What is the function of Public Health services?
To screen, monitor, and educate about infectious diseases
DO NOT provide treatment
define kinesics
STudy of nonverbal communication (body language)
Who developed the Guideline for Isolation Precautions in Hospitals?
CDC (center for disease control) and HICPAC (healthcare infection control practices advisory committee)
*NOTE - OSHA BBP standard requires gloves during phlebo
Right-to-know law?
Requirement to provide MSDSs
Layers of skin + what's found there
Epidermis: avascular
Stratum germinativum: layer of epidermis
Statum corneum: layer of epidermis
Corum (dermis): blood vessels
Subcutaneous: blood vessels, adipose tissue
Layers of blood vessel (both names) + brief description
Tunica adventita (externa): outer layer
made of CT
thicker in arteries
Tunica media: middle layer
smooth muscle + elasic fibers
much thicker in arteries
Tunica intima (interna): inner layer
single layer of endothelial cells + basement membrane, CT layer, and elastic membrane
Which are the anticubital veins?
Acessory cephalic, median basilic, median
*NOTE- subclavian is shoulder -> chest
What are these things - CK, LD, ALP, ALT, BUN, PT, GTT, ESR
CK: creatine kinase - enzyme in cardiac muscle
LD: lactate dehydrogenase - enzyme in cardiac muscle
(both released during myocardial infarction)
ALP: alkaline phosphatase - enzyme that determines liver function
ALT: alanine aminotranfersale - enzyme that determines liver function
BUN: blood urea nitrogen - kidney function test
GTT: glucose tolerance test - glucose metabolism test
ESR: erythrocyte sedimentation rate - nonspecific disease indicator (esp inflammatory conditions)
NPO
NPO (nil per os): nothing by mouth (not even water)
Describe the methods of anticoagulation and their agents
binding/chelating or ppt calcium to make it unavailable for the coag process: Sodium citrate, oxalate, EDTA, SPS
inhibiting formation of thrombin: lithium and sodium heparin
Most common antiglycolytic agents? Purpose?
sodium fluoride and lithium iodoacetate prevent glycolysis (metabolism of glucose)
When should a discard tube be used?
When drawing for a coag test (not PT or PTT) because tissue thromboplastin activates extrinsic coag pathway
what is accessioning the specimen?
Steps taken to unmistakably connect a specimen and the accompanying paperwork to a specific individual
What veins should you use? Which should you avoid?
Use - cephalic or median cephalic
Don't use - basilic (too close to brachial artery)
Tourniquet should not be left on for more than...
1 minute
Release after blood flows into first tube
What fluids are contained in a capillary specimen?
arterial blood
venous bloud
tissue fluids (interstitial and intracellular)
What reference values shift with capillary draws?
increase: Glucose
decrease: Calcium, Phosphorous, and total protein
What does an ABG req typically include?
body temp
respiratory rate
method of ventilation/delivery
patient activity
body position
normal patient ID info
What is the modified Allen test?
compression of both the ulnar and radial arteries to stop arterial flow to the hand
hand should appear blanched
IF collateral circulation is present hand will flush pink when only ulnar artery is released (positive result)
Name 4 analytes that need LP
bilirubin
vitamin C
vitamin B12
carotene
Name 3 tests that require cooling.
Ammonia
glucagon
lactic acid
name a tests that can be damaged/altered by cooling
potassium: cold inhibits glycolysis which causes accumulation of K outside the cell (elevated results)
Cold also causes hemolysis which elevates results
How quickly must an ESR be performed on an EDTA spec at room temp? When refriged?
room: 4 hours
ref: 12 hours
Maximum time limit for serum/plasma separation?
2 hours from collection (should be ASAP)
What departments issue regulations re: off-site transportation of spec?
DOT (department of transportation)
FAA (federal Aviation administration)
OSHA (occupational safety and health administration)
What is unique about an ammonia spec?
extremely volitile
must be transported ASAP and on ice
serum vs plasma
Serum: does not contain fibrinogen (used during clotting)
Plasma: contains fibrinogen (no clotting)
What is a C&S? What is it's purpose?
Culture and sensitivity
diagnosis of UTI
what is AFP?
alpha-fetoprotein: antigen found in fetus, amniotic fluid, and maternal serum
abnormal values can indicate developmental issues
What is POCT?
Point-of-care testing (performed at/near site of patient care)
Interpretations of a TB skin test
based on induration (firm, raised area)
<5mm: negative
5mm-9mm: doubtful
10mm+: positive
What do POCT urine test strips usually detect?
gluocse, bilirubin, bacteria, blood, pH, protein, specific gravity, urobilinogen
What organizations offer certification to lab professionals?
AMT (american medical technologists)
ACA (american certification agency)
ASCP (american society for clinical pathology)
what organizations accredit phlebotomy programs?
NAACLS (national accrediting agency for clinical laboratory services)
PHS (public health services)
what is PHI?
Protected health information
What is CLIA '88?
clinical laboratory improvement amendments of 1988
established standards for regulation of laboratories
CLSI standards state that heel puncture depth should not exceed ____
2 mm
What is CLSI?
Clinical & Laboratory Standards Institute
publishes standards for phlebotomy procedures
What are diurnal variations?
normal fluxuations that occur throughout the day (think diurnal cycle)
Hematomas - where can you collect? Why?
Distal to, or below (blood flow least affected)
Collecting in the area of a hematoma can cause pain and yield erroneous results