Unit 8 - Special Collection & Point-Of-Care-Testing (POCT) Flashcards
1
Q
Yield information that determines which blood products can be transfused safely into a patient.
A
Blood bank specimens
2
Q
Blood bank tests require the collection of one or more __________ tubes In some cases, __________ tube is used.
A
Lavender- or pink-top EDTA
Nonadditive glass red-stoppered tube is used.
3
Q
T/F
Blood bank specimens require strict patient identification and specimen labeling procedures.
A
T
4
Q
T/F
Specimens that have labeling errors of any kind or are unlabeled will not be accepted for testing.
A
T
5
Q
T/F
An error in specimen identification or labeling requires recollection of the specimen and causes a delay in patient treatment.
A
T
6
Q
T/F
An undetected error can result in administration of an incompatible blood product and the possibility of a fatal transfusion reaction.
A
T
7
Q
T/F
One system uses a special ID bracelet such as the PDC Securline Blood Bank, which is attached to the patient’s wrist.
A
T
8
Q
In a special ID bracelet system, the patient’s identity is confirmed and the information written on a self-carbon adhesive label on the special bracelet contains a ___________.
A
Unique ID number
9
Q
Labeling requirements for blood bank specimens.
A
– Patient’s full name (including middle initial)
– Patient’s date of birth
– Date and time of collection
– Phlebotomist’s initials
- Room number and bed number (optional)
- Patient’s hospital identification number (or social security number for outpatients)
10
Q
A place where blood is collected and stored before it is used for transfusions.
A
Blood bank
11
Q
Perform tests to ensure that blood from donors and other blood products are safe before blood transfusion.
A
Blood bank
12
Q
We use blood bank specimens for _____ and _____.
A
Compatibility testing
Screening for blood-borne pathogens
13
Q
Compatibility testing
A
Blood typing
Screening for unexpected cell antibodies
14
Q
Screening for blood-borne pathogens
A
Hepatitis viruses
HIV
HTLV
Syphilis
West nile virus
Malaria
15
Q
What are the special identification systems in blood bank specimens?
A
ID bracelet
Blood product validation
16
Q
ID bracelet with barcoded ID number contains _____ information.
A
Patient
17
Q
Blood product validation contains what?
A
Clinician identity
Patient identity
Donor identifier
Blood product’s barcode on the blood unit
18
Q
Commonly performed tests in blood banking.
A
Blood typing and screening
19
Q
T/F
In blood bank tests, we screen for infections and unexpected RBC ANTIGENS.
A
F. It should be RBC ANTIBODIES
20
Q
Procedure for compatibility testing and selection of safe blood for transfusion.
A
Cross-matching
21
Q
Testing of donor’s red cells with patient’s serum to detect antibodies in the patient.
A
Major cross-match
22
Q
Testing of patient’s serum with donor’s red cells.
A
Major cross-match
23
Q
Testing of donor’s serum with patient’s red cells to detect antibodies in the donor serum.
A
Minor cross-match
24
Q
Testing of donor’s serum with patient’s red cells.
A
Minor cross-match
25
In cross matching procedures, we check for blood _____ and _____.
Agglutination
Hemolysis
26
Manifestation of incompatibility.
Agglutination
Hemolysis
27
T/F
In blood bank donor collection, we collect blood to be used for blood transfusion procedures rather than for diagnostic procedures.
T
28
During a regular donation, we give around how much blood?
450 mL of whole blood
29
T/F
Presence of anxiety, drug or alcohol to the donor should be deferred.
T
30
Donor eligibility check for AGE.
17 to 66 y/o
31
Donor eligibility check for TEMPERATURE.
37.5 C or 99.5 F
32
Donor eligibility check for WEIGHT.
Minimum weight of 110 lbs or 49.8 kg ~ 50 kg
33
Donor eligibility check for NORMAL BLOOD PRESSURE.
180 mmHg (systolic pressure)
100 mmHg (diastolic pressure)
34
Donor eligibility check for NORMAL PULSE RATE.
50 to 100 bpm
35
Donor eligibility check for ACCEPTABLE HEMOGLOBIN LEVELS.
12.5 g/dL
36
Donor eligibility check for ACCEPTABLE HEMATOCRIT LEVELS.
