Clinical Laboratory Tests

• Testing provides data for patient diagnosis and treatment.
• Tests are done in hospitals, clinics, and reference labs.
• Medical assistants collect and process specimens.
• Accurate tests are vital for informed decisions on diagnosis, treatment, and monitoring.

Clinical Laboratory Departments

• Urinalysis tests urine samples.
• Hematology studies blood.
• Chemistry analyzes chemical levels in body fluids.
• Microbiology examines bacteria, fungi, and parasites.
• Blood Banks process blood.
• Microbiology tests for strep throat.

Laboratory Requisitions

• Requisitions must include patient demographics and provider signature.
• Tests ordered should be clearly marked.
• Specimen source and collection time must be documented.
• Diagnosis codes are required for medical necessity.

Point-of-Care Testing

• Testing is done rapidly at the patient's bedside.
• Common tests include pregnancy, strep, glucose, and hemoglobin.
• CLIA-waived tests are simple with minimal risk.
• Results are available in minutes.
• Benefits include rapid results, quick decisions, better, monitoring, faster treatment, and convenience.

Specimen Collection

• Use the right containers and labels, and collect at the right times.
• Follow procedures and transport specimens properly.
• Verify patient identity.
• Mislabeled specimens cause incorrect diagnoses and treatment.

Urine Specimen Collection

• Random urine samples are taken any time.
• First morning samples are most concentrated.
• Clean-catch requires a cleaning procedure.
• 24-hour collections involve a full day.
• Clean catch samples are needed to test urine for bacteria.

Quality Control

• Check equipment calibration, and monitor storage conditions.
• Use control samples and document activities.
• Report problems immediately.
• It ensures standards are met, leading to satisfaction, compliance, and trust.

Common Testing Errors

• Errors involve patient preparation, labeling, collection, storage, transport, and equipment.
• Preventative strategies include strict patient ID, training, and quality control.

Vision Testing

• The Snellen chart tests distance vision.
• The Jaeger chart tests near vision.
• Ishihara plates test color vision.
• Results are recorded as fractions.
• 20/20 vision means normal visual acuity at 20 feet.

Hearing Tests

• An audiometer measures hearing using sound frequencies.
• Measurements are recorded in decibels (dB).
• Normal hearing is below 25 dB for adults.
• Factors like earwax and noise can affect results.

Spirometry Testing

• Spirometry measures lung function by forcefully exhaling into a machine.
• It records air volume and speed.
• Patient preparation is important.
• Patients should avoid smoking due to its impact on the test results.

Allergy Testing

• Scratch tests check for allergic reactions.
• Intradermal testing uses injected allergens.
• Stop antihistamines before testing.
• Observe for skin reactions.
• Antihistamines should be stopped because they may alter test results.

Blood Glucose Testing

• A glucometer is used for quick results.
• Normal fasting range is 70-100 mg/dL.
• A small blood sample is required.
• This test is important for diabetes monitoring.
• Symptoms of low blood sugar include sweating and dizziness.

Chain of Custody

• Chain of custody documents specimen handling.
• It is Required for drug testing.
• All handlers must sign a form.
• Documentation prevents tampering and ensures integrity.

Critical Values

• Critical Value results require immediate action due to life-threatening conditions.
• Follow facility protocol for reporting.
• These results fall outside the normal range and demand action.

Laboratory Safety

• Wear protective equipment.
• handle specimens carefully.
• Follow biohazard procedures.
• Dispose of waste properly.
• Protective equipment when working protects against exposure to hazards.

Patient Education

• Explain test procedures clearly, provide instructions, and answer questions.
• Document all education given.
• It helps patients make informed decisions and improve outcomes.

Test Results Communication

• The provider must review results first.
• Maintain patient confidentiality.
• Document all communications.
• Follow up as directed.
• Medical Assistants (MAs) can share basic clinical information relaying information from the doctor regarding diagnosis and treatment plans, and confirming appointment details, but they cannot provide medical advice, make independent diagnoses, or interpret test results.

Review and Documentation

• Record all testing and document results accurately.
• Note any problems or concerns.
• Maintain complete records.
• Key elements to document include patient information, specimen details, and any observations.

Key Takeaways

• Accuracy is critical, and proper procedures must be followed.
• Maintain safety and privacy.
• Document everything thoroughly.
• The MA's role includes collecting data, preparing patients, performing procedures, and documenting results.

Class Review

• A1C lasts 3 months.
• Normal range of hemoglobin is less than 5.7%.
• Normal cholesterol is 130-200.
• Normal white blood cell count is 4500-11000.
• Normal platelet count is 150,000-400,000.
• Microbiology looks for bacteria, fungi, and parasites.
• Vision tests use the Snellen chart and Ishihara plates.
• Normal fasting glucose range is 70-100.
• If a fecal occult blood test is ordered, avoid aspirin, red meat, and vitamin C.
• Collect a first morning urine specimen for which test?
• Antihistamines should be discontinued 72 hours before allergy testing.
• Pregnancy is determined by hCG.
• Before a pulmonary function test, avoid smoking and large meals.
• When swabbing for a strep test, swab the tonsils and posterior pharynx.
• For specimen collection, don't touch the inside of the container.
• Normal hearing test results should be less than 15 dB for children and less than 25 dB for adults.

Pre-Analytic Phase

• This phase involves ordering the test, filling out the requisition, collecting and labeling the specimen, and transporting it to the lab.
• Errors in this phase include inappropriate test requests, misidentification of the patient, improper labeling, and inadequate sample collection.

Analytic Phase

• This phase is about instrument maintenance and calibration.
• Controls are run and analyzed, and the specimen is tested and compared with reference ranges.
• Errors include equipment malfunctions sample mix-ups and failure of quality controls.

Post-Analytic Phase

• This phase involves proper disposal of specimens, analysis of control results, and provider interpretation of lab reports.
• Errors include failure to report, improper data entry, and excessive turnaround time.