Phlebotomy Essentials 4Th Edition, Chap 11

Front 1

undetected error in blood bank specimens can result in?

Back 1

administration of an incompatible blood product and possiblity of a fatal transfusion reaction

Front 2

list the blood bank label requirements

Back 2

check label against ID braclet( it is only good for 72 hrs)
full name
hospital ID# or SS#
DOB
date and time of collection
phlebotomist initials
witness (must be 2 persons in room during collection)
room # and Bed # (optional)

Front 3

most common test performed by blood bank?
Test determines

Back 3

type and screen
blood type (ABO) and RH factor (+/-)

Front 4

compatibility during crossmatch
Done on what blood parts?
if incompatible what happens?

Back 4

sutability to be mixed
plasma or serum (patient)
RBCs(donor)
can be fatal(because of aggulation and lysis of RBCs

Front 5

aggulation

Back 5

clumping

Front 6

lysis

Back 6

rupturing

Front 7

lookback program ( in ref to blood collection)

Back 7

requires notification to all blood recipients when a donor for a blood product they have received has turned positive for a transmissible disease

Front 8

autologous donation

Back 8

process by which a person donates blood for his own use.
several weeks normal..can be 72 hrs

Front 9

FUO

Back 9

fever of unknown orgin

Front 10

bacteremia

Back 10

bacteria in the blood

Front 11

septicemia

Back 11

microbes or their toxins in the blood

Front 12

blood cultures help determine?

Back 12

presence and extent of infection..type of organism..antibiotic most susceptible..effectiveness of treatment

Front 13

blood cultures typically ordered when a FUO is?

Back 13

immed before or after anticipated fever spikes(bacteria most likely to be present)

Front 14

blood culture specimen bottles contain?

Back 14

media(nutrient broth..encourages growth of microbes)

Front 15

blood culture specimen typically collected in sets of two..they are?
which collected first?

Back 15

aerobic(with air)
anaerobic(without air)
collect anaerobic first with syringe
aerobic first with butterfly(because of air in tubing)

Front 16

skin antisepsis for blood culture

Back 16

destruction of microorganisms on the skin
10% povidone or
1-2% tincture of iodine or
benzalkonium Chloride (special cleaning pads)infants 2 mos and older and PTs idione sensitive
chloroprep(dry for 5 min)
chlorhexidine gluconate/isopropyl alcohol preparations (one step application effective with a 30 second scrub)

Front 17

PT on antimicrobial therapy
collect blood culture in an?

Back 17

(antibotic therapy)
ARD-antimicrobial removal device (or)
FAN-fastidious antomicrobial nuturalization bottles

Front 18

ARD blood collection bottles contain

Back 18

resin

Front 19

FAN blood collection bottles contain

Back 19

activated charcoal

Front 20

coagulation sodium citrate tubes must be filled until vacumme exhausted. WHY?

Back 20

9:1 ratio of blood to anticoagulant a must

Front 21

D-Xylose absorption test used to diagnose?

Back 21

malabsorption or failure of the small intestine to absorb nutrients

Front 22

what is D-Xylose?

Back 22

simple sugar
pentrose
present in fruit not normal for blood or urine unless foods are eaten that contain it

Front 23

PP-postprandial

Back 23

after a meal

Front 24

blood collected 2 hrs after a meal rarely are elevated in what?
elevated indicates what?

Back 24

glucose
diabetic

Front 25

2-hour PP screens for

Back 25

(glucose test 2 hrs after meal)
diabetes and other metabolism problems

Front 26

GTT
diagnosis ?

Back 26

(glucose tolerance test)
carbohydrate metabolism problems

Front 27

major carb is blood is?

Back 27

glucose(bodys source of energy)

Front 28

OGTT
evaluates?

Back 28

(oral glucose test)
body's ability to metabolize glucose

Front 29

2 major types of glucose disorders?

Back 29

hyperglycemia(diabetes mellitus-glucose increased)
hypoglycemia(decreased)

Front 30

lactose tolerance test used to determine

Back 30

Pt lacks enzyme (mucosal lactase) that is necessary to convert the milk sugar lactose into glucose and galactose

Front 31

Pt lacks enzyme (mucosal lactase) suffers from

Back 31

gastrointestinal distress and diarrhea following ingestion of milk or other lactose containing food

Front 32

lactose tolerance test is perfomed in same manner as?

Back 32

2-hour GTT

Front 33

paternity testing can also be performed by?

