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32 Cards in this Set
- Front
- Back
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What is the 3 main variables for error associated with lab testing?
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1. Pre-analytical (pre-testing)
2. Analytical (testing) 3. Post-analytical (result generated) |
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What pre-analytical variables are important to Plebotomist?
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- Patient assessment
- Test Requests -Specimen collection - Specimen transport - Specimen receipt in the laboratory |
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When should blood be drawn?
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When the patient is in the basal state = early morning, about 12 hour after eating.
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What sorts of diet conditions are instructed of patients?
Why are they asked? |
- Fasting (8-12 hrs) = no food, drink only water
- NPO = nothing by mouth; no water, no food - Why?--> blood composition affected by food; sugar --> high glucose; fast food --> high fats. |
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If the patient is obese, what usually what vein do you choose?
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The cephalic vein is often the vein of choice
Ask patient for best site. |
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Where to draw when veins are obstructed?
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Draw below the damaged area or choose another site
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What if the patient has an allergy to antiseptic, adhesive or latex?
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-use alternative antiseptic
- use paper tape - use non-latex tournequettes and gloves |
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How can stress affect test results?
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- increase WBC count, renin, TSH, and the hormone cortisol.
- hyperventilation will alter blood gas results |
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How can exercise affect test results and what to do?
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- affect certain test such as fibrinolysis
- inform physician; up to physcian to interpret results |
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Why is it important to collect sample at designated time?
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- body fluid flunctuates during the day
- some hormone level decrease in afternoon (e.g. cortisol highest in morning) |
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How does posture affect test result and what to do?
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-increased enzyme, protein, iron, lipid and calcium levels
- if the patient has been lying down for a long time, let them stay lying down. |
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How does age affect test result?
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Different normal ranges for different age groups
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How does mastectomy affect lab tests and what to do to avoid?
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- Mastectomy - surgical removal of breast
- may have lymph edema on the same side as surgery - more prone to infection --> due to decrease in flow of lymphatic system - Do not draw on same side as mastectomy |
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How does Edema affect lab results?
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Edema = abnormal accumulation of gluid in tissues that causes swelling
- localized or diffused in the body - cause difficulties in palpating for veins - blood --> contamination with fluid |
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How does drugs interfere with lab results? and what to do?
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- drugs interfering with lab test or clotting e.g. aspirin
- To determine blood levels of medication, blood should be collected prior to next dose -Collect blood at correct time otherwise lab values may be falsely increased/decreased |
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What to do when thrombosis occurs in patients?
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Thrombi = solid masses comprised of blood cell that are lodged in blood vessels.
- clot blocks vein or artery --> makes venipucture difficult |
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What to do if patient has burns or scars?
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- Avoid tattooed, burned, scarred areas
(scarred areas --> hard to palpate) (healed burnt/scar sites = bad circulation --> false test results) (new burnt area = infection prone, painful) |
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What to do when patient feels like vomitting/ is nausious?
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- Ask them to take deep breaths
- use cold washcloth on his/her head -inform physician |
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Is there diffference in testing results in gender?
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Different gender have different reference ranges
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How does tourniquet pressure or fist pumping afffect lab results?
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Hemoconcentration = increase in plasma potassium, lactate, and phosphate concentrations
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what are factors that affect blood draw?
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-not inserting needle deep enough
- inserting needle all the way thru the vein - holding needle bevel against the vein wall - loss of vacuum in tube |
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What to do when patient starts to faint during process?
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1. remove tounequet
2. withdraw needle quickly 3. talk to patient to keep him/her alert 4. lower patient's head and have them breath deeply 5. loosen tight clothing 6. put cold washcloth on forehead or back of neck 7. alert nurse/doctor of patient doesn't respond 8. have patient REMAIN for 15 min. |
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How does a hematoma affect lab result?
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hematoma = bruises that forms when blood leaks into tissues.
- do not draw from hematoma site - if hemotoma develops while drawing, STOP and apply pressure |
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What factors that causes hematoma?
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- Veins to small for needle size
- Needle penetrates thru vein - Needle partially inserted into vein - needle removed while tourniquet still on - inadequate pressure after venipuncture |
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What is petechia and what to do?
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Petechiae = small red spots that indicate bleeding disorder
- Keep drawing |
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What to do if patient has excessive bleeding?
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-Maintain pressure until bleeding stops
-not stopped after 5 min, call the nurse |
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What to do if you hit a nerve?
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-Patient experience a painful sharp sensation radiating down the arm
- STOP draw, remove needle and apply pressure to the site - fill out incident report and notify patient's physcian |
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What to do when patient is under IV?
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- Draw from the other arm
- if no site is available, draw BELOW the IV (have RN turn off IV for min of 2 min) (Draw 5-10 mL and discard) (Collect, afterwards turn back on IV) |
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How does hemolysis affect test results?
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Hemolysis = the breakdown of RBC and the release of hemoglobin
- plasma/serum --> pink to red - affect certain test like potassium |
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What to do when patient is lipemic?
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-Serum appears milky = high lipids
- can result in bacterial contamination - can't do anything except report |
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What to do if patient has a fistula?
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fistula = fusion of vein and artery (by surgery)
-Specimen should be drawn on other arm. |
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What may happen when serum is separated for cells after 2 hrs
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false test may occur:
Glucose: falsely decreased Potassium: falsely increased LDH: falsely increased |
