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CCMA CH 11
CCMA CH 11 REVIEW (Testing and Laboratory Procedures)
| Term | Definition |
|---|---|
| (Urine Specimens) - Random Urine | patient urinates in clean, non-sterile container - used for screening purposes |
| (Urine Specimens) - First Morning Specimen | collected in clean container first thing in the morning - more concentrated - used for pregnancy testing, or when other analytes (protein, nitrites) need to be evaluated |
| (Urine Specimens) - Clean-catch Midstream | perineal cleaning w/ moist wipes, begins to urinate, and collect specimen midstream in sterile urine container - for cultures or when non-contaminated specimen is desired |
| (Urine Specimens) - 24-hour | uses container w/ preservatives; patient discards first morning specimen and collects all specimens for next 24 hours, including 1st void of 2nd day - to collect quantitative analysis of components like protein to analyze kidney function |
| (Urine Specimens) - Catheterized collection | insertion of sterile tube through urethra into bladder ; performed by provider or nurse w/ MA helping prep - used when sterile urine sample is needed or patients are unable to provide specimen on their own |
| (Stool Specimens) - Fecal Occult Blood Test | stool specimen to screen for presence of blood where meds and certain foods are stopped for 3 days ; three separate specimens are collected on filtyer paper - could indicate disease process or gastrointestinal bleeding |
| (Stool Specimens) - Tape Test | provide parents a slide w/ a piece of tape on it ; tape is placed over child's anus before getting up in the morning and then back on the slide - used to detect pinworms - typically affect small children |
| (Stool Specimens) - Tape Test cont. | - could be collected for parasite or bacterial infections (specific containers for these tests - ova and parasites (O&P) testing detects presence of parasites and their eggs |
| Collection of Sputum Specimens | collect in sterile containers ; ask patients to produce deep productive cough ; best collected in early morning before eating or drinking ; no mouthwash before |
| Collection of Specimens for Cultures | always collected in sterile containers; DO NOT contaminate lid, swab, container, specimen - appropriate time - site of suspected infection - minimize transport time to reference lab - appropriate amount - appropriate containers, labeled |
| Clinical Laboratory Improvement Amendments (CLIA) | Federal standards that regulate laboratory testing, handling, and processing - waived testing is simplest lab procedures |
| (CLIA) Pregnancy Testing | detecting the presence of human chorionic gonadotropin (HCG) antibodies |
| (CLIA) Rapid Streptococcus Testing | throat swabs are obtained to screen for Group A streptococcus |
| (CLIA) Dipstick, Tablet, or Multi-Stick Urinalysis | screening tool for analytes that are excreted in urine |
| (CLIA) Hemoglobin | machine used to screen for oxygen-carrying protein in whole blood, performed using capillary blood from finger stick |
| (CLIA) Spun Hematocrit | fingerstick collection of blood in microcapillary tubes is centrifuged and evaluated for percentage of red blood cells |
| (CLIA) Blood Glucose | whole blood is analyzed in a glucometer for a quantitative glucose level, performed using capillary blood from finger stick (capillary puncture) - screening test for diabetes |
| (CLIA) Hemoglobin A1C | capillary blood test - shows diabetes control over an approximate 3-month period |
| (CLIA) Cholesterol Testing | capillary blood test - evaluates lipids |
| (CLIA) Helicobacter Pylori | blood sample - screen for H. pylori, main cause of gastric ulcers |
| (CLIA) Mononucleosis Screening | capillary blood test - test for presence of Epstein-Barr virus |
| (CLIA) Nasal Smear for Influenza types A and B | uses swab inserted into nostril - qualitative test for influenza antigens |
| (CLIA) Drug Testing | urine and blood samples - detect substances |
| (CLIA) Fecal Occult Blood | stool test - hidden blood |
| CLIA Regulations | established in 1988 to ensure quality of diagnostic testing through lab regulations |
| CLIA-waived | most common designation for ambulatory care w/ lowest level of complexity ; performed in the home environment or medical office |
| Moderate- and High-Complexity | tests are non-waived, must have CLIA certificate and undergo inspections to ensure standards are met - reference or hospital labs |
| Provider-performed Microscopy Procedures | microscopic screening of some specimens like urine or body excretions |
| Commission on Office Laboratory Accreditation (COLA) | independent accreditor for laboratories ; focuses on meeting CLIA regulations with goal of providing best care to patient |
| Quality Assurance | comprehensive, relates to policies/procedures implemented for reliability of test results - ex) policies related to rotating stock to put newest containers in back of storage area - ex) policy of checking temp and maintaining between 39 F and 41 F |
| Quality Control | included in quality assurance but more specific - test reliability and accuracy while uncovering errors and eliminating them - ex) reviewing exp date of urine multi-sticks - ex) checking temp of lab fridge and documenting on log |
| Quality Control Procedures | testing specimens, quality control samples tested to ensure patient samples are accurate ("controls") - use quantitative result range or qualitative descriptor - ex) control cuvette in machine for hemoglobin can be calibrated to valid range |
| Quality Control Logs | MA is responsible for monitoring pieces of equipment to ensure proper and accurate functionality - maintain logbooks to validate test conduction under optimal conditions and accurate control samples prior to patient samples |
| Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) | legislation that deals with payment for health care under the direction of CMS |
| Who can enter lab orders into an electronic medical record? | licensed or legally authorized individuals |
