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IMMUNE1 LAB PRELIMS > PRE LAB EXPERIMENT 2 and 3 > Flashcards

PRE LAB EXPERIMENT 2 and 3 Flashcards

1
Q

the drawing of blood- is an integral part of medical laboratory practice

A

PHLEBOTOMY

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2
Q

It is good to remember that no laboratory procedure will be any better than the quality of the specimen that is being tested.

A

PHLEBOTOMY

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3
Q

Each step in the process affects the quality of the specimen and is this important for preventing laboratory error and patient injury.

A

PHLEBOTOMY

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4
Q

For us medical technologist, this is the only time that we have
patient interaction.

A

PHLEBOTOMY

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5
Q

For us medical technologist, this is the only time that we have
patient interaction.

A

PHLEBOTOMY

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6
Q

affects the test result of the patient and the affects the quality of the specimen.

A

hemolysis

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7
Q

– get blood from veins, suitable for serology

A

• Venipuncture

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8
Q

– for micro sampling

A

• Capillary puncture

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9
Q

– it is not used in serology

A

• Arterial puncture

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10
Q

SOURCES BLOOD SPECIMEN

A

• Capillaries
• Arteries
• Veins

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11
Q

(55% of total volume)

A

• Plasma

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12
Q

o Fluid part

A

• Plasma

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13
Q

(45% of total volume)

A

• Formed elements

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14
Q

• Formed elements

A

o RBC
o WBC
o Platelets

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15
Q

• Test tube containing

A

whole blood

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16
Q

VENIPUNCTURE

A

• Open system
• Evacuated Tube system
• Winged Infusion set

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17
Q

• utilization of hypodermic syringe, most used syringe is 10ml.

A

OPEN SYSTEM

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18
Q

• Gauge used is

A

21-23; 25

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19
Q

o note: the (?) the gauge the (?) the bore each gauge has corresponding hub color

A

higher

smaller

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20
Q

• Length:

A

1 or 1.5 inches (1/2 to 1⁄4 in butterfly needle)

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21
Q

• also called CLOSED SYSTEM

A

EVACUATED TUBE SYSTEM

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22
Q

it is also used to collect multi samples or multi sampling

A

EVACUATED TUBE SYSTEM

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23
Q

• this type of sampling is only used if the vein is superficial

A

WINGED INFUSION SET

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24
Q

it is also known as BUTTERFLY SET

A

WINGED INFUSION SET

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25
Q

EQUIPMENTS

A

• Tourniquet
• Antiseptic solution
• Syringe and needle
• Evacuated tube set
• Butterfly infusion set

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26
Q

Antiseptic solution

A

o Isopropyl alcohol – iodine
o Chlorohexidine gluconate
o Benzalconium Cl / Zephiran

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27
Q

SITES OF COLLECTION

A

VEINS OF ANECUBITAL FOSSA ( 50-300 ANGLE)

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28
Q

VEINS OF ANECUBITAL FOSSA ( 50-300 ANGLE)

A

• Median cubital vein (1st choice)
• Cephalic vein (2nd)
• Basilic vein (3rd)

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29
Q

( 50-300 ANGLE)

A

VEINS OF ANECUBITAL FOSSA

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30
Q

(CAN BE LOWER THAN 50-300 ANGLE)

A

WRIST VEIN

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31
Q

Superficial vein of the dorsal hand

A

o cephalic vein, basilica vein, dorsal or metacarpal vein

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32
Q

WRIST VEINS

A

Superficial vein of the dorsal hand

VEINS ON DORSAL HAND

VEINS OF THE FOOT

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33
Q

Last resort for blood collection is from the (?) after the arm veins have been determine unsuitable.

A

VEINS OF THE FOOT

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34
Q

Always check with the hospital policy before this type of sampling is carried out.

A

VEINS OF THE FOOT

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35
Q

• Instituted by the Center of Disease Control in 1987

A

UNIVERSAL PRECAUTIONS 1987

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36
Q

all patients are considered to be possible carriers of blood-borne pathogens.

A

UNIVERSAL PRECAUTIONS 1987

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37
Q

wearing gloves when collecting or handling blood and body fluids contaminated with blood

A

UNIVERSAL PRECAUTIONS 1987

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38
Q

• The CDC excluded urine and body fluids that is not visibly contaminated by blood

A

UNIVERSAL PRECAUTIONS 1987

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39
Q

Although many specimens can contain a considerable amount of blood before it becomes visible.

