week 3 & 4 class notes

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studysuccess
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week 3 & 4 class notes
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2011-08-31 23:28:57
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phlebotomy
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  1. accreditation
    process that an agency or organization recognizes a program of study or institution as having met certain standards
  2. certification
    process by which an agency or organization recognizes individuals as having met certain standards
  3. licensure
    state or federal regulation of a program or individual (never voluntary)
  4. ASCP is
    the american society for clinical pathology
  5. JCAHO
    • joint commission on Accreditation of Healthcare Organizations
    • -accredits hospitals inspects every 2 years, and regulates
  6. CAP
    • college of american pathologists
    • subscription based competency training for labs (inspects every 2 years).
  7. How is QA constantly improved
    TQM (total quality management)
  8. what is QA
    group of activists and programs designed to guarantee the highest level of patient care
  9. QC is
    quality control: steps to obtain accurate reliable clinical specimens
  10. how are normal ranges developed and what are they
    • arrived at by plugging in thousands of results over time.
    • 1 standard deviation= 68% of the data
    • 2 standard deviations=95% of the data
    • 3 standard deviations=99% of the data
  11. what are panic levels
    levels that are way too high or too low that it may endanger the patient's life

    STAT level
  12. LIS
    • laboratory information system
    • -collects data to report
    • -pre/post and analytical phases of specimens
  13. HIS
    hospital information system
  14. RIS
    radiology information system
  15. ADT
    admissions, discharge, and transfer
  16. EMR
    electronic medical record
  17. pre-analytical
    specimen receiving, transfer and test routing
  18. analytical phase
    perform testing, result testing
  19. post-analytic
    printing and distribution of results
  20. Reporting
    billing, statistical reports, and management or reports such as corrections
  21. Chemistry specimen type, tube,
    • Serum specimens type
    • -red SST and mint or green marble PST tube
    • (unless a pregnancy test)

    *PST serum in green marble or mint tube
  22. SST stands for and clot time
    • Serum separator tues (clot in 15-30 minutes)
    • w/thrombin (clot time is 5 minutes)

    (p219)
  23. PST stands for and top color
    Plasma separator tube, gray/green or green marble and mint
  24. busiest department in a lab?
    chemistry
  25. list 7 chemistry tests:
    • (mnemonic: be careful to trace creatinine dolphins)
    • Basic metabolic pannel (BMP)
    • electrolyte pannel (lytes)
    • comprehensie metabolic pannel (CMP)
    • thyroid stimulating hormone (TSH)
    • Trace elements of heavy metals
    • Creatinine clearance test
    • drug levels
  26. what would Lyte stand for in chemistry department?
    give 4 examples
    • electrolyte pannel in chemistry department
    • -carbon dioxide
    • -chloride
    • -sodium
    • -potassium
  27. what does BMP stand for and give 4 examples
    • basic metabolic panel in chemistry department
    • -calcium
    • -BUN
    • -creatine
    • -glucose
  28. what does CMP stand for
    • comprehensive metabolic panel (chemistry department)
    • includes BMP list, lytes and others
  29. what does TSH stand for give some examples
    • thyroid stimulating hormone
    • hyperthyroidism
    • hypothyroidism
    • *never done STAT
  30. list 2 trace elements and the tube color?
    lead and arsenic in royal blue tube which is metal free with label colored additive. in chemistry department,
  31. digoxin
    phenobarbital
    phenytoin
    lithium
    theophylline are all ____ drawn for ____ department
    all therapeutic drugs drawn for the chemistry department
  32. creatinine clearance test would be done for a ____ test.
    how would it be tested for
    kidney test is a 24 hour urine test w/big brown jug. always check for blood test with the jug, because creatinine needs a blood test in PST or TST tube.
  33. what's a peak level
    medication is at the highest concentration
  34. when are IV drug levels at peak levels
    15-30 minutes after dose is administered
  35. when are oral medications at their peak?
    2 hours after administered
  36. that is a trough level
    medication is at it's lowest
  37. when would medication be at it's trough level
    just before the next dose
  38. GTT stands for ______, and is for people who are ____
    fasting glucose tolerance test is mainly for diabetics
  39. procedures for GTT maternal testing
    50 grams of glucola draw blood after 30 minutes, then 100 g of glucola then test every hour for 3 hours
  40. what are the procedures if a patient vomits
    the test is over
  41. what's the cutoff for maternal fasting test
    200mg/dL
  42. what's the cutoff for a non-maternal glucose fasting test
    170 mg/dL
  43. differences between the maternal and nonmaternal glucose tests
    • -screening test for maternal, but not non-maternal
    • -cutoff is 170 for nonmaternal and 200 for maternal
  44. procedures for non-maternal glucose test
    draw specimen after 30 minutes and every hour after that.
  45. henoglobin A1C tube color
    tests the diabetic control over 3 month period of time with whole blood and goes to chem department
  46. tube and specimen is used for hematology department
    EDTA whole blood specimen homogenous sample well mixed and free from clotting
  47. 5 tests for hematology
    (mnemonic: hippies can't eat any bugs)

