(NHA) Medical Assisting Certification Study Guide 2021/2022

CC Chief Complaint Segment Line between two waveforms P Wave Arterial Depolarization How many 1mm boxes are in a 6 second rhythm strip? 30 one millimeter boxes The SA node represents which waveform on the EKG? Only the P wave What is the reading you can get from the RR interval? Ventricular Pulse What is the primary stage of Hemolysis? Vascular phase and platelet phase together What is Electrophoresis? Analyzation of the chemical components of blood, e.g. hemoglobin, serum, urine, cerebrospinal fluid based on electrical charge. Positive testing for occult blood in a stool sample turns which color? Turns blue on a positive test for occult blood in feces The stages of Hemostasis 1. Vascular, 2. Platelet Phase, 3. Coagulation Phase, 4. Fibronolysis Blood vessels Aorta, Arteries, Arterioles, Capillaries, Venues, Veins, Superior and Inferior Vena Cavae Outer connective tissue layer of a blood vessel Tunica Adventitia Upgrade to remove ads Only $35.99/year Inner endothelial tissue of a blood vessel Tunica Intima The inner smooth layer of a blood vessel Tunica tunica media The standards of right and wrong in a medical setting Code of Ethics What do you find in capillaries? A mixture of venous and arterial blood is found The average adult has how many liters of blood? 5-6 Liters What is the percentage of water in the blood? 92% Percentage of plasma in the blood? 55% Percentage of formed elements in the blood? 45% 99% of formed elements in the blood RBC,s or Erythrocytes Where do you find hemoglobin? RBC,s Where do all blood cells originate? Bone marrow How many RBC,s per microliter of blood 4.2-6.2 million What is the second most numerous WBC Lymphocyte with 20-40% Their numbers increase in intracellular infections and TB Monocytes Their numbers increase in bacterial infections and are often first on the scene Neutrophils These WBC,s play an important role in viral infection as well as in immunity Lymphocytes Number of leukocytes for average adult per microliter Leukopenia Decrease in WBC,s seen with viral infection and leukemia Comprises 3-8% of WBC or leukocytes Monocytes Largest in size of the leukocytes Monocytes Carries histamine Basophil Injury to a blood vessel that causes it to constrict, slowing the clod of blood. Vascular phase of Hemostasis Preferred site for a venipuncture Antecubital Fossa Test used to evaluate the intrinsic pathway and monitor heparin therapy APTT also know as PTT Test used to evaluate the extrinsic pathway and also used to monitor warfarin therapy PT Fibrinolysis Breakdown and removal of a clot Converts the temporary platelet plug in a stable fibrin clot Coagulation Phase 2nd choice vein for venipuncture and most often the only one palatable in an obese Pt. Cephalic vein Antiseptics used in Phlebotomy 70% isopropyl alcohol pads most common, provolone - iodine for BC,s and Chlorhexidine gluconate for patients that are allergic to Betadine/ Iodine Length of needle commonly used in venipuncture 1 inch (up to 1.5") Average gauge of needle used for drawing blood 21-22 Gauge of needle that can cause hemolysis smaller than 23 gauge 3 skills of the phlebotomist Social, clerical, technical Analytical errors during collection of blood Extended tourniquet time, hemolysis, wrong order of draw, failure to invert tubes, faulty technique under filling tubes Analytical errors before collection of blood Patient misidentification, improper time, wrong tubes, not fasting, exercise (Cortisol levels), Pt. Posture, Poor coordination with other treatments, improper site prep, medication interference Analytical errors After collection of blood Failure to separate serum from cell (Glycolisis), improper use of serum separator (Not inverting tubes or not spinning tubes), delays in processing, exposure to light, improper storage conditions, dimming clots Fistula Permanent surgical connection between an artery and a vein, never used for venipuncture Edima Accumulation of fluid in tissue Thrombophlebitis Inflammation of a blood clot formation Explanation of Hemoconcentration The increase in proportion of formed elements to plasma caused by leaving on the tourniquet for more than two minutes Consequence of insufficient pressure applied after withdrawal of a needle Thrombus Additives in a green top tube Heparin, sodium, lithium, ammonium Why is the green top tube never used for hematology? Green tops additive heparin interferes with the Wright's stained blood test Common tests for the lavender EDTA tube CBC, differential or diff, ESR, sickle cell screening Common tests for this color tube are Chemistry tests performed on plasma such as ammonia, carboxyhemoglobin and STAT electrolytes Green top tube (Heparin) tests How long does it take for blood to clot by the normal coagulation process in the red top tube 30-60 mins The primary purpose is to provide reliable data about a patients health status by ensuring the accuracy of a test while detecting and eliminating error What is Quality Control? Common test for the red topped tube Serum Chemistry tests, serology tests, blood bank (Glass only) Order of the draw for capillary specimens Lavender first, than tubes with other additives, than tubes without additives Antiseptic not used on a dermal puncture site Betadine (Because it interferes with several tests like bilirubin, uric acid, phosphorus, and postassim) For which procedure would you warm the site for a minimum of 3-4 minutes to increase blood flow? Dermal punctures (Heels sticks) Which are the preferred sites for dermal punctures? The distal segment of the third or fourth finger of the non-dominant hand Heel sticks are performed on which patients? Infants less than 1 years old Where on the foot is the dermal puncture made on patients less than 1 years old? The medial and lateral areas of the plantar surface of the foot Dermal puncture is made in The fleshy portion of the finger slightly to the side of the center perpendicular to the lines of the fingerprints what will occur if you puncture the heel too deep? More than 2mm Osteomyalitis what are the identification requirements for the blood bank? Patients full name or DOB, Hospital ID# or SNN for outpatient care, date and time of collection as well as the phlebotomist's initials What does the toxicology section of the lab analyze? Plasma levels of drugs and poisons What is the percentage of the population with the D antigen present? 