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43 Cards in this Set

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Why do practitioners order laboratory tests?
1. Detect and quantify the risk of future disease
2. Establish and exclude diagnoses
3. Asses the severity of the disease process and determine the prognosis
4. Guide the selection of interventions
5. Monitor the progress of the disorder
6. Monitor the effectiveness of the treatment
The clinical value of a test is related to what four factors?
1. Specificity (correctly identifying who does NOT have the disease)
2. Sensitivity (correctly identifying those who DO have disease)
3. Incidence (prevalence of disease in population)
4. Predictive Value (correctly identify disease state; true positive vs true negative)
What are the colors for test tubes for venipuncture?
Red (no addivitive)
Lavender (EDTA)
Light Blue (sodium citrate)
Green (sodium heparin)
Gray (potassium oxalate)
Black (sodium oxalate)
What is hemoconcentration? How is it caused?
Hemoconcentration is reduced volume of plasma water. It can be caused by:
- prolonged standing
- prolonged time of application of touniquet
- dehydration
What is hemolysis and how is it caused?
Hemolysis is the breakdown of red blood cells. Caused when blood is rapidly flowed through small-bore needles and exposed to large negative pressures.
How can you prevent hemoconcentration?
Keep to a minimum the length of time a client stands and length of time a tournique is applied.
How can you prevent hemolysis?
Use large-bore needles, moderate flow rate, and moderate negative pressure.
Is it OK to draw blood from below an intravenous infusion?
Yes: you should not draw from ABOVE to avoid contamination of blood sample with intravenous solution.
Mr. Joseph comes in for a venipuncture, and states that he is taking an anticoagulant. What should the nurse do after the venipuncture is finished?
Apply pressure to the puncture site for 3-5 minutes.
When should a nurse spend time to clean a puncture site for 2-3 minutes?
When they have to puncture the skin of a client with depressed white blood cell count.
What is the purpose of an ABG?
Arterial blood gases: shows ability of lungs to exchange gas.
When should arterial punctures NOT be performed?
1. Client is hyperthermic
2. Client has had a breathing and suctioning treatment
3. Client has had changes on their ventilator settings.
How long should you wait to perform an arterial puncture on a patient who has had a respiratory treatment?
You must wait at least 20 minutes.
What are some contraindications of arterial punctures?
1. Anticoagulant therapy
2. Clotting disorders
3. Symptomatic peripheral vascular disease
4. Negative Allen test (measures the collateral circulation to the radial artery)
Mr. Joseph has had an arterial puncture performed, and is telling his nurse that he has numbness occuring in the arm used. What could this indicate?
Impaired circulation.
What are the common sites of capillary punctures?
Heels, fingertips, and earlobes.
When performing a capillary puncture on a neonate or infant, where should it be preformed?
On the heel.
When performing a capillary puncture on the earlobe, what condition is the client in?
The client is either in shock or has edematous extremities.
When are central lines generally used?
When a peripheral route cannot be obtained, for treatment, and to withdraw blood for analysis.
Mr. Joesph has a central line that is the Hickman Catheter (two lumens). One line is being used for medication. What should the nurse do with the other line?
The extra lumen should be capped and flushed with heparin every 8 hours to prevent clotting.
Is the use of a sterile container necessary for a random collection of urine?
No: a clean cup works. Client pees into a cup or clean bedpan, and that urine is transported to the lab.
How does the client collect their urine for a timed collection?
Client pees into a clean container, then pours urine into a collection bottle. The first voided collection is discarded.
Why should you collect urine from a Foley's closed drainage tubing aspiration port instead of the drainage bag?
Bacteria grow quickly in the drainage bag.
What are the six types of WBC?
Neutrophils, basophils, lymphocytes, eosinophils, monocytes, plasma cells.
What is used to determine the type of anemia a patient has?
Red cell indices, including
- mean red cell hemoglobin
- mean red cell hemoglobin concentration
- mean red cell volume
If a patient has an abnormal result from a test on their red blood cell count, what is the clinical significance?
Increased: dehydration
Decreased: anemia
If a patient has an abnormal result from a test on their hemoglobin, what is the clinical significance?
Increased: COPD, polycythemia, high altitudes, burns, shock
Decreased: anemia, severe hemorrhage
If a patient has an abnormal result from a test on their hematocrit, what is the clinical significance?
Increased: dehydration, polycythemia
Decreased: Leukemia, hemorrhage
If a patient has an abnormal result from a test on their white blood cell count, what is the clinical significance?
Increased: Acute leukemia, infections, surgery, trauma
Decreased: Acute chronic leukemia, aplastic anemia, agranulocytosis
If a patient has an increased range of neutrophils, what is the clinical significance?
Severe bacterial disease, diabetic acidosis, infarction, inflammatory diseases, malignancies
If a patient has an increased range of lymphocytes, what is the clinical significance?
Chronic lymphocytic leukemia
If a patient has an decreased range of neutrophils, what is the clinical significance?
Lupus, Hodgkin's disease
If a patient has an increased range of monocytes, what is the clinical significance?
Chronic inflammatory diseases
If a patient has an increased range of eosinophils, what is the clinical significance?
Allergies, parasites
If a patient has an increased range of basophils, what is the clinical significance?
Myelofibrosis
What does the PTT test measure?
The ability of blood to clot; prolonged with any intrinsic factor deficiencies such as hemophilia
What does the PT test measure?
PT measures the total quantity of prothrombin in the blood. Used to monitor effectiveness of coumarin therapy and prolonged by deficiencies in the extrinsic factors and vitamin K.
What are the nurse's roles with diagnostic testing?
1. Interpret results for patient status
2. Schedule and prepare patient
3. Ensure patient safety prior to, during, and after test
What is the clinical significance of increased and decreased ranges of Sodium levels?
Increased: salt water drowning, diarrhea, diabetes insipidus, renal failure
Decreased: excessive water intact, heart failure, cirrhosis
What is the clinical significance of increased and decreased ranges of Potassium levels?
Incrased: renal disease, drugs (steroids, etc.), Addison's, burns
Decreased: Diuretics, metabolic alkalosis, Cushing's disease, vomiting
What is the clinical significance of increased and decreased ranges of Chloride levels?
Increased: Hyperparathyroidism, dehydration
Decreased: Prolonged vomiting and gastric suction, diarrhea, diuretics
What is the clinical significance of increased and decreased ranges of Magnesium levels?
Increased: chronic renal failure
Decreased: chronic diarrhea, starvation, bowel resesction
What is the clinical significance of increased and decreased ranges of Phospate levels?
Increased: Renal insufficiency, blood transfusion, muscle necrosis
Decreased: alcohol withdrawal, hyperventilation, diabetic ketoacidosis