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GCE Phlebotomy

What are the 3 major veins for venipuncture? Median Cubital, Cephalic, Basilic
What 12 items are needed to perform venipuncture? Gloves, tourniquet, antiseptic, vacutainer needle, vacutainer tube, needle adapter, butterfly needle (if needed), chux (gauze), specimen label, plastics container, requisition slip, tape
What is the most commonly used antiseptic? And name 2 more. -70% isopropyl alcohol swabs -iodine, or (for those that are allergic to iodine) chlorhexidine gluconate
The smaller the gauge... The bigger the gauge... -the bigger the needle -the smaller the needle
What must always be worn when performing venipuncture? Gloves
Why should you never recap a needle? And what should you do before putting a USED needle in a plastics container? -Possibility of fingerpricks -Close with safety device
-This indicates that blood has accumulatd in the tissue surrounding the vein. -What are the 2 most common reasons for this complication? -Hematoma -1. the needle is too deep 2. failure to apply enough pressure
-The increase in proportion of formed elements to plasma -What causes this? -Hemoconcentration -Tourniquet being on too long
A tourniquet should not be left on no longer than... 2 minutes
To palpate the veins in the antecubital fossa what finger should you use? index finger
With the bevel facing upward, you insert the needle at what degree of angle? 15-30 degrees
What is the motto to venipuncture? Find it, pick it, and stick it!!!
What are some common reasons for failure to obtain blood? -The tube has lost its vacuum -Improperly positioned needle -Collapsed vein
What are some reasons a vacutainer tube has lost its vacuum? -Manufacturing defect -A tiny crack in the tube -Expired tube
What does BC stand for? And what is that test for? -Blood cultures -To test for microorganisms in the patient's blood
What is a PKU test for? This test is done on blood from... -To detect phenylketonuria in infants -Heel or on urine
What is PKU (phenylketonuria)? A genetic disease that causes mental retardation and brain damage
Some tests require chilled specimens and they must be collected and chilled how? -In chilled ice water
Name one test that requires to be chilled. Ammonia
Name one light-sensitive specimen. Bilirubin (Jaundice)
The American Academy of Pediatrics recommends that heel punctures for infants not exceed ____ mm. 2.0
Butterfly needles are only to be used on what three kinds of patients? -Elderly -Infants -People with small veins
What is the correct order of draw? *REMEMBER*: Because Better Specimens Generate Perfect Goals Blood Cultures (BC) Blue Serum (Red) Green Purple (Lavender) Gray
A red top tube contains: Common tests are? -No additives or anticoagulants, just serum -Serum chemistry tests, serology tests, blood bank
A red speckled top tube contains: Common tests are? -Clot activators -Most chemistry tests
A red speckled tube is also sometimes called... Tiger-top tube or Serum Seperator tube (SST)
How many times should a Red speckled tube be inverted? 5 times
A gray top tube contains: Common tests are? -Sodium fluoride, potassium oxalate -Fasting blood sugar (FBS), Glucose tolerance test (GTT)
A green top tube contains: Common tests are? -Heparin -Ammonia, STAT electrolytes
What is the rule of thumb when using a blue top tube? The tube must be filled completely, and should be inverted 3 to 4 times
What is the blood ratio to maintain during venipuncture? 9:1 nine parts blood to one part additive
A blue top tube contains: Common tests are? -Sodium Citrate -Prothrombin time (PT), Activated Partial Thromboplastin Time (APTT, PTT), Bleeding Time (BT), PT/INR
A lavender top tube contains: Common tests are? -Ethylenediaminetetraacetic acid (EDTA) -CBC (complete blood count), Hemoglobin and Hematocrit, ESR (Erythrocyte Sedimentation Rate)
(RED TOP TUBE) Collected blood, clots by normal coagulation process in ____ minutes. 30 minutes
How many times do you invert the RED TOP TUBE after collection? 0, there is no need
What happens when there is insufficent return of blood flow to the heart, because of inadequate supply of oxygen to all organs and tissues of the body? Shock
What are some common symptoms of shock? (4) -pale, cold, and clammy -rapid, weak pulse -increased, shallow breathing -expressionless face/ staring eyes
What is the most important means of preventing the spread of infection? Hand washing
What are 5 pieces of personal protective equipment (PPE's)? -Gloves -Goggles -Masks -Face shields -Respirators
What are the 2 most important things that need to be on a requisition slip? -Dr. name -Patient's name
What does palpate mean? To look for a vein
Tourniquets should be ______ inches above the site. It should not be left on no longer than _____ minutes. -3-4 inches -2 minutes
Where are the 3 major veins located? Antecutial Fossa
Why is the basilic vein the third vein of choice? Because it is the least firm vein, and is located near the brachial artery
(SA) What is a Sino-atrial node? pacemaker
What must be signed before any kind of procedure is performed? Informed consent
What is HIPAA's main key concept? Patient confidentiality
What vaccination is required to be a licensed phlebotomist? Hepatitis B
In order from outer to inner, what are the layers of blood vessels? 1.Tunica adventitia - outer layer 2.Tunica media - middle 3.Tunica intima - inner or lining layer 4.Lumen - the internal space of blood vessel (or hollow portion)
-recording of cardiac cycle (ECG) electrocardiograph
What is another name for a heart attack? Myocardial infarction
Name 2 Winged Infustion needles. ETS (Evacuated Tube System), Syringes
Anticoagulants are to prevent what? Blood from clotting
Name 3 centrifuging coagulants. red cells: bottom platelets/WBC (buffy coat) middle plasma (pale yellow fluid) top
With a Dr's order, out of ASAP or STAT, which one is first priority? STAT = Emergency (cardiac enzymes) ASAP = As soon as possible
Early in the morning when the body is at rest (fasting 12 hrs) RBC an WBC influence this state: Basal state
When a patient has had a Mastectomy (breast removal) which vein should be used and why? -A vein in the arm opposite of the side of removal -lymphostasis may cause injury or infection to patient or inaccurate test results
If anything ever goes wrong during venipuncture, for example: shock or syncope fainting, what is the number one rule? NEVER LEAVE YOUR PATIENT, EVER!!!
