Chapter 11-14

The correct answer is "All of the above." This is because commonly measured ABG (Arterial Blood Gas) parameters include pH, PCO2 (partial pressure of carbon dioxide), and O2 saturation. These parameters are important in assessing a patient's acid-base balance, respiratory function, and oxygenation status.

A centrifuge is a machine used to separate the serum or plasma from blood cells in a sample. It works by spinning the sample at high speeds, causing the heavier blood cells to settle at the bottom while the lighter serum or plasma rises to the top. This separation is important for various medical and laboratory procedures, as it allows for the analysis of the different components of blood. Autolet is a device used for blood sampling, Glucometer is used to measure blood glucose levels, and Hemostat is a surgical tool used to control bleeding.

Arterial puncture is performed primarily to evaluate blood gases. This procedure involves inserting a needle into an artery to collect a sample of arterial blood, which is then analyzed to determine the levels of oxygen, carbon dioxide, and pH in the blood. This information is crucial in assessing a patient's respiratory and metabolic status, as well as guiding treatment decisions. Arterial puncture is commonly performed in critical care settings, such as intensive care units and emergency departments, where close monitoring of blood gases is essential.

Urine is the most frequently analyzed nonblood specimen in the lab. This is because urine provides valuable information about the body's metabolic and physiological processes. It can be used to detect various diseases, monitor kidney function, screen for drug use, and assess hydration levels. Urine analysis involves examining physical, chemical, and microscopic properties of the sample, allowing for the diagnosis and monitoring of various conditions.

A CBC (Complete Blood Count) collected in a lavender top tube would most likely be accepted for testing. Lavender top tubes are typically used for hematology tests, including CBCs. The lavender top tube contains an anticoagulant called EDTA, which helps preserve the blood cells and prevent clotting. This type of tube is specifically designed for collecting blood samples for hematology testing, making it the most suitable option for testing in this scenario.

Arterial puncture can lead to various complications. Arteriospasm refers to the constriction of the artery, which can cause reduced blood flow and potentially lead to tissue damage. Hematoma is the collection of blood outside of blood vessels, which can occur if there is bleeding from the puncture site. Infection is another possible complication, as the puncture creates an opening for bacteria to enter and cause an infection. Therefore, all of the above complications can be associated with arterial puncture.

Saliva specimens can be used to detect alcohol, drugs, and hormones. Saliva testing is a non-invasive and convenient method for collecting samples, making it suitable for detecting various substances in the body. Alcohol can be detected in saliva through the presence of ethanol metabolites. Drugs can also be detected in saliva, as many substances can be found in saliva due to their passage through the bloodstream. Hormones can be measured in saliva as well, as they can be present in the saliva and provide information about hormonal levels in the body. Therefore, all of the mentioned substances can be detected using saliva specimens.

Antisepsis of the collection site is the most critical part of blood culture collection because it helps prevent contamination of the blood sample, ensuring accurate and reliable results. By properly cleaning and disinfecting the collection site, the risk of introducing bacteria or other microorganisms into the bloodstream is minimized, reducing the chance of false-positive or false-negative results. This step is crucial in preventing healthcare-associated infections and ensuring the validity of the blood culture test.

The 1-hour specimen should be collected at 0920 because it is one hour after the patient finishes the glucose beverage at 0821.

A guaiac test is used to detect the presence of blood in the stool, which can indicate various gastrointestinal conditions such as colorectal cancer or ulcers. Therefore, the correct specimen needed for a guaiac test is feces. This test involves applying a chemical called guaiac to a stool sample, and if the guaiac turns blue, it indicates the presence of blood in the stool.

The phlebotomist should consult with the patient's nurse because they are responsible for the patient's care and will have the most up-to-date information on the patient's condition and any necessary precautions or procedures that need to be followed. The nurse will be able to provide guidance on whether it is safe to collect the specimen while the patient is still on the ventilator or if any adjustments need to be made.

The TDM peak concentration refers to the highest concentration of the drug in the body during a dosing interval. This is the point at which the drug reaches its maximum concentration and is typically used to determine the drug's efficacy and potential side effects. Monitoring the peak concentration can help ensure that the drug is reaching therapeutic levels and that the dosage is appropriate for the patient.

A bleeding time test is used to detect platelet function disorders. Platelets are responsible for clotting the blood, and any abnormalities in their function can lead to excessive bleeding. This test measures the time it takes for bleeding to stop after a small incision is made on the skin. If the bleeding time is prolonged, it indicates a problem with the platelets' ability to form a clot, suggesting a platelet function disorder. This test is useful in diagnosing conditions such as von Willebrand disease or thrombocytopenia.