Atleast 38%
37
T/F
A donor is eligible if he or she doesn't have skin lesions or any skin disorders that are not cause for deferral like ivy and other rashes.
T
38
The anticoagulant and preservative used in collecting units of blood for transfusion purposes.
Citrate Phosphate Dextrose (CPD) or CPD plus adenine (CPDA1)
39
It prevents clotting by chelating calcium.
Citrate
40
A compound that stabilizes the pH.
Phosphate
41
It provides energy to the cells and helps to keep them alive.
Dextrose
42
T/F
Donor units are normally collected from a large antecubital vein.
T
43
The vein is SELECTED in a manner similar to routine _____ and CLEANED in a manner similar to _____ collection.
Venipuncture
Blood culture
44
The collection unit is a sterile, closed system consisting of a bag to contain the blood connected by a length of tubing to a sterile _____ needle.
16G to 18G
45
T/F
The bag fills by gravity and must be placed lower than the patient’s arm.
T
46
T/F
The collection bag contains an anticoagulant and preservative solution and is placed on a mixing unit while the blood is being drawn.
T
47
The unit is normally filled by weight but typically contains around _____ of whole blood when full.
450 mL
48
T/F
Only one needle puncture can be used to fill a unit. If the unit only partially fills and the procedure must be repeated, an entire new unit must be used.
T
49
The process by which a person donates blood for his or her own use.
Autologous donation
50
T/F
Autologous donation is done for elective surgeries when it is anticipated that a transfusion will be needed.
T
51
T/F
Using one’s own blood eliminates many risks associated with transfusion, such as disease transmission and blood or plasma incompatibilities.
T
52
Although blood is normally collected several weeks prior to the scheduled surgery, the minimum time between donation and surgery can be as little as _____ hours.
72 hours or 3 days
53
T/F
To be eligible to make an autologous donation, a person must have a written order from a physician.
T
54
A blood bank procedure that reduces the chance of hemolytic reactions and transmission of blood-borne diseases.
Autologous donation
55
We perform blood cultures to test the presence of _____.
Bacteremia
Septicemia
56
It helps to determine the PRESENCE AND EXTENT of infection as well as indicating the type of ORGANISM responsible and the ANTIBIOTIC to which it is most susceptible.
Blood culture
57
Blood culture if collected _____ prior to fever peak, before the body can eliminate some of the microorganisms.
30 minutes to 2 and 1/2 hours
58
In detecting bacteria in blood, aside from performing blood culture, we do _____ testing.
Susceptibility or sensitivity
59
The medium used in special collection bottles.
Nutrient broth
60
What are the sets of specimens used in blood culture?
Aerobic bottle
Anaerobic bottle
61
It allows preferential growth of AEROBIC and FACULTATIVE ANAEROBIC microorganisms.
Aerobic bottle
62
Allowing preferential growth of strict anaerobic bacteria.
Anaerobic bottle
63
Microorganisms that needs oxygen to survive.
Aerobic bacteria
64
Microorganisms that can survive with or without oxygen.
Facultative anaerobic bacteria
65
Microorganism that survive in the absence of oxygen because it is toxic to them.
Obligate anaerobic bacteria
66
Anticoagulant used in blood culture.
0.025% to 0.050% Sodium Polyanethol Sulfonate (SPS)
67
Tubes that inhibits the growth of microorganism.
Sodium citrate
Heparin
EDTA
68
How many blood cultures are needed to optimize the detection of microorganisms in the blood.
2 to 4 blood cultures
69
Blood cultures are drawn _____ apart.
30 to 60 minutes
70
T/F
Blood cultures are drawn consecutively and immediately from different sites.
T
71
Blood-broth ratio.
1:5 – 1:10
72
T/F
For adults, the patient weighing greater than 80 lbs or 36 kg is required.
T
73
Recommended blood volume for blood culture.
20 to 30 mL
minimum of 10 mL per draw
74
Recommended draw for pediatric patients weighing less than 1 kg.
2 mL
75
Recommended draw for pediatric patients weighing 2 kg.
4 mL
76
Recommended draw for pediatric patients weighing 12.7 kg.
6
77
Recommended draw for pediatric patients weighing 36.3 kg.
