Curriculum to Accompany
Medical Assisting:
Administrative and Clinical Competencies,
6th Edition
Course:
Specimen Collection and Laboratory Procedures
Curriculum to Accompany Medical Assisting: Administrative and
Clinical Competencies, 6th Edition
Course: Specimen Collection and Laboratory Procedures
Contents
Part A: The Microscope
Part B: Capillary Blood Collection
Part C: Venous Blood Collection
Part D: Common Physician’s Office Lab Diagnostic Tests
Part E: Bacterial Specimen Collection, Cultures, and Diagnostic Tests
Part F: Other Frequently Ordered Laboratory Tests and Normal Values
Curriculum to Accompany Medical Assisting: Administrative and
Clinical Competencies, 6th Edition
Course: Specimen Collection and Laboratory Procedures
Course Overview
This unit covers basic elements of blood collection techniques, CLIA waived lab
diagnostic tests, and bacterial/microbiological testing. In the physician’s office it is not
uncommon for the medical assistant to collect capillary and/or venous blood samples and
perform simple testing on the samples to aid in diagnoses and maintenance of good
health. Understanding the importance of proper sample collection as well as analysis of
the specimens is extremely important for quality patient care. Although microbiological
responsibilities may be limited in many offices, one will find that frequently
pediatricians, family practice physicians, and general practice providers may order throat
cultures and/or rapid strep screens. This means that the medical assistant needs a general
familiarity with these procedures for success in the externship and beyond. Many
providers request lab studies to be completed by an outside source (hospital lab or
reference lab) so you need to know what the most commonly ordered tests are, what they
check for, and what their normal values are. By recognizing normal and panic values,
you will play an important role in helping to screen and follow up test results.
Resource List
Textbook: Medical Assisting: Administrative and Clinical Competencies, Sixth Edition,
by Lucille Keir, Barbara Wise, Connie Krebs, and Cathy Kelley-Arney. © 2007, Delmar
Cengage Learning, ISBN 1-4180-6633-8. Chapter 15.
Student CD-ROM: CD-ROM that accompanies Medical Assisting: Administrative and
Clinical Competencies, Sixth Edition. This CD-ROM contains StudyWARE, The Critical
Thinking Challenge, and an Audio Library.
Workbook: Workbook to accompany Medical Assisting: Administrative and Clinical
Competencies, Sixth Edition, by Lucille Keir, Barbara Wise, Connie Krebs, and Cathy
Kelley-Arney. © 2007, Delmar Cengage Learning, ISBN 1-4180-3267-0. Chapter 15.
Instructor’s Materials: Instructor’s Resource Manual to accompany Medical Assisting:
Administrative and Clinical Competencies, Sixth Edition, by Lucille Keir, Barbara Wise,
Connie Krebs, and Cathy Kelley-Arney. © 2007, Delmar Cengage Learning, ISBN 14180-3268-9.
Instructor’s CD-ROM: Electronic Classroom Manager to accompany Medical
Assisting: Administrative and Clinical Competencies, Sixth Edition, by Lucille Keir,
Barbara Wise, Connie Krebs, and Cathy Kelley-Arney. © 2007, Delmar Cengage
Learning, ISBN 1-4180-3269-2.
The Internet: It is strongly recommended that faculty and learners alike have a working
knowledge of the Internet.
Equipment List
1. Multimedia projector
2. Computer with Internet access
3. Multimedia equipment
4. AAMA credentialing information
5. AMT credentialing information
6. DVD player
CAAHEP content
III.C.1.g.(3)
Diagnostic testing
III.C.1.g.(2)
Specimen collection and processing
III.C.1.g.(4)
Patient care and instruction
III.C.1.g.(6)
Medical emergencies
ABHES content
VI.B.1.b.10.a.5
Care of the microscope
VI.B.1.b.10.c.1.
Personal protective equipment
VI.B.1.b.10.c.2.b.
Finger puncture
VI.B.1.b.10.c.2.a.
Venipuncture
VI.B.1.b.10.b.
Urinalysis
VI.B.1.b.10.c.
Hematology
VI.B.1.b.10.d.
Basic blood chemistries
VI.B.1.b.10.g.
