Phlebotomy Chapter 3 & 4

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BBP
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Blood-borne pathogen
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Bio-hazard
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Short for biological hazard; anything potentially harmful to health.
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Centers for Disease Control and Prevention (CDC)
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The division of the U.S. Public Health Service charged with the investigation and control of disease with epidemic potential.
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Chain of infection
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A number of components or events that, when present in a series, lead to an infection.
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Droplet Transmission
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Transfer of an infectious agent to the mucous membrane of the mouth, nose, or conjunctiva of the eyes via infectious droplets generated by talking, coughing, sneezing or during procedures such as suctioning.
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Engineering controls
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Devices such as sharps disposal containers and needles with safety features that isolate or remove a blood-borne pathogen hazard from the workplace.
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Environmental Protection Agency (EPA)
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*Federal agency that regulates hazardous waste.
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Fire tetrahedron
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The latest way of looking at the chemistry of fire, in which the chemical reaction that produces fire is added as a forth component to the traditional fire triangle components of fuel, heat, and oxygen.
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Fomites
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Inanimate objects, such as counter-tops and computer keyboards, that can harbor material containing infectious agents.
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HAI
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Healthcare-associated infection
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HazCom
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Abbreviation for the OSHA Hazard Communication Standard
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HBV
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Hepatitis B virus
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HCV
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Hepatitis C virus
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HICPAC
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Healthcare Infection Control Practices Advisory Committee, federal organization established in 1991 that advises the CDC on updating guidelines regarding the prevention of nosocomial infection guidelines.
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HIV
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Human immunodeficiency virus
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Immune
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Protected from or resistant to a particular disease or infection because of the development of antibody through vaccination or recovery from the disease.
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Infectious agent
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The pathogen responsible for causing an infection; also called the causative agent.
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Isolation procedures
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Procedures intended to separate patients with certain transmissible infections from contact with others.
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Microbe
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Short for microorganism; a microscopic organism or one that is not visible to the naked eye.
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Material Safety Data Sheet (MSDS)
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A written document containing general information as well as precautionary and emergency information for any product with a hazardous warning on the label.
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Neutropenic
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Pertaining to an abnormally small number of neutrophils in the blood.
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National Institute for Occupational Safety and Health (NIOSH)
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The federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness.
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Nosocomial infection
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An infection acquired in a healthcare facility.
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Occupational Safety and Health Administration (OSHA)
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U.S. government agency that mandates and enforces safe working conditions for employees.
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Parental
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Administration by any route other than the digestive tract.
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Pathogenic
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Capable of causing disease.
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Pathogens
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Microbes capable of causing disease.
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Percutaneous
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Through the skin.
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Permucosal
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Through mucous membranes.
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PPE
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Personal protective clothing (equipment)
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Reservoir
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The source of an infectious microorganism.
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Reverse Isolation
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Same as protective isolation.
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Standard precautions
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Precautions intended to minimize the risk of infection transmission when caring for patients regardless of their status. They apply to blood , all body fluids (including all secretions and excretions except sweat, whether or not they contain visible blood) non-intact skin, and mucous membranes.
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Susceptible host
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An individual who has little resistance to an infectious agent.
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Transmission based precautions
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Precautions used in addition to standard precautions for patients known or suspected to be infected or colonized with highly transmissable or epidemiologically significant pathogens.
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Vector transmission
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Transmission of an infectious agent by an insect, arthropod, or animal.
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Vehicle transmission
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Transmission of an infectious agent through contaminated food, water, drugs, or the transfusion of blood.
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Work practice controls
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Practices that alter the manner in which a task is performed so as to reduce the likelihood of blood-borne pathogen exposure.
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According to standard first aid procedures, severe external bleeding is best controlled by
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Applying direct pressure and elevating the extremity.
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True or False? Sterile gloves must be used when collecting and handling blood specimens.
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False
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Droplet
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Type of infection transmission involves transfer of an infective microbe to the mucous membranes of a susceptible individual by means of a cough or sneeze.
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Eating fresh vegetables and whole grains
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can help a person stay healthy.
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The Needle-stick Safety and Prevention Act directed OSHA to revise the BBP standard in all of the following areas except
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Availability of vaccination against HBV for all employees.
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The most important means of breaking the chain of infection is
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washing hands.
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What is the proper order for putting on protective clothing?
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Gown first, then mask, gloves last.
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The OSHA HAZCOM Standard is also commonly called the
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“Right to know law”
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Occupational exposure to blood-borne pathogens can occur if
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a human bite breaks the skin, blood comes in contact with a cut or scratch, body fluids splash into the mouth.
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Vaccination against HBV involves
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A dose of vaccine, another 1 a month later, and a final dose 6 months later.
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Applying lip balm in the lab
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is unacceptable.
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The medical term for white blood cell is
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Leukocyte
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The suffix in the term lipase is
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ase
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The singular form of alveoli is
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Alveola
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“Aer” is a
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Prefix
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What part of the term “osteochondritis” is the suffix?
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itis
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The “o” located between “path” and logist” in the term “pathologist” is known as the
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combining vowel.
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The letter “g” is pronounced like a “j” in
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gestation.
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The term “polycythemia” means
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Many-cell blood condition.
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What does the suffix of the term “glycolysis” mean?
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breakdown
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What is the root word in the word “electrocardiogram”?
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cardi
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The JCAHO “Do Not Use” list applies to
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handwritten medication related documents, handwritten laboratory reports, items written on preprinted forms.
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A prefix
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adds information about a term, modifies the meaning of a term, precedes the root word.
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The abbreviation “ESR” means
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Erythrocyte sedimentation rate.
