Clinical Laboratory Services and Phlebotomy: An Overview, Exams of Medicine

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AMT RPT Review Accuracy - A "quality control" term that refers to how close a laboratory result is to the actual value, which is measured by comparing test results in a specified laboratory to results obtained from an established standard Acute Care - Health care delivered in a hospital setting that's associated with a hospital stay of usually less than 30 days Aliquot - A portion of a blood sample that has been removed/separated from primary specimen tube Ambulatory Care - Health care services that are delivered in an outpatient, or non-hospital, setting American Society for Clinical Laboratory Science (ASCLS) - Professional organization for laboratory personnel that provides continuing education and conference activities American Society for Clinical Pathology (ASCP) - Professional organization that certifies many types of laboratory personnel through the Board of Certification (BOC) based on their passing a certification examination Anatomic Pathology - Major area of laboratory services whereby autopsies are performed and cytology procedures and surgical biopsy tissues are analyzed Center for Medicare and Medicaid (CMS) - A federal agency that oversees financing and regulation of the healthcare industry, which are responsible for Medicare, Medicaid, HIPPA, and Clinical Laboratory Improvement Amendments (CLIA), and includes oversight or clinical laboratories Clinical Decisions - Decisions made by physicians based on medical standards of practice, diagnostic testing (e.g., laboratory tests and xrays), a patient's history, and observation of signs and symptoms Clinical Pathology - Major area of laboratory services where blood and other types of body fluids and tissues are analyzed Competency Statement - Performance expectations that include entry-level skills, tasks, and roles performed by the designated health care worker Continuing Education (CE) - Educational programs often required/recommended by certifying or licensing agencies to update health care workers or help them maintain competency in practice Continuous Quality Improvement (CQI) - A theoretical framework and management strategy to improve health care structures, processes, outcomes, and customer satisfaction Examination (analytical phase) - The phase in a laboratory testing whereby the specimen is actually assessed or evaluated, and the results are confirmed and reported Food and Drug Administration (FDA) - Federal agency responsible for safety, clinical efficacy, and medical efficacy of the country's food and drug supply, which includes equipment and supplies used in blood collection When used in describing laboratory test results, it refers to how consistent the test results are if they are repeated several times; also refers to dependability Six Sigma - Method designed to improve process performance by reducing variation, improving quality, enhancing financial performance, and improving customer satisfaction. (Define, Measure, Analyze, Improve, and Control (DMAIC)) Stakeholders - Individuals, groups, organizations, and/or communities that have an interest in or are influenced by health care services. Stakeholders can be internal or external to the organization Standards of Practice - The practices or guidelines that a reasonably prudent person would follow in any particular circumstance. Many agencies, licensing boards, certifying boards, and accrediting organizations write standards of care or standards of practice to guide healthcare workers in their duties Aorta - The largest artery in the body Anticoagulants - Substance introduced into the blood or a blood specimen to keep it from clotting Antibody - Primary immune response molecule. combines with unique complementary antigen binding site. when bound to foreign antigen signals other immune responses. Antigen - Any substance that can stimulate the production of antibodies and combine specifically with them Apathy - Lack of feelings or emotions Arteries - Highly oxygenated blood vessels that carry blood AWAY from the heart Autologous Transfusion - Collection of blood from a single patient and retransfusion back to the same patient when required Basal state - A phlebotomy procedure, this refers to the patient's condition in the early morning, approximately 12 hrs after last meal (Determines glucose, cholesterol, triglycerides, proteins and electrolytes) Buffy coat - Blood specimens that contain anticoagulants, the WBCs and platelets form a thin layer above the RCBs Capillaries - Tiny microscopic blood vessels connected or arteries (arterioles) and veins (venules) Chain of Infection - Process by which infections are transmitted. Components would include the source of infection, non-sterile items, and contaminated equipment. The mode of