TIA Mid-term Updated

Emergency safety and responses

• Syncope: temporary loss of consciousness due to transient cerebral hypoperfusion; risk during venipuncture; prevent by having patient sit or lie down and monitor.
• What to do when a patient has a seizure: ensure safety, do not restrain, remove nearby hazards, time the event, do not insert objects in mouth, after seizure place patient in recovery position and seek help as needed.
• Compartment syndrome: increased pressure within a muscle compartment causing ischemia; symptoms include severe pain, swelling, paresthesias, and diminished pulses; treat by relieving pressure and medical evaluation.
• Max tourniquet time: 1 minute; release promptly to reduce hemoconcentration and artifact.
• Where to draw blood if patient has an IV site: prefer the arm without the IV; if only option, follow facility policy and consult supervisor (typically not from the IV arm).
• Average adult blood volume for ~150Ls{text{b}}? (weight ~150 pounds): approximately 5 L.
• Distal: farther from the center of the body; proximal means closer to the trunk.
• Hemolysis effect on bilirubin tests: hemolysis can interfere with bilirubin testing and may yield inaccurate results; avoid hemolyzed samples.
• If patient has an IV in one arm, preferred site: opposite arm.
• Normal pH of blood: $7.35-7.45$
• Tourniquet placement: about $3-4$ inches above the venipuncture site.
• Recommended needle gauge for arterial puncture: $22G$ (common for arterial sampling).
• During an oral GTT, allowed beverages: water only (no food; follow protocol for glucose load scheduling).
• Approx. unit donor blood volume: $450\text{ mL}$
• Blood smear spreader slide angle: approximately $30^ ext{ to }40^ ext{ degrees}$
• Urine sample delivery: within $2$ hours of collection (or refrigerate if delayed per protocol).
• CSF diagnosis: used to diagnose meningitis and other CNS disorders involving infection or inflammation.
• Inversions for anticoagulant tubes: typically $8-10$ inversions to mix.
• Hemolysis (repeat): see above; hemolysis is the rupture of red blood cells, causing potential interference with many tests.
• BNP test purpose: assess heart failure and cardiac function.
• Rapid strep test detects: Group $A$ Streptococcus.

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• PHI: Protected Health Information; any identifiable health information transmitted or stored electronically.
• Inappropriate action during child phlebotomy: rough handling, coercive behavior, lack of parental presence or consent, or unsafe practices.
• Organ processing bilirubin to prevent high levels: the liver (conjugation of bilirubin).
• Jaundice: yellowing of skin/eyes due to elevated bilirubin.
• Edema: abnormal accumulation of fluid in interstitial spaces leading to swelling.
• Preferred venipuncture site for a child <2: scalp vein (scalp/cephalic region) is commonly used in small children.
• Maximum blood removal in 24 h from an infant: typically a policy-based limit (often cited as $5\text{ mL/kg}$ per 24 h; follow institution protocol).
• Joint Commission responsibilities: accredits and ensures safety/quality standards in healthcare facilities.
• Test greatly affected by hemolysis: Potassium (K⁺) levels are highly affected; other tests can be affected as well.
• What is basal state: fasting/resting metabolic state; no caloric intake before testing when required.
• Test for gestational diabetes: OGTT (Oral Glucose Tolerance Test).
• Autologous donation: patient donates blood for their own future use.
• Hemochromatosis: iron overload disorder due to increased absorption (often hereditary).
• Antibody in Mycoplasma pneumonia infection: cold agglutinins (IgM).
• Organ that creates urine: kidneys (nephrons).
• Specimen identification number used in lab: accession number.
• Safety risk removing stopper from tubes: potential aerosolization and exposure to bloodborne pathogens.
• Test most affected by glycolysis in tube: glucose measurement.
• Blood smear must be made within: $1\text{ hour}$ of collection to prevent cell morphology distortion.
• Aliquots: portions of a specimen separated for testing.
• Statutory Law: laws enacted by a legislative body.
• Penalties for violating HIPAA: civil and/or criminal penalties including fines and possible imprisonment.
• Touching another person without permission is called: battery.
• pH: measure of hydrogen ion concentration; scale roughly 0-14; basic formula $\mathrm{pH}=-\log[H^+]$.
• Another name for smooth muscle: visceral (involuntary) muscle.

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• Peristalsis: wave-like muscle contractions moving contents through the GI tract.
• Anatomic position: standing upright, feet together, arms at sides, palms forward.
• Supine position: lying face up.
• Thermoregulation body system: primarily nervous system (hypothalamus) with endocrine contributions.
• Structure returns blood to the heart: veins (e.g., venae cavae).
• Sounds heard when listening to the heart: S1 and S2 (lub-dub).
• Aorta: main artery carrying oxygenated blood from the left ventricle to the body.
• Vena Cava: large veins returning deoxygenated blood to the right atrium.
• Chambers of the heart: right atrium, right ventricle, left atrium, left ventricle.
• Path flow of blood through the heart: right atrium → right ventricle → pulmonary artery → lungs → pulmonary veins → left atrium → left ventricle → aorta.
• Diagnosis: process of identifying a disease.
• PHI: Protected Health Information.
• Smallest blood vessels: capillaries.
• Vein locations in antecubital space: veins in the antecubital fossa (inner elbow area).
• Veins in the antecubital space: median cubital vein, cephalic vein, basilic vein.
• Most popular vein for blood draws: median cubital vein.
• Plasma percentage of blood: $55\%$.
• Granulocytes: neutrophils, eosinophils, basophils.
• Neutrophils: a type of granulocyte; primary phagocytes.
• Another term for RBCs: erythrocytes.
• Cells that attack bacteria: neutrophils (a type of leukocyte).
• Enzymes that break down fibrin in clots: plasmin.
• Cells infected and destroyed in HIV infection: CD4+ T lymphocytes (helper T cells).
• Lymph nodes are part of which system: lymphatic/immune system.
• Antigens: substances that provoke an immune response; foreign.
• SST: Serum Separator Tube.
• Vacuum tubes: tubes that contain vacuum for blood collection; used to collect specimens.
• Steps for performing phlebotomy: identify patient, confirm order, gather supplies, position patient, apply tourniquet, locate vein, insert needle, collect tubes in proper order, remove tourniquet, remove needle, apply pressure, label specimen, transport.
• Common needle gauge sizes: 21G, 22G, 23G; most common is 21G or 22G.