OSHA compliance rules and regulations
CAAHEP competencies
III.C.3.c.(2)(f)
Demonstrate knowledge of federal and state health care
legislation and regulations
III.C.3.c.(4)(b)
Perform routine maintenance of (administrative and)
clinical equipment
III.C.3.b.(2)(b)
Perform capillary puncture
III.C.3.b.(2)(a)
Perform venipuncture
III.C.3.b.(3)(c)(i)
Perform urinalysis
III.C.3.b.(3)(c)(ii)
Perform hematology testing
III.C.3.b.(3)(c)(iii)
Perform chemistry testing
III.C.3.b.(3)(c)(iv)
Perform immunology testing
III.C.3.b.(4)(i)
Screen and follow up test results
III.C.3.c.(4)(d)
Use methods of quality control
III.C.3.b.(3)(c)(v)
Perform microbiology testing
III.C.3.b.(4)(i)
Screen and follow up test results
ABHES competencies
VI.B.1.a.5.(g)
Monitor legislation related to current healthcare issues and
practices
VI.B.1.a.6.(b)
Operate and maintain facilities and perform routine
maintenance of (administrative and) clinical equipment
safely
VI.B.1.a.4.(t)
Perform capillary puncture
VI.B.1.a.4.(s)
Perform venipuncture
VI.B.1.a.4.(i)
Use quality control
VI.B.1.a.4.(l)
Screen and follow up test results
VI.B.1.a.4.(y)
Perform urinalysis
VI.B.1.a.4.(z)
Perform hematology
VI.B.1.a.4.(aa)
Perform chemistry testing
VI.B.1.a.4.(bb)
Perform immunology testing
VI.B.1.a.4.(l)
Screen and follow up test results
Learning Activities
(HW) Terminology Notebook. Assign chapter for reading and have students define key
terms and retain in a key term notebook for future reference.
(ICA) MSDS Activity. Print or copy several MSDS sheets for students to review and
identify key components.
(ICA) Biohazardous Waste Manifests. Provide completed biohazardous waste manifests
from your institution for reference; discuss state requirements for regulation of
biohazardous waste.
(ICA) OSHA Review. Discuss laboratory OSHA regulations for engineering controls,
work practice controls, and personal protective equipment.
(ICA) Guest Speaker. Invite the local fire department to demonstrate the proper use of
the fire extinguisher and discuss fire safety in the workplace.
(ICA) Microscope Labeling. Ask the students to review Figure 15-2; following this,
have them to identify the various components of the microscope.
(ICA) Competency evaluation, Procedure 15-1. Demonstrate the proper use of the
microscope and require the students to return the demonstration for evaluation of their
competency for Procedure 15-1.
(HW) Chapter 15, Unit 1 Workbook Assignment Sheet
(ICA) Capillary Puncture Determination. Have students to observe their fingers to
determine fingerprints for correct capillary puncture technique.
(ICA) Competency evaluation, Procedure 15-2. Allow students to practice proper
capillary puncture technique on each other followed by evaluation of competency for
Procedure 15-2
(HW) Chapter 15, Unit 2 Workbook Assignment Sheet
(ICA) Applying tourniquets. Demonstrate the proper application of the tourniquet and
have the students practice application of such on each other. Assist them in palpating
veins in the antecubital fossae.
(ICA) Equipment assembly. Assemble various types of venipuncture collection devices;
after showing the class how to assemble, allow each student to do so.
(ICA) Phlebotomy practice, Part I. After demonstrating correct methods of venipuncture,
provide the students time to practice and perfect their techniques on a mannequin arm.
(ICA) Phlebotomy practice, Part II. As students gain confidence and competence in
phlebotomy skills, progress them to practicing on each other or volunteers (unless
precluded by state law or institutional policy).
(ICA) Competency evaluation, Procedures 15-3 through 15-5. Evaluate each student on
their competence for Procedures 15-3 through 15-5.
(ICA) Order of Draw documentation. Provide the students the order of draw posted on
this text’s online companion site,
http://www.delmarlearning.com/companions/content/1418032662/i_resource/updates/ind
ex.asp. (This is in the Instructor’s Resource section of the online companion; the user
name is “keirolc” and the password is “enter”.)
(HW) Research project. Assign research project for students to outline what tests are
drawn in what tubes.
(HW) Chapter 15, Unit 3 Workbook Assignment Sheet
(ICA) Competency evaluations, Procedures 15-6 and 15-7. Instruct the students on the
correct operation of the facility’s hemoglobinometer and microhematocrit centrifuge. Put
students in pairs to collect and measure hemoglobin and hematocrit on one another for
evaluation of competency for Procedures 15-6 and 15-7 (attach the results as evidence of
the work products).
(ICA) Competency evaluation, Procedure 15-8. Have each student collect an EDTA
tube; cover the steps for ESR testing. Evaluate the students on their competency for
Procedure 15-8 (attach the results as evidence of the work product).
(ICA) Competency evaluation, Procedure 15-9. Cover the operation of the facility’s
glucometer(s); assign each student a partner on which to collect a capillary puncture and
perform a blood glucose test. Evaluate the students on their competency of Procedure 159 (attach the results as evidence of the work product).
(ICA) Competency evaluation, Procedure 15-10. After explaining the operation of the
Hemoglobin A1C instrument, have the students to perform analysis on each other.
Evaluate their competency of Procedure 15-10 (attach results of the tests as evidence of
the work product).
(ICA) Competency evaluation, Procedure 15-11. Explain how to perform cholesterol
testing on the facility’s instrument or methodology; have each student to perform a
capillary puncture and testing for evaluation of competency of Procedure 15-11 (attach
the results as evidence of the work product).
(ICA) Competency evaluation, Procedure 15-12. Have the students remove Procedure
15-12 and the case studies from their workbooks to complete for evaluation of
competency of the procedure.
