Program of Checks & balances designed to ensure the quality of a lab's services. It must have a mechanism for the detection of problems and provide an opportunity to improve service.
The Three Stages of Quality Assurance Program
Pre-analytical, analytical, post-analytical
Turn-around-time
time from test is ordered until time results are reported.
Documentation and Corrective action is required. Why?
To show improvement in system quality.
Post-analytical: Critical Values
Results that are far from normal. It may indicate abnormalities in the patient's health. Doctor's are notified to render treatment.
Urinalysis
Fluid biopsy of the kidney. Aids in diagnosis of disease, screen for genetic diseases that the patient may have not known about. Monitor disease progression, and monitor therapy effectiveness.
Urine
ultrafiltrate of plasma.
First morning specimen is the most concentrated urine sample of the day.
a. true
b. false
a. True. You sleep for 8 hours while urine accumulates and sit in the bladder.
The patient doesn't have to go to pee at night if he has to pee the next morning for a first morning specimen.
a. true
b. false
a. false
you have to void your pee. so that the new pee will accumulate for 8 hours.
In this specimen, formed elements (cells& casts) are more stable in concentrated, acidic urine. The number of epithelial cells present can be significant. It is ideal for cytological studies.
A. First morning specimen
Most convenient urine specimen to collect.
B. Random
It is also most often used. It is collected without prior preparation. BUT it is affected by excessive fluid intake and exercise.
What's Fractional collection and what's the use?
double voided. Both a blood specimen and urine specimen is collected. Pee than draw blood.
It is used for diabetic screening.
Time collection aka Quantitative assay
Collected for a predetermined length of time or specific time of the day.
Routine void
Requires no patient prep, and it can be used for routine urinalysis.
Midstream "clean catch"
collecting urine and limiting contamination. Catching the stream that is clean.
Catherized
Requires medical personnel. Inserting a tube directly to the bladder and collecting urine.
Supra pubic aspiration
sticking a needle into the abdomin to the bladder to collect urine.
Pediatric collection
Put a bag over their urine exit. Usually used on infants who can't urinate voluntarily.
It is ok to label the patient identification information on the lid of the container.
a. True
b. False
b. False
You must label on the container itself since the medical technologist will be removing the lids.
Ideally, a specimen should be in the lab with __ hours of collection and analyzed at room temperature.
A. 2 hours
If longer, it'll require perservatives.
Explain what chemical changes the urine may experience that can affect its pH, glucose, and ketones.
pH : decomposition of urea to ammonia or glucose to acids.
Glucose: glycolysis (break down glucose)
Ketone: Bacterial metabolism.
What breaks down bilirubin in urine?
Photo-oxidation / Light
Microscopic changes in urine specimen...
What happens to RBC, WBC, and protein casts?
What happens to bacteria?
RBC, WBC, and casts can disintegrate due to dilute alkaline urine.
Bacteria will proliferate and increase in number.
What's the easiest and most common form of preservation of urine specimens?
Refrigeration
Why shouldn't you refrigerate a routine urine specimen if it will be analyzed within 2 hours of collection?
It'll form preciptation of crystals and solutes- making them difficult to exam.