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Phlebotomy Session 8

What are some communication strategies Verbal communication Nonverbal communication Active Listening
What are the "Four Components Of Communication" -THE SENDER(Person sending the message) -MESSAGE SENT(What the sender wants to convey) -SYMBOLS(How the sender communicates the message) -MESSAGE RECEIVED(How the message is perceived)
What is the measurement considered for "PERSONAL SPACE" 18in.-4ft. (Interactions with friends and some patients)
What is the measurement considered for "SOCIAL SPACE" 4ft.-12ft. (Most interactions of daily life)
What is the measurement considered for "PUBLIC SPACE" >12ft. (lectures, speeches)
What is the "Zone of Comfort" Area around patient that is private territory(CHILDREN may feel uncomfortable if you get to close)
What is the "GOLDEN RULE" Treat patient as you would want yourself or a family member treated in a health care setting
What is "Culture Sensitivity" System of values, beliefs and practices that stem from a person's concept to reality
Physical Impact of Stress can cause? -Hypertension -Hyperglycemia -Stroke -Myocardial Infarction -Diabetes -Ulcers -Neck and back pain
What are the early signs of stress Headaches/fatigue (due to burnout and overload)
Immediate physical signs of stress are? -Cold -Nervousness -Tense -Sweaty Hands
What are some coping strategies for stress -keep caffeine to a minimum -try not to use alcohol/nicotine(may increase level of stress) -exercise regularly -set aside time to relax each day
define ethics Morales duty to determine right and wrong
define accountability You are responsible for your actions
Define Hemophilia Tendency to bleed
define Thrombophilia tendency to clot
Define Hemostasis Process of blood clotting and then the subsequent dissolution of the clot following repair of injured tissue
Define Fibrinolysis Breaking of the fibrin
What are the 5 Steps of the hemostatic process Vascular Phase .. Platelet Phase .. Coagulation Phase.. Clot Reaction.. Fibrinolysis
What is Primary Hemostasis -Process of forming a platelet plug at the sit of vessel injury -Consists of a vasoconstriction of platelet adhesion
Define Vasoconstriction(Vascular Phase) "tightening" of blood vessels to divert blood flow around the damaged vessel -enhances contact activation of platelets and coagulation factors
Define Platelet Adhesion( Platelet Phase) Platelets become activated and aggregate at the site of injury, forming a temporary loose, platelet plug
What happens in Secondary Hemostasis Stabilizes the initially loose platelet plug, a sequence of enzymatic reaction is initiated which culminates in fibrin strands forming at the platelet plug
What happens in the "Coagulation Phase" -Coagulation factors interact with each other to form a fibrin clot (reinforces the platelet plug...ADP, thromboxon, PFB) "FIBRIN FORMING SYSTEM
What are "Coagulation Factors" Proteins normally presented in the blood (most are produced by the liver) ...normally "turned off" (inactive)..."A" signals the factor in its "active" form of coagulation cascade
What happens in the "Extrinsic Pathway" Activated when endothelial cells are injured and tissue factor is released -activated factor VII and tissue factor bind to form a complex.(this complex, plus calcium, activates factor XTissue Factor)
What happens in the "Intrinsic Pathway" Initiation occurs when factor XII is exposed to a negatively charged surface(termed the contact phase) "REQUIRES CLOTTING FACTORS VIII-XII
What is the "COMMON PATHWAY" When factor Xa bigs to the platelet surface, a complex is formed composed of platelet phospholipid, calcium and factor Va...-Complex converts prothrombin to thrombin which in turn converts fibrinogen to fibrin
Explain Fibrinolysis Bodys ways of keeping coagulation from becoming excessive and occluding the blood vessels
Thromboplastin activates what factor? FACTOR 7
define the REGULATION STAGE Balance between coagulation and fibrinolyctic process must be maintained otherwise excess clotting or fibrinolysis will occur
Thrombophilia causes what D.V.T. (Deep Venouse Thrombosis) or P.E. (Pulmonary Embolism)
define THROMBOPHILIA Hypercoagulable state due to inherited(heriditary/genetic) defects or acquired defects in one or several factors of the coagulation cascade
How many patiens in the US are diagnosed with DVT each year? ....(thrombotic alert #1 MORE than 500,000
How many pulmonary embolisms are diagnosed each year in the US? ...(thrombotic alert #2 MORE than 630,000
FACTOR 1(fibrinogen) ...define .AFIBRINOGENEMIA Total absense of measurable fibrinogen (RARE CONGENITAL DISORDER)
FACTOR 1(fibrinogen)...define HYPOFIRINOGENEMIA Below normal levels of fibrinogen -treated by cryoprecipitate or FFP
FACTOR 1(fibrinogen)...define DYSFIBRINOGENEMIA altered structure of the fibrinogen molecule -usually asymptomatic but has been associated with both bleeding and thrombotic events
explain ...FACTOR V (proaccelerin)GENE DEFECT (MOST COMMON CAUSE OF THROMBOPHILIA) coafactor in coagulation cascade..defieceny causes bleeding but factor V mutation causes thrombotic events due to impaired degradation of factor V resulting in continued thrombin generation
what does MTHFR do ? Breaks down homo cysteine
deficiency of MTHFR causes ? increase of homocysteine leading to thrombosis
Acquired Homo cysteine is due to deficiency of vitamin B6 and B12
What happens if Prothrombin does not break down keeps on activating thrombin to convert fibrinogen into a fibrin clot
deficiency in vWF causes (FACTOR VIII) vonWillebrand's Disease
Defect or absense of coagulant portion causes Classic Hemophilia A
Acute Phase Reactant Increase in inflammation, stress, pregnancy and infectin which can lead to clot formation
What is the purpose of Quality Assurance Gathering/evaluating information and data about services/tests provided
What is the purpose of P.I. Implement an interdisciplinary approach to collection, analysis and reporting of performance measures
What is the overall goal of P.I. Effect quality improvement including accuracy and precision
Where does P.I. begin in a hospital setting Begins in the lab before specimen is collected
What are Logbooks Logs examined in quality assurance meeting to determine problem areas (also document problem areas with incident reports)
Define INCIDENT REPORTS a formal written description of an incident/unusual occurrence
What is the purpose of incident reports To objectively document exactly what happened (GOAL is to prevent another episode)
Define DELTA TEST comparison between current results of the lab test and previous test results for same patient (CLS)
What are FLOOR BOOKS Containcs information that lists the name of each test/procedure (useful to aid in consistency of testing for quality control purposes "AKA PROCEDURE, REFERENCE or TEST MANUAL)
what does JCAHO stand for Joint commission on accrediation of healthcare organization (PRIVATE NON-GOVERNMENT AGENCY)
What does JCAHO do Establishes guidelines for healthcare agencies regarding quality of care
What is CQI Continuous Quality Improvement
What does CQI do ? Framework and management commitment to improve healthcare structure, processes, outcomes, and customer satisfaction
What is the ultimate goal for CQI IMPROVE PATIENT OUTCOMES
what are the "Poor patient outcomes (5 D's)" -DEATH -DISEASE -DISABILITY -DISCOMFORT -DISSATISFACTION
Define P.D.C.A. Plan-Do-Check-Act
What is the purpose of PDCA Cycle for assessing, making changes, then reassessing and putting in action
Created by: moralesm05



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