(ICA) Competency evaluation, Procedure 15-13. Explain the manufacturer’s instructions
for the infectious mononucleosis kit; have the students to collect and analyze screening
results for evaluation of competency of Procedure 15-13 (attach the results as evidence of
the work product).
(HW) Project. Assign the students to design and prepare a professional brochure for
males and females for a clean-catch, midstream urine specimen.
(ICA) Competency evaluation, Procedure 15-14. Using the brochures the students
created as a Project (see Homework Assignments), proceed to Procedure 15-14 and
evaluate the students on their competency for patient instruction and collection of
specimens (attach the brochure as evidence of the work product).
(ICA) Competency evaluation, Procedure 15-15. Demonstrate the manual use of the
Multistix 10 SG or comparable chemical analysis strips; have the students to practice
testing followed by evaluation of their competency of Procedure 15-15 (attach the results
as evidence of the work product).
(ICA) Competency evaluation, Procedure 15-16. Following completion of Procedure 1515, instruct the students to pour 10-12 mL of the specimen into a centrifuge tube to
complete Procedure 15-16.
(ICA) Competency evaluation, Procedure 15-17. After explanation on the use of the
facility’s pregnancy test, evaluate the students on their competency of Procedure 15-17
(attach the results as evidence of the work product).
(ICA) Competency evaluation, Procedure 15-18. Tell the students to remove Procedure
15-18 with the case studies from their workbooks for completion and evaluation of
competency of the procedure.
(ICA) Competency evaluation, Procedure 15-19. Place the students in pairs and have
each to explain the collection of a stool specimen; evaluate each on their competency of
Procedure 15-19.
(ICA) Competency evaluation, Procedure 15-20. Prepare hemoccult slide with a
simulated specimen; have the students to analyze, perform the QC, and record their
results. Evaluate the students on their competency of Procedure 15-20 (attach the results
as evidence of the work product).
(ICA) Competency evaluation, Procedure 15-21. Following the guidelines for instructing
patient on collection of a sputum specimen in the text, evaluate the students on their
competency of Procedure 15-21.
(HW) Chapter 15, Unit 4 Workbook Assignment Sheet
(ICA) Competency evaluation, Procedure 15-22. Demonstrate the proper technique for
performing a wound culture for microbiological testing and have each student return the
demonstration for evaluation of competency of Procedure 15-22.
(ICA) Competency evaluation, Procedure 15-23. Demonstrate the technique for
obtaining a throat culture and have each student return the demonstration for evaluation
of competence for Procedure 15-23.
(ICA) Competency evaluation, Procedure 15-24. Using throat cultures from Procedure
15-23, explain the manufacturer’s instructions for Rapid Group A Strep screening.
Evaluate the students on their competency of Procedure 15-24.
(HW) Chapter 15, Unit 5 Workbook Assignment Sheet
(ICA) What are Normal Values? Discuss the normal values in Table 15-4.
(HW) Chapter 15, Unit 6 Workbook Assignment Sheet
(HW) The Critical Thinking Challenge, page 830.
(HW) The StudyWare Challenge, Chapter 15. Have students take the Quiz in “Quiz
Mode” and either email their scores to the instructor, or print the scores to turn in.
(ICA) Following review of the chapter and homework assignments, give a quiz on this
chapter that includes the content and competencies listed for CAAHEP and ABHES.
Part A: The Microscope
Learning Objectives
Cognitive
1. Spell and define all the Words to Know in the unit.
2. Identify the parts of the microscope and the purpose of each.
3. Describe the proper way to adjust and focus the objectives and state their
magnification powers.
4. Explain how to properly maintain the microscope.
5. Explain the general purpose of the microscope in a medical office.
Psychomotor
6. Properly use a microscope.
Initial Questions and Activities
 Show the students simulated lab logbooks and QC logs for your institution
Key Concepts
References & Activities
Quality control
Page 759
Slides
(HW) Terminology
Notebook
Efficient POL
Page 760
(ICA) MSDS Activity
(ICA) Biohazardous
Waste Manifests
(ICA) OSHA Review
(ICA) Guest Speaker
Microscope components
Figure 15-2
Page 751
(ICA) Microscope
Labeling
(ICA) Competency
evaluation, Procedure
3-10
15-1
(HW) Chapter 15, Unit 1
Workbook Assignment
Sheet
(ICA) In-Class Activities
1. MSDS Activity. Print or copy several MSDS sheets for students to review and
identify key components.
2. Biohazardous Waste Manifests. Provide completed biohazardous waste manifests
from your institution for reference; discuss state requirements for regulation of
biohazardous waste.
3. OSHA Review. Discuss laboratory OSHA regulations for engineering controls,
work practice controls, and personal protective equipment.
4. Guest Speaker. Invite the local fire department to demonstrate the proper use of
the fire extinguisher and discuss fire safety in the workplace.
5. Microscope Labeling. Ask the students to review Figure 15-2; following this,
have them identify the various components of the microscope.