A

UNIVERSAL PRECAUTIONS 1987

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40
Q

it only recommends wearing of gloves when there is a visual contamination of blood but if it is not visibly contaminated by blood, basically gloves are not recommended for use. This is one of the disadvantages

A

UNIVERSAL PRECAUTIONS 1987

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41
Q

• Guidelines are not limited to blood-borne pathogens

A

BODY SUBSTANCE ISOLATION

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42
Q

they consider all body fluids and moist body substances to be potentially infectious.

A

BODY SUBSTANCE ISOLATION

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43
Q

• (Unlike UP na kinoconsider lang as infectious ang body fluids that is contaminated by blood, BSI considers ALL body fluids).

A

BODY SUBSTANCE ISOLATION

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44
Q

• Personnel should wear gloves at all times when encountering
moist body substances.

A

BODY SUBSTANCE ISOLATION

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45
Q

• Major disadvantage: They do not recommend hand washing
following removal of gloves unless visual contamination is present.

A

BODY SUBSTANCE ISOLATION

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46
Q

• The CDC combined the major features of UP and BSI guidelines.

A

STANDARD PRECAUTIONS (1996)

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47
Q

• It is more complete and specific

A

STANDARD PRECAUTIONS (1996)

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48
Q

• We are now utilizing this one.

A

STANDARD PRECAUTIONS (1996)

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49
Q

• Addition of the following guidelines:
1. Hand washing
2. Gloves
3. Mask, eye protection and face shield
4. Gown
5. Patient care equipment
6. Environmental control
7. Linen
8. Occupational Health and Blood borne Pathogens
9. Patient placement

A

STANDARD PRECAUTIONS (1996)

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50
Q

WHAT TYPES OF EVACUATED TUBES ARE USED FOR
SEROLOGIC TESTING?

A

No additive (Red Top) and Serum Separator Tube are used for serologic testing

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51
Q

• This tube has no anticoagulant and it is used for blood clotting and the serum is separated by centrifugation.

A

NO ADDITIVE (RED TOP)

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52
Q

Wait for 30 minutes in order for the blood to clot and after that prepare the tube for serum.

A

NO ADDITIVE (RED TOP)

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53
Q

• These tubes contain clot activator and serum gel separator.

A

SERUM SEPARATOR TUBE (GOLD TOP) AND RED/GRAY MOTTLED TOP (TIGER TOP)

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54
Q

They contain serum gel at the bottom to separate the blood from serum upon centrifugation and used to form clot quickly and separate serum with gel at the bottom of the tube.

A

SERUM SEPARATOR TUBE (GOLD TOP) AND RED/GRAY MOTTLED TOP (TIGER TOP)

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55
Q

we don’t need to wait for 30 minutes. Direct to centrifugation.

A

SERUM SEPARATOR TUBE (GOLD TOP) AND RED/GRAY MOTTLED TOP (TIGER TOP)

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56
Q

NOTE:
A. No additive (red top)
B. Gold Top (SST)- We can see serum, gel, red cell (bottom of
the pic)
C. Tiger top (SST)

A
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57
Q

BLOOD SPILLS CAN ACCIDENTALLY HAPPEN IN THE LABORATORY. WHAT SHOULD BE DONE IN CASES OF SPILLAGE?

A

• Wipe immediately the blood spill.

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58
Q

The most commonly used disinfectant is a (?) prepared weekly and stored in a (?), not a glass, bottle.

A

1:10 dilution of sodium hypochlorite (household bleach)

plastic

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59
Q

The bleach should be allowed to air-dry on the (?) prior to removal.
a. Ibababad natin yung blood spill with the disinfectant, after na nag dry, iwipe natin siya ng cloth.

A

contaminated area

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60
Q

The National Committee for Clinical Laboratory Standards (NCCLS)states that a (?) can be used for routine cleaning

A

1:100 dilution

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61
Q

• If the patient is unconscious – take a look at the wristband, to confirm their identity

A

IN PATIENT

62
Q

• Ask the watcher if the patient is unconscious

A

IN PATIENT

63
Q

• If the patient is conscious, let them state their own name

A

IN PATIENT

64
Q

• If the patient is a mute and has no wrist band, confirm it to the nurse station. Most of the time the beds have labels.

A

IN PATIENT

65
Q

• Much easier, since they are conscious and ambulatory/mobile.

A

OUT PATIENT

66
Q

• Always ask the patient to state his/her full name

A

OUT PATIENT

67
Q

HOW IS PATIENT CARE SHOWN DURING PHLEBOTOMY?
• Not only done at the end of procedure but also when the patients (?) the phlebotomy area.