Drug screens are tests that detect the presence of drugs or their metabolites in a person's body. Since the results of drug screens can have legal implications, such as in workplace drug testing or legal cases, special chain-of-custody documentation is required to maintain the integrity and traceability of the specimen from collection to analysis. This documentation ensures that the specimen has not been tampered with or contaminated, and provides a clear record of who had possession of the specimen at each stage. Blood culture, crossmatch, and TDM tests do not typically require this level of documentation.

An angle of 45o is an acceptable angle of needle insertion for radial ABGs because it allows for optimal access to the radial artery while minimizing the risk of complications such as arterial puncture or hematoma formation. This angle allows the needle to enter the artery at a shallow angle, reducing the likelihood of damage to surrounding structures and ensuring accurate sampling of arterial blood for analysis.

Polycythemia is a condition characterized by an excessive production of red blood cells. One of the treatments for polycythemia is removing a unit of blood from the patient, a procedure known as therapeutic phlebotomy. This helps to reduce the number of red blood cells in the body and alleviate symptoms associated with polycythemia. ABO Rh incompatibility, leukemia, and tuberculosis are unrelated conditions and do not require the same treatment.

The radial artery is the first choice location for performing arterial puncture because it is easily accessible and close to the surface of the skin. It is located on the thumb side of the wrist and is commonly used for measuring blood pressure and obtaining blood samples for various diagnostic tests. Puncturing the radial artery is less invasive and carries a lower risk of complications compared to other arteries such as the brachial, ulnar, or femoral arteries.

The additional information typically required on a nonblood specimen label includes the specimen type. This is important because it helps to identify and categorize the specimen correctly, ensuring that it is handled and analyzed appropriately. The specimen type can vary depending on the specific test or analysis being conducted, so it is crucial to include this information on the label to avoid any confusion or errors in the laboratory.

A lab-generated computer label is used to identify and track samples or specimens in a laboratory setting. It typically includes information such as accession number, department for testing, and patient identification. However, the patient diagnosis is not typically included on a lab-generated computer label. The purpose of the label is to provide information related to the sample, not the diagnosis of the patient. Therefore, patient diagnosis is not found on a lab-generated computer label.

Benzalkonium chloride is an acceptable option for cleaning the area when drawing a blood alcohol specimen. It is a common antiseptic that is effective against a wide range of bacteria and viruses. It is often used in healthcare settings for disinfection purposes. Using benzalkonium chloride ensures that the area is properly cleaned and reduces the risk of contamination during the blood alcohol specimen collection process.

Protime, also known as prothrombin time, is a test used to measure how long it takes for blood to clot. In order to ensure accurate results, a specific ratio of blood to anticoagulant is required. A 9:1 ratio means that for every 9 parts of blood, there should be 1 part of anticoagulant in the collection tube. This ratio helps prevent the blood from clotting too quickly or too slowly, ensuring that the test results are reliable. Therefore, Protime must have a 9:1 ratio of blood to anticoagulant in the collection tube.

The test that measures packed cell volume is called Hct, which stands for hematocrit. Hematocrit is a blood test that determines the percentage of red blood cells in the total blood volume. It is used to evaluate the amount of oxygen-carrying capacity of the blood and to diagnose conditions such as anemia or polycythemia.

A clean catch urine specimen is used to detect urinary tract infections (UTIs). This type of specimen is collected after thoroughly cleaning the genital area to avoid contamination from external sources. It is considered the most reliable method for diagnosing UTIs as it provides a sample that is less likely to be contaminated by bacteria from the surrounding area. The clean catch method involves collecting a midstream urine sample, where the first portion of urine is discarded to ensure that the sample is representative of the urine in the bladder.

The correct answer is "Peural." The term "peural" is likely a misspelling of "pleural," which refers to the pleural fluid that surrounds the lungs. Pleural fluid helps to lubricate and protect the lungs as they expand and contract during breathing. It also helps to maintain the pressure balance between the lungs and the chest wall.

A trace-element-free tube is used to collect specimens that need to be free of any trace elements. Lead is a trace element, so it cannot be collected in a trace-element-free tube. Therefore, the correct answer is Lead.

ABG equipment refers to equipment used for arterial blood gas analysis. The items listed are commonly used in ABG procedures, except for the tourniquet. A tourniquet is not typically used in ABG procedures as it is used to restrict blood flow during venipuncture, not arterial blood sampling.

After arriving in the laboratory, all specimens are immediately logged or accessioned. This means that they are assigned a unique identification number or barcode, and their details such as patient information and test requested are recorded in the laboratory information system. This step is important to ensure proper tracking and organization of the specimens throughout the testing process. It also helps in maintaining the integrity and chain of custody of the specimens.

