NHA CCMA

CC

Chief Complaint

Segment

Line between two wave forms

P-wave

Atrial Depolarization

How many 1mm boxes are in a 6 second Rythm strip?

30 one millimeter boxes

The SA node represents which waveform on the ekg?

Only the P-wave

What is the reading you can get from the RR interval?

Ventricular Pulse

What is the primary stage of Hemolisis?

Vascular phase and platelet phase together

What is Electophoresis?

Analyzation of the chemical components of blood e.g. hemoglobin, serum, urinem cerebrospinal fluid based on electrical charge.

Positive testing for occult blood in a stool sample turn which color?

Turns Blue on a positive test for occult blood in feces.

The stages of Hemostasis:

1. Vascular 2. Platelet Phase 3. Coagulation Phase 4. Fibronolysis

Blood Vessels

Aorta, arteries, arterioles, capillaries, venues, veins, superior and inferior vena cavae.

Outer connective tissue layer of a blood vessel

Tunica adventitia

Inner endothelial tissue layer of a blood vessel

Tunica Intima

The inner smooth layer of a blood vessel

Tunica media

The standards of right and wrong in a medical setting

Code of Ethics

What do you find in capillaries?

A mixture of venous and arterial blood is found

The average adult has how many liters of blood?

5-6 liters

What is the percentage of water in blood?

92%

Percentage of plasma in blood

55%

Percentage of Formed Elements in the blood

45%

99% of formed elements in blood

RBC's or Erythrocytes

Where you find Hemoglobin

RBC's

Where do all blood cells originate?

Bone Marrow

How many RBC's per microliter of blood

4.2-6.2 million

What is the second most numerous WBC?

Lymphocyte with 20-40%

Their numbers increase in intracellular infections and TB

Monocytes

Their numbers increase in bacterial infections and often are first on scene

Neutrophils

These WBC's play an important role in viral infection as well as in immunity.

Lymphocytes

Number of leukocytes for average adult per micrometer

5000-10000

Leukopenia

Decrease in WBC's seen with viral infection and leukemia

Comprises 3-8% of wbc or leukocytes

Monocytes

Largest in size of the leukocytes

Monocytes

Carries Histamine

Basophil

Injury to a blood vessel that causes it to constrict, slowing the clot of blood

Cascular phase of hemostasis

Preferred site for venipuncture

Antecubital fossa

Test used to evaluate the intrinsic pathway and monitor heparin therapy

APTT also know as PTT

Test used to evaluate the extrinsic pathway and also used to monitor warfarin therapy

PT

Fibrinolysis

Breakdown and removal of a clot

Converts the temorary platelet plug into a stable fibrin clot

Coagulation phase

2nd choice vein for venipuncture most often the only one palpatable in an obese pt

Cephalic vein

Antiseptics used in Phlebodtomy

70% isopropyl alcohol pads most common, provolone iodine for bc, s and chlorhexidine gluconate for patients that are allergic to betadine/ iodine

Length of needle commonly used in venipuncture

1 ince (up to 1.5")

Guage of needle that can cause hemolysis

Smaller than 23 guage

Average gauge of needle used for drawing blood

21-22

3 skills of the phlebotomist

social, clerical, technical

Analytical errors during collection of blood

extended tourniquet time, hemolysis, wrong order of draw, failure to invert tubes, faulty technique under filling tubes

Analytical errors before collection of blood

Patient misidentification, improper time, wrong tube, not fasting, exercise (cortisol levels), PT posture, poor coordination with other treatments, improper side prep, medication interference

Analytical errors after blood collection

Failure to separate serum from cell (glycolisis), improper use of serum separator (not inverting tubes or not spinning tubes) delays in processing, exposure to light, improper storage conditions, dimming clots

Fistula

Permanent surgical connection between an artery and a vein, never used for venipuncture

Edima

Accumulation of fluid in tissue

Thrombophlebitis

Inflammation of a vein with a clot formation

Explanation of Hemoconcentration

The increase in proportion of formed elements to plasma caused by leaving on the tourniquet for more than two minutes

