Sample Consideration and Special Procedures Flashcards
daily variation in blood levels at a particular time of day
CHOICES: Peak Level (Post-dose), Meconium, Keloid, Gestational Diabetes, Fasting, Diurnal, Induration, Lyse, NPO, Postprandial
Diurnal
having had nothing to eat for at least 8 to 12 hours
CHOICES: Peak Level (Post-dose), Meconium, Keloid, Gestational Diabetes, Fasting, Diurnal, Induration, Lyse, NPO, Postprandial
Fasting
diabetes that develops during pregnancy
CHOICES: Peak Level (Post-dose), Meconium, Keloid, Gestational Diabetes, Fasting, Diurnal, Induration, Lyse, NPO, Postprandial
Gestational Diabetes
a hard, red spot that is the result of lymphocytes migrating to the injection area
CHOICES: Peak Level (Post-dose), Meconium, Keloid, Gestational Diabetes, Fasting, Diurnal, Induration, Lyse, NPO, Postprandial
Induration
fibrous tumor arising from a cut; results in excessive scar tissue
CHOICES: Peak Level (Post-dose), Meconium, Keloid, Gestational Diabetes, Fasting, Diurnal, Induration, Lyse, NPO, Postprandial
Keloid
process of cell destruction; results in nonintact cell structure
CHOICES: Peak Level (Post-dose), Meconium, Keloid, Gestational Diabetes, Fasting, Diurnal, Induration, Lyse, NPO, Postprandial
Lyse
a dark, tarry material passed from the neonate’s rectum in the first days after birth until milk- or formula-based stool appears
CHOICES: Peak Level (Post-dose), Meconium, Keloid, Gestational Diabetes, Fasting, Diurnal, Induration, Lyse, NPO, Postprandial
Meconium
nothing by mouth
CHOICES: Peak Level (Post-dose), Meconium, Keloid, Gestational Diabetes, Fasting, Diurnal, Induration, Lyse, NPO, Postprandial
NPO
drug level in the blood is collected 15 to 30 minutes after the dosage has been administered or when the highest serum concentration of the drug is expected
CHOICES: Peak Level (Post-dose), Meconium, Keloid, Gestational Diabetes, Fasting, Diurnal, Induration, Lyse, NPO, Postprandial
Peak Level (Post-dose)
after a meal
CHOICES: Peak Level (Post-dose), Meconium, Keloid, Gestational Diabetes, Fasting, Diurnal, Induration, Lyse, NPO, Postprandial
Postprandial
condition in which microorganisms (mainly bacteria) are circulating and multiplying in the
patient’s blood
CHOICES:
Therapeutic Drug Monitoring (TDM), Therapeutic Range, Fasting Sample, Wheal, Trough Level (Pre-dose), Septicemia
Septicemia
collection and testing of the blood to evaluate and manage medication therapy effectively and safely
CHOICES:
Therapeutic Drug Monitoring (TDM), Therapeutic Range, Fasting Sample, Wheal, Trough Level (Pre-dose), Septicemia
Therapeutic Drug Monitoring (TDM)
the concentration of medication that is effective and not toxic in-patient management
CHOICES:
Therapeutic Drug Monitoring (TDM), Therapeutic Range, Fasting Sample, Wheal, Trough Level (Pre-dose), Septicemia
Therapeutic Range
drug level in the blood is collected when the lowest serum concentration is expected, which is usually 30 minutes before administering the next dose
CHOICES:
Therapeutic Drug Monitoring (TDM), Therapeutic Range, Fasting Sample, Wheal, Trough Level (Pre-dose), Septicemia
Trough Level (Pre-dose)
a whitish raised bump produced by the fluid from an intradermal injection
CHOICES:
Therapeutic Drug Monitoring (TDM), Therapeutic Range, Fasting Sample, Wheal, Trough Level (Pre-dose), Septicemia
Wheal
Usually collected in the morning before breakfast
CHOICES:
Therapeutic Drug Monitoring (TDM), Therapeutic Range, Fasting Sample, Wheal, Trough Level (Pre-dose), Septicemia
Fasting Sample
the patient can drink water when fasting. True or False
True
indicates that the px should
not be given anything to eat or drink
NPO or Non-Per Orem
What to do after collecting blood from a fasting patient?
- Inform the nurse that you have just drawn a sample from the patient for the fasting blood work.
- Do not give hospital patients food or tell them they can eat without first checking with the nurse.