A

enters

68
Q

• Introducing yourself to the patient

A

WELCOMING THE PATIENT

69
Q

• Letting the patient know you’re happy to see them

A

WELCOMING THE PATIENT

70
Q

• Making the patient feel important

A

WELCOMING THE PATIENT

71
Q

• You can also mention the test that will be performed

A

WELCOMING THE PATIENT

72
Q

• Assessing the patient’s comfort level quickly

A

PROVIDING PATIENT COMFORT

73
Q

• Alleviating patient anxiety

A

PROVIDING PATIENT COMFORT

74
Q

• Letting the patient know you care about their well being

A

PROVIDING PATIENT COMFORT

75
Q

• Reassuring the patient they’re in good hands

A

PROVIDING PATIENT COMFORT

76
Q

LETTING THE PATIENT KNOW IT WAS A PLEASURE TO SEE THEM

A
77
Q

• Talking with the patient about the procedure so they’re kept informed and know what to expect

A

EFFECTIVE PATIENT COMMUNICATION

78
Q

• Asking the patient if they’ve ever fainted during a blood draw

A

EFFECTIVE PATIENT COMMUNICATION

79
Q

Asking for patient feedback during the procedure

A

EFFECTIVE PATIENT COMMUNICATION

80
Q

• Thanking the patient for visiting the medical facility

A

AFTER PATIENT CARE

81
Q

• After applying gauze, apply pressure

A

AFTER PATIENT CARE

82
Q

• Puncture only the uppermost wall of the vein

A

HEMATOMA

83
Q

• Remove the tourniquet before removing the needle

A

HEMATOMA

84
Q

• Use the major superficial veins (preferred: median cubital
vein)

A

HEMATOMA

85
Q

• Make sure the needle fully penetrates the upper most wall of
the vein. (Partial penetration may allow blood to leak into the
soft tissue surrounding the vein by way of the needle bevel)

A

HEMATOMA

86
Q

• apply pressure to the venipuncture site

A

HEMATOMA

87
Q

(WHICH CAN INTERFERE WITH MANY TESTS)

A

HEMOLYSIS

88
Q

• Mix tubes with anticoagulant additives gently 5-10 times (inversions depend on the anticoagulant used. EDTA: 8 times ; Sodium citrate: 3-5 times)

A

HEMOLYSIS

89
Q

• Avoid drawing blood from a hematoma

A

HEMOLYSIS

90
Q

• Avoid drawing the plunger back too forcefully, if using a
needle and syringe, or too small a needle, and avoid frothing
of the sample.

A

HEMOLYSIS

91
Q

• Make sure the venipuncture site is dry

A

HEMOLYSIS

92
Q

• Avoid a probing, traumatic venipuncture

A

HEMOLYSIS

93
Q

• Avoid prolonged tourniquet application (max of 2 minutes) or
fist clenching

A

HEMOLYSIS

94
Q

o Fist clenching is not advised in terms of

A

venipuncture

95
Q

o Fist clenching is advisable during

A

blood donation

96
Q

• an increased concentration of larger molecules and formed elements in the blood

A

HEMOCONCENTRATION

97
Q

• Prolonged tourniquest application (no more than 1 minute)

A

HEMOCONCENTRATION

98
Q

• Massaging, squeezing, or probing a site

A

HEMOCONCENTRATION

99
Q

• Long- term IV theraphy

A

HEMOCONCENTRATION

100
Q

• Primary effect is hemoconcentration of non-filterable elements (i.e.proteins).

A

PROLONGED TOURNIQUET APPLICATION

101
Q

The hydrostatic pressure causes some water ad filterable elements to leave the extracellular space.

A

PROLONGED TOURNIQUET APPLICATION

102
Q

• Significant increases can be found in total protein, aspartate aminotransferase (AST), total lipids, cholesterol, iron

A

PROLONGED TOURNIQUET APPLICATION

103
Q

• Affects packed cell volume and other cellular elements

A

PROLONGED TOURNIQUET APPLICATION

104
Q

• Hemolysis may occur, with pseudohyperkalemia

A

PROLONGED TOURNIQUET APPLICATION

105
Q
  • false increase of potassium
A

Pseudohyperkalemia

106
Q

• Preferred site:

A

antecubital fossa (median cubital vein)

107
Q

• Median cubital vein (unavailable):

A

cephalic vein

108
Q

• Least preferred area in the antecubital fossa:

A

basilic vein

109
Q

• Antecubital fossa (unavailable): proceed to

A

superficial
veins of the dorsal hand

110
Q

• Wrist vein (unavailable):

A

superficial veins of the foot

111
Q

The last resort for blood collection is

A

• Superficial Veins of the foot

112
Q

Always check with t5he hospital policy before this type of sampling is carried out