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Do not use IU
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mistaken for “IV” or “10”/ write “international unit”
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Do not use U
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mistaken for “0” (zero), “4” (four) or “cc”/ write “unit”
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Do not use MS
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can mean morphine sulfate or magnesium sulfate/ write “morphine sulfate” or “magnesium sulfate”
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Do not use MSO4 and MgSO4
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can be confused with one another/ write magnesium sulfate” or “morphine sulfate”
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Do not use Q.D., QD, q.d., qd (daily)
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mistaken for each other/ write “daily”
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Do not use Q.O.D., QOD, q.o.d., qod (every other day)
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period after the Q mistaken for “I” and the “O” mistaken for “I”
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Do not use no leading zero (.X mg)
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decimal point is missed / write 0.x mg
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Do not use trailing zero (X.0 mg)
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decimal point is missed / write Xmg
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(AFB) / Acid-fast bacillus culture (blood)
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Green-top tube, isolator tube, or gel barrier tube. Special cleaning for site and tube stopper.
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(Acid p’tase) / Acid phosphatase
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Gel barrier tube. Centrifuge, separate and freeze serum immediately. Transport frozen.
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ALT (SGPT) / Alanine transferase
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Gel barrier tube. Centrifuge for complete separate as soon as possible and refrigerate.
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(ETOH) / Alcohol
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Gray (preferred) or gel barrier tube. Use non-alcohol germicidal solution to cleanse skin; chain of custody required if for legal purposes.
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Aldosterone
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Plain red top; gel barrier tube unacceptable. Centrifuge , separate and refrigerate serum. Draw “up-right” sample at least 1/2 hour after patient sits up.
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(ALP) Alkaline phosphatase
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Gel barrier tube. Centrifuge for complete separation as soon as possible. Fasting 8-12 hours is required.
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(AFP) Alpha-fetoprotein
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Gel barrier tube. Avoid hemolysis; can be performed on amniotic fluid.
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(Al) Aluminum
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Royal blue tube; no additive. Avoid all sources of external contamination.
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(NH3) Ammonia
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Lavender topped tube placed immediately on ice slurry. Centrifuge within 15 minutes without removing stopper; separate plasma and freeze in plastic vial.
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Amylase
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Gel barrier tube. Centrifuge and refrigerate serum. Avoid hemolysis and lipemia.
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(Coombs’ test, indirect) Antibody screen
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Collect whole blood (lavender); special procedure.
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(ANA) Antinuclear antibodies (screen or titer)
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Gel barrier tube, refrigerated serum. Avoid hemolysis and lipemia.
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Antinuclear antibody preparation
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Special ID procedure
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(ASO) Antistreptolysin O test
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Perform test immediately or refrigerate or freeze serum.
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(AT-III) Antithrombin III activity
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Light blue top. Invert 3-4 times, centrifuge, separate and immediately freeze plasma in plastic vial. Transport frozen.
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(AST, GOT, SGOT) Aspartate aminotransferase
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Gel barrier tube. Centrifuge for complete separation and refrigerate.
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(BMP) Basic metabolic panel
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Gel barrier tube, refrigerate unopened spun barrier tube. Separate within 45 minutes of venipuncture. Fasting 8-12 hours is required.
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(Bili) Bilirubin, total and direct
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Gel barrier tube, spin and separate within 45 minutes. Wrap in foil to protect from light; refrigerate.
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(BC) Blood culture
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Whole blood inoculated into two blood culture bottles; one anaerobic and one aerobic from two different sites or yellow tube. Do not refrigerate.
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(ABO & Rh) Blood group & Rh type
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Dedicated large lavender or pink top tube. Special ID procedure; hand label with special band.
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Standard precautions
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are used regardless of patient diagnosis or presumed infection status.
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Examples of engineering controls
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Self-sheathing needle, splash shield, sharps container, etc.
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The best defense against HBV infection is
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HBV vaccination
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Proper procedure in the event of injury with a contaminated needle is
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washing with soap and water for at least 30 seconds
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Most effective means of controlling external hemorrhage is
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direct pressure and elevation
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In the event of a chemical splash to the eyes, they should be flushed for
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15 minutes
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In the NFPA 704 marking system health hazards are indicated in the
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blue quadrant on the left
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Approximately 20% of all workplace injuries involve
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back injury
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Collecting a throat culture specimen from a coughing patient without wearing a mask
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Droplet Transmission
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Entering a TB patients room without an N95 respirator
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Airborne Transmission
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Filling a TB test syringe with antigen without first cleaning the top of the antigen vial
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Indirect Transmission
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Handling a dead rodent
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Vector Transmission
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Kissing someone with mononucleosis
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Direct Transmission
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Rubbing your eye after touching a contaminated blood tube
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Vehicle Transmission
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Class A Fire
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Wood or papers
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Class B Fire
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Flammable liquid
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Class C Fire
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Electrical equipment
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Class D Fire
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Combustible metals
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Class K Fire
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Cooking oils
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Three types of exposure routes
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permucosal, percutaneous, ingestion
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Together they create the need for a fire extinguisher
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heat, oxygen, fuel, chemical reaction
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They play a role in radiation exposure
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time, shielding, distance
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A chemical safety requirement
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material safety data sheet
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A symptom of shock
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rapid or weak pulse
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They play a role in personal wellness
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exercise, nutrition, hygiene.
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C. difficile
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(Stool-spores) Neither bloodborne nor airborne.
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CMV
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(Mono) Bloodborne
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Group A strep
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Airborne
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HBV, HCV, HIV, HAV
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Bloodborne
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Meningitis microbe
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(Droplet) Neither bloodborne nor airborne.
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RSV
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Airborne
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Rubeola virus
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Airborne
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Staph bacteria
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(Contact) Neither bloodborne nor airborne.
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Syphilis microbe
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(Contact) Neither bloodborne nor airborne.
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TB microbe
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Airborne
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Varicella virus
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Airborne

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