10 mL
78
Recommended draw for pediatric patients weighing greater than 36.3 kg.
2 to 30 mL
79
Some pediatric bottles may be supplemented with _____ to enhance the recovery of _____.
X and V factors
Haemophilus influenzae
80
Antiseptic or sterile technique is done to minimize the risk of the _____ of the skin.
Normal flora
81
Duration of friction scrub.
30 to 60 s
82
Antiseptics used for blood culture collection.
Tincture of iodine
Chlorhexidine gluconate*
Povidone/70% ethyl alcohol combination
83
Antiseptics in a form of swab sticks.
10% povidone iodine
1% to 2% tincture of iodine
84
Antiseptics in a form of cleaning-pad kits.
Benzalkonium chloride
85
The area covered should be _____ at the puncture site.
3 to 4 in. in diameter
86
Tests performed in evaluation of hemostasis.
Activated Partial Thromboplastin Time (APTT)
Prothrombin Time (PT)
87
Anticoagulant of choice in evaluation of hemostasis.
Trisodium citrate
88
Ratio of citrate to blood.
1:9
89
Ratio of blood to citrate.
9:1
90
Blood samples for coagulation testing should be collected by clean atraumatic venipuncture, and excessive application of vacuum should be avoided to minimize activation of ______.
Platelets
91
Cooling on ice during transport may be required for some test specimens to protect the _____.
Coagulation factors
92
Tests should be performed within __ hours of sample collection.
4
93
Plasma should be frozen within __ hour of harvesting.
1
94
Tube used for special coagulation testing.
Blue-top CTAD tube
95
Anticoagulants in CTAD tubes.
Sodium citrate
Theophylline
Adenosine
Dipyridamole
96
CTAD tube is used to inhibit _____ activation between collection of the blood and performance of the test.
Thrombocyte
97
All anticoagulant tubes must be gently inverted three or four times immediately after collection to avoid _____, which can invalidate test results.
Microclots
98
It means after a meal.
Postprandial (PP)
99
Excellent screening test for diabetes and other metabolic problems
2-hour PP
100
T/F
Glucose levels in blood specimens obtained 2 hours after a
meal are rarely elevated in normal persons but may be significantly increased in diabetic patients.
T
101
A 2-hour PP test is also used to monitor _____.
Insulin therapy
102
T/F
Correct timing of specimen collection is very important.
T
103
T/F
Glucose levels in specimens collected too early or late may be falsely elevated or decreased, respectively, leading to
misinterpretation of result
T
104
In 2-hour PP specimen collection, the patient is placed on a high-carbohydrate diet for _____ days prior to the test.
2 to 3 days
105
T/F
In 2-hour PP specimen collection, the patient fasts prior to the test. This means no eating, smoking, or drinking other than water for at least ___ hours before the test.
10
106
T/F
In 2-hour PP specimen collection, a fasting glucose specimen may be collected before the start of the test.
T
107
T/F
In 2-hour PP specimen collection, the patient is instructed to eat a special breakfast or given a measured dose of glucose beverage on the day of the test.
T
108
T/F
In 2-hour PP specimen collection, a blood glucose specimen is collected 2 hours after the patient finishes eating.
T
109
Used to diagnose problems of carbohydrate metabolism.
Glucose Tolerance Test (GTT)
110
The major carbohydrate in the blood and is the body's source of energy.
Glucose
111
GTT is also called as _____.
Oral Glucose Test (OGTT)
112
T/F
OGTT evaluates the body’s ability to metabolize glucose by
monitoring the patient’s tolerance to high levels of glucose without adverse effects.
T
112
Major types of disorders involving glucose metabolism.
Hyperglycemia
Hypoglycemia
113
Blood glucose level is increased, as in diabetes mellitus.
Hyperglycemia
114
Blood glucose level is decreased.
Hypoglycemia
115
Produced by the pancreas, is primarily responsible for regulating blood glucose levels.
Insulin
116
Used to determine if a patient lacks the enzyme that is necessary to convert lactose (milk sugar) into glucose and galactose.
Lactone tolerance test
117
Enzyme that is necessary to convert lactose into glucose and galactose.
Mucosal lactase
118
T/F
A person lacking the enzyme suffers from gastrointestinal distress and diarrhea following the ingestion of milk and other lactose-containing foods. Symptoms are relieved by eliminating milk from the diet.
