Clinical Chemistry Blog Notes 25

Hi.. Welcome to our Clinical Chemistry Blog notes. This blog is about topics in relation to our Clinical Chemistry subject.
so enjoy... and explore... c:

My First......

IMMUNOLOGY...

First things you'll observe to know it's IMMUNOLOGY SECTION:
a.) Axsym ( na plagi nasisira) ahahah
b.) BIG log books
c.) Yellow top blood specimen
d.) Wlang "tao" (ahahaha)

Hmm those were the first things i have observed in the section, hmm...? i really can't remeber mt fist day in the Immunology section,, first is because there is really nothing much to do,, many times i get bored, specially when it's not running day or if the machine was out of order.. and second is because i was afraid of my first staff, Ma'am Michelle (chief MT), but later on i realized that there is nothing to fear,, as she always tell me " I DON'T EAT PEOPLE" aheheh,

HEMATOLOGY

I was so excited to be in the Hematology section, (since it was my favorite subject way back in school) i enjoy the work a lot, i enjoy being busy(aheheh) but it was also in the section that i got my first "CASE", what is it? it's a secret.. something a bit serious.. I remeber my self crying when i got home.. but on the brighter side its another Lesson learned..


CLINICAL CHEMISTRY

The first day? i was absent,, ahahah,, the only thing i could remember about the section is the word "TIRED" its something you'll really feel after a day at the section,, but its worth it,,

Centrifuge-Log-Label with number-Run all Electrolytes-Run the test-while waiting get Previous Results-Record results-have it checked by the staff-Type-let the staff sign-have it counter signed-DONE!!!!

It's a bit long process huh??

Next sections?? You'll see them soon...

Answers to questions

TRUE 1. Proper Patient identification is essential in the Health care profession.

FALSE 2. If patient is not conscious, one must leave and wait until the patient wakes up before the performance of the procedure.

FALSE 3. If a witness is needed for a consent, always volunteer yourself, to help the patient.

FALSE 4. If the patient is not lucid, you should do everything to find the patient.

FALSE 5. In identifying the patient, you should ask the patient his name loud and clear.

ARMBANDS 6. It is a means of identifying unconscious patients in the hospital.

PATIENT IDENTIFICATION 7. It is one of the most common clerical errors in the laboratory.

8,9,10
Give essential information for proper Patient Identification.

8. NAME (COMPLETE NAME)
9. AGE
10. GENDER

II. Case Study

Make an outline for the proper pre-testing procedure with the cases below:

1. Patient A located at the Intensive Care Unit of the hospital was given a request for a blood culture.

IDENTIFY PATIENT WITH THE ARMBANDS

2. Patient B, a walk-in patient with a request for CBC

IDENTIFY THE PATIENT BY ASKING HIS/HER NAME SUPPORTED BY OTHER INFORMATION LIKE AGE AND BIRTH DATE

3. Patient C, in-patient at admission, not found in the room reported in the nurse station.

REPORT THE INCIDENCE TO THE STAFF, PROCEED ONCE THE PATIENT IS ALREADY FOUND.

Drug testing

Drug testing, is there really a need?

Personally, I really can’t make a stand whether to agree or disagree if drug testing must be done as a requirement in admission to schools, because there are lots of opposing reasons that keep me from deciding, I have list down some of the pros and cons of requiring drug testing for admission.

Pros	Cons
It would assure that the school has drug free students thus giving the school a virtuous reputation.	Not all schools can afford the expenses for the drug testing (e.g. Public schools)
Parents of the students studying with a school requiring Drug testing for admission would be worry free of their sons and daughters being involved in such acts.	Not all students could remain drug free for the rest of the years he/she would be staying in school, and since the school would only require drug testing in admission, there are still chances that students would be involved in drugs.
Students are guided more with the effects of illegal drugs, since a part of drug testing is counseling students about the consequences of drug addiction.	No one can really be certain that students could control themselves from taking illegal drugs since students are not always in school or at home, they go out with their friends once in awhile.

When I was in high school, the school was startled to hear the news that one student was actually selling street drugs in school, so urgently they called for the students involved and called for their respective parents, and so to cut the story short, they decided to conduct drug testing among students involved.

With that story, I realized the importance of drug testing in schools, but as stated above, there are a lot of reasons and opposing factors like moral issues since most of the students are minors, plus one thing is, what if the student was found out positive for the drugs?, is that the end of the scene? Would the administration just let the applicants and just not admit him/her to school? It would be negligence on the part of the administration to just let the students who are proved to be positive for drugs.

