CI-CPT flashcards
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32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Order of draw
- Sequence for filling venous tubes to prevent additive cross-contamination: culture, citrate, serum, heparin, EDTA, then glycolytic inhibitor tubes.
- Citrate tube fill requirement
- Sodium citrate tubes must be filled to at least 90 percent of nominal volume; underfilling falsely prolongs PT and aPTT results.
- Tourniquet time limit
- Tourniquet should remain on no longer than one minute; longer stasis causes hemoconcentration, raising potassium and protein and promoting hemolysis.
- Hemolysis effect on potassium
- Red cell rupture releases intracellular potassium, falsely elevating measured potassium; hemolyzed specimens are typically rejected for potassium testing.
- Preferred venipuncture vein
- The median cubital vein is first choice because it is large, well anchored, and remote from the brachial artery and major nerves.
- Capillary puncture first drop
- Wipe away the first drop of capillary blood because it contains tissue fluid and may dilute the sample or alter results.
- Blood culture volume
- Adults typically require 20 to 30 mL per culture set, divided between aerobic and anaerobic bottles, collected before antimicrobial therapy begins.
- Serum clotting time
- Serum tubes should clot for about 30 minutes at room temperature before centrifugation to prevent fibrin strands from interfering with analysis.
- Separation within two hours
- Serum or plasma should be separated from cells within two hours of collection to limit potassium rise and glucose consumption by cells.
- Light-sensitive analytes
- Bilirubin, vitamin B12, folate, and porphyrins degrade with light exposure and require amber tubes or foil wrapping during handling.
- Cold agglutinin transport
- Cold agglutinins and cryoglobulins require transport and separation at 37 degrees Celsius; chilling causes antibody binding and invalid results.
- Ammonia specimen handling
- Ammonia specimens require immediate icing and rapid plasma separation because red cells release ammonia and falsely elevate results at room temperature.
- Specimen rejection criteria
- Common rejection reasons include unlabeled tubes, gross hemolysis, clotted anticoagulated samples, short citrate fills, and expired collection devices.
- EDTA carryover effect
- EDTA chelates calcium, so carryover into a later tube can falsely lower calcium and alkaline phosphatase; proper order of draw prevents this.
- Fasting requirement
- Most lipid and glucose testing requires 8 to 12 hours without caloric intake; water is permitted and does not alter results.
- Two patient identifiers
- Verify identity using two independent identifiers such as full name and date of birth, checked against the requisition at the bedside.
- Needlestick first aid
- Wash the exposed site with soap and water without squeezing, then report immediately for post-exposure evaluation and prophylaxis decisions.
- Syncope prevention
- Draw patients with a fainting history while lying down and remain with them until bleeding stops to prevent injury from a fall.
- Antiseptic site preparation
- Cleanse with 70 percent isopropyl alcohol in concentric circles and allow it to air dry completely before puncture for effective antisepsis.
- Hemoconcentration causes
- Prolonged tourniquet time, vigorous fist pumping, and drawing above an IV site concentrate cells and falsely raise potassium and protein.
- Standard precautions
- Gloves are required for every venipuncture, with gown, mask, and eye protection added when splash or spray exposure is anticipated.
- POC glucose hematocrit effect
- High hematocrit lowers whole-blood glucose readings and low hematocrit raises them, so anemia can falsely elevate meter results.
- POC quality control
- Meters require documented quality control, calibration verification, and correlation with central laboratory results per accreditation standards.
- POC INR interference
- Whole-blood INR devices are affected by hematocrit and lupus anticoagulant; discrepant results require central laboratory confirmation.
- Air bubble effect on blood gas
- Air bubbles shift pH, pCO2, and pO2 in blood gas samples; expel bubbles and analyze within minutes of collection.
- POC strip lot verification
- Confirm lot number, expiration date, and proper storage before use, and record operator identity and control results with each test.
- POC critical value reporting
- Critical point-of-care results must be verified and communicated per policy to the responsible provider, not simply entered into the chart.
- Patient confidentiality
- Results and identifiers are disclosed only to authorized care team members and never discussed in public areas or with unauthorized persons.
- Informed consent elements
- Explain the procedure, its risks such as bruising and fainting, and the patient's right to refuse or ask questions before collection.
- Interpreter requirement
- Use a qualified medical interpreter for patients with limited language proficiency; family members should not interpret clinical information.
- Phlebotomy scope of practice
- Phlebotomists may collect, label, and transport specimens but must not interpret results or give clinical advice to patients.
- Error disclosure
- Report collection errors, mislabeling, or adverse events promptly and factually through the facility incident reporting process.