    • -Hemoglobin and hematocrite (H & H)
    • -complete blood count (CBC)
    • - erythrocyte sedimentation rate (ESR)
    • -automated blood count (ABC) or hemogram
    • -blood smere
  48. what is a CBC and what does it look for what department
    Complete blood count looks for RBC, WBC and platelet with total blood count, and includes a differential

    *hematology deparment
  49. what's a differential
    breakdown of 5 WBCs
  50. what's an ABC
    automated blood count or hemogram is like a CBC w/out differential

    *hematology department
  51. what's an H & H
    • hemoglobin and hematocrite is included in a CBC and ABC
    • -hemoglobin counts the areas for oxygen to bind to RBCs
    • -hematocrite considers the percentage of RBC's compared to plasma

    *hematology department
  52. what's an ESR? department
    • erythrocyte sedimentation rate is a nonspecific test that tells us if there is a problem
    • hematology deparment
  53. what's the normal RBC sedimentation rate? for men and women
    • less than 10 mm/hr for men
    • less than 20mm /hr for women
  54. what's the procedure for a blood smear?
    generally made from well mixed EDTA sample put on a slide used for CBC w/differential, RBC morphology, or platelet estimate
  55. list 4 coagulation tests
    • (mnemonic: PPDB)
    • -partial thromboplastin time (PTT)
    • -Prothrombin time (PT or pro time)
    • -D-dimer
    • -bleeding time
  56. what tube is most often used for glucose tests and why? what department does it go to?
    grey top because it's an antiglycolytic goes to the chemistry department
  57. what tube and specimen is used for coagulation
    light blue tubes are centrifuged to get plasma collection
  58. That's a PT, what department does it go to, tube color, and what's it test for
    prothrombin time goes to coagulation department in light blue tube tests for medication levels of coumadin
  59. what does PTT stand for, what department does it go to, tube color, and what does it test for?
    partial thromboplastin time goes to coagulation department in light blue tube tests for heparin
  60. what does IM stand for and what does IV stand for
    inter muscular and intravenous
  61. what department does a D-dimer go to, what does it test for, that tube, and who would usually get it
    they go to coagulation, to test for a hypercoagulable state by looking for fibrin degridation products, in a light blue tube. Usually done on new moms
  62. FDP stands for
    fibrin degradation products
  63. list 2 nonspecific tests and their department
    bleeding time goes to coagulation and erythrocyte sedimentation rate goes to hematology
  64. procedures for bleeding time?
    incision made on forearm observed until stopped and recorded in minutes
  65. 5 phases of coagulation
    • 1) vascular phase
    • 2) platelet phase
    • 3) coagulation phase
    • 4) clot retraction
    • 5) fibrinolysis
  66. what happens in the fibrinolysis phase of coagulation
    final repair is going on and new cells are produced and new tissue generated while the clot desolves
  67. what happens in the clot retraction phase
    the clot pulls together
  68. what happens in the coagulation phase
    platelets release specific compounds which tell the body to produce coagulation factors to form a fibrin mesh
  69. what happens in the platelet phase
    platelets de-grnulate and clump together 9aggregation) and stick to the area of injury
  70. what is aggregation
    clumping together of degranulated platelets
  71. what happens in the vascular phase of coagulation
    vasoconstriction tries to reduce blood flow to the area

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