Point of Care Testing and Laboratory Procedures Flashcards
What are some ways the MA can assist with quality assurance in the laboratory?
Proper collection and labeling of specimens, properly transport specimens, ensure instruments and equipment are maintained and calibrated, periodically check expiration dates on supplies, confirm patients have prepared properly for test, perform quality controls
What information must be included on a specimen container label?
Patient’s name, date of birth, date and time of collection and medical assistant’s initials
Why is it crucial to label the container itself and not the lid of the specimen?
To prevent misidentification if the lid is accidentally placed on a different specimen container
What verification steps should be taken before sending a specimen to the lab for processing?
Verify the label information against the patient’s health record and the lab order
What should be included on a lab requisition?
patient’s demographic information, provider’s signature, specific tests ordered must identified and marked
What type of analysis is performed in a urinalysis?
Physical, chemical, and microscopic examination of urine.
What does a hematology test measure?
Blood cell counts, including RBCs, WBCs, and platelets.
What types of substances are analyzed in a chemistry laboratory?
Chemicals found in blood, CSF, urine, joint fluid, lipid profiles, and fasting glucose.
What types of microorganisms are studied in a microbiology laboratory?
Bacteria, fungi, parasites, yeasts, and viruses.
What is the primary purpose of cytology testing?
Microscopic examination of cells for diagnostic purposes.
What services are provided by a blood bank?
Processing and storing blood and blood products for transfusion and blood disorder treatments.
What action must a medical assistant take before sending a specimen to the lab?
Select the appropriate laboratory tests on the laboratory requisition based on the provider’s orders.
Why is urine temperature sometimes documented during collection?
Some urine screenings require documentation of the urine temperature at the time of specimen collection.
What must a medical assistant confirm with a patient when fasting is required for a blood test?
Confirm if the patient has abstained from food and liquids as required.
What demographic information is typically found on a requisition form?
Patient name
Address
Date of birth
Sex
Telephone number
Insurance information
Provider information
Diagnosis code or indications for testing
Order date
What substance is detected in urine or blood to determine pregnancy, and how is it typically tested in point-of-care settings?
Human chorionic gonadotropin (hCG) antibodies are detected, and a urine sample is commonly used for point-of-care testing.
What are the key considerations for collecting specimens to ensure accurate and reliable laboratory results?
Collect at the appropriate time, from the suspected infection site, minimize transport time, collect the appropriate quantity, and use appropriate, correctly labeled containers.
When is a random urine sample collected, and what is it used for?
Collected at any time of day, used for general screening purposes.
Why is a first morning urine specimen preferred for some tests?
It’s more concentrated, ideal for pregnancy testing and detecting protein or nitrites.
What are the key steps for a clean-catch midstream urine collection?
Cleanse genitalia with antiseptic wipes (front to back for females, glans penis for males), urinate in toilet first, then collect midstream in a sterile container.
What is the procedure for a 24-hour urine collection, and what is it used for?
Discard first morning urine, collect all urine for 24 hours, including the next morning’s first void. Used for quantitative analysis of kidney function or substances released sporadically.
When is a catheterized urine collection necessary, and who performs it?
When a sterile sample is needed or the patient can’t provide a sample on their own; performed by a provider or nurse.
How does a positive pregnancy test appear?
Two lines.
How does a negative pregnancy test appear?
One line.
What does a fecal occult blood test screen for?
Hidden blood in stool, which can indicate disease or gastrointestinal bleeding.
What dietary and medication restrictions are necessary before a fecal occult blood test?
Avoid red meats, red dyes, aspirin, vitamin C, and iron supplements for three days prior.
What type of container is used for culture specimens, and why?
Sterile containers, to prevent contamination.
What precautions should be taken when collecting specimens for cultures?
Avoid touching the insides of lids, swabs, or containers.
Why is proper specimen collection important for cultures?
To accurately identify the causative agent and ensure proper treatment.
Which of the category of tests is most often offered in a laboratory at a provider’s office?
Waived
What does a dipstick urinalysis screen for?
Analytes excreted in urine.
What does a hemoglobin test measure, and how is the specimen collected?
Oxygen-carrying protein in whole blood; capillary blood from a fingerstick.
What does a spun hematocrit test evaluate?
Percentage of red blood cells in capillary blood.
What does a blood glucose test measure, and how is the specimen collected?
Quantitative glucose level in whole blood; capillary blood from a fingerstick.