85% of the population The 4 blood types A, B, AB, O Which blood type has neither the Anti-A nor the Anti-B plasma antibodies AB This section of the lab uses serum to analyze the presence of antibodies to bacteria, fungi, viruses, parasites, and antibodies against the body's own substances? Serology (Immunology) Section Mycology Study of fungi The physical examination of urine consists of Color, Clarity, Specific gravity A low power microscope has a magnifying power of 100X Oil immersion objectives on the microscope reach a maximal magnification of 1000X This objective of the microscope is used for observing bacteria, WBC differential count and RBC morphology Oil immersion Eyepiece of the microscope Ocular lens Focal length is? The distance of the object to be examined to the center of the lens Meter to inches 39.37 High power objective on a microscope magnification 400X 1000 meter are equal to 1km 1mm to inches 0.04 0.3 meter of tubing is how many inches 12 inches 1kg is how many pounds 2.2 pounds Abbreviation of microliter ul Abbreviation for decimeter dm Gram stain positive stains Deep violet (Violet to black) Gram stain negative stains which color Light to dark red Bacteria that take up and retain the crystal violet and resist alcohol discoloration Gram positive bacteria, appear blue to black Bacteria that are decolorized completely by ethanol and take safrin counterstain Gram negative bacteria, appear red Gram stain sequence Crystal violet, Gram's iodine, 95% ethyl alcohol/acetone mix/safranin stain The degree of angle of the pusher slide 30 degrees The urinary system Two kidneys, two ureters, bladder, urethra When checking for hormones in urine when do you collect the urine sample? First voiding in the morning Which urine specimen provides the clearest, most accurate results? Clean catch midstream specimen Which urine sample requires aseptic technique Clean catch specimen Examination of urine consists of Physical, chemical, microscopic Physical examination of urine consists of Volume (Adequate for testing, observing color, appearance, odor, and specific gravity What amount of urine must you have to be sufficient for analysis? 25ml What is the normal range of specific gravity of random collection 1.005 - 1.030 What is the normal range of the specific gravity of urine in adults with normal diet and fluid intake 1.015 - 1.025 Microscopic examination of urine requires this amount 10-15ml Urine Specific Gravity The ratio of weight of a given volume of urine to the weight of the same volume of distilled water at a constant temperature Glycosuria Presence of glucose in the urine Normal pH of freshly voided urine 4.5-8.0 within this range the pH of the most healthy patients is around 6.0 Symptoms of patients with diabetes mellitus Glycosuria, polyuria, and thirst pH of 0-7.0 Acidic pH of 7-14 in urine Alkaline Distilled water has a pH of? 7.0 pH or neutral A urine pH of what is considered neutral? 7.0 pH A positive urine nitrate test is an indication for A significant number of bacteria are present What color is a test positive for in nitrate in urine Pink The copper reaction test us used for what? Screening for glucose in urine The presence of leukocytes in urine is an indicator for what? Bacteriuria or UTI Urine screening for UCG or hCG Pregnancy test HIPAA is for? Patient confidentiality The four elements of negligence are 1. Duty of care, 2.Derelict: Breach of duty, 3.Direct cause, 4.Damage Tort Wrongful act that results in injury to one person or another Examples of A Tort Battery, invasion of privacy, and defamation of character Defamation of character by written statement is considered Libel Consists of injury to another person's reputation, name, or character through spoken (Slander) or written (Libel) Defamation of character Unprivileged touching Battery The release of medical records without the patient's knowledge or permission Invasion of privacy Good Samaritan Law Rendering first aid within the scope of knowledge by a healthcare worker without the fear of being sued for negligence Hypothalamus Regulates and maintains body temperature Functions necessary for life Heart function, blood pressure, respiration, and temperature Rectal temperature range in Celsius 37.0-38.1 C Oral temperature range in Fahrenheit 97.6-99.6 F Axillary temperature range in Celsius 35.9-37.0 C Tympanic temperature range in F and C 98.6F and 37C Intermittent fever Fluctuating fever that returns to or below the baseline than rises again Remittent fever Fluctuating, remains elevated does not return to baseline Continuous fever Remains constant above baseline, does not fluctuate Rectal temperature is not taken from the following patients Patients with heart disease When taking axillary temperature how long should it be taken 5-10 mins or as required by office policy Pulse is taken where and how long Radial for 30secs x2, it tachy or brady take it for 1 minute Explain blood pressure Measurement of amount of force blood excretes on peripheral artery walls BP cuffs too short and narrow can give a false reading of what? Hypertension If the brachial artery is far below the heart level the BP reading can be Falsely high readings While taking BP the deflation rate is 2-3mm Hg Taking BP hearing two consecutive beats gives which reading Systolic The disappearance point whilst taking BP is usually what? A few mm Hg below the muffling point which marks the diastolic pressure How long should the arm rest between re-inflating the cuff during BP taking 1-2 minutes Repetitive inflation of BP cuff can result in Venous congestion Venous caused by repetitive inflation of BP can lead to Artificially low systolic and high diastolic reading Anthropometric measurements BMI and growth development in infants, children, and adults The four principals of physical examination Inspection, palpation, percussion, auscultation