A

• Superficial Veins of the foot

113
Q

place in an anticoagulated tube – after mixing it will be the

A

WHOLE BLOOD

114
Q

anticoagulated – centrifuge – separate the supernatant and red cell

A

PLASMA

115
Q

plain tube/red top with clot activator/ or with gel separator – centrifuge – separate supernatant and pack red cell

A

SERUM

116
Q

• heat the serum at 56 degrees Celsius for 30 minutes

A

SERUM INACTIVATION

117
Q

RED CELL SUSPENSION
• collect the pack red cell - washed with saline or the NSS

A

3x

118
Q

concentration of red cell suspension

A

• 2-5%

119
Q

• Desired red cell suspension (RCS) =

A

Washed packed red blood cell (WPRCB) volume x 100/Total volume (TV) of the RCS preparation

120
Q

Total volume of RCS =

A

WPRBC + volume of diluent NSS added to prepare desired %RCS

121
Q

• Liquid portion of unclotted blood

A

PLASMA

122
Q

• Contains the fibrinogen group of coagulation factors

A

PLASMA

123
Q

• Lighter yellow and little turbid

A

PLASMA

124
Q

• Chemically does not contain much platelet derivatives

A

PLASMA

125
Q

• Liquid portion of the clotted blood

A

SERUM

126
Q

• Does not contain the fibrinogen group of coagulation factors

A

SERUM

127
Q

• Darker yellow and clearer

A

SERUM

128
Q

• Contains higher levels of platelet derivatives

A

SERUM

129
Q

• Is a common reagent used for many serologic procedures

A

RED CELL SUSPENSION

130
Q

• Provide the appropriate serum to allow for grading and
interpretation of test results

A

RED CELL SUSPENSION

131
Q

• The concentration of RCS is 2-5%

A

RED CELL SUSPENSION

132
Q

Since the antibodies are found in (?), it is the preferred sample to use in serologic testing.

A

serum

133
Q

(?), also don’t have fibrinogen or other anticoagulant factors that may alter the results of the tests, while (?) that contains anticoagulant, is subject to affect the 50% of the total of the total laboratory turnaround.

A

Serum

plasma

134
Q

is done to allow separation of the cells and clotting factors and to avoid the formation of fibrin clots while still maintaining proteins and other molecules that represent the whole-body system when centrifuged.

A

Complete clotting

135
Q

After collection of the whole blood, it should be allowed to clot by living it undisturbed at room temperature. This is usually taking

A

15-30 minutes.

136
Q

Remove the clot by centrifuging at (?) in a refrigerated centrifuge.

A

1,000-2,000 x g for 10 minutes

137
Q

To prevent the formation of fibrin clots, since fibrin
clots may also cause a false positive reaction specially in terms of hemagglutination procedures

A

Complete clotting

138
Q

DESCRIBE AND DISCUSS WHY THE FOLLOWING SAMPLES ARE NOT USED IN SEROLOGIC TESTING

A

HEMOLYZED SAMPLE

LIPEMIC SAMPLE

ICTERIC SAMPLE

139
Q

once the red cells will lyze the hemoglobin will go out of the cell and because od that It cause non specific binding)

A

HEMOLYZED SAMPLE

140
Q

• Serum samples containing more than (?) of hemoglobin can cause non-specific binding in serologic testing is not recommended for a serum sample containing more than this amount of hemoglobin.

A

100mg/dl

141
Q

can interfere with measured analytes and chemical interactions.

A

LIPEMIC SAMPLE

142
Q

This is especially important in electrophoretic methods.

A

LIPEMIC SAMPLE

143
Q

can also non-specifically interfere in various immunoassays.

A

LIPEMIC SAMPLE

144
Q

can interfere with antigen- antibody reaction by blocking binding sites on antibodies.

A

LIPEMIC SAMPLE

145
Q

This can happen even when antibodies are bound to a solid surface.

A

LIPEMIC SAMPLE

146
Q

Depending on the nature of the reaction, the interference can cause both, falsely elevated of falsely decreased result.

A

LIPEMIC SAMPLE

147
Q

in serologic tests, some procedures require the use of

A

inactivated serum

148
Q

Since Inactivation is the process that destroys complement activity, complement is known to interfere with the reactions certain syphilis tests and complement components.

A

inactivated serum

149
Q

It can agglutinate latex particles and cause a false positive reaction in latex passive agglutination assays.

A

inactivated serum

150
Q

Complement may also cause lysis of the indicator cells in hemagglutination assays

A

inactivated serum

151
Q

wearing face shields when there is danger of blood splashing on mucous membranes and when disposing of all needles and sharp objects in puncture-resistant containers.

A

UNIVERSAL PRECAUTIONS 1987

IMMUNE1 LAB PRELIMS (9 decks)

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