What does a hemoglobin A1C test indicate?
Blood sugar control over approximately three months.
What type of specimen is used for cholesterol testing?
Capillary blood.
What does an H. pylori test screen for, and what type of specimen is used?
H. pylori, the main cause of gastric ulcers; blood sample.
What does a mononucleosis screening test detect, and what type of specimen is used?
Epstein-Barr virus; capillary blood.
What type of specimen is used for influenza A and B testing?
Nasal swab.
What types of specimens are used for drug testing?
Urine and blood samples.
What does a fecal occult blood test screen for?
Hidden blood in stool.
What is the purpose of a chain of custody form when collecting legal specimens like urine for drug or alcohol analysis, and who must sign it?
To document the handling of the specimen and prevent tampering. Everyone who handles the specimen, including the patient, must sign it.
Why is informed consent crucial when collecting legal specimens for drug or alcohol testing, and what information must be included in the consent form?
Supplying the specimen could be incriminating; the form must explain the test’s purpose, grant permission for collection and transport, and authorize release of results, and it should inform the patient that medications and substances could affect results.
How should urine specimens and contaminated materials be disposed of after collection for legal analysis, and what safety standards must be followed?
Non-breakable containers go into red biohazard bags, sharps into sharps containers, urine into a designated sink, and all disposal must adhere to facility policies and OSHA standards.
Which method will ensure urine specimen preservation?
Storing the urine in the refrigerator
What steps should a medical assistant take when communicating lab results to a patient via phone or mail?
Verify the patient’s identity (phone) and ensure the correct address (mail) for HIPAA compliance. Do not release results without provider review and sign-off.
What actions should a medical assistant take when receiving a critical lab value from the laboratory?
Repeat the results back to the lab for accuracy, notify the provider immediately, and document the communication and actions taken in the medical record.
What is the reference range for hemoglobin (HGB) in males and females?
Male: 13.5 to 17.5 g/dL; Female: 12 to 16 g/dL.
What is the reference range for hematocrit (HCT) in males and females?
Male: 41% to 53%; Female: 36% to 46%.
What is the reference range for a white blood cell count?
4,500 to 11,000/mm3.
What is the reference range for a red blood cell count in males and females?
Male: 4.5 to 5.9 million/mm3; Female: 4 to 5.5 million/mm3.
What is the reference range for a platelet count?
150,000 to 400,000/mm3.
What is the reference range for fasting blood glucose?
70 to 100 mg/dL.
What is the reference range for hemoglobin A1C?
Below 5.7%.
What is the reference range for total cholesterol?
130 to 200 mg/dL.
What is the reference range for LDL cholesterol?
Less than 100 mg/dL.
What is the reference range for HDL cholesterol?
Greater than 60 mg/dL.
What is the reference range for triglycerides?
40 to 150 mg/dL.
What are two common errors in specimen collection and patient preparation that can compromise test results, and what are the potential consequences of these errors?
Improper instructions for clean-catch urine samples can lead to bacterial contamination and necessitate a repeat sample, while lack of patient adherence to pre-test requirements (e.g., fasting) can delay testing and affect result accuracy.
What are the key steps involved in the preanalytical phase of laboratory testing?
Provider orders test, requisition is filled out, specimen is collected/labeled/processed, and specimen is transported.
What are common errors that can occur during the preanalytical phase and affect test results?
Inappropriate test request, order entry error, patient misidentification, inappropriate container, improper labeling, inadequate sample collection, and inadequate sample/anticoagulation ratio.
What are the main activities performed during the analytical phase of laboratory testing?
Instrument maintenance/calibration, running and analyzing controls, specimen testing, and result documentation.
What are common errors that can occur during the analytical phase and affect test results?
Equipment malfunctions, sample mix-up, quality control failures, and improper procedure adherence.
What are the key steps involved in the postanalytical phase of laboratory testing?
Specimen disposal, control result analysis, logging external lab reports, provider interpretation/sign-off, patient notification, and documentation.
What are common errors that can occur during the postanalytical phase and affect patient care?
Failure to report results, improper data entry, and excessive turnaround time.
How is distance vision acuity typically assessed in children, and at what distance is the chart placed?
Children stand 10 feet away from a chart at eye level and identify letters, shapes, or the direction an “E” is pointing.
What does 20/20 vision mean, and what do the numerator and denominator represent in a Snellen chart result?