Quiz: Proper Patient Identification

I. True or False

1. Proper Patient identification is essential in the Health care profession.

2. If patient is not conscious, one must leave and wait until the patient wakes up before the performance of the procedure.

3. If a witness is needed for a consent, always volunteer yourself, to help the patient.

4. If the patient is not lucid, you should do everything to find the patient.

5. In identifying the patient, you should ask the patient his name loud and clear.

6. It is a means of identifying unconscious patients in the hospital.

7. It is one of the most common clerical errors in the laboratory.

8,9,10
Give essential information for proper Patient Identification.

II. Case Study

Make an outline for the proper pre-testing procedure with the cases below:

1. Patient A located at the Intensive Care Unit of the hospital was given a request for a blood culture.
2. Patient B, a walk-in patient with a request for CBC
3. Patient C, in-patient at admission, not found in the room reported in the nurse station.

Proper Identification of Patient

PROPER IDENTIFICATION OF PATIENT

One of the most common errors in the laboratory, besides from incorrect labeling of specimens, is the incorrect identification of patients. Personally, I believe that when in small things you commit a mistake, presumably that in more important things you will also commit one. Living in the perilous world of the healthcare profession, one should take note of the vital steps not just in the experimental works but also in the in the pre-experimental works (Patient identification, Specimen collection, Specimen identification, etc.) because it is where most of the errors begin.

Say for example, if you are ask to draw blood from patient whose name is Ann Antonio and just go on with the procedure without double checking on the information of the patient. You can’t always get rid of the probability of patients having the same name, not just your “real” patient will be on danger, and even the patient you have mistakenly drawn blood could possibly be in danger.

Listed below are the guidelines on the Proper Identification of Patients:

• If the patient is an inpatient at admission which is unconscious, you can verify on the information in the armband with the request form, which are commonly used today in most hospitals to identify their patient.

• If armbands are not available or if the patient is a walk-in patient, you should ask the patient of his/her complete name including the middle name, birth date, gender, and check on the requisition form. (Example. Ma’am may I please know what is your complete name? And not, Ma’am are you Ms. Sarah Gomez? Because the patient might not be in his proper senses and just simply say yes to any question that you have.

• (Taken from the Book of Henry's, Clinical Diagnosis And Management, page 1404) “If the patient is not lucid or if the proper identification is not on the patient (identification on the bed or in the room is not acceptable, since patients are moved without changing such identification), laboratory personnel should be instructed to seek positive identification by other persons who know the patient. Such identification should be documented on the requisition."
• You should always address a patient to Ma’am or Sir; this is done for courteous purposes.

• Always smile =), to make the patient feel comfortable and relaxed.

Additional reminders that could help… (From Louise Simmer’s, Introduction to Health Science Technology)

• "Once the patient is already identified never go on directly to the procedure, ask first for the patient’s consent, if the patient says no, never insist to do the procedure, one should confirm to the superior staff, because some procedures require written approval of the patient."

• "Never sign your name as a witness to any written document unless you are authorized to do so."

references:

Louise Simmer’s, Introduction to Health Science Technology

Henry's Clinical Diagnosis And Management

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Video by:

Youtube

Top 10 influential blog

"people with such wonderful thoughts...."

if there is a thing we call, last song syndrome,, after reading their blogs,, i think there is what we could call, last line syndrome,, lines which you keep thinking for the rest of the day...

The picture showcases different inspirational words, and as i look on the picture, these 10 influential bloggers are the ones that crossed my mind, simply because they are our inspirations..

Reading their blogs have greatly influenced me to make better post.., i admire how they can write on almost everything =), i wonder where they get their inspiration and selflessly share to everyone their thoughts and unknowingly touch everyone's life, and so i nominate them to be in The Top 10 Emerging Influential Blogs of 2009!


These are my nominees for Top 10 Emerging Influential Blogs of 2009:

1. Roy The Struggling Blogger

2. Doctor Z of Zorlone

3. Jan Geronimo of WritingToExhale

4. Angel Cuala of Father Blogger dot com

5. Irene of LifeLots

6. Luke of A Walk In The Dark

7. Holly Jahangiri of It’s all a matter of Perspective: Mine

8. Bingkee of I Love/Hate America

9. Kelvin Servigon of Kelvinonian Ideas 2.0

10. Dee of Tales From The Mom Side

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Educational Videos about the Adrenal Glands

Adrenal Glands Animation

What your Adrenal Glands Do

How To Find The Adrenal Glands And Feel Your Adrenal Fatigue

The Adrenal Cortex and Medulla

answer to quiz

1. Adrenal glands are also called suprarenal because they are situated above the kidney

2.Adrenal Cortex that produces hormones that are important in the body.
3.Adrenal Medulla that produces Emergency hormones