Fluid-resistant shoe covers are not typically required personal protective equipment when processing specimens. While a fully closed, fluid-resistant lab coat, disposable gloves, and a chin-length face shield are all necessary to protect against potential hazards and contamination, shoe covers are not specifically mentioned or required.

Iontophoresis is a procedure that uses a small electrical current to stimulate sweat production. Therefore, it is used in the collection of sweat specimens.

The modified Allen test is used to determine the presence of collateral circulation. Collateral circulation refers to the presence of alternate pathways for blood flow in case the main artery becomes blocked or compromised. This test is commonly performed before procedures that involve the radial artery, such as arterial blood gas sampling or radial artery cannulation. By assessing the presence of collateral circulation, healthcare professionals can ensure that the radial artery is a suitable site for these procedures and minimize the risk of complications.

Cooling a specimen with a high white blood count can cause erroneous ABG values because cooling can cause the white blood cells to clump together, leading to inaccurate results.

Common chemistry tests performed by POCT instruments include measuring the levels of sodium (Na) and potassium (K) in the blood. These tests are important for assessing electrolyte balance and kidney function. Sodium and potassium are essential electrolytes that play a crucial role in maintaining proper fluid balance, nerve function, and muscle contraction. Abnormal levels of these electrolytes can indicate various medical conditions, such as dehydration, kidney disease, or hormonal imbalances. Therefore, monitoring Na and K levels is essential for diagnosing and managing these conditions.

If the pulse distal to the site of the radial artery where the ABG specimen is being collected is weak or absent, it would indicate a potential thrombus formation. A thrombus is a blood clot that can obstruct blood flow, leading to a weak or absent pulse beyond the clot. This would be a cause for suspicion that a thrombus has formed in the radial artery during the collection of the ABG specimen.

The correct answer is "At body temperature" because cold agglutinins are antibodies that can agglutinate or clump together at lower temperatures. Transporting the specimen at body temperature ensures that the antibodies do not agglutinate during transportation, which could lead to inaccurate test results.

The correct order of draw for skin puncture is blood smears, capillary tubes, lavender, plain red, and SST. This order is important to ensure accurate and reliable test results. Blood smears are collected first to prevent contamination from other tubes. Capillary tubes are then used to collect a small amount of blood for specific tests. Lavender tubes are used for hematology tests, plain red tubes are used for chemistry tests, and SST tubes are used for tests that require serum separation. Following this order helps to minimize the risk of cross-contamination and ensure accurate test results.

The test that typically requires a refrigerated stool specimen is the fecal fat test. This test is used to measure the amount of fat in the stool, which can help diagnose malabsorption disorders. Storing the stool specimen in a refrigerated environment helps to preserve the fat content and ensure accurate test results.

Chloride levels in the body can be falsely elevated due to perspiration contamination. Perspiration contains various electrolytes, including chloride, which can contaminate blood samples if not properly cleaned before collection. This contamination can lead to inaccurate results when measuring chloride levels in the body. Therefore, chloride levels should be interpreted with caution if there is a possibility of perspiration contamination.

Serous fluid is a clear, watery fluid that acts as a lubricant between the membranes that line the ventral body cavities. These cavities include the thoracic cavity and the abdominopelvic cavity. The serous fluid helps reduce friction between organs and allows them to move smoothly against each other. It also provides a protective cushion for the organs within these cavities.

According to CLSI guidelines, serum for most tests should be removed from the cell within 120 minutes. This means that after blood is collected and allowed to clot, the serum should be separated from the cells within 2 hours. This is important because prolonged contact between serum and cells can lead to changes in the composition of the serum, potentially affecting the accuracy of test results. Therefore, it is crucial to follow the recommended time frame to ensure reliable and accurate test outcomes.

A breath test can be used to detect organisms that cause peptic ulcers. This is because certain bacteria, such as Helicobacter pylori, have been linked to the development of peptic ulcers. By analyzing the breath for the presence of these bacteria, medical professionals can diagnose and treat peptic ulcers more effectively.

Homecysteine and rennin are both sensitive to temperature and can degrade if not kept at a cool temperature. Transporting them in an ice slurry helps to maintain their stability and integrity during transportation. BUN and creatinine, cold agglutinin and bilirubin, and glucose and electrolytes do not require special temperature control during transportation.

Bar coding in healthcare is used for drug administration, labeling and supply inventory, and physical location of the patient. Bidirectional interfacing, on the other hand, is not directly related to bar coding in healthcare. Bidirectional interfacing refers to the ability of two systems to communicate and exchange data in both directions. While it may be used in healthcare settings for various purposes, it is not specifically related to bar coding.

Electrolytes collected in a PST can be centrifuged immediately because PST stands for Plasma Separator Tube, which contains a gel that separates the plasma from the blood cells during centrifugation. This allows for immediate separation and analysis of the plasma, including the electrolytes.