T
119
T/F
If the patient has mucosal lactase, the resulting glucose curve will be similar to a GTT curve, and the result is considered negative.
T
120
T/F
If the patient is lactose intolerant, the glucose curve will be flat, rising no more than a few mg/dL from the fasting level.
T
121
If the person is lactose intolerant, the symptoms are relieved by eliminating ___ from the diet.
Milk
122
Performed to determine the probability that a specific individual fathered a particular child.
Paternity or parentage testing
123
T/F
Generally paternity test results exclude the possibility of paternity rather than prove paternity.
T
124
Which of the following is/are people that requests paternity testing.
A. Physician
B. Lawyer
C. Child support enforcement bureaus
D. Individuals
E. All of the above
E
125
Paternity testing requires _____ and specific identification procedures that may include fingerprinting.
Chain-of-custody protocol
126
T/F
The mother, child, and alleged father are all tested.
T
127
T/F
Blood samples are preferred for testing; however, buccal (cheek) swabs are increasingly being used.
T
128
T/F
Blood sample testing usually includes ABO and Rh typing.
T
129
The paternity or parentage testing determines other _____.
Red cell antigens
Red cell enzymes
Serum proteins
White cell enzymes
White cell antigens or Human Leukocyte Antigen (HLA)
129
The paternity or parentage testing determines other _____.
Red cell antigens
Red cell enzymes
Serum proteins
White cell enzymes
White cell antigens or Human Leukocyte Antigen (HLA)
130
DNA extracted from the cells is “mapped” to create a _____.
DNA profile
131
Used in the management of patients being treated with certain drugs to establish and maintain a drug dosage, thus avoiding toxicity.
Therapeutic Drug Monitoring (TDM)
132
_____ of blood sample collection is critical in TDM.
Timing
133
T/F
When a patient takes a drug dose, the amount in the bloodstream rises initially.
T
134
For a drug to be beneficial, the peak (maximum) level must not exceed toxic levels, and the trough (minimum) level must remain within the therapeutic range.
T
135
T/F
Timing of specimen collection in regard to dosage administration is critical for safe and beneficial treatment and must be consistent.
T
136
It involves the withdrawal of large volumes of blood usually measured by the unit (as in blood donation), or approximately 500 mL.
Therapeutic phlebotomy
137
Therapeutic phlebotomy is used to treat conditions such as?
Polycythemia
Hemochromatosis
138
A disease involving the body’s overproduction of RBCs, which is detrimental to the patient’s health and the most common reason for performing therapeutic phlebotomy.
Polycythemia
138
The patient’s RBC levels are monitored regularly, usually by the _____ test.
Hematocrit
139
T/F
Periodic removal of blood when the hematocrit exceeds a certain level is used to help keep the patient’s RBC levels within the normal range.
T
140
A disease characterized by excess iron deposits in the tissues.
Hemochromatosis
141
It can be caused by a defect in iron metabolism or result from multiple blood transfusions or excess iron intake.
Hemochromatosis
142
T/F
In treating hemochromatosis, periodic removal of single units of blood from the patient gradually depletes iron stores, because the body then uses the iron to make new RBCs to replace those removed.
T
143
The detection of toxins and treatment for the effects
they produce.
Clinical toxicology
144
Concerned with the legal consequences of toxin exposure, both intentional and accidental.
Forensic toxicology
145
Which of the following is/are toxicology tests examine.
A. Blood
B. Hair
C. Urine
D. Other body substances for the present of toxins
E. All of the above
E
146
Tests may detect a specific drug or screen for up to __ different drugs, depending upon the circumstance.
30
147
Drug screening is typically performed on _____ rather than blood because it is easy to obtain and a wide variety of drugs or their metabolites (products of metabolism) can be detected in urine for a longer period of time.
Urine
148
Trace elements or metals includes?
Lead
Iron
Zinc
Arsenic
Aluminum
Copper
149
It is measured in such small amounts that traces of them in the glass, plastic, or stopper material of evacuated tubes
may leach into the specimen, causing falsely elevated test
values.
Trace elements
150
Trace elements must be collected in?