Certain samples must be drawn at precisely timed intervals because of medication or biological rhythms.
Timed samples
Drug level inpatient must be maintained within the therapeutic range. True or False
True
Pre sample collected when the drug is at the lowest level in the patient
Trough level or Predose
The trough is usually drawn 30
minutes before the next dose of the drug is administered. True or False
True
The drug is usually administered through an intravenous (IV) injection. True or False
True
Once a drug has been completely administered for a specific period, a peak level (postdose) is collected. True or False
True
Drug levels in the blood are collected after an hour after the dosage has been administered. True or False
False - 15 to 30 minutes
When samples for trough drug levels be collected?
Immediately before the next dose is given
Test that exhibits a diurnal effect
o Serum iron
o Corticosteroids
o Cortisol
monitored at a particular time of day or a time interval after the dose of a drug.
Digoxin
TDM aims to promote optimum drug treatment by maintaining a serum drug concentration within a therapeutic range. True or False
True
STAT is about 45 minutes to 1 hour after the sample is received. True or False
True
Samples that need to be collected immediately due to the critical state of a patient require the phlebotomist’s immediate attention. True or False
True
Often not ordered for emergency reasons but for timing reasons.
STAT Samples
Typically available within 2 to 4 hours
ASAP requests
Blood alcohol testing must be collected without the use of alcohol to clean the arm. True or False
True
A form with the sample indicating the name and signature of each person who has handled the sample prior to testing
Chain of custody
Sometimes called trace elements.
Heavy metal testing
method of treating disease that draws large amounts of blood from the patient.
Therapeutic phlebotomy
type of blood cancer that causes your bone marrow to make too many RBCs
Polycythemia vera
The amount of blood taken at one treatment (Therapeutic phlebotomy)
500mL
Used to look for abnormalities in blood cells
blood smear
A good smear has a feathery edge that is nearly square and a rainbow sheen when reflecting light. True or False
True
measures the amount of glucose in your blood.
blood glucose test
A blood glucose meter is a small, portable machine that’s used to measure how much glucose (a type of sugar) is in the blood (also known as the blood glucose level). True or False
True
A complicated disease that may cause more complications for the patient than just an increased blood glucose level.
Diabetes Mellitus
once known as juvenile diabetes or insulin-dependent diabetes
TYPE 1 DM
High glucose values accompanied by high insulin levels
TYPE 2 DM
a chronic condition in which the pancreas produces little or no insulin
TYPE 1 DM
don’t respond to insulin as well as they should and later in the disease often don’t make enough insulin
TYPE 2 DM
DM seen in younger patients (children and young adults)
TYPE 1 DM
DM seen in adult patients
TYPE 2 DM
blood glucose levels are too high, but not high enough to be called diabetes.
Prediabetes
Used for glucose tolerance test
Fasting Glucose
Fasting Blood Glucose: Normal fasting glucose
70 – 99 mg/dL
Fasting Blood Glucose: Prediabetic
100 – 125 mg/dL
Fasting Blood Glucose: Diabetic
Greater or equal to 126 mg/dL
Detects borderline diabetes by measuring the patient’s ability to dispose of a large oral intake of glucose.
Glucose Tolerance test (GTT)
The patient should omit medications that are known to affect glucose tolerance and be on a diet of at least 150 g of carbohydrates for 3 days prior to the test. True or False
True
Most pregnant women have a glucose screening test between 24 and 28 weeks of pregnancy. True or False
True
Oral Glucose Tolerance
(2 hours after 75g glucose load): Normal
Less than 140 mg/dL
Oral Glucose Tolerance
(2 hours after 75g glucose load): Prediabetic
140-200 mg/dL
Oral Glucose Tolerance
(2 hours after 75g glucose load): Diabetic
Greater than 200 mg/dL
This test is done to see how
your body responds to sugar and starch after you eat a meal.
Postprandial Glucose test
Gestational Diabetes Glucose Tolerance (after 100 g glucose load): Fasting
96 mg/dL
Gestational Diabetes Glucose Tolerance (after 100 g glucose load): 1 hr. after glucose load
180 mg/dL
Gestational Diabetes Glucose Tolerance (after 100 g glucose load): 2 hrs. after glucose load
155 mg/dL
Gestational Diabetes Glucose Tolerance (after 100 g glucose load): 3 hrs. after glucose lead
140 mg/dL
Glucose drink is given to patient containing either 50,
75, or 100 grams of glucose. True or False
True
Patients finger-stick themselves
and put a drop of blood on a small testing pad. True or False
True
Testing for glucose in the urine is a standard analyte tested in a urinalysis. True or False
True
Used to monitor the glucose of a person with diabetes over time. It measures the average blood glucose over the past 2 or 3 months.
