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osha? occupational saftey and health administrations
what vaccination does OSHA require all health care personnel get? OSHA requires that all health care personnel exposed to blood and other bodily fluids must recieve a vaccination agaisnt Hepatitis B.
Pulmonary Edema fluid in the lungs.
How much blood can a person donate in a session. 500ML
Patients have the right to what? under the Patients Bill of Rights they always have the option to decline medical treatment and to know what tests are being performed on them.
what can you NOT give a patient? Results and a diagnoses. Because you are not medically qualified to do so.
Negligence is? failure to give appropriate care. DONT BE NEGLIGENT!
PPe stands for Personal Protective Equipment.
One of the most important practices is? Hand washing is one of the most important (and easiest) practices used to prevent transmission of blood borne pathogens.
Needles should never be Recapped.
Sharps containers must be what? Puncture-resistant, leak proof on the sides and bottom and must be labeled or color-coded.
IN infection control, WHO is the agent? Person
In infection control, WHAT is the portal of exit? Needle.
in infection control WHAT can we control? Mode of Transmission OR exit of infection.
In infection control WHAT is a portal of entry? Mucus membrane
In infection control WHO is a susceptile host? Person
Mode of Transmission Specific whats in which microorganisms travel from the reservoir to the susceptible host.
ALLERGIC reaction* latex sensitivity is a physical reaction to a health worker but a allergic reaction to the pt.
types of hazards biologic, chemical, physical, fire and explosive and sharps
biologic infectious agent that can cause bacterial, viral, fungal, and parasitic infections.
chemical toxin, carcinogenic, caustic
fire and explosive Bunsen burners oxygen and chemicals that can cause burns or dismemberments
sharps needle, lancets, broken glass anything that can cut, pierce, and or puncture causing blood borne pathogens exposure
physical wet floors, heavy lifting cause falls, sprains and strains.
five main types or mode of transmission contact, droplet, airborne, common vehicle and vector borne.
Contact direct and indirect (fomite)
droplet cold, flu, and sneezing
airborne viral- breath in
common vehicle person, fomite and not hand washing
vector borne illness that is transmitted through an invertebrate such as an insect
mode of infection the point in the infection chain where we aim at preventing the spread of infectious disease
standard precautions do what? infection control method designed to prevent direct contact with blood and other body fluids and tissues by using a barrier of protection and work control practices
what do we assume all Pts to be? Patients are presumed to be infective for blood borne pathogens
standard precautions consists of what? gloves, face shields, disposal and disinfectants
medical asepsis this condition is best defined as " the destruction of pathogenic microorganisms after they leave the body" it also involves environmental hygiene measures such as equipment cleaning and disinfection procedures.
what are barrier protections? masks, gloves, face shields, respirator gloves
how do you remove PPE equipment? 1st- gloves 2nd- gown 3rd- shields.
what type of soap should be used? non-abrasive, antibacterial soap
what do you do if blood splashes in the eye or mucous membrane? flush with warm water (hotter the better) for 15 mins report to supervisor asap.
who cannot be identified in an incident report? a minor
bedside manner includes? introduce yourself, verify pt. explain procedure, small talk, advise them when your ready to poke, and speak to them on a first name basis.
what phase is best practice? "pleasant with the pt, professional with the poke"
if pt has an I.V where do you draw blood? downstream from the I.V.
double mastectomy pts should only have blood drawn from what? hands.
left mastectomy pts should have blood drawn from what side? right.
what is fistula? artificial connections of veins.
what is graft? artificial artery connections of veins.
sclerosis is? hard and cord like veins.
for obese pts what vein is used? cephalic vein is most likely to be the one you can palpate and draw blood from.
cephalic means? head.
most common complication in phlebotomy hematoma
to prevent a hematoma prevented if pressure is placed on the venipuncture sire until bleeding stops
if a pt faints what is the 1st thing to do ? get the needle out of the arm
vasovagal syncope is fainting dizziness before, during or after venipuncture
circulatory system function is to deliver oxygen, nutrients, hormones and enzymes to the cells. transport cellular waste such as carbon dioxide and urea to the organs where they can be expelled from the body.
circulatory exchange is done where? capillary level
45% of blood is formed elements
formed elements erythrocytes (red blood cells) = 99% of formed elements leukocytes (white blood cells) and thrombocytes (platelets)
all blood cells originate from stem cells in the bone marrow
the heart acts as what two pumps (right and left sides)
left and right sides of heart are connected by two circulations with each pump equipped with two valves the function of which is to maintain a one way flow of blood
pulmonary circulations carries deoxygenated blood from the right ventricle to the lunges (alveoli) and return oxygenated blood from the lunges to the left atrium
oxygenation takes place at the alveoli - sacks in the lunges
systemic circulation carries oxygenated blood from the left ventricle throughout the body
tricuspid valve an atrioventricular valve, being situated between the right atrium and the right ventricle
pulmonic valve semi lunar valve situated between the right ventricle and the pulmonary artery
mitral valve (bicuspid valve) is another atrioventricaular valve, being situated between the left atrium and the left ventricle
aortic valve semi lunar valve situated between the left ventricle and the aorta
how long does it take for a full circulation? one min
the average person weighting 155 pds has app. 5-6 liters of blood in their system
blood composes of 7-9% of total body weight of a person
blood has how much plasma? 55% is plasma
plasma is what? a clear, pale yellow fluid
what does plasma do it carries nutrients, lipids, glucose, sodium, magnesium, calcium, potassium, oxygen, carbon dioxide, nitrogen, antibodies as wells as vitamins and hormones ect.
what is 45% of blood RBC, WBC and platelets. known as the formed cellular elements.