Trace element-free Royal Blue Top
151
T/F
It is important to prevent introducing even the smallest
amount of the contaminating substance into the royal blue top tube .
T
152
POCT is also known as?
Alternate site testing (AST)
Ancillary
Bedside
Near-patient testing
153
It brings laboratory testing to the location of the patient.
POCT
154
T/F
POCT utilizes small, portable, and often handheld testing devices.
T
155
T/F
One of the benefits of POCT include convenience to the patient and a short turnaround time (TAT) for results that allow healthcare providers to address crucial patient needs, deliver prompt medical attention, and expedite patient recovery.
T
156
T/F
POCT is performed where patient care is delivered including physician office testing, various hospital locations outside the laboratory, such as the emergency department, operating room, and intensive care unit.
T
157
T/F
Equipment, if needed, must be evaluated in POCT.
T
158
T/F
In POCT, a person of sufficient managerial authority is designated as being responsible for the site.
T
159
T/F
In POCT, persons performing the test must be trained and competency assessed, and this must be. documented.
T
160
T/F
In POCT, a written procedure must be available and followed.
T
161
T/F
In POCT, calibrations and quality control samples must be run at regular intervals.
T
162
T/F
In POCT, all patient results must be documented, and the relationship to quality control measures must be clear.
T
163
T/F
In POCT, appropriate action must be taken and documented on all out-of-range quality control results.
T
164
T/F
In POCT, appropriate action must be documented on all abnormal patient results.
T
165
The PT test is used to monitor _____ therapy.
Warfarin
166
Prothrombin time measures the activity of coagulation factors involved in _____ coagulation pathway
Extrinsic
167
It tests on whole blood from a fingerstick to provide timely
laboratory results.
Prothrombin time (PT)
International Normalized Ratio (INR)
168
Test is used to screen for bleeding disorders prior to surgery, investigate bleeding or clotting disorders, detect clotting factor deficiencies.
Activated Partial Thromboplastin Time
169
APTT is used to monitor unfractionated _____ therapy.
Heparin
170
APTT is used to screen for _____ pathway deficiencies.
Intrinsic
171
APTT is used to screen for _____ anticoagulant.
Lupus
172
APTT is clot-based screening test for _____ coagulation.
Intrinsic
173
This analyzes activity of the intrinsic coagulation factors and is used to monitor heparin therapy.
Activated Clotting Time (ACT)
173
Whole-blood clotting time test often used in cardiac surgical suites
Activated Clotting Time (ACT)
174
It is also used to monitor high-dose unfractionated heparin therapy.
Activated Clotting Time (ACT)
175
It is also used to monitor high-dose unfractionated heparin therapy.
Activated Clotting Time (ACT)
176
Testing allows the clinician to determine a patient’s response to medication before open heart surgery or cardiac catheterization.
Platelet function
177
Time required for blood to stop flowing from a standardized puncture on the inner surface of the forearm.
Bleeding-time (BT)
178
It evaluates platelet plug formation in the capillaries to detect platelet function disorders and capillary integrity problems.
Bleeding-time (BT)
179
Time interval in BT is required for blood to stop flowing from a puncture wound on the _____ surface of the
forearm.
Volar
180
It is performed to evaluate vascular and platelet function.
BT
181
BT is performed on the volar (inner) lateral surface
of the forearm, using a blood pressure cuff (__ mmHg) to standardize and maintain a constant pressure.
40
182
Arterial blood gases (ABGs) measured by POCT methods include?
pH
Partial pressure of CARBON DIOXIDE (PCO2)
Partial pressure of OXYGEN (O2)
Oxygen saturation (SO2)
183
An abbreviation for potential hydrogen, a scale representing the relative acidity or alkalinity of a solution.
pH
184
A measure of the body’s acid–base balance and indicates his or her metabolic and respiratory status.
Arterial blood pH
185
The normal range for arterial blood pH.
pH 7.35 to 7.45
186
Below-normal pH is referred to as _____.
Acidosis
187
Above-normal pH is referred to as _____.
Alkalosis
188
A measure of the pressure exerted by dissolved CO2 in the blood plasma and is proportional.
Partial pressure of carbon dioxide
189
An indicator of how well air is being exchanged between the blood and the lungs.
Partial pressure of carbon dioxide
190
T/F
CO2 levels are maintained within normal limits by the rate and depth of respiration.
T
191
An abnormal increase in PCO2 is associated with _____ and a decrease with _____.
Hypoventilation
Hyperventilation
192
A measure of the pressure exerted by dissolved O2 in the blood plasma and indicates the ability of the lungs to diffuse O2 through the alveoli into the blood.
Partial pressure of oxygen
193
It is used to evaluate the effectiveness of oxygen therapy.
Partial pressure of oxygen
194
A measure of the percentage of hemoglobin binding sites occupied by oxygen in the bloodstream.
Oxygen saturation
195
It is used by physicians to determine a patient’s oxygenation status.
SO2
196
A normal, healthy individual will usually exhibit oxygen saturation around __%
98%
197
A person with an arterial SO2 below 90% is said to have _____ (a low oxygen level in the blood) and may be _____.
Hypoxemia
Cyanotic
198
The most common electrolytes measured by POCT.
Sodium (Na+)
Potassium (K+)
Chloride (Cl-)
Bicarbonate ion (HCO3-)
Ionized calcium (iCa2+)
199
Most plentiful electrolyte in the blood.
Na+
200
It plays a major role in maintaining osmotic pressure and acid–base balance and in transmitting nerve impulses.
Na+
201
Reduced sodium levels are referred to as _____.
Hyponatremia
202
Elevated sodium levels are referred to as _____.
Hypernatremia
203
Primarily concentrated within the cells, with very little found in the bones and blood.
K+
203
It is released into the blood when cells are damaged.
K+
204
Plays a major role in nerve conduction, muscle function, acid–base balance, and osmotic pressure.
K+
205
Influences cardiac output by helping to control the rate and force of heart contraction.
K+
206
The presence of a _____ on an electrocardiogram indicates potassium deficiency.
U wave
207
Decreased blood potassium.
Hypokalemia
208
Increased blood potassium.
Hyperkalemia
209
Responsible for maintaining cellular integrity by influencing osmotic pressure and both acid–base and water balance.
Cl-
210
Chloride must be supplied along with _____ when hypokalemia is being corrected.
Potassium
211
Plays a role in transporting carbon dioxide (CO2) to the lungs and in regulating blood pH.
HCO3-
212
Can be used by the body for such critical functions as muscular contraction, cardiac function, transmission
of nerve impulses, and blood clotting.
iCa2+
213
Proteins specific to heart muscle.
Cardiac troponin T (TnT)
Troponin I (TnI)
214
Analytes that are utilized to assess the
occurrence of myocardial infarction (MI) or the extent of
damage produced by cardiovascular disease.
Cardiac markers
215
One of the most common POCT procedures and is most often performed to monitor glucose levels of patients with diabetes mellitus.
Glucose
216
T/F
Glucose analyzers predominantly use whole-blood specimens obtained by routine skin puncture.
T
217
In glucose testing, drop of blood is applied to the test
strip or _____.
Microcuvette
218
T/F
Analyzer determines the level of glucose in the blood, and the result appears on a display screen.
T
219
Primary constituent of red blood cell cytoplasm and transports molecular oxygen from the lungs to the tissues and returns carbon dioxide to the lungs.
Hemoglobin (Hb)
220
T/F
In measuring the Hb, a small amount of blood sample is placed in a special microcuvette and inserted into
the machine for a reading.
T
221
A diagnostic tool for monitoring diabetes therapy.
Glycosylated hemoglobin
222
Hct is also called _____.
Packed cell volume (PCV)
223
A measure of the volume of RBCs in a patient’s blood.
Hct or PCV
224
T/F
The measurement of hemoglobin (hgb) levels is an important part of managing patients with anemia.
T
225
Pregnancy tests detect the presence of _____.
Human chorionic gonadotropin (hcG)
226
A hormone produced by the placenta.
hcG
227
hcG appears in
Urine and serum
228
hcG appears in both urine and serum beginning approximately _____ days after conception.
10
229
T/F
Most rapid pregnancy testing is performed on blood.
F
230
Peak urine levels of hcG occur at approximately how many weeks of gestation?
10 weeks of gestation
231
Consists of a physical and chemical analysis of the specimen as well as microscopic analysis if indicated.
Urinalysis
