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PMLS 2 > PMLS2_LEC8 > Flashcards

PMLS2_LEC8 Flashcards

1
Q

● For diagnosis and monitoring
● Collected early morning or during collection sweeps or schedule
● Collected from the outpatient department (OPD) patients

A

ROUTINE SAMPLES

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2
Q

● Response time varies from each laboratory; what sample

A

ASAP SAMPLES

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3
Q

● For managing of critical cases
● Collected, analyzed, and results are reported
immediately

A

STAT SAMPLES

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4
Q

Factors that can influence the composition of blood:
To try to eliminate these factors, we try to collect
blood when the body is in a _____.

A

○ Age
○ Altitude
○ Body position
○ Dehydration
○ Diet
○ Diurnal variation
○ Drugs
○ Environment
○ Exercise
○ Gender
○ Pregnancy
○ Smoking
○ Stress;

basal state

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5
Q

Body’s state after 8 to 12 hours of fasting and
abstention from strenuous exercise.

A

BASAL STATE

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6
Q

Fasting and timed collection includes:

A

○ Analytes with Diurnal Variation
○ Therapeutic Drug Monitoring
○ Glucose Tolerance Tests
○ Lactose Tolerance Tests

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7
Q

➔ “Nothing by mouth”
➔ No food and water

A

NPO

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8
Q

In fasting collection:

A

Patient Preparation:
● The patient refrains from eating for
a period of time (8-12 hrs)
● Refrains from exercise
Special Procedure:
Phlebotomist will take note of the:
● Time of last meal
● Time of collection
Laboratory Tests:
● Fasting Blood Sugar
● Lipid Panel

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9
Q

● Taken to determine the changes in the level of some substances that are to be monitored over time.
● Samples should be collected at the precise time;

laboratory tests of these are:

A

TIMED COLLECTION;
● Myoglobin
● Troponin I
● CPK-MB
● Prothrombin Time
● APTT

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10
Q

Reasons for Timed Samples:

A

● Measurement of the body’s ability to metabolize a
particular substance
● Monitoring changes in a patient’s condition (such as a
steady decrease in hemoglobin)
● Determining blood levels of medications
● Measuring substances that exhibit diurnal variation
(normal changes in blood levels at different times of
the day)
● Measurement of cardiac markers following acute
myocardial infarction
● Monitoring anticoagulant therapy

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11
Q

occurs when substances that exhibit diurnal variation change their levels at different times
of the day.
● Recommended collection time is when they are at their peak level.

A

DIURNAL VARIATION

LABORATORY TESTS PEAK TIME
Plasma Cortisol 8:00 - 10:00 AM
Serum Iron 8:00 - 10:00 AM
Hormones Morning Collection
Leukocytes Morning Collection

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12
Q

● To manage patients being treated with certain drugs in order to help establish a drug dosage.
● While adjusting the dosage when in combination with other drugs taken.
● Identifying noncompliant patients
● Maintaining the dosage at a therapeutic (beneficial) level.
● To avoid drug toxicity

A

THERAPEUTIC DRUG MONITORING

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13
Q

Time of collection (therapeutic drug monitoring) depends on the time the medication was given.
○ Intravenous (IV) - ____ (after the
medication was given);
○ Intramuscular (IM) - _____;
○ Oral dosage - _____

A

30 minutes; 1 hour; 1 to 2 hours

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14
Q

➔ Shortly after the medication was given.;

➔ Time right before the next dosage is given.

A

PEAK LEVEL; TROUGH LEVEL

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15
Q

● Used for the diagnosis of diabetes mellitus and
differentiating it from gestational diabetes

A

GLUCOSE TOLERANCE TESTS

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16
Q

● For diabetes mellitus, use to monitor insulin therapy
● It compares the fasting glucose level with the level 2 hours after consuming glucose (Full meal is consumed after the 1st blood testing)
● Normally glucose will go back to fasting level 2 hours after the meal

A

2 HOUR POSTPRANDIAL (2HPP)

17
Q

● Done for diabetes mellitus and gestational diabetes
● The patient drinks a standard glucose load (75 / 100 gm) and returns for testing on an hourly basis up to 6 hours in length.
● For small adults & children: 1 g/kg body weight

A

CLASSIC GLUCOSE TOLERANCE TEST

18
Q

CONTRAINDICATIONS FOR CLASSIC GLUCOSE
TOLERANCE TEST:

A

● Smoking during the test period
● Patient is under extreme stress
● Eating a snack or candy after the meal and before testing
● Unable to consume entire meal / solution
● Exercise during the testing period

19
Q

MEDICATIONS THAT PATIENT MUST STOP 3-5 DAYS BEFORE THE TEST:

A

● Alcohol
● Anticonvulsants
● Aspirin
● Birth control pills
● Blood pressure medications
● Corticosteroids
● Diuretics
● Estrogen-replacement pills

20
Q

● The recommended method for the diagnosis of
diabetes mellitus.
● Same procedure as 2HPP but uses a glucose
solution instead of a full meal as glucose load.

A

2-HOUR ORAL GLUCOSE TOLERANCE TEST

21
Q

● 1-hour glucose screening test or gestational glucose screening test.
● Special Procedure:
○ Px drinks 50 gm of glucose solution
○ Test for Glucose 1 hour after
●____ = abnormal results (px is recommended
for follow-up testing)

A

ORAL GLUCOSE CHALLENGE TEST;
>140 mg/dL

22
Q

➔ Utilizes the same procedure as the diagnostic
Oral Glucose Tolerance Test (OGTT) used to
diagnose diabetes mellitus

A

ONE-STEP METHOD FOR
GESTATIONAL DIABETES

23
Q

➔ Done for 2 days
◆1st day: Oral Glucose Challenge Test
(OGCT) is done
◆2nd day: Oral Glucose Tolerance Test
(OGTT) is done

A

TWO-STEP METHOD FOR
GESTATIONAL DIABETES

24
Q

● Used to determine if a patient lacks the mucosal lactase that is necessary to convert lactose, or milk sugar, into glucose and galactose.
● Patients with lactose intolerance experience
gastrointestinal discomfort and diarrhea.
● Same procedure as a 2-hr OGTT, but the patient drinks a lactose solution instead.

A

LACTOSE TOLERANCE TEST

25
Q

are requested in patients with:
○ Fever and chills
○ Other signs of septicemia
○ Fever of unknown origin (FUO)
● Collected in sets of 2 (____) right
before the spike of fever

A

Blood cultures; 30 or 60 mins apart

26
Q

Happens when microorganisms get access into the blood system.

A

SEPTICEMIA

27
Q

STRICT ASEPTIC TECHNIQUE
A. Cleanse site 3 times with alcohol and
iodine

A
  1. 70% isopropyl alcohol
  2. 2% iodine tincture or povidone iodine
  3. 70% isopropyl alcohol
  4. 2% iodine tincture or povidone iodine
  5. 70% isopropyl alcohol
  6. 2% iodide tincture or povidone iodine
  7. 70% isopropyl alcohol (to remove
    residual iodine)
  8. Allow to air dry
28
Q

STRICT ASEPTIC TECHNIQUE
B. One-step procedure - This is done when the patient is allergic to iodine.

A
  1. Rub vigorously with chlorhexidine
    gluconate for 30-60 seconds (needs friction)
29
Q

In blood cultures,
● There should be 2 bottles per collection: 1) ___ and 2) ____
● Blood to media ratio: ____
● For adults, about ____ of blood is required.
● For pedia, ____ of blood.

A

Aerobic, Anaerobic;
1:10;
8-10 mL;
1-3 mL

30
Q

➔ Microorganisms that are able to survive and grow in an oxygenated environment.

A

AEROBIC

31
Q

➔ Support the growth of microorganisms that can grow in the absence of oxygen.
➔ Harmed by oxygen, cannot grow in the presence of it

A

ANAEROBIC

32
Q

➔ Often used for patients who require frequent venous or arterial access.

A

VASCULAR ACCESS DEVICE (VAD)

33
Q

● Another way of obtaining blood samples for blood culture.
● Provide access to the central venous system via the superior vena cava (SVC) or the inferior vena cava (IVC).
● Exit end is surgically tunneled under the skin to a site several inches away in the chest.
★ MedTechs are not allowed to do this.

A

CENTRAL VENOUS CATHETER

34
Q

● A small chamber attached to an indwelling line that is surgically implanted under the skin and most commonly located in the upper chest or arm.
● With self sealing septum
● No visible tubing, so site care is less tedious
● Flushing is done monthly

A

IMPLANTED PORT

35
Q

● Line is inserted into the peripheral veins and threaded into the central venous system.
● Typically placed in an antecubital vein just above or below the antecubital fossa.
● With clamps for multimen
● Flushes are necessary

A

PERIPHERALLY INSERTED CENTRAL CATHETER
(PICC)

36
Q

ORDER OF DRAW

A

First Syringe 1st 5mL is discarded
(Clear top / Discard tube)

Second Syringe Blood Cultures
Third Syringe Anticoagulated tubes
(Light blue top, lavender top, gray top)

Fourth Syringe Clotted tubes (Red top and Gold top)

PMLS 2 (6 decks)

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