how long does your body take to regenerate RBC you lose during donation 6-8 weeks if you donate the maximum of 500ml
three layers of the heart endocardium, myocardium, Epicardium
Endocardium the endothelial inner layer lining of the heart
myocardium the muscular layer, this is the contractile element of the heart
Epicardium the fibrous outer layer of the heart. the coronary arteries, which supply blood to the heart are found in this layer
blood vessels are aorta, arteries, arterioles, caplliaries, venules and veins, superior and inferior vena cava
Erythrocytes red blood cells (RBC)
Erythocrytes contain hemoglobin, the oxygen-carrying protein
hemoglobin enters the blood as an immature reticulocyte where in one to two days, it matures into erythrocyte
how many RBS's per microliter 4.2 to 6.2 million RBC's per microliter of blood.
what is the normal lifespan of RBC's is 120 days
what is leukocytes function provide the body protection against infection
how many WBC's for adults per microliter 5,000-10,000
leukocytosis is what? an increase in WBC's is seen in the case of infection and leukemia
Leukopenia is what? a decrease in WBC's is seen with viral infection or chemotherapy
how many types of WBC's are in the blood? 5
a differential count does what? determines the percentage of each type
neutrophils are what? phagocytic cells, meaning they engulf and digest bacteria. their number increase in bacterial infection
neutrophils comprise how much of WBC's population 40-60 percent of WBC's population
lymphocytes do what? their numbers increase in viral infection, they also play a role in immunity
lymphocytes comprise how much of the WBC population 20-40 percent of the WBC population
monocytes do what? increase in intracellular infection and tuberculosis
monocytes comprise how much of the WBC population? 3-8 percent and are the largest WBC's
Eosinophils do what? they are active against antibody-labeled foreign molecules
Eosinophils increase in allergies, skin infections, and parasite infections
ensinophils come first in allergic reactions. during an allergic reaction it would show and increase in Eosinophil count
Basophils do what release histamine
Basophils count for what of the WBC's population 0-1% in the blood
thrombocytes are essential for what? blood coagulation
thrombocytes are also known as platelets are small irregularly shaped packets of cytoplasm in bone marrow
three major veins are located in the antecubital fossa
the three major veins are? median cubital vein, cephalic vein, basilica vein
1st order of draw red topper tube
red top also known as plain vacuum tube and contains no additive or anticoagulant
collected blood clots by normal coagulation process is 30 minutes
do you need to invert a red tube? No
common tests for red tubes are serum chemistry, serology, blood bank, Lytes
arterial blood gad (ABG) sample must be run within 15 minutes of collection
arterial blood is used to determine blood gas levels and blood PH. usually collected by a nurse or respitory therapist
basal state is when the patient has fasted and not exercised is 12 hours.
do you note if a patient has not fasted? yes
2nd order of draw? light blue
light blue has what additive? sodium citrate different ratios
light blue tubes must be inverted many times 5-10
light blue tubes are used to test coagulation determinations on plasma specimens, certain test require chilled specimens, always fill to max fill line
3rd order of draw color is tiger top/gold top
tiger top/gold top have what additive clot activator- or glass particles fix tropic gel
blood coagulates with additive in 15-30 minutes
4th order of draw green top, mint top, hash marks on label
mint green top has what additive PST-Plasma separator tube
Green top has what additive heparin combined with sodium and lithium and ammonium ion
Hash marked tube has what additive sodium heparin
common tests for green tubes are ammonia carboxyhemoglobin (HCG= human chorionic gonadotropin (hormone) test for pregnancy) STAT lytes
Lytes are? Electrolytes- potassium, sodium
BMP Panel is Basic, Metobolic, Panel
A panel is a group of tests ordered together
sodium additive tubes test for lithium
5th order of draw tube color is lavender
lavender tube has what additive? EDTA- Ethylenediaminetetraacetate
BMP- Chem 8 tiger/gold tube Basic Metatbolic panel
CMP-chem 14 tiger/ gold tube comprehensive metabolic panel
Dark purple tube has 7 ML of EDTA- calcium binding agent
LT purple tube has 3.6 ml of EDTA- calcium binding agent
pink top tubes are used for blood banks/ transfusion- for blood typing
lavender top tubes are used for CBC-complete blood count, CBCAN- complete blood count automatic differential, CBCDN- complete blood count manual differential
ESR-lavender top tube Erythrocytes sedimentation rate
ESR test for suckle cell screening
EDTA inhibits coagulation by binding to calcium in the specimen
what tube is used for coagulation studies? light Blue
tubes must be filled at least2/3 full
tubes must be inverted 8 times
hematocrit measures the percentage of the RBC's in a given volume of whole blood
what test is always given before blood donation? hematocrit
1-blood enters the heart superior and inferior Vena Cava
2-goes to Right Atrium
3-from there to tricuspid valve
4-then onto right ventricle
5-and now out to the pulmonary artery and lungs
6-back into the pulmonary viens
7-then onto the left atrium
8-moves onto the Bicuspid valve
9-down to the left ventricle
10-fonall to your hot dob via the aorta
veins have valves
ABG (arterial Blood Gas) analyses arterial blood for oxygen, carbon dioxide, and bicarbonate content in addition to blod PH and used to determine the effectiveness or respiration
Aseptic the absence of microorganisms or by contrast, something that just discourages the growth of microorgansims is antiseptice
what are the three preferred veins of the arm for phlebotomy? cephalic, median cubital, basalic.
what artery is to be avoided for venipuncture? brachial
the integumentary system is skin hair nails
the outermost layer of the skin is epidermis
the layer that contains the touch receptor dermis
the fat layer is called subcutaneous tissue
what is the function of the outermost layer epidermis is dead cells that protect the body.
wwhat dermal layer regulates body heat? the subcutaneous fat layer
which layer holds the capillaries dermis
the cardiovascular system comprises the heart vessels the blood
what color is plasma light yellow
91% