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Department Procedures
What am I ?
Occurs in living organisms
Who am I?
Potpourri
100
Place where tests that are ordered and performed for diagnostic purposes and for evaluation of prescribed treatments.
What is the "Laboratory Department"?
100
I performs tests that are related to the physical properties of the blood and other body fluids (including blood cells and their appearance), tests related to clotting and bleeding disorders and coagulation (clotting) studies done to monitor patients undergoing anticoagulant therapy.
What is the "Hematology" Division that is within the Laboratory Department?
100
I perform tests that are related to the study of certain reactions that occur in living organisms. When the disease process occurs, my levels within the body fluids vary from normal. Any variance permits a diagnosis or evaluation of the patient's health status.
What is the "Chemistry" Division that is within the Laboratory Department?
100
I am the type of blood tests that are ordered when a myocardial infarction (heart attack) is suspected.
What are “Cardiac Enzymes “that are resulted in the Chemistry division? The common tests are the CK-MB, LDH-1 and Troponin –this is the test performed to diagnose an acute myocardial infarction (AMI) from a few hours to as long as 120 hour after onset. It is more sensitive than the CK-MB in detecting unstable angina with minor myocardial cell damage. Two subtypes may be ordered: troponin I and troponin T.
100
I am the area that studies specimens for color, clarity, pH, 9degree of acidity or alkalinity) specific gravity (degree of concentration), protein (albumin), glucose (sugar), blood, bilirubin, and urobilinogen. Sediment is viewed microscopically for organisms, intact cells, and crystals.
What is the “Urinalysis” division of the lab? May also be considered “Urine, Feces, and Fluids” Procedures for obtaining these specimens are: “Voided” (patient voids into a clean container); “Clean catch” ( midstream, urine specimen): The nursing staff uses a special cleansing technique to obtain this type of specimen. Catheterized urine specimen: This specimen is sterile and is obtained by catheterizing the patient. This procedure is usually done for culture and sensitivity testing performed by microbiology. Many times a Dr. will order a UA/C&S this means the Dr.wants two urine specimens: 1. Routine urine 2, urine for culture and sensitivity. This department also receives “Stool” specimens. A common Drs’ order for a stool specimen is “Stool for Occult Blood” occult (blood that is undetectable to the eye) Usually collected in sets of three. (Stool for Occult Blood x 3) Each specimen is numbered.
200
It is necessary to be able to identify these "areas" in the laboratory department in order to be able to correctly enter them into the computer. There are three "Major Areas" Hematology; Chemistry; and Microbiology.
What are the three major "Divisions" of the Laboratory Department?
200
I am the test that is composed of a number of tests including RBC; Hgb; Hct; RBC Indices; WBC count with differential, blood smear, and platelet count. These tests may be ordered separately. The number of tests included vary among hospitals. This is also a "common"lab test in this division.
What is a "CBC with Plt.Ct."? (Complete Blood Count with Platelet Count) CBC aka (hemg;hemogram) CBC with Platlett Count aka (hemogram with plt ct. or hemgp)
200
We are the two most commonly collected specimens’ in this division. Many of the tests can have the same name for both of us.
What is blood (whole blood; plasma; serum) or urine?
200
I am the scientific study of poisons, their detection, their effects, and method for conditions they produce. Tests that are included in my area detect drug and alcohol abuse and also helps for monitoring drug usage.
What is “Toxicology”? Sometimes certain medications the patient is receiving may cause toxic blood levels accumulate instead of being excreted. Antibiotics such as amikacin, gentamycin, kanamycin, and tobramycin. Other drugs may include Dilantin, and Digoxin. These tests require the blood to be collected at different times These medications are ordered for a peak and trough levels. “Trough” means a set time prior to the drug being given and “Peak” a set time given to draw the blood after the med is given. ordered by the doctor and drawn by the nurse. The RN will give you the set of times.
200
I am a test that requires two specimens to study kidney function. It requires testing the blood and a timed urine specimen that is collected over 12 to 24 hours.
What is a “Creatinine Clearance” Test? The urine is collected in an Amber colored container obtained from the lab. It is collected over 12 to 24 hours
300
The nurse or laboratory personnel obtains this commonly used speciman through venipuncture (puncture into the vein), fingerstick, (puncture into a capillary) or peripheral arterial or venous lines.
What is "Blood"? Blood is the common specimen aka "serum" or "level".
300
I am the test in this division that measures the clotting ability of blood. This test assists the doctor in determining the dosages of the drugs -usually warfarin (Coumadin)- prescribed in anticoagulant therapy.
What is a "PT and INR"? (Prothrombin Time with International Normalized Ratio)? )
300
Many of these types of tests in this category are ordered as a group. They are standardized nationally according to Current Procedural Terminology (CPT) OR Healthcare Common Procedure Coding System (HCPCS) Guidelines so a facility may receive Medicare reimbursement. They may be designed by the facility and must be approved on an annual basis.
What are panels or profiles?
300
I am the study of microorganisms that cause disease.
