PT (prothrombin time)
time it takes for a blood sample to coagulate after thromboplastin and calcium are added; detects clotting abnormalities of the extrinsic pathway
indicates the likelihood of a patient to have a bleeding or clotting problem during or after surgery
Normal values are between 10-13 seconds
PTT (parietal thromboplastin time)
measures the time it takes a clot to form and is also used to evaluate the effects of heparin therapy.
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PT (prothrombin time)
time it takes for a blood sample to coagulate after thromboplastin and calcium are added; detects clotting abnormalities of the extrinsic pathway
indicates the likelihood of a patient to have a bleeding or clotting problem during or after surgery
Normal values are between 10-13 seconds
PTT (parietal thromboplastin time)
measures the time it takes a clot to form and is also used to evaluate the effects of heparin therapy.
INR (international normalized rate)
method developed to standardize PT results among laboratories by accounting for the different thromboplastin reagents used to determine PT
What is the best approach for a thoracentesis?
subcostal; reduces the risk of a pneumothorax
What is the most common indication for a biopsy?
to confirm if a mass is malignant.
advantages of using ultrasound for biopsy?
main advantage: continuous real-time visualization of the needle
biopsy malignant or benign masses
drain various fluid collections (cysts, joint effusions, ascites, pleural fluid)
mark spots for fluid taps to be performed without direct sono guidance
contraindications / risks of having a procedure:
uncorrectable bleeding disorder, lack of a safe needle pathway, uncooperative patient ( risk of complication for pt and sonographer/ sonologist by needle stick)
PSA (prostate specific antigen)
evaluate the prostate for cancer
AFP (alpha- fetoprotein)
elevation could indicate a liver lesion
needle type used for paracentesis
centesis catheter
ascites
What is administered after a significant amount of fluid is removed by paracentesis?
Albumin
and patient may need a platelet transfusion
What instances would you use a core biopsy?
to remove larger core tissue samples for histologic analysis.
also called a biopsy gun.
FNA (fine needle aspiration)
thin-gauge needles to obtain cells from within the mass.
performed using a 20-25 gauge needle.
2 advantages of having a cytopathology team
increases the number of successful biopsies
helps to minimize the number of passes
reduces overall procedure time
what does the cytopathologist determine:
looks at the slides to determine if the material is diagnostic
What is a time out?
the national patient safety standards mandate that a “time-out” be performed before beginning any procedure.
pt recites full name and reason they are there. pt ID or history number is confirmed along with type and location of procedure. must be documented and may be a part of the consent form or filled out in the pt electronic record.
types of transducers
linear, curved linear, phased array
linear: surface
curved linear: deeper
phased: limited FOV
Local anesthetic needle gauge
25 gauge needle
Post op complications:
postprocedural pain or discomfort
vasovagal reaction
hematoma
bleeding
seeding of the needle track
serious complications: hemorrhage, pneumothorax, pancreatitis, infection, death.
What is the spleen a high risk for?
Hemorrhage
what does the diaphragm separate?
the chest cavity from the abdominal cavity