20/20 represents typical vision. The numerator is the test distance (20 feet), and the denominator is the distance at which people with typical vision can read that line.
How many errors are allowed on a line during a Snellen chart test before moving to the next line, and how is the final result determined?
One error is allowed per line. If two errors occur on a line, the previous line read without error is the final result.
What conditions does near vision testing screen for, and what chart is used?
Presbyopia and hyperopia; the Jaeger eye chart.
How is the Jaeger eye chart used to assess near vision acuity?
The patient reads words from various-sized prints on cards held 14 to 16 inches away from the eyes, without corrective lenses.
When is it appropriate for a patient to wear corrective lenses during vision testing, and what must be documented?
During distance vision testing; it must be documented in the patient’s EHR.
What is the Ishihara test used to screen for, and what is the most common type of color deficiency it detects?
Color deficiency, specifically red-green deficiency.
How many color plates must a patient miss in the Ishihara test to indicate a potential color deficiency?
Four or more plates.
What does audiometry measure, and what units are used for sound amplitude and frequency?
Hearing acuity; decibels (dB) for amplitude and hertz (Hz) for frequency.
What does tympanometry record, and what is it used to detect?
Tympanic membrane movement; fluid and infections in the middle ear.
What does a normal tympanogram result look like on a graph, and what does an abnormal result indicate?
Normal: a peak; abnormal: a flat line.
How is audiometry performed by a medical assistant, and what patient response is required?
Patient wears headphones, various tones are played, and the patient indicates when they hear the tone by pushing a button or raising their hand.
What are the normal hearing levels in decibels for adults and children?
Adults: below 25 dB; children: below 15 dB.
What does spirometry measure, and what does it assess?
Measures how fast and how much air a patient can move into and out of their lungs; assesses lung function.
What demographic factors are used to calculate predicted respiratory values, and what patient preparation is required before a spirometry test?
Age, gender, weight, and height; no large meals 2 hours before, no smoking 1 hour before, and discontinuation of bronchodilators/breathing therapies 6 hours before.
How should a patient be positioned during spirometry, and what instructions should they be given?
Upright sitting or standing, lips pursed around mouthpiece, nose clipped, chin lifted, neck extended; “Take the deepest breath possible. Seal your lips around the mouthpiece. Blow as hard and as fast as you can, blowing until you empty the air from your lungs.”
How many acceptable maneuvers or attempts are typically required during spirometry?
Three acceptable maneuvers or attempts.
What does FEV1 measure, and what is the expected value range?
Forced expiratory volume in 1 second; 80% to 120% of predicted.
What does FVC measure, and what is the expected value range?
Forced vital capacity; 80% to 120% of predicted.
What is the expected range for the absolute FEV1/FVC ratio?
Within 5% of the predicted ratio.
What are the expected value ranges for total lung capacity (TLC), functional residual capacity (FRC), and residual volume (RV)?
TLC: 80% to 120%; FRC: 75% to 120%; RV: 75% to 120%.
What does a peak flow meter measure, and what is its primary use for patients with chronic respiratory diseases?
Measures forced expiratory volume; monitors lung function at home.
What peak flow rating indicates well-controlled lung function, and what does it signify?
80% or better; indicates lung function is well-controlled and does not require treatment.
What are the key instructions for a patient using a peak flow meter?
Wear nonrestrictive clothing, start with marker at the bottom, sit or stand upright, take a deep breath and forcefully blow out, record the marker’s position, and repeat 2-3 times.
What is the medical assistant’s role in assisting a patient with peak flow meter use?
Provide instructions, demonstrate the technique, and allow the patient to practice.
Ishihara color plates are used to screen for what sensory disorder?
Color deficiency
What specimen collection performs tests for substances that are sporadically released into the urine?
24 hour urine - this type of collection is important for the qualitative analysis of components such as proteins when analyzing kidney function. This collection of urine can analyze substances that are sporadically released into the urine over a 24-hour period
Which of the following is the best instruction to give a patient on how to perform a peak flow test?
“Take the deepest breath possible. Seal your lips around the mouthpiece. Blow out as hard and as fast as you can.”
Which would cause a specimen to be rejected from the lab?
Name on the specimen does not match the lab requisition
Which should be included when labeling a patient’s specimen?
Collector’s initials
Which of the following phases of quality assurance are instruments maintained and calibrated?
Analytical phase
What is the amount of time it takes to process a result for a urine pregnancy test?
5 minutes