| Demographical Information | name, sex, DOB, address, phone number, provider and insurance information, diagnosis, order date |
| panel | a group of tests that are connected to one particular body system ; profile |
| All specimens should be labeled with... | 1) pt name 2) date and time specimen was drawn 3) Collector's initials 4?) maybe DOB and provider's name |
| You must match each collected specimen with the... | lab requisition form |
| Most common types of specimens found in ambulatory care setting are | blood, urine, and swab samples |
| Some nonblood specimens like drug tests or test for a court subpoena may require | a chain of custody |
| Chain of Custody | series of processes and procedures used to ensure security and accuracy |
| Tests for bilirubin must be place in what kind of container? Why? | a dark container because light affects the results |
| Bilirubin | an orange-yellow pigment in bile ; formed by breakdown of hemoglobin when red blood cells are destroyed |
| Normal Hemoglobin Levels | Male: 13-18 g/100mL Female: 12-16 g/100mL |
| Normal Hematocrit Levels | Male: 42%-52% Female: 36%-48% |
| Normal Fasting Blood Glucose Levels | 60-110 mg/dL |
| Normal Total Cholesterol Level | <200 mg/dL |
| Normal LDL Levels | <130 mg/dL |
| Normal HDL Levels | >40 mg/dL |
| Normal Triglyceride Level | <150 mg/dL |
| Normal Erythrocyte Sedimentation Rate (ESR) | Males: 0-20 mm/hr Females: 0-30 mm/hr |
| ESR (erythrocyte sedimentation rate) | type of blood test that measures how quickly erythrocytes (rbc) settle at the bottom of test tube that contains a blood sample |
| Normal International Normalized Ratio Level (INR) Level | 0.8-1.2 |
| International Normalized Ratio (INR) | Blood coagulation test ; commonly performed on patients taking anticoagulants (i.e. coumadin/warfarin) |
| Normal Prothrombin Time | 10.4-15.7 seconds |
| Prothrombin Time (PT) | test that helps evaluate ability to appropriately form blood clots |
| Normal Urine pH Range | 4.5-8 |
| Normal Specific Gravity of Urine Range | 1.005-1.030 |
| Normal Urobilinogen in Urine Range | 0.01-1.0 |
| All other analytes in urine should be | negative |
| Critical Value | lab result outside of established reference range and presents potential health risk to a patient |
| CLIA requires rapid reports of | Critical Values |
| if MA receives call out crit value, they should | tell provider and document the info |
| hyperopia | difficulty seeing things up close ; aka farsightedness |
| myopia | difficulty seeing things far away ; aka nearsightedness |
| presbyopia | gradual, age-related loss of eyes' ability to focus actively on nearby objects |
| near vision test | screens for people with hyperopia and presbyopia ; pts read jaeger chart from 14-16 in away from eyes w/ no glasses or lenses ; test each eye separately, then together |
| distance vision test | tests for myopia ; pts stand 20 in away from chart that has letters on it that decrease in size (Snellen test) ; test eyes separately and then together ; pt can wear glasses/contacts |
| Normal Vision is called... | 20/20 |
| Color Vision tests | use of multicolored charts (Ishihara charts) to determine ability to recognize color |
| who is mostly affected by color blindness? | males |
| what is the most common type of color blindness | red and green deficiency |
| Ishihara plates | display of colored dots used to test for the presence of color deficiency |
| what might patient need further testing to determine color blindness? | after missing 4+ Ishihara plates |
| Visual field testing | aka Perimetry test ; performed to determine losses in peripheral vision and eye diseases like glaucoma ; pt instructed to look straight ahead and respond to instructions ; light (automated test) finger (manual test) to test |
| Glaucoma | group of eye diseases characterized by increased intraocular pressure |
| Tympanometry | process of recording movement of the tympanic membrane through pressure variances in external ear canal |
| What does normal Tympanogram display | peak on graph |
| What does abnormal Tympanogram display | a flat line |
| Audiometry | process of measuring hearing |
| Audiometric Testing | measurement of hearing, usually with an instrument called an audiometer ; graphic representation of results is called audiogram |
| What are tuning forks used for? | to determine the pts ability to hear tones transmitted through air and bone conduction |
| Anaphylaxis | life threatening allergic reaction |
| Scratch Test | type of allergy testing in which the body is exposed to diluted allergens through a light scratch or prick in skin ; if wheal occurs in the first 15 min, may be allergen ; intradermal testing can further prove ; large wheal, more significant allergy |
| Intradermal Test | an allergy test in which dilute solutions of allergens are introduced into skin of forearm and pt is observed ; initial wheal expected but if inflammation with induration (raised, hard area), substance is identified as allergen |
| Radioallergosorbent (RAST) test | blood test used to detect antibodies associated with allergens ; more intensive test but safer because it reduces risk of allergic reaction |
| Food Challenge test | pt receives increasing amounts of food suspected of causing an allergy ; must be conducted in a controlled environment where meds and treatment are available for acute allergic reactions |
| Peak Flow testing | used to measure pts forced expiratory volume ; monitors lung function in pts with chronic respiratory diseases like asthma |
| Forced Expiratory Volume (FEV) | the amount of air that can be forcible exhaled |
| Spirometry | an automated test that produces a graphic result |
| When taking lung functioning tests pts should | wear loose fitting clothing, sit in upright or standing position, breathe through mouth, no large meals 2 hrs before, no smoking 1 hr before, no breathing therapies before for at least 6 hrs (inhalers, nebulizers) |
Created by:
linju156
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