transmission (direct contact, airborne, medical instruments) and the susceptible host (patient) Circulatory System - Body system referring to the heart, blood vessels, and blood, responsible for transporting oxygen and nutrients to cells and transport carbon dioxide and waste until they are eliminated. Transports hormones, regulates body temperature, and helps defend against disease Coagulation - A phase in the blood clotting sequence in which many factors are released and interact to form a fibrin meshwork or blood clot Differentials - Laboratory test that categorizes blood cells and any abnormalities Empathy - Recognition of and entering another's feeling Erythrocytes - Red blood cells, measuring about 7mm with a thickness of 2 mm Fibrin - Part of the coagulation process that involves the clotting factors contained in the blood Fomites - An inanimate object that can harbor infectious agents and transmit infection such as sinks, door knobs, glasses, phlebotomy trays, etc. Fistula - Permanent internal connection between an artery and a vein Geriatric patient - Physical changes the elderly undergo include skin that is less elastic thinner, have a tendency to bruise easily, more fragile, and can take much longer to heal Heart - Key component of the cardiovascular system, it is the pump that forces blood throughout the body Plasma - the liquid portion of the blood in which the blood cells are suspended Serum - Contains the same constituents as plasma except that the clotting factors are contained within the clot. steady state - also referred to as HOMEOSTASIS, it is a condition that allows the normal body to stay in balance by continually compensating with necessary changes, thereby remaining in a healthy condition. TDM (therapeutic drug monitoring) - a testing procedure to evaluate drug levels in patient's blood Thrombocytes - platelets Source - the origin of an infection such as, human hands, lab coats or other clothing, and contaminated equipment. Syncope - a loss of consciousness caused by diminished blood flow of the brain Susceptible host - a component in the "chain of infection", the degree to which an individual is at risk for acquired infection. Trough - term used for therapeutic drug monitoring to describe the blood sample that is taken just to the next dose, or when the drug is at its lowest concentration in the patient's serum Universal Precautions - a term now replaced by "standard precautions" and is sometimes referred to as standard universal precautions Vasoconstriction - a rapid constriction of the blood vessels to decrease blood flow to the area Vectors - an insect or other organism that transmits a pathogenic fungus, virus, bacterium, etc. any agent that acts as a carrier or transporter Venipuncture - a surgical puncture of a vein Veins - the blood vessels that carry blood TO the heart after oxygen has been delivered to the tissues -algia, dynia - pain -cele - hernia, tumor, swelling -emesis - vomiting -lysis - destruction, seperation -megaly - enlargement, large -oid - resemble -oma - tumor -osis - condition of -pathy - disease -penia - deficiency -phobia - fear -plegia - paralysis -ptosis - drooping crushing -blast - immature cell, germ cell -cyte - cell -ist - one who specializes, agent -logy - study of -phagia - to eat -phasia - to speake -phillia - attraction to -phraxis - to obstruct -physis - growth -plasia - formation -pnea - breathing -poiesis - formation -therapy - treatment -tropny - nourishment, development -uria - urine Which layers make up human skin? - epidermis, dermis, and subcutaneous Which body systems provides for CO2 and O2 gas exchange? - Respiratory System What are important anatomical structures of the respiratory system? - pharynx, trachea, bronchioles, and alveoli The skeletal system provides which of the body's functions? - support, calcium storage, blood cell formation Germ cells are defined as _____. - ova and sperm What cell structure is the control center for a cell? - nucleus Which of the following is responsible for skin coloring? - melanin What role does DNA play in the human body? - provides a genetic blueprint What portion of human body weight is water? - 90% Homeostasis is referred to as a _____. - steady-state condition or equilibrium of the body An "orthopedic condition" would refer to what type of disorder? - Bone or joint What is Supine position? - lying on the back, facing upward A- or An- - without, lack of Ab- - For a blood glucose test, patients should fast for how long? - 8-12 hours What test results are affected most if the patient isn't fasting? - Triglycerides Diurnal Rythm has a major effect on what blood analytes? - ACTH Emotional stress decreases _______. - Serum iron levels What is affected by underfilling a sodium citrate tube? - PT (Prothrombin Time) What levels are lower, caused by underfilling an EDTA tube? - Hematocrit