Hemoglobin A1c (Glycosylated Hemoglobin)
Hemoglobin A1c indication: Normal
4 – 5.6%
Hemoglobin A1c indication: Prediabetic
5.7 – 6.4 %
Hemoglobin A1c indication: Diabetic
6.5% or higher
a sugar that is used in a tolerance test to determine malabsorption and used as an indication of the absorption function of the intestine.
D-xylose
the time it takes a standardized incision to stop bleeding.
Bleeding time
Collected whenever it is suspected that a patient has septicemia, a condition in which microorganisms (mainly bacteria) circulate and multiply in the patient’s blood
Blood Culture
Syringe blood culture
collection: Anaerobic first. True or False
True
Butterfly blood culture collection: Aerobic first. True or False
True
Both aerobic bottles and anaerobic bottles must be collected. True or False
True
The amount of blood needed is 8-10 mL per blood culture bottle with two bottles taken in a set. True or False
True
PPD injected under the skin to produce wheal (whitish raised bump) under the skin to test the patient for exposure to mycobacterium tuberculosis. True or False
True
Alternative for tuberculin skin test: Quantiferon blood test or T spot blood test. True or False
True
the most common sample the patient needs to collect.
Urine
All samples except the 24-hour collection are best collected using the clean-catch midstream urine method. True or False
True
Most concentrated sample
First morning or 8-hour sample
Can be collected any time
Random sample
Sample (analyte) is tested at two specific times
Double-voided sample
Patient collects urine, then drinks 200mL of water and waits 2 hours (or a specified time) to collect another sample.
Double-voided sample
Collected at a specific time during a 24-hour period or after a specific activity
Timedsample
Sample is collected over a 24- hour period to test for diurnal variation
24-hour sample
In a 24-hour sample, the First-morning sample is discarded, then all urine is saved, including the next first-morning sample. True or False
True
Patients clean themselves with antiseptic wipes, urinates in the toilet, and then stops, continues to urinate in the collection container.
Clean-catch midstream urine
(CCMS) collection
Only collected when the voluntarily produce urine patient cannot
Catheterized urine collection
Usually used as part of a pre-employment physical or in legal sample collections.
Chain-of-custody urine
The sample is collected from the patient, and the temperature of urine is checked to determine if urine is fresh or not.
Chain-of-custody urine
The sample is collected midstream into a sterile container. Sample must be cultured within 1 hour of collection and refrigerated or a special preservative container used.
Urine culture collection
delay of testing may deteriorate chemical and cellular components. True or False
True
If testing is delayed for more than 1 hour, special precautions must be taken: o Refrigeration at 5°C o Special preservatives tubes: urine preservative tubes and transfer straw
True or False
True
Semen samples are collected to determine the number and activity of sperm contained in the semen. This can be done as part of a fertility study. True or False
True
Urine cultures are collected in the same manner as a mid-stream urine collection. True or False
True
The phlebotomist may also collect throat culture or sputum samples for culture. True or False
True
Nasopharyngeal cultures are cultures of the nasal cavity and pharynx. True or False
True
A swab is used to collect the sample for a throat culture. True or False
True
Nasopharyngeal cultures are done with a Dacron or cotton-tipped flexible wire swab. True or False
True
_________ is the mucus and phlegm that a person will cough out from the lungs, bronchi, or trachea.
Sputum
mucus is the sample that will need to be tested for infections or types of body cells being expelled during
coughing episodes. True or False
False - Sputum
Fecal samples are used to help evaluate gastrointestinal (GI) disorders. True or False
True
Evaluation for the presence of occult (hidden) blood (guaiac test) is the most common test completed on feces. True or False
True
Intestinal parasites and their eggs (ova and parasite [O & P]) can be detected through feces examination. True or False
True
Special test cards are used for patients to collect feces on the card and the card is then tested in the laboratory. True or False
True
Chemistry tests for fats and
urobilinogen can be conducted on feces. True or False
True
A female taking prescription or illegal drugs during gestation may adversely affect neonatal development, resulting in infant mortality or developmental or behavioral problems for neonate. True or False
True
Early detection of a neonate addicted to drugs can be done through testing either the neonate’s meconium or a section of the neonate’s umbilical cord. True or False
True