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How do you ask for the px ID in Conscious in-px?
Ask them to state their complete name, age and birthday
NEVER identify the patient by mainly checking their what?
ID bracelet
Who should you ask first when the px is mentally incompetent?
Nurse
In out-px, the px ID is the same as the conscious px although in out-px you should ask for the px’s?
Valid ID
This is the most analyzed specimen in clinical chemistry
Serum
Venous whole blood is only used in clinical chemistry when testing for the px’s?
HbA1C (glycosylated hemoglobin)
HbA1C is a test to estimate your blood sugar within?
3 months
Which blood specimen is rarely used in clinical chemistry?
Plasma
What does plasma have that causes turbidity on serum/plasma
Protein (coagulation factors; fibrinogen)
In clinical chemistry, when do we only use plasma?
When serum is not available (short draw)
Which of the blood specimen is not collected by a medical technologist?
Arterial blood
TRUE OR FALSE. Medtech neither collects nor process arterial blood
FALSE
Which blood specimen do we use in clinical chemistry when testing for the measurements of blood gases and blood pH determination
Arterial blood
Average blood of a human body
4.73 Liters/5 quartz
Average blood of an adult male
5-6 Liters
Average blood of an adult female
4-5 Liters
COMPOSITION OF WHOLE BLOOD. Plasma
55-60%/2.84 Liters/3 quartz
COMPOSITION OF WHOLE BLOOD. Blood Cells
40-45%/1.89 Liters/2 quartz
What type of blood is oxygenated blood with bright red color
Arterial Blood
RBC w/ Hg in which Hg has oxygen
Oxyhemoglobin
What are the sites for Arterial puncture?
Radial, Brachial, Femoral, Scalp, Umbilical
When doing radial arterial puncture, in what angle should the syringe be?
45 to 90 degrees
TRUE OR FALSE. In doing artery puncture, you are required to use a tourniquet
FALSE
In doing brachial arterial puncture, in what angle should the syringe be?
45 degrees
Where can we find our brachial artery?
Cubital fossa
What is the anticoagulant used in arterial puncture?
Heparin
TRUE OR FALSE. The green top tube is never used in arterial blood collection even though it contains heparin.
TRUE
In arterial blood collection, this additive is put in the syringe itself
Heparin
What test do you use in determining if the artery is suitable for arterial blood collection, especially when collecting in radial artery
Modified Allen Test
When the modified allen test is positive it means the hand turns into what color?
Red/pink
When the modified allen test is negative it means the hand turns into what color?
Pale
In modified allen test, when the hand turns red/pink ______ seconds it means that the radial artery is suitable for blood collection
within 15 seconds
Capillary puncture is also known as?
Skin/dermal puncture
Capillary is usually used in _____________ px
Pediatrics and geriatrics
Why is capillary blood rarely used in clinical chemistry
Clinical chemistry requires a lot of blood for analysis
Composition of capillary blood
Arterial blood, venous blood, intracellular fluids
Aside from quantity insufficiency, we also do not use capillary blood in clinical chemistry because of?
Concentration difference
In what blood specimen is higher in glucose?
Capillary blood
What analytes are lower in capillary blood than in venous blood?
Potassium, total protein, calcium ions
What are the sites for capillary puncture?
Heel, finger
Heel pricking for capillary puncture for infants, specifically, which part of the heel should be punctured?
Lateral plantar area
What finger is suitable for capillary puncture?
Ring and middle finger
Which hand should be punctured in capillary puncture?
Non-dominant hand
Any antiseptic can be used in capillary puncture, except?
Povidone iodine
TRUE OR FALSE. Povidone iodine can interfere with Clinical chemistry test results
TRUE
It is the most common blood collection
Venipuncture
Deoxygenated blood with dark red color
Venous blood
Hg in the RBC that has no oxygen attached to it
Deoxyhemoglobin
Antecubital fossa is also known as?
Elbow pit
What are the 3 sites for antecubital fossa?