What additive destroys enzymes in the gray-topped tube? - Sodium flouride Hemostasis and coagulation - is a complex series of processes in which platelets, plasma and coagulation factors interact to control bleeding while at the same time maintaining circulating blood in the liquid state Congestive heart failure - A life threatening condition in which the hearts pumping action cannot overcome increasing vascular pressure so that fluid leaks out of the vessels into the body's tissues. Artherosclerosis - cholesterol deposits (plaque) form on the lining of the vessels resulting in partial or complete blockage of blood flow. mostly Aorta and coronary arteries Aneurysm - localized weakened area of the blood vessel wall, in severe conditions, the vessel wall balloons out and may rupture causing an internal hemorrhage. Polycythemia - condition in which low levels of oxygen cause the body to produce excessive amounts of RBCs to try to transport more oxygen Anemia - a blood condition with lowered RBC count or abnormal or deficient hemoglobin carrying capacity in the RBC so that the tissues are not receiving enough oxygen. Symptoms include: pale skin tone, fatigue, muscle weakness, shortness of breath, chest pain Latrogenic anemia - occurs when large quantities of blood are drawn from critically ill patient and can result in the need for a transfusion Leukemia - Usually classified as a bone marrow cancer in which excessive, immature WBCs are produced and do not funtion properly to fight infections. Thrombocytopenia - low platelet count that may result in excessive bleeding. it is caused by liver dysfunction , vitamin K deficiency,radiation exposure,or bone marrow cancer. Lavender tubes - Contain EDTA used for most hematology procedures such as: CBC,RBC,WBC,platelet count,hematocrit differentials DIFF, Gray tubes - contains potassium oxalate or sodium fluoride, which are primarily used for glycolytic inhibition tests. Lipemic Serum - if person has eaten fatty substances recently they may have elevated lipid levels and serum will be lipemic, or cloudy. May indicate chemical abnormalities. Turbid serum - serum will appear milky, and results from bacterial contamination high lipid levels in blood. Hematomas - when the area around the puncture site starts to swell, usually blood is leaking into the tissues, AKA a bruise Nerve complications - if the health care worker accidentally inserts the needle all the way through the vein, selects the wrong vein, or moves the needle excessively sideways, they may hit the nerve below the vein I.V. therapy - Every time a catheter is used, vein damage occurs. Circulatory blood is rerouted to collateral veins and can result in hemoconcentration Venipuncture site selection - It's important to choose the least hazardous site that has the greatest likelihood of successful blood collection. Use a tourniquet, palpation, gauze, alcohol swab, and medical tape/coban. Fasting specimens - Best location to draw blood on a 7 year old child - A treatment room Performing a blood draw on a child is difficult because - A child is not as emotionally mature as an adult The adolescent behavior during a painful procedure is described as - Embarrassed to show fear The first thing you collect on an infant with skin puncture is - Hematology specimens Assessing their past experience with blood, drawing is an important part of ________. - Preparing the child and the parent for a procedure An acceptable alternative to hand washing would be ______. - Hand sanitizer The preferred technique for restraining a child is ________. - Vertical with child sitting on parent's lap The test that measures cardiac analyze monitoring is ________. - TROPT PT or PTT - Test for monitoring anti-coagulation Oral sucrose is for - Pain management in infants Heel stick preferred location - Sides of the heel (lateral) Na+, Cl-, HCO3-, K+ are common ______. - Electrolytes Preferred angle of a needle - 30 degrees A good distraction for a child - Music Uncontrollable tremors come from _____. - Parkinson's disease Trough level should be taken - Before the dose of medication To detect an infection what should be collected? - Urine A geriatric physician treats - Elderly patients Order of draw - 1.) Blood cultures 2.) Light blue 3.) Red, Tiger top, or gold 4.) Green (light or dark) 5.) Lavender 6.) Pink 7.) Royal Blue 8.) Gray Blood gas analysis measures _____. - pCO2, pO2, and pH CLIA - Oversees categorization at laboratories HDL is referred to as - Good cholesterol Diabetes mellitus is caused by _______. - The pancreas inability to make or use insulin Comfortable distance for most personal interaction among most friends and some patients is ____. - 18 inches to 4 feet If you hit a nerve you need to _______. - Document it in the patient's chart Deposition - Examination before trial Pancreas produces ______. -