Back 33

amniocentesis or chorionic villus sampling(projections of vascular tissue, have same genetic makeup as fertilized egg, become fetal portion of placenta)

Front 34

TDM
used for?
timing

Back 34

Therapeutic drug monitoring
testing of drug levels at specific intervals
timing is critical

Front 35

for a drug to be benefical the TDM, peak (max) levels must not? and the trough (min) levels must?

Back 35

exceed toxic levels
remain within therapeutic range

Front 36

therapeutic phlebotomy involves?
used to treat?

Back 36

withdrawl of large quanities of blood(unit, 500mL)
polycythemia(overproduction of RBCs)
hemochromatosis(excess iron deposits in tissues)

Front 37

chain of custody

Back 37

when forensic specimens collected-special protocol and form

Front 38

ETOH ethanol test
skin antispesis?
tube used?

Back 38

Blood alcohol test
povidone iodine or (BZK)benzalkonium chloride
gray top(sodium floride)

Front 39

Drug screening
NIDA(national institute on drug abuse) collection requirements?

Back 39

-Prep:
explain test purpose and procedure
advise of rights
obtain witnessed signed consent form
-collections:
special area
proctor
labeled propely (establish chain of custody
sealed and placed in a clocked container
documentation carefully maintained

Front 40

POCT

Back 40

point of care testing
brings laboratory testing to the PT
aka..AST-alternate site testing
or ancullary
or bed side
or near-patient

Front 41

BT test
used for?

Back 41

Bleeding time
evaluates platelet plug formation in capillaries to detect platelet function disorders and capillary integrity problems
also used in diagnosing problems with hemostasis and as a presurgical screening test

Front 42

accuracy of the results depend on technique in what test

Back 42

BT

Front 43

BT test
procedure

Back 43

bleeding time
performed on volar(inner) lateral surface of forearm, using BP cuff to maintainconstant pressure

Front 44

INR

Back 44

international normalized ratio
tests on whole blood from a finger stick

Front 45

ACT

Back 45

activated clotting time

Front 46

HMT

Back 46

Heparin management test

Front 47

Pt test used to monitor

Back 47

warfin(coumadin) therapy

Front 48

APTT/PTT used to screen for?

Back 48

bleeding disorders prior to surgery
investigate bleeding or clotting disorders
detect clotting factor deficiencies
monitor low dose heparin therapy

Front 49

ACT test analyzes activity of

Back 49

coagulation factors (used to monitor heparin therapy

Front 50

HMT test is used for

Back 50

testing high dose heparin monitoring needed in cath labs and surgery

Front 51

ABGs measured by POCT
what measured?

Back 51

pH(potential hydrogen, acid-base balance)
PCO2(partial pressure of carbon dioxide)
PO2(partial pressure of oxygen)

Front 52

PCO2 partial pressure of carbon dioxide is a measure of

Back 52

pressure exerted by dissolved co2 in blood plasma, proportional to PCO2 in aveoli
(indicator of how well air is exchanged between blood and lungs)
increase is hypoventilation
decrease is hyperventilation

Front 53

PO2 partial pressure of oxygen is a measure of

Back 53

pressure exerted by dissolved O2 in blood plasma
(indicates the ability of the lungs to diffuse O2 through the alveoli into the blood
evalutes the effectiveness of oxygen therapy

Front 54

five most common electrolytes measured by POCT

Back 54

Sodium(Na+)
potassium (K+)
chloride(Cl-)
bicarbonate ion(HCO3-)
ionized calcium (iCa2-)

Front 55

most plentiful electrolyte in blood

Back 55

sodium
plays major role in maintaining osmotic pressure, acid-base balance, and transmitting nerve impulses

Front 56

hyponatremia
hypernatremia

Back 56

reduced and elevated levels of sodium

Front 57

electrolyte primarily concentrated within cells

Back 57

potassium
very little found in bones and blood
released into blood when cells are damaged
(major role in nerve conduction, muscle function,acid-base balance,osmotic pressure)
influences cardiac output by helping to control rate and force of contractions

Front 58

hypokalemia
hyperkalemia

Back 58

decreased and increased blood potassium

Front 59

electrolytes that exists mainly in extracelluar spaces

Back 59

chloride
(sodium chloride or hydrochloric acid)
responsible for maintaining celluar integrity
influences osmotic pressure, acid-base balance, water balance

Front 60

what must be supplied together to correct hypokalemia

Back 60

potassium and chloride

Front 61

electrolyte that plays role in transporting carbon dixoide to lungs and regulation of blood pH

Back 61

biocarbonate ion
removal of CO2 by lungs results in decrease of H+ ions and increase of pH
hypoventilation results in higher CO2 levels and production of more H+ ions can lead to acidosis

Front 62

electrolyte that accounts for approx. 45% of calcium in blood

Back 62

Ionized calcium
( rest bound to protiens and other substances)
used for muscular contraction, cardiac function, transmission of nerve impulses and blood clotting

Front 63

Cardiac troponin T (TnT) and troponin I (TnI) are?