What is “Microbiology”? These specimens are cultured, grown in a reproducing medium, identified with the use of biochemical tests, and then tested for antibiotic sensitivity. Clues: C & S, Culture and Sensitivity (can be ordered on almost any specimen, including blood, urine, stool, sputum, wound drainage, pleural fluid, bronchial wash fluid, cerebrospinal fluid, intravenous and urinary catheters and nose and throat specimens. Common test: Blood Cultures (Can be drawn at different times and sites) Ex: Blood Cultures X 3 Q 15 minutes apart. AFB (Acid Fast Bacilli) – performed to detect tuberculosis. “Gram Stain” is treatment that begins immediately while awaiting the results of cultures thus allowing for differential diagnosis of the causative agent. It classifies bacteria into gram negative or gram positive groupings.
300
3. We are what the Dr. needs to add to the lab orders so that the nurse and HUC know how to carry it out.
What are the time “details” for ordering a lab test? “routine” – when the Dr. does not specify a time. Ex: CBC with Plt. Ct.; “timed”- Dr. orders a specific time. Ex: CBC with Plt. Ct. at 1500; “stat” – Dr. orders the test to be done now immediately. Ex: CBC with Plt. Ct. stat.
400
I am the "laboratory procedure" that is used when a specimen is collected and analyzed in the hospital unit by the nursing personnel. Usually done when departments require immediate results. These types of tests decrease the need for stat specimens to be sent to the lab.
What is "Point-of-Care" Testing?
400
We are the tests that that are performed individually and are commonly used to monitor heparin dosage. Actual levels of heparin (done in toxicology) may be performed in some hospitals to monitor an anticoagulant medication. These tests are "coagulation" studies. (coagulation-related to the clotting and bleeding of the blood).
What are the lab tests "APTT" (activated partial thromboplastin time and "PTT" (partial thromboplastin time)?
400
One of the common standard types of a test that is ordered as a group includes NA, K, CL, C02 + glucose, BUN, creatinine, and CA.
What is a “BMP” (Basic Metabolic Panel or Profile)? This test includes the “lytes” (electrolytes) NA, K, C02, CA. Old terminology “Astra 8” “Sma. 4-8”, Chem. 4-8, A-8
400
I am the test performed on stool specimens to identify an infection. It often occurs while an individual is in the hospital. (Nosocomial). The patient may be put in isolation.
What is “C-diff or C. difficille (Clostridium difficille) Toxin?
400
My area is usually a part of the clinical lab. We have the responsibility of typing and crossmatching patient blood, obtaining blood for transfusions, storing blood, and blood components.
What is the “Blood Bank”? Clues to recognize a Blood Bank order. T & C; T & X; Type and X-Match; Give ____units of PRBC; Transfuse _____ units of PRBC. Three things that can be transfused. Blood, Plasma, and Platelets. Other blood tests done in blood bank are Coombs test, type and screen, type and tag. The pt. needs to sign an informed consent or a consent for refusal if pt. declines transfusion.
500
We are "special type's of fluids" that need to be collected such as "Spinal Fluid" - (Lumbar Puncture); aka Spinal Tap; "Bone Marrow" - (Sternal puncture also called bone marrow biopsy); "Abdominal cavity fluid"-(Abdominal Paracentesis); 'Pleural Fluid"-(Thoracentesis); "Amniotic fluid"- (Amniocentesis); "Biopsy specimen"- (biopsy of a body part); "Cervical Smear"- (Pelvic exam) that require certain tasks in order for them to be obtained. We are usually retrieved by a physician and we require a signed patient informed consent.
What are types of non-retrievable specimens and their associated procedures? These procedures need sterile procedural trays from CS (Central Supply) or they will be on the nursing unit with the emergency equipment. The procedure is done at the bedside by the physician. There are three or four tubes the physician puts the aspirated fluids into. They are numbered 1,2,3,and 4. These types of specimens must be hand delivered "stat" to the lab once completed.
500
I am the test that determines the rate at which red blood cells settle out of the liquid portion of the blood. This test is used to evaluate the progress of inflammatory and autoimmune disease. The physician may request that this test be done by a specific methodology called "Westergren".
What is an "ESR" (Erythrocyte Sedimentation Rate)?
500
One of the common standard types of a test that is ordered as a group includes NA, K, CL, C02, glucose, BUN, creatinine, and CA, albumin, total bilirubin, alk phos, total protein, AST, ALT
What is a “CMP” (Complete Metabolic Panel or Profile; Comprehensive Metabolic Panel or Profile)? This test includes the “lytes” (electrolytes) NA, K, C02, CA Old terminology “SMAC”; “Sma 9-24” ; “Chem. 9-24” “Chemistry Profile”
500
I am the study of antibodies and antigen useful in detecting the presence and intensity of a current infection. It also may be useful in identifying a previous infection or exposure to an organism.
What is “Serology”? Studies autoimmune diseases and pretransplant and posttransplant conditions evaluated and treated. Tests for syphilis, rheumatoid arthritis, human immunodeficiency virus (HIV). Common tests: ANA-(Antinuclear Antibody); RA (Rheumatoid Factor) –tests for rheumatoid arthritis.
500
I am the study of the nature and cause of disease as seen in body changes. Most of my specimens come from surgery.
What is “Pathology”? Histology and Cytology are subdivisions of the pathology dept. “Histology” is the study of microscopic structure of tissue. “Cytology” is the study of cells obtained from body tissues and fluids to determine cell type and to detect cancer or a precancerous condition.