6. Competency evaluation, Procedure 15-1. Demonstrate the proper use of the
microscope and require the students to return the demonstration for evaluation of
their competency for Procedure 15-1.
(ICD) In-Class Discussion
1. What is quality control and how does it impact the POL?
Quality control is defined as a process that validates the final test results and determines
any variations. All laboratories are required to have a carefully performed, documented,
and on-going QC program to ensure that test results are accurate and errors and trends
are discovered and addressed.
2. Name as many parts of the microscope as you can.
Oculars, objectives, stage, arm, observation tube, illuminator, diaphragm, coarse and
fine adjustment knobs, slide clips, neck
(HW) Homework Assignments
1. Terminology Notebook. Assign the unit for reading and have students define key
terms and retain in a key term notebook for future reference.
2. Chapter 15, Unit 1 Workbook Assignment Sheet.
Presentation Tools
Note to Instructors: If you change Objectives or Assignments, don’t forget to change the
slides accordingly.
Chapter
15, Slides
1-2
Introduce the course and unit.
Slide 3
Purpose of a microscope
Slides 4-8
Parts of a microscope
Slide 9
How to focus a microscope
 Microscopy can only be performed by specifically trained and
qualified individuals
Slide 10
Performing routine maintenance on a microscope
Slide 11
Have students answer the checkpoint questions on the slide to review
the content in the unit.
Part B: Capillary Blood Collection
Learning Objectives
Cognitive
1. Spell and define the Words to Know in the unit.
2. State the purpose of wearing gloves when performing capillary blood collection
procedures.
3. Explain the reasons for performing capillary blood collection in the medical
office.
Psychomotor
4. Perform capillary blood collection procedures for obtaining specimens.
Key Concepts
References & Activities
Slides
Skin puncture
Procedure 15-2
13-15
Pages 765-766
(HW) Terminology
Notebook
(ICA) Capillary Puncture
Determination
(ICA) Competency
evaluation, Procedure
15-2
(HW) Chapter 15, Unit 2
Workbook Assignment
Sheet
(ICA) In-Class Activities
1. Capillary Puncture Determination. Have students observe their fingers to
determine fingerprints for correct capillary puncture technique.
2. Competency evaluation, Procedure 15-2. Allow students to practice proper
capillary puncture technique on each other followed by evaluation of competency
for Procedure 15-2.
(ICD) In-Class Discussion
1. What is the most common reference to capillary or skin punctures?
Finger stick.
2. What are the most practical sites for capillary punctures?
The ring and great finger
3. Why isn’t topical alcohol preparation recommended for home finger sticks?
Alcohol tends to break down the skin over extended periods of times.
(HW) Homework Assignments
1. Terminology Notebook. Assign the unit for reading and have students define key
terms and retain in a key term notebook for future reference.
2. Chapter 15, Unit 2 Workbook Assignment Sheet.
Presentation Tools
Note to Instructors: If you change Objectives or Assignments, don’t forget to change the
slides accordingly.
Chapter
Introduce the unit.
15, Slides
12
Slide 13
Standard precautions for capillary puncture
Slides 1415
Performing capillary puncture
Slide 16
Have students answer the checkpoint questions on the slide to review
the content in the unit.
 Note that the heel is used for infants and no other patients.
Part C: Venous Blood Collection
Learning Objectives
Cognitive
1. Spell and define the Words to Know in this unit.
2. Explain how to obtain serum from whole blood.
3. List the different colors used to code blood specimen tubes.
4. List the correct order of draw for blood specimen tubes.
5. Identify by the colors of the tubes what additives are contained in the tubs.
Psychomotor
6. Perform a venipuncture using a syringe and needle.
7. Perform a venipuncture using a vacuum tube and multiple sample needle and
adapter.
Key Concepts
References & Activities
Venipuncture overview
Page 767
Slides
(HW) Terminology
Notebook
Applying the tourniquet
Page 767
(ICA) Applying
tourniquets
Butterfly needle method
Page 769
Procedure 15-3
(ICA) Equipment
23
assembly
Needle and syringe method
Page 769
24-25
Procedure 15-4
Vacuum tube method
Page 774
26-27
Procedure 15-5
(ICA) Phlebotomy
practice, Part I
(ICA) Phlebotomy
practice, Part II
(ICA) Competency
evaluation, Procedures
15-3 through 15-5
Specimen collection and order of draw
Pages 774-779
18-22
(ICA) Order of Draw
documentation
(HW) Research project
(HW) Chapter 15, Unit 3
Workbook Assignment
Sheet
(ICA) In-Class Activities
1. Applying tourniquets. Demonstrate the proper application of the tourniquet and
have the students practice application of such on each other. Assist them in
palpating veins in the antecubital fossae.
2. Equipment assembly. Assemble various types of venipuncture collection devices;
after showing the class how to assemble, allow each student to do so.
3. Phlebotomy practice, Part I. After demonstrating correct methods of venipuncture,
provide the students time to practice and perfect their techniques on a mannequin
arm.
