube as altermative

A

EDTA, Red-top

96
Q

Blood donors should be __ to ___ in age, while also weighing at least ______ pounds

A

17 to 66, 110 lbs.

97
Q

patients donate their own blood to themselves

A

Autologous Donation

98
Q

test that checks the blood for pathogens for patients who have a fever of unknown origin (FUO)

A

Blood Culture

99
Q

blood culture requires ___ to ____ blood culture sets placed in 2 bottles: one with _________ and one without _____________

A

2 to 4, with air or aerobic, without air or anaerobic

100
Q

Coagulation Specimen tests include the following:

A

PT- Prothrombin Time
aPTT- Activated Partial Thromboplastin Time
TT- Thrombin Time

101
Q

If coagulation specimen is drawn, draw a clear tube with ______ ml to discarded prior to collection

A

1-2

102
Q

This Blood Test is done to check if the patient is suffering from diabetes

A

2-Hour Postprandial Glucose (2 hour PP)

103
Q

a P/x suffering from carbohydrate metabolism problems is subjected to ______________________________

A

glucose tolerance test

104
Q

in GTT procedure the Patient must eat a balanced diet meal containing appx. ______ grams of carbohydrates for ______ days, and must fast for ______________ hours before testing

A

150g, 3 days, 12 to 16 hours

105
Q

Glucose Beverage dose for Adults

A

75g

106
Q

Glucose Beverage dose for children

A

1g per kg of weight

107
Q

Glucose Beverage dose for Gestational Diabetes

A

50g to 70g

108
Q

measures the ability of the body to process lactose and determines if the patient lacks mucosal lactase

A

Lactose Tolerance Test

109
Q

an enzyme that converts lactose into glucose or galactose

A

Mucosal Lactase

110
Q

Consequence of consuming milk or food containing lactose for those who lack the lactase enzyme

A

gastrointestinal distress and diarrhea

111
Q

is performed by drawing a large volume of blood about 500ml from the patient as part of the treatment procedure for polycythemia and hemochromatosis

A

Therapeutic Phlebotomy

112
Q

overproduction of blood cells that is harmful to the patient

A

Polycythemia

113
Q

characterized by excess iron deposits in the tissues which could be due to problems with iron metabolism cause by multiple blood transfusions or excessive iron intake

A

Hemochromatosis

114
Q

Detection of toxins and treatment

A

Clinical Toxicology

115
Q

legal consequences of toxin exposure

A

Forensic Toxicology

116
Q

any analytical test that is done outside the centralized laboratory and near the site where the patient receives treatment

A

POCT - Point of Care Treatment

117
Q

Non instrumentalized test ordered by the physician to evaluate the capillaries for platelet plug formation, which is indicative of disorder in the platelet function or problems in capillary intergrity

A

Bleeding TIme

118
Q

________________ helps keep the balance of fluids in the body as well as plays a role in transmitting nerve impulses

A

Sodium

119
Q

elevated levels of sodium in the body

A

Hypernatremia

120
Q

reduced levels of sodium in the body

A

Hyponatremia

121
Q

an electrolyte that helps in nerve conduction and muscle function

A

Potassium

122
Q

Increased levels of potassium in the blood

A

hyperkalemia

123
Q

Decrease levels of potassium in the blood

A

hypokalemia

124
Q

maintains the integrity of the cells by helping balance the osmotic pressure as well as the acid-base balance of the body

A

Chloride

125
Q

Checking the presence of human chorionic gonadotropin in the urine or serum

A

Pregnancy Test

126
Q

Gauge the effectiveness of the thrombolytic therapy being administered to patients who have suffered from heart attacks

A

Cardiac Troponin T (TnT) and Troponin I (TnI)

127
Q

measures the alanine transferase (ALT) of patients under lipid-lowering medication

A

Lipid Testing

128
Q

Measures the volume of the red blood cells

A

Hematocrit

129
Q

checks the hemoglobin level to manage patients suffering from anemia

A

Hemoglobin

130
Q

Test for the Intrinsic Pathway

A

Activated Partial Thromboplastin Time

131
Q

Test for the Extrinsic Pathway

A

Prothrombin Time

132
Q

also known as skin puncture is a method that uses a lancet to make a small incision into the capillary bed of the skin to obtain a small volume of blood specimen

A

Capillary Puncture

133
Q

These are sterile, sharp instruments
ONLY intended for one-time use
Designed for use in making cuts in the skin for finger or heel puncture.

A

Lancet

134
Q

Produces a small hole in the skin by vaporizing the water in the skin
Eliminates the risk of sharp injury
Used in 2 types of Capillary Puncture: (1) Finger Puncture Lancet & (2) Heel Puncture Lancet.

A

Laser Lancet

135
Q

Also known as microtubes, container is a small plastic tube
HOLDS the blood specimen collected in the capillary puncture
MARKINGS to show minimum and maximum levels
Occasionally comes with a narrow capillary tube

A

Microcollection Tubes

136
Q

Narrow bore tubes that are made of either plastic or glass
Typically used for hematocrit determination
Can hold 50 to 75 µL to be filled with a capillary system
One end is usually sealed with sealants made of clay or plastic

A

Hematocrit Tubes

137
Q

Used for blood films for hematology determinations

A

Microscope Slides

138
Q

Used to increase the blood flow seven-fold by warming the puncture site.

A

Warming Devices

139
Q

bright red blood found in the pulmonary vein, left chamber of the heart and the arteries
oxygenated blood in the circulatory system

A

Arterial Blood

140
Q

blood that travels from the peripheral veins passing through the venous system then through the right chamber of the heart
deoxygenated blood in the circulatory system and dark red in color

A

Venous Blood

141
Q

prefered specimen for infants, young children, elderly patients, and patients with severe burns
extracted from the venules and arterioles found in the capillary bed

A

Capillary Blood

142
Q

fills the spaces around the cells, filtered from the blood capillaries, drained away as lymph

A

Interstitial Fluid

143
Q

found inside the cells, facilitates the movement of fluid in the membrane, blocks the entrance of unwanted materials

A

Intracellular Fluid

144
Q

Capillary Blood concentration of the glucose in the blood is ________ while protein (TP), calcium (Ca4+), potassium (K+) concentrations are _______

A

higher, lower

145
Q

Order of Draw for Capillary Puncture

A

Blood Gas
Microscope Slides
EDTA
Other Anticoagulated Tubes
Serum Tubes
Newborn Blood Spot Card

146
Q

is a blood test that is used to check abnormalities in the blood cells

A

Routine blood film/smear preparation

147
Q

is used to determine if the patient has malaria, which is diagnosed by its presence in the peripheral blood smear.

A

Thick Blood Smear

148
Q

Newborn screening blood spot collection is done ________ hours after the baby is born

A

24 to 48

149
Q

The site for capillary puncture should be warmed for _________ minutes

A

3 to 5 Minutes

150
Q

detects gastrointestinal bleeding

A

Occult Blood

151
Q

check contact with allergens and determines if the body has developed antibodies

A

Skin Test

152
Q

detects and evaluates infection, tissue injury, and other inflammation orders

A

C Reactive Protein

153
Q

Ionized Calcium comprises _____ of our blood calcium

A

45%