Back 63

protiens specific to heart muscle,.
rise within hours of myocardial damage

Front 64

ALT-analine transferase

Back 64

liver enzyme
monitored on lipid lowering meds
done during lipid testing

Front 65

BNP

Back 65

B-type natriuretic peptide-(1st objective measurment for CHF-congestive heart failure)cardiac hormone produced by heart in response to ventricular volume expansion and pressure overload

Front 66

BNP levels help differentiate between?

Back 66

COPD and CHF

Front 67

most common POCT test

Back 67

glucose

Front 68

glucose testing used to monitor?

Back 68

diabetes mellitus

Front 69

glycosylated Hemoglobin is a diagnostic tool for?

Back 69

monitoring diabetes therapy
reflect the average blood glucose for preceding 4-6 weeks
A1c is type Hgb tested

Front 70

Hct
measure of?

Back 70

Hematocrit
aka..PCV-packed cell volume
measure of volume of RBCs in blood

Front 71

Hgb levels are used to monitor PTs with

Back 71

anemia

Front 72

Guaiac
ued to detect

Back 72

Occult blood
hidden blood in feces
disease in digestive tract (gastric ulcer and colon cancer)
test for peroxidase activity of Hbg molecule (diet free of meat and veggies sources ..will lead to false-positive results)

Front 73

HCG

Back 73

human chorionic gonadotropin
hormone produced by placenta (appers in both urine and serum -approx 10 days after conception)
preganancy test

Front 74

skin tests?

Back 74

TB (PPD)tuberculosis (purified protien derivative)
Aspergillus test (test for hypersensitivity to aspergillus-type of mold)
Cocci test - tests for infectious fungus disease caused by coccidioides immitis
histo test -test for past or present infection by the fungus histoplasma capsulatum

Front 75

TB test

Back 75

determines if developed an immune response to Mycobacterium tuberculosis

Front 76

Strep test

Back 76

throat swab for detection of group A streptococci

Front 77

UA

Back 77

regents test(paper strip impregnated with reagents that test for presence of bacteria, blood, bilirubin, leukocytes, protein, urobilinogen, pH, specific gravity)
urinalysis consist of a physical and chemical analysis of specimen as well as microscopic analysis if indicated

Front 78

blood cultures ordered when Patient has?

Back 78

FUO
Septicemia
bacteremia

Front 79

when drawing a blue top tube
clear/discard tube not required for?
required for?
why clear?

Back 79

not necessary for PT or PTT
necessary all other coagulation tests
to clear needle of thromblastin contamination picked up as penetration of skin

Front 80

toxicology

Back 80

scientific study of toxins(poisons)

Front 81

tosicology tests examine?

Back 81

blood
hair
urine
other body substances

Front 82

drug screening

Back 82

random screening (without prior notice)

Front 83

bed side testing is also called

Back 83

POCT-point of care testing

Front 84

BT test evaluates?

Back 84

platelet plug formation in capillaries

Front 85

coagulation monitoring includes tests for?

Back 85

Protime(PT) and INR
activated partial thromboplastin time (APTT or PTT)
activated clotting time (ACT)
Heparin management test (HMT)

Front 86

coumadin is monitored by?

Back 86

PT testing

Front 87

arterial blood pH test is a measure of ?
indicates what?

Back 87

the body's acid balance
PTs metabolic and respiratory status
range 7.35-7.45

Front 88

below normal pH is refered to as

Back 88

acidosis

Front 89

above normal pH is refered to as

Back 89

alkalosis

Front 90

PCO2 is a measure of?
indicator of?

Back 90

pressure exerted by dissolved co2 in plasma
indicator of how well air exchanged between blood & lungs

Front 91

PO2 is a measure of?
indicator of?

Back 91

pressure exerted by dissolved O2 in plasma
indicator of ability of lungs to diffuse O2-alveloi into blood

Front 92

bicarbonate ion plays a role in?

Back 92

transporting CO2 to lungs and regulating pH

Front 93

measurement of what protiens is a valuable tool in diagnosing (AMI) acute myocardial Infarction?

Back 93

Cardiac troponin T (TnT)
troponin (TnI)

Front 94

what is the first objective measure of CHF(congestive heart failure?

Back 94

BNP
B-type natriuretic peptide

Front 95

detection of occult blood in stool is done by what test?

Back 95

Guaiac