Median cubital vein, Cephalic vein, Basilic vein
It is the most preferred site in antecubital fossa as this is the biggest and the most anchored.
Median cubital vein
Second most preferred site in antecubital fossa, it is farther from the body.
Cephalic vein
This is the least preferred in antecubital fossa as this is more painful due to the nerve endings near it.
Basilic vein
What is the most preferred site for obese px?
Cephalic vein
When antecubital fossa is not accessible, where are the other possible puncture site?
Other arm/hand veins
What are the sites to be avoided?
Arm w/ IV fluid, Hematoma, Burned/scarred area, Mastectomy area, Casts on arm, AV shunt/fistula
When one arm has an IV line injected and the other arm is not available for puncture what is the first thing that a medtech should do?
Ask the nurse to stop the IV line
How many minutes should you wait when the IV line has been stopped?
2 minutes
What is the condition when collecting blood in the arm that had an IV line?
Discard the 1st 5mL of blood collected
Why should you discard the 5mL of blood when collecting blood in the arm that had an IV line?
It is contaminated with IV fluid
What are the possible analytes that may INCREASE when the blood is contaminated with IV fluid?
Glucose, sodium, potassium, and fluoride
What is decreased when blood is contaminated with IV fluid?
Urea and creatinine
Evacuated Tube System is also known as the?
Closed Collection System
This is the most efficient way of collecting venous blood
Evacuated Tube System
The most frequently used method in venipuncture
Evacuated Tube System
Alternative method when drawing blood sample; used in thin veins
Syringe method
Syringe needle has ____ that serves as an indicator if the needle is outside or inside the vein
Hub
Some needle has some protective part called?
Hypodermic needle
Butterfly system is also known as the?
Winged Infusion Set
In the past, what was used as their IV injection that is no longer used now
Butterfly system
This is used for small and fragile veins, usually patients with pediatric/geriatric
Butterfly system
Luer fitting is partnered with?
Syringe barrel
Luer adapter is partnered with?
Tube holder of the ETS
Standard size of needle in ETS and Syringe
1.0-1.5 inches
Standard size of needle in butterfly method
1/2-3/4 inches
Gauge is inversely proportional to the?
Bore
What is the standard size of gauge
21g
What is the size of the gauge used for children
23g
What is the size of the gauge used for butterfly needles
23-25g
What is the size of the gauge used for collection of blood through scalp or tiny veins (infants)
25g
What is the size of the gauge used for blood donation?
18g
Tourniquet application should be ______ inches above from the puncture site
3-4
Tourniquet should not be applied for ______ as it may cause ______
More than 1 minute; hemoconcentration
If you do not have any tourniquet, what can be the alternative?
Blood pressure cuff, gloves
When using blood pressure cuff as an alternative to tourniquet, what is the required mmHg?
60 mmHg
Antiglycolytic agent prevents what?
Glycolysis
This is used when there is an expected delay in measurement of glucose
Antiglycolytic agent
What are the two antiglycolytic agent?
Sodium fluoride and Lithium Iodoacetate
What is the optimal anticoagulant concentration of EDTA (lavender top)
1.5-2.2 mg/mL of blood
What is the mechanism action of EDTA (lavender top)
Chelating calcium
This analyte is essential for blood coagulation
Calcium
EDTA (lavender top) is mostly used in?
Hematological studies
TRUE or FALSE. Aside from using EDTA for HBA1C testing in clinical chemistry, it can also be used to measure electrolytes.
FALSE
Inversion of EDTA (Lavender top)
8x
What is the Optimal Anticoagulant concentration of heparin (Light green/green top)
15-20 units/mL of blood
Mechanism of action of heparin?
Inhibits thrombin
This is a naturally occurring anticoagulant and it is present in our body
Heparin
Inversion of heparin (light green/green top)
8x
This is commonly used in clinical chemistry, especially in measuring electrolytes
Heparin
What is the additive in light blue top?
3.2% Sodium Citrate