cls 100 midterm

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cls 100 midterm
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  1. Preanalytical Phase of Testing
    Begins when test are ordered, ends when testing begins.
  2. Reference Ranges/Intervals
    • •Tests confirm health or screen, diagnose, & monitor disease
    • •Test results are compared with specimens of healthy people
    • •Consist of range of values with high & low limits
    • •Most often based on healthy, fasting people
  3. Basal State
    Definition: resting state of body early in morning after fasting 12 hours
  4. Basal-state specimen
    • –Ideal for establishing reference ranges on inpatients
    • –Effects of diet, exercise, etc. on test result are minimized
  5. Basal state is influenced by
    • –Age
    • –Gender
    • –Conditions of body
  6. Physiological variable -age
    RBC, WBC, creatinine clearance
  7. Physiological variable -dehydration
    Hemoconcentration, RBC, enzymes, Fe, Ca, Na
  8. Diurnal variation
    TSH, cortisol, Fe
  9. Exercise/IM injection
    pH, PCO2, CK, LDH, glucose
  10. Temperature and humidity
    Hemoconcentration
  11. problems sites Burns, Scars, & Tattoos
    • –Veins are difficult to palpate here
    • –May have impaired circulation
    • –New burns are painful
    • –Tattoos may be more susceptible to infection; dyes may interfere
  12. Damaged Veins
    • –Sclerosed: hardened
    • –Thrombosed: clotted
    • –Difficult to puncture & yield erroneous results
  13. problem site edema
    • –Swelling caused by abnormal accumulation of fluid in tissues
    • –Results when fluid from IV infiltrates surrounding tissues
    • –Contaminates blood with tissue fluid
    • –Veins are harder to locate, & tissue is fragile
  14. Problem sites hematoma
    • –A swelling or mass of blood
    • –Caused by blood leaking from vessel during venipuncture
    • –Can be painful, contaminate blood sample, obstruct blood flow
  15. Arterial Line
    • –A catheter placed in an artery (usually radial)
    • –Provides accurate & continuous measurement of blood pressure
    • –No tourniquet or venipuncture on an arm with an arterial line
  16. Arteriovenous Shunt or Fistula
    • –The permanent, surgical fusion of an artery & a vein
    • –Created to provide access for dialysis
    • –Located on back of arm above wrist
  17. Heparin or Saline Lock
    • –A catheter or cannula connected to a stopcock/cap w. diaphragm
    • –Provides access for administering medicine or drawing blood
    • –Placed in vein in lower arm above wrist for up to 48 hrs
    • –Flushed w. heparin or saline to prevent clogging
  18. Intravenous (IV) Sites
    • –IV line: a catheter inserted in a vein to administer fluids
    • –Avoid collecting blood from arm w. IV
    • –Blood may be contaminated w. IV fluid
    • –If necessary, collect below IV
  19. Central Vascular Access Devices (CVADs)
    • –Known as indwelling lines
    • –Consist of tubing inserted into a main vein or artery
  20. Central Vascular Access Devices (CVADs)
    • –Used for:
    • •Administering fluids & medications
    • •Monitoring pressures
    • •Drawing blood
  21. Types of CVADs
    • –Central venous catheter or line
    • •Inserted into large vein (subclavian)
    • •Advanced into superior vena cava
    • –Implanted port
    • •A small chamber attached to indwelling line
    • •Surgically implanted under skin (upper chest or arm)
    • –Peripherally inserted central catheter
    • •Inserted in veins of extremities & threaded into central veins
  22. Excessive Bleeding
    • –Patients on aspirin or anticoagulant may bleed longer
    • –Maintain pressure until bleeding stops
    • –If bleeding continues >5 min, notify appropriate personnel
  23. Fainting
    • –A loss of consciousness & postural tone
    • –Caused by insufficient blood flow to brain
    • –Have patients w. history of fainting lie down during venipuncture
  24. Nausea and Vomiting
    • –Discontinue blood draw until feeling subsides
    • –Give patient emesis basin or wastebasket
    • –Apply cold, damp washcloth to forehead
  25. Pain
    • –Warn patient before needle insertion
    • –Avoid excessive, deep, blind, or lateral redirection of needle
    • –Extreme pain or numbness indicates nerve involvement; remove needle immediately, apply ice, document incident if pain persists
  26. Seizures/Convulsion
    • –Discontinue draw immediately
    • –Hold pressure over site without restricting patient’s movement
    • –Do not put anything in patient’s mouth
    • –Protect patient from self-injury
    • –Notify first-aid personnel
  27. •Nerve Injury
    –Caused by:
    • •Improper site or vein selection
    • •Inserting needle too deeply or quickly
    • •Excessive lateral redirection of needle
    • •Blind probing
    • –If initial vein entry is unsuccessful:
    • •Use slight forward or backward redirection of needle
    • •Remove needle & try an alternate site
  28. Hemoconcentration
    • –A decrease in fluid content of blood
    • –An increase in nonfilterable large molecules
    • –Caused by stagnation of normal venous flow due to tourniquet
  29. Hemolysis
    • –Damage to or destruction of RBCs
    • –Hemoglobin escapes into fluid part of specimen
  30. Partially Filled Tubes
    • •(short draw)
    • –Blood-to-additive ratio may be incorrect
  31. Specimen Contamination
    • –Allowing alcohol residue, fingerprints, glove powder, baby powder, urine on newborn screening samples
    • –Getting glove powder on blood films or capillary specimens
    • –Dripping perspiration into capillary specimens
    • –Following improper antiseptic procedure
    • –Using wrong antiseptic
  32. Persistant vomiting and diarrhea can cause
    hemocentration
  33. Outpatient specimens are they basal state
    No.
  34. Lipemic means
    High levels of lipids cause the serum to appear milky
  35. circadian
    means having a 24 hour cycle
  36. Occult
    means hidden
  37. many drugs toxic to liver which enzymes are affected
    AST, ALP, SCOT (GGT, LD
  38. CRUD stands for
    Compounds reacting unexpectedly as the desired
  39. drugs that interfere with blood shold be stopped
    4-24 hours
  40. drugs that interefere with urine should be stopped
    48-72 hours.
  41. Fever affects levels of
    hormone.
  42. Jaundice is also called
    icterus
  43. Biliribin
    is breakdown of RBC
  44. Icerteric means
    specimens urine, plasma and serum have deep yellow color due to the deposits
  45. Blood to the point of life-loss
    exsanguination
  46. Define iatrogenic
    Adjective used to described adverse condition brought on by the affects of treatment.
  47. Light blue top
    buffered sodium citrate
  48. Green
    heparin
  49. Word Roots
    • •Foundation on which term is built
    • •Typically indicates tissue, organ, body system, color, condition, substance, or structure
  50. Word root TO CLOT
    Thrombo
  51. Prefixes
    • •A word element that comes before a word root
    • •Modifies meaning of word root by adding information, such as presence, absence, location, number, or size