4.Zona Glomerulosa
5. Zona Fasciculata
6. Zona Reticularis

7. Adrenal Medulla

8. Chromaffin cells

9. Zona Glomerulosa

10. Zona Fasciculata

----CASE----

1. What could be the doctor’s diagnosis of Tony’s condition?

The patient has hypertension and hypokalemia can be diagnosed to have hyperaldosteronism

2. What could account for Tony’s complaints

The patients headaches, dizziness, restlessness, and nervousness are probably due to hypertension, while the palpitation, fatigue and polyuria are due to hypokalemia

3.What other diseases could have triggered the condition of Tony?

• Primary Aldosteronism where there is low renin


• Secondary Aldosteronism where there is elevated renin


• Pseudoaldosteronism

picture by: http://www.youthchg.com/bulb3.jpg

Quiz

1. Why are adrenal glands also called as supra renal glands?

2-3. What are the two useful parts of the adrenal glands?

4-6. 3 Functional parts lying at the margin of the Adrenal Gland

7. Is a modified sympathetic ganglion of the Autonomic Nervous System

8. cells that secrete epinephrine and norepinephrine

9. Zone responsible for the production of mineralocorticoid

10. Zone responsible for the production of glucocorticoid

Case

Tony a school bus driver went home from work complaining of dizziness, restlessness, and headache, so he went to see his doctor for check-up.

He also informed his doctor that he easily gets tired and had frequent palpitations or increased ventricular ectopy and polyuria. The doctor had ordered different tests and when the laboratory tests were done, the doctor noticed that Tony’s laboratory tests showed significant metabolic alkalosis and hypokalemia.

1. What could be the doctor’s diagnosis of Tony’s condition?

2. What could account for Tony’s complaints?

3. What other diseases could have triggered the condition of Tony?

Picpicture by: www.kennardconsulting.com

Clincal Chemistry Blog Notes 25

ADRENAL GLANDS

The Adrenal Gland is a part of the Endocrine system that produces hormones in the fluid surrounding the secretory cells. The Endocrine system is made up of the Pituitary, Thyroid, Parathyroid, Pineal and the Adrenal glands, but there are also different organs and tissues that possess the functions of the different glands of the Endocrine system, some of them are the liver, skin, small intestine, heart, pancreas, ovaries, kidneys, testes, stomach, adipose tissue, hypothalamus, thymus and the placenta. Hormones are important because they normalize the different cells in the body, thus producing the normal functioning of the body.

The Adrenal glands are also called as Suprarenal Glands because they lie above the kidneys and has a trodden pyramidal figure. "In adults, each adrenal gland is about 3-5 cm in height and 2-3 cm in width, and a little less than 1 cm thick",as stated in book of authors Gerard J. Tortora and Sandra Reynolds Grabowski, Principles of Anatomy and Physiology 10th ed. The adrenal glands are separated into two useful parts; the adrenal cortex which is located at the edge or the margin of the adrenal gland, and the adrenal medulla which is found at the interior part of the gland. Like most glands, the adrenal gland is also rich in blood vessels.

The Adrenal Cortex is divided into regions/zones that secrete their own hormone that have their own essential function. The outmost region is the zona glomerulosa it is located below the connective tissue covering, it has cells that are set in round huddles and domed columns that produce hormones called Mineralocorticoids that influences mineral hemostasis. The spacious of the three zones is the zona fasciculata; it is located at the center of the adrenal cortex and has cells arranged in long, straight columns that produce the hormone glucocorticoid responsible in glucose hemostasis. The innermost of the zone, zona reticularis has cells arranged in bough strings; these produce minute quantity of feeble androgens that have muscularizing end products.

The Adrenal Medulla on the other hand is a modified sympathetic ganglion of the autonomic nervous system (Tortora et.al), it also secretes hormones through the chromaffin cells, epinephrine and norepinephrine are the two hormones produced by the chromaffin cells of the adrenal medulla, and they act on the autonomic nervous system during cases of stress.

Like other glands of the body, the adrenal gland is important for it aids in the normal functioning of some parts of the body, that when the supply of hormones are insufficient could be fatal to the person. Bottom line is, the Adrenal glands are not so famous as other organs are, but the adrenal glands are also one of the most important parts that we have to consider.

Reference:
Gerard J. Tortora and Sandra Reynolds Grabowski, Principles of Anatomy and Physiology 10th edition

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