4. Phlebotomy practice, Part II. As students gain confidence and competence in
phlebotomy skills, progress them to practicing on each other or volunteers (unless
precluded by state law or institutional policy).
5. Competency evaluation, Procedures 15-3 through 15-5. Evaluate each student on
their competence for Procedures 15-3 through 15-5.
6. Order of Draw documentation. Provide the students the order of draw posted on
this text’s online companion site,
http://www.delmarlearning.com/companions/content/1418032662/i_resource/upd
ates/index.asp. (This is in the Instructor’s Resource section of the online
companion; the user name is “keirolc” and the password is “enter”.)
(ICD) In-Class Discussion
1. What types of tourniquets are available for use?
Flat elastic (latex and non-latex) bands, Velcro, and blood pressure cuffs
2. Name the equipment typically assembled for performing a venipuncture.
Butterfly, vacutainer needle, or needle and syringe; vacutainer holder; tourniquet;
gloves; alcohol prep pads or cotton balls/gauze saturated in alcohol; dry gauze or cotton
balls; ammonia inhalant; specimen tubes; sharps container; biohazard container;
bandage; pen
3. What information is recorded in the reference laboratory log book?
Collection date; patient name; date of birth; social security number or medical record
number; date sent; test(s) requested; date results received
(HW) Homework Assignments
1. Terminology Notebook. Assign the unit for reading and have students define key
terms and retain in a key term notebook for future reference.
2. Research project. Assign research project for students to outline what tests are
drawn in what tubes.
3. Chapter 15, Unit 3 Workbook Assignment Sheet
Presentation Tools
Note to Instructors: If you change Objectives or Assignments, don’t forget to change the
slides accordingly.
Chapter
15, Slides
17
Introduce the course and unit.
Slide 18
Obtaining serum from whole blood
 Mustard color stoppers are also used for serum specimen
collection
Slides 1920
Blood specimen collection tubes
Slide 21
Additives in colored tubes
Slide 22
Order of draw
 Click on the icon to show a brief video clip.
 Insert the corrected order of draw from the update document
which is found on this text’s online companion website
Slide 23
Applying a tourniquet
Slides 2425
Venipuncture—needle and syringe method
Slides 2627
Venipuncture—vacuum tube method
Slide 28
Have students answer the checkpoint questions on the slide to review
the content in the unit.
Part D: Common Physician’s Office Lab Diagnostic Tests
Learning Objectives
Cognitive
1. Spell and define the Words to Know in this unit.
2. List and describe the regulatory bodies that govern the POL.
3. List and describe the laboratory practices that yield quality assurance in the POL.
4. Define the terms quality control and quality assurance.
5. Differentiate between normal and abnormal results for common diagnostic tests
performed in the POL.
6. Identify panic values for diagnostic test results.
7. List normal values for RBC for males and females.
8. List normal values for WBC overall and identify the various WBCS by function
and normal counts.
9. List normal values for platelet counts.
10. Define the purpose of the WBC differential.
11. Describe how the erythrocyte sedimentation rate is useful in diagnoses.
12. Explain the purpose of the glucose tolerance test (GTT).
13. Define and describe the indications for the hemoglobin A1C test.
14. Identify common immunology tests ordered by health care providers and how
they are used in diagnoses.
15. Identify the implications of an infant who has a positive PKU results.
16. Explain the need for collecting a PKU test and describe the proper collection
procedure for the specimen.
17. Differentiate between a properly collected and improperly collected blood
specimen.
18. Identify different types of urine specimens and why they are ordered for testing.
19. Define the three components of the routine urinalysis.
20. Explain the procedure for collecting urine specimens for substance analysis and
the chain-of-custody procedure.
21. Understand various collection techniques for fecal specimens.
22. Identify tests that require sputum specimens and properly instruct a patient on
collection a specimen.
Psychomotor
23. Perform a hemoglobin test on a blood specimen and document the quality
control(s) for the test.
24. Perform a hematocrit test on a blood specimen.
25. Perform an erythrocyte sedimentation rate (ESR).
26. Perform a glucose test on a blood specimen and document the quality control(s)
for the test.
27. Perform a pregnancy test and document the quality control(s) for the test.
28. Perform the physical and chemical parts of a urinalysis.
29. Prepare a urine specimen for examination of urine sediment.
30. Instruct a male and female patient on the proper procedure for obtaining a
midstream, clean-catch urine specimen.
31. Instruct a patient on the proper procedure for collecting a fecal specimen for
occult blood screening.