    aspesis
  52. Suffixes
    • •A word ending
    • •Follows a word root & changes or adds to its meaning
    • •To determine meaning of a medical term, first identify the meaning of the suffix.

    Gastro -word root ic gastric
  53. Infection:
    –When a microorganism invades body, multiplies, & causes injury or disease bacteria, protozoa, fungi, viruses
  54. Pathogen:
    a microbe capable of causing disease
  55. Types of Infection Communicable
    • •Able to be spread from person to person
    • •CDC investigates & controls communicable diseases & epidemics
  56. –Nosocomial & healthcare-associated infections (HAIs)
    • Infections acquired in hospitals & other healthcare settings
    • •1.7 million HAIs & 99,000 associated deaths occur each year
    • •Caused by infected personnel, patients, visitors, food, drugs, or equipment
  57. Chain of Infection
    Causative agent, reservior, exit pathway, means of tansmission, entry pathoway and suspectable host.
  58. What are some means of transmission
    • –Airborne
    • –Contact
    • –Direct (touching, kissing)
    • –Indirect (contaminated objects)
    • –Droplet (coughing, sneezing)
    • –Vector (insect, arthropod, animal)Vehicle (food, water, drugs
  59. What is viability
    ability of the microbe to survive on an object
  60. what is virulence
    degree to which capable of causing disease
  61. NIOSH requires upon entering a room of patient who has airbone disease.
    national institute of occupational safety and health respirator n95
  62. OSHA requires which vaccine to be provided free
    HBV
  63. What is some PPE
    • •Gloves
    • •Gowns
    • •Lab coats
    • •Masks, face shields, & goggles
    • •Respirators
  64. Isolation Procedures
    –Protective/reverse isolation
    For patients highly susceptible to infections
  65. Universal precautions (UP) CDC what year started
    Blood & body fluids of all people are potentially infectious, 1985
  66. Airbone precautions
    negative air pressure with cycles 8-12/hr
  67. Biohazard Exposure Routes
    • –Airborne
    • –Ingestion
    • –Nonintact skin
    • –Percutaneous (through the skin)
    • –Permucosal (through mucous membranes)
  68. Hepatitis B virus (HBV) & hepatitis D virus
    • •Present in blood & other body fluids
    • •Can survive up to a week on objects
    • •Transmitted via needlesticks, sexual contact
  69. Hepatitis C virus (HCV)
    •HCV exposure hazards
    • •Present in blood & serum; sometimes saliva
    • •Infection primarily occurs after large or multiple exposures
    • •Transmitted via needlesticks, sexual contact
  70. •Exposure Control Plan
    • –Must be written
    • –Must be reviewed & updated at least annuallyNonmanagerial
  71. Surface Decontamination (required by OSHA)
  72. •Components Needed for Fire to Occur
    • –Fuel: combustible material
    • –Heat: raises temperature of material until ignition
    • –Oxygen: to maintain combustion
  73. Fire symbol is a
    tetrhedron
  74. •Classes of Fire
    –Class A
    –Class B
    –Class C
    •Electrical equipment
    •Require nonconducting agents to extinguish
    • •Ordinary combustible materials (wood, paper)
    • •Require water/water-based solutions to extinguish
    • –Class B
    • •Flammable liquids & vapors (paint, oil, grease, gasoline)
    • •Require blocking oxygen or smothering to extinguish
    • –Class C
    • •Electrical equipment

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