In the event of a patient fainting what steps should be taken? (5) -remove needle and tourniquet ASAP -talk to patient to keep them alert -lower head -apply cold compress -call for first aid help
In event of a patinet having a seizure what should you do? remove needle and tourniquet quickly
Bilirubin = And what precaution should be taken? =Jaundice -protect from light
This measures valuable data about patient's oxygen, ventilation, and acid base balance (done by respiratory therapist) ABG Arterial Blood Gases
Name on non-blood specimen test. Clean catch urine-detects infection
The 2 circulations of the heart are? Pulmonary circulation Systemic circulation
-this carries deoxygenated blood form the right ventricle to the lungs and returns oxygenated blood from the lungs to the left atrium Pulmonary circulation
this carries oxygenated blood from the left ventricle throughout the body Systemic circulation
This is an atrioventricular valve, between the right atrium and right ventricle tricuspid valve
A semi lunar valve between the right ventricle and the pulmonary artery pulmonic valve
What must be signed before any kind of procedure is performed? Informed Consent
APTT Activated Partial Thromboplastin Time
PT Prothrombin Time
OGTT Oral Glucose Tolerance Test
FUO Fever of Unknown Origin
BC Blood Culture
The right side of the heart has two valves which are: -tricuspid valve -pulmonic valve
What is the location of the tricuspid valve? between the right atrium and right ventricle
What is the location of the pulmonic valve? between the right ventricle and pulmonary artery
What is the flow of the pulmonary circulation? from right ventricle to the lungs and then from lungs to left atrium
What is the flow of the systemic circulation? from the left ventricle throughout the body
What test is used to evaluate the intrinsic pathway? (Also used to monitor Heparin therapy) APTT
What test is used to evaluate the extrinsic pathway? (Also used to monitor Coumadin therapy) PT
The most common size for a winged infusion set (butterfly) is a 23 gauge, 1/2 to 3/4 inches long
-This prevents the venous outflow of blood from the arm causing the veins to bulge, then making it easier to locate the vein. tourniquet
The most commonly used tourniquet is: the latex strip
What does fasting mean? To abstain from eating for at least 12 hrs prior to the testing
What is the most critical error a phlebotomist can make? Patient mididentification
Cleaning a site should be done how before a procedure? using a circular outward motion
The formed elements are: WBC RBC Platelets
In order from outer to inner what are the 4 layers of blood vessels? 1.Tunica adventitia 2.Tunica media 3.Tunica intima 4.Lumen
What non-blood specimen test can be used to detect infection? clean catch urine
APTT Activated Partial Thromboplastin Time
PT Prothrombin Time
BC Blood Culture
Phenylketonuria PKU
RBC Red Blood Cell
WBC White Blood Cell
CBC Complete Blood Count
Ethylenediaminetraacetic Acid EDTA
H & H Hemoglobin and Hematocrit
ESR Erthrocyte Sedimentation Rate
BT Bleeding Time
FBS Fasting Blood Sugar
GTT Glucose Tolerance Test
SST Serum Seperator Tube
PPE Personal Protection Equipment
BBP Bloodborne Pathogen
SA Sino atial node (pacemaker)
ECG Electrocardiogram
ETS Evacuated Tube System
2HPP Timed Test
ABG Arterial Blood Gases
The extrinsic pathway is associated with anticoagulant therapy known as? Coumadin
A CBC consists of what 3 things? WBC, RBC, Platelets
Failure to obtain sufficient amounts of blood is known as: short draw
The four major anticoagulants are? -coumadin -heparin -EDTA -Oxalate
What is the medical term for blood in the urine? Hematuria
Panels, profiles, and enzymes tests are generally drawn in which laboratory? Chemistry
STAT electrolytes are performed on? Plasma
Blue tubes must be filled to what ratio? 9:1
ESR is done in what tube? Lavender
Heparin is in what color tube? Green
In what color tube is a CBC drawn? Lavender
What is the additive in a lavender tube? EDTA
What color is a PT/PTT test drawn? Blue
What is the additive in the gray tube? Sodium fluoride, oxalate
What color tube should STAT electrolyes be drawn? Green
In phlebotomy, aspirin affects? BT
Is a PT part of the extrinisic pathway or intrinsic pathway? Extrinsic
What is the purpose of warming a site prior to venipuncture? Increase blood flow
An anticoagulant tube that has been centrifuged has a buffy coat that is filled with? Platelets and WBCs
What is the destruction of RBCs? Hemolysis
The middle layer of the vein is the? Tunica Intima
Is heparin associated for an intrinsic or extrinsic pathways? Intrinsic
If a patient has an IV in both arms where should you draw blood? Feet
What is the most common complication in phlebotomy? Hematoma
The hollow portion of the vein is known as: Lumen
Created by: emychick08