32. Instruct a patient on collecting a sputum specimen.
Key Concepts
References & Activities
Slides
Laboratory classification and regulation
Page 781
30
(HW) Terminology
Notebook
Quality assurance and control
Page 782
31-33
Hemoglobin and hematocrit
Pages 783-787
34
Table 15-1
(ICA) Competency
evaluations, Procedures
15-6 and 15-7
Automated testing and complete blood
count (CBC)
Page 788
WBC differential
Page 789
36-37
Table 15-2
ESR
Page 789
Slide 38
(ICA) Competency
evaluation, Procedure
15-8
Glucose testing
Pages 791-795
39-43
(ICA) Competency
evaluation, Procedure
15-9
Hemoglobin A1C
Page 795
44
(ICA) Competency
evaluation, Procedure
15-10
Cholesterol testing
Page 796
45
(ICA) Competency
evaluation, Procedure
15-11
(ICA) Competency
evaluation, Procedure
15-12
Immunology testing (mono, pregnancy
testing, allergy testing, HIV testing)
Pages 797-799
(ICA) Competency
evaluation, Procedure
46
15-13
PKU testing
Page 799
47
Urine specimens and urinalysis
Pages 800-812
48-57
(HW) Project
(ICA) Competency
evaluation, Procedure
15-14
(ICA) Competency
evaluation, Procedure
15-15
(ICA) Competency
evaluation, Procedure
15-16
(ICA) Competency
evaluation, Procedure
15-17
(ICA) Competency
evaluation, Procedure
15-18
Chain of custody
Page 812
58
Fecal specimens
Pages 812-816
59-62
(ICA) Competency
evaluation, Procedure
15-19
(ICA) Competency
evaluation, Procedure
15-20
Sputum specimens
Pages 816-818
(ICA) Competency
evaluation, Procedure
15-21
(HW) Chapter 15, Unit 4
Workbook Assignment
Sheet
63-65
(ICA) In-Class Activities
1. Competency evaluations, Procedures 15-6 and 15-7. Instruct the students on the
correct operation of the facility’s hemoglobinometer and microhematocrit
centrifuge. Put students in pairs to collect and measure hemoglobin and
hematocrit on one another for evaluation of competency for Procedures 15-6 and
15-7 (attach the results as evidence of the work products).
2. Competency evaluation, Procedure 15-8. Have each student collect an EDTA
tube; cover the steps for ESR testing. Evaluate the students on their competency
for Procedure 15-8 (attach the results as evidence of the work product).
3. Competency evaluation, Procedure 15-9. Cover the operation of the facility’s
glucometer(s); assign each student a partner on which to collect a capillary
puncture and perform a blood glucose test. Evaluate the students on their
competency of Procedure 15-9 (attach the results as evidence of the work
product).
4. Competency evaluation, Procedure 15-10. After explaining the operation of the
Hemoglobin A1C instrument, have the students to perform analysis on each other.
Evaluate their competency of Procedure 15-10 (attach results of the tests as
evidence of the work product).
5. Competency evaluation, Procedure 15-11. Explain how to perform cholesterol
testing on the facility’s instrument or methodology; have each student to perform
a capillary puncture and testing for evaluation of competency of Procedure 15-11
(attach the results as evidence of the work product).
6. Competency evaluation, Procedure 15-12. Have the students remove Procedure
15-12 and the case studies from their workbooks to complete for evaluation of
competency of the procedure.
7. Competency evaluation, Procedure 15-13. Explain the manufacturer’s instructions
for the infectious mononucleosis kit; have the students to collect and analyze
screening results for evaluation of competency of Procedure 15-13 (attach the
results as evidence of the work product).
8. Competency evaluation, Procedure 15-14. Using the brochures the students
created as a Project (see Homework Assignments), proceed to Procedure 15-14
and evaluate the students on their competency for patient instruction and
collection of specimens (attach the brochure as evidence of the work product).
9. Competency evaluation, Procedure 15-15. Demonstrate the manual use of the
Multistix 10 SG or comparable chemical analysis strips; have the students to
practice testing followed by evaluation of their competency of Procedure 15-15
(attach the results as evidence of the work product).
10. Competency evaluation, Procedure 15-16. Following completion of Procedure 1515, instruct the students to pour 10-12 mL of the specimen into a centrifuge tube
to complete Procedure 15-16.
11. Competency evaluation, Procedure 15-17. After explanation on the use of the
facility’s pregnancy test, evaluate the students on their competency of Procedure
15-17 (attach the results as evidence of the work product).
12. Competency evaluation, Procedure 15-18. Tell the students to remove Procedure
15-18 with the case studies from their workbooks for completion and evaluation
of competency of the procedure.
13. Competency evaluation, Procedure 15-19. Place the students in pairs and have
each to explain the collection of a stool specimen; evaluate each on their
competency of Procedure 15-19.
14. Competency evaluation, Procedure 15-20. Prepare hemoccult slide with a
simulated specimen; have the students to analyze, perform the QC, and record
their results. Evaluate the students on their competency of Procedure 15-20
(attach the results as evidence of the work product).
15. Competency evaluation, Procedure 15-21. Following the guidelines for instructing
patient on collection of a sputum specimen in the text, evaluate the students on
their competency of Procedure 15-21.