Consequence of insufficient pressure applied after withdrawal of needle

Thrombus

additives in green top tube

heparin, sodium, litium, ammonium

Why is the green top tube never used for hematology

Green tops additive heparin interferes with the Wright's stained blood test

Common tests for the lifht blue sodium citrate tube

Coagulation studies, PT (extrinsic, warfarin) APTT, PTT (intrinsic, heparin) TT, BT, FDP

Common tests for the lavendar edta tube

CBC, differential or diff., ESR, sickle cell screening

Common tests for this color tube are chemistry tests performed on plasuma such as Ammonia, carboxyhemoglobin and STAT electrolytes

Green top tube (heparin) Tests

How long does it take for blood to clot by normal coagulation process in the red top tube?

30-60 mins

The primary purpose is to provide reliable data about a patients health status by ensuring the accuracy of a test while detecting and eliminating error

What is quality control

Common test for the red topped tube

Serum chemistry tests, serology tests, blood bank (glass only)

Order of draw for cappilary specimens

lavender first, then tubes with other additives, then tubes with out additives

Antiseptic not used on a dermal puncture site

Betadine (because it interferes with several tests like bilirubin, uric acid, phosphorus and potassium

For which procedure would you warm the site for a minimum of 3-4 minutes to increase blood flow?

dermal punctures (heel sticks)

Which are the preferred sites for dermal punctures

the distal segment of the third or fourth finger of the non-dominant hand

heel sticks are performed on which patients?

infants less than 1 year old

Where on the foot is the dermal puncture made on patients less than a year old

the medial and lateral areas of the plantar surface of the foot

dermal puncture is made in

the fleshy portion of the finger slightly to the side of the center perpendicular to the lines of the fingerprints

What will occur if you puncture the heel too deep? more than 2 mm

osteomyalitis

What are the identification requirements for blood bank

Pt's full name and DOB, hospital id # or ssn for outpatient, date and time of collection as well as the phlebotomist's initials

This section of the lab uses serum to analyze the presence

Serology (immunology) Section

When checking for hormones in urine when do you collect the urine sample

first voiding in the morning

Which urine specimen provides the clearest, most accurate results?

Clean catch midstream specimen

Which urine sample requires aseptic technique?

Clean catch specimen

Examination of urine consists of

physical, chemical, microscopic

Physical examination of urine consists of

colume (adequate for testing, observing color and appearance, odor, specific gravity

What amount of urine must you have to be sufficient for analysis?

25ml

What is the normal range of specific gravity of random collection

1.005-1.030

normal range of specific gravity of urine in adults with normal diet and fluid intake

1.015-1.025

Microscopic examination of urine requires this amount

10-15ml

Urine Specific gravity

The ratio of weight of a given colume of urine to the weight of the same volume of distilled water at a constant temperature

Glycosuria

presence of glucose in the urine

Symptoms of patients with diabetes mellitus

glycosuria, polyuria, and thirst

A urine pH of what is considered neutral?

7.0 pH

the copper reaction test is used for what?

screening for glucose in urine

The presence of leukocytes in urine is an indicator for what?

bacteruria or UTI

Urine Screening for UCG or HCG

Pregnancy Test

HIPPA is for?

Patient Confidentiality

The four elements of Negligence

Duty, duty of care, derelict= breach of duty of care, direct cause, damage

Tort

Wrongful act that results in injury to one person to another

Examples of Tort

Battery, invasion of privacy, defamation of character

Defamation of character by written statement is considered

libel

Consists of injury to another person's reputation , name or character through spoken (slander) or written (libel)

Defamation of character

unpriveleged touching

Battery

The release of medical records with out the patient's knowledge or permission

Invasion of privacy

Good Samaritan Law

Rendering first aid within the scope of knowledge by a health care worker with out fear of being sued for negligence

Hypothalamus

regulates and maintains body temperature

Functions necessary for life

heart function, blood pressure, respiration, temperature

Rectal Temperature range in celsius

37.0 -38.1 C

Oral temperature range in Fahrenheit

97.6-99.6 F