(ICD) In-Class Discussion
1. What is the normal hemoglobin range for adult males? Adult females?
Males: 14-18 g/dL; females: 12-16 g/dL
2. What is the reporting measurement for hematocrit?
Percentage (%)
3. What are the functions of (a) red blood cells (b) white blood cells (c) platelets?
erythrocytes transport oxygen and carbon dioxide from the body’s cells (b) leukocytes
protect us against infections and invaders (c) thrombocytes work to help stop bleeding in
conjunction with other plasma clotting factors
4. When is an ESR helpful in assessing a patient’s condition?
Acute infections, acute inflammatory processes, chronic infections, rheumatoid arthritis
and other autoimmune diseases, temporal arteritis, polymyalgia rheumatica, and
monitoring inflammatory and malignant diseases
5. What tests are helpful in diagnosing and monitoring diabetes?
Fasting blood sugar, random blood sugar, glucose tolerance tests, and hemoglobin A1C
6. What is the normal level for cholesterol?
< 200 mg/dL
7. What hormone is tested for in pregnancy tests?
Human chorionic gonadotropin (hCG)
8. What infant blood test is required for screening in the US and Canada?
Phenylketonuria (PKU)
9. What is probably the most frequently performed test in the POL?
Urinalysis
10. What urine specimen is preferred for testing and why?
The first morning specimen is preferable because it is the most concentrated due to the
fact that the urine has been in the bladder for several hours.
11. Name the tests in the physical urinalysis.
Color, clarity, volume, odor, and specific gravity
12. List guidelines for chain-of-custody collection.
(1) add bluing to the toilet or tape the toilet handle down (2) your presence may be
required during the collection (3) check the urine temperature immediately following
collection and record (4) tape the lid of the specimen cup down and have the patient to
initial as verification (5) when indicated, have the patient to initial the requisition form
13. What reagent is present in fecal occult blood tests?
Guaiac
14. Why might a sputum specimen be ordered?
To diagnose conditions such as cancer, viral infections, fungal infections, and
tuberculosis
(HW) Homework Assignments
1. Terminology Notebook. Assign the unit for reading and have students define key
terms and retain in a key term notebook for future reference.
2. Project. Assign the students to design and prepare a professional brochure for
males and females for a clean-catch, midstream urine specimen.
3. Chapter 15, Unit 4 Workbook Assignment Sheet.
Presentation Tools
Note to Instructors: If you change Objectives or Assignments, don’t forget to change the
slides accordingly.
Chapter
15, Slide
29
Introduce the unit.
Slide 30
Regulatory bodies that govern POLs
Slides 3133
Quality assurance and control
Slide 34
Hemoglobin and hematocrit
Slide 35
Capillary tubes
Slides 3637
Complete blood count
Slide 38
ESR
 Emphasize the unit of measurement is mm/hr
Slides 3943
Glucose testing
Slide 44
Glycohemoglobin
Slide 45
Cholesterol testing
 Emphasize the unit of measurement is g/dL
 Emphasize the unit of measurement is mg/dL
Slide 46
Immunology testing
Slide 47
PKU testing
 The test is required in all 50 states of the US as well as in
Canada
Slide 48
Urinalysis
 Click on the icon to show a brief video clip.
Slides 4951
Urinalysis—physical, chemical, microscopic
 Specific gravity measures the amount of dissolved substances
(solutes) in the solvent (liquid)
 Also included on the test strips commonly are protein,
urobilinogen, specific gravity, and nitrites
Slides 5253
Guidelines for urine specimen collection
Slides 54-
Midstream urine collection
57
Slide 58
Chain of custody
 Be certain to complete all applicable part of the chain-of-custody
form to ensure reliability and validity of specimen
Slides 5960
Specimen collection guidelines
Slide 6162
Stool specimen collection
Slides 6365
Sputum specimen collection
Slide 66
Have students answer the checkpoint questions on the slide to review
the content in the unit.
Part E: Bacterial Specimen Collection, Cultures, and Diagnostic Tests
Learning Objectives
Cognitive
1. Spell and define the Words to Know in the unit.
2. Explain the need for bacterial specimen collection.
3. Identify various types of microbiologic collection techniques and diagnostic tests
that would be ordered on such specimens.
4. Differentiate between culture and sensitivity.
5. Explain the proper procedure for performing the Gram’s stain and identify each of
the components of the stain.
6. Differentiate between Gram-positive and Gram-negative reactions on a Gram’s
stain.
7. Identify the basic morphologic shapes for various types of microorganisms.
8. Differentiate between some common gram positive and gram negative
descriptions for bacterial identification.
9. Describe various media for cultures; differentiate between primary media,
selective media, and enrichment media.
10. Describe how to properly label specimens.
11. Appropriate document information regarding specimens on the patient’s chart.
Psychomotor
12. Obtain a throat culture.
13. Test a throat swab for group A step with a rapid diagnostic test and interpret the
results.
14. Obtain a wound culture.
Key Concepts
References & Activities
Slides
Bacterial specimen collection
Pages 819-821
68-69
(HW) Terminology
Notebook
(ICA) Competency
evaluation, Procedure
15-22
Gram staining and microbiologic smears
Page 821
71-72
Morphologic shapes
Page 822
73
Table 15-3
Culture media
Pages 823-825
Throat cultures
Pages 825-827
74-78
Patient education box,
page 825
(ICA) Competency
evaluation, Procedure
15-23
(ICA) Competency
evaluation, Procedure
15-24
(HW) Chapter 15, Unit 5
Workbook Assignment
Sheet
(ICA) In-Class Activities
1. Competency evaluation, Procedure 15-22. Demonstrate the proper technique for
performing a wound culture for microbiological testing and have each student
return the demonstration for evaluation of competency of Procedure 15-22.
2. Competency evaluation, Procedure 15-23. Demonstrate the technique for
obtaining a throat culture and have each student return the demonstration for
evaluation of competence for Procedure 15-23.
3. Competency evaluation, Procedure 15-24. Using throat cultures from Procedure
15-23, explain the manufacturer’s instructions for Rapid Group A Strep screening.
Evaluate the students on their competency of Procedure 15-24.
(ICD) In-Class Discussion
1. Discuss the difference in a culture and a sensitivity.
A culture is the test that determines if a pathogenic microorganism is present; a
sensitivity tests the pathogen for susceptibility to various antibiotics that may be used to
treat the infection.
2. Difference the color differences in Gram positive and Gram negative organisms.
Gram positive organisms stain dark purple to blue while Gram negative organisms stains
pink to red.
3. What is the difference in primary culture media and selective media?
Primary culture allows all present microorganisms to grow where selective media
inhibits the growth of certain microorganisms.
4. What oral structures should not be touched when collecting a throat culture?
The lips, teeth, tongue, gums, and cheeks
(HW) Homework Assignments
1. Terminology Notebook. Assign the unit for reading and have students define key
terms and retain in a key term notebook for future reference.
2. Chapter 15, Unit 5 Workbook Assignment Sheet.
Presentation Tools
Note to Instructors: If you change Objectives or Assignments, don’t forget to change the
slides accordingly.
Chapter
15, Slide
67
Introduce the unit.
Slide 68
Why bacterial specimen collection is important
Slide 69
Collection techniques
Slide 70
Cultures and sensitivity
Slides 7172
Gram stains
Slide 73
Morphological shapes
Slides 7475
Culture media
Slides 7678
Inoculation and labeling of an Agar plate
Slide 79
Have students answer the checkpoint questions on the slide to review
the content in the unit.
Part F: Other Frequently Ordered Laboratory Tests and Normal Values
Learning Objectives
Cognitive
1. Spell and define the Words to Know in this unit.
2. Have the ability to identify panic values for commonly ordered laboratory tests.
3. Discuss various types of blood tests frequently ordered by health care providers.
4. Differentiate between normal and abnormal results for common diagnostic tests
performed in reference and hospital laboratories.
Psychomotor
5. Screen and follow up test results appropriately.
Key Concepts
References & Activities
Screening test results
Page 828
Slides
(HW) Terminology
Notebook
Normal values
Page 828
Table 15-4
(ICA) What are Normal
Values?
Panels
Page 830
83-84
(HW) Chapter 15, Unit 6
Workbook Assignment
Sheet
(HW) The Critical
Thinking Challenge,
page 830
(HW) The StudyWare
Challenge, Chapter 15
(ICA) Chapter quiz
(ICA) In-Class Activities
1. What are Normal Values? Discuss the normal values in Table 15-4.
2. Chapter quiz. Following review of the chapter and homework assignments, give a
quiz on this chapter that includes the content and competencies listed for
CAAHEP and ABHES.
(ICD) In-Class Discussion
1. What is the difference in serum and plasma?
Serum Is derived from clotted whole blood specimens while plasma is found in
anticoagulated whole blood specimens.
2. What health implications may be represented in hypercholesterolemic specimens?
Atherosclerosis and/or arteriosclerosis
3. BUN and creatinine are useful tools for monitoring what organ system function?
Renal (kidney) function
4. What enzyme is especially important in helping to diagnose a myocardial
infarction?
CK
5. The PT test is used to monitor what type of therapy?
Coumadin (warfarin) therapy – blood thinner
(HW) Homework Assignments
1. Terminology Notebook. Assign the unit for reading and have students define key
terms and retain in a key term notebook for future reference.
2. Chapter 15, Unit 6 Workbook Assignment Sheet.
3. The Critical Thinking Challenge, page 830
4. The StudyWare Challenge, Chapter 15. Have students take the Quiz in “Quiz
Mode” and either email their scores to the instructor, or print the scores to turn in.
Presentation Tools
Note to Instructors: If you change Objectives or Assignments, don’t forget to change the
slides accordingly.
Chapter
15, Slide
80
Introduce the unit.
Slides 8182
Commonly ordered lab tests and normal values
Slide 83
Have students answer the checkpoint questions on the slide to review
the content in the unit.
Slides 8485
The Keys to Career Success slides emphasize the relationship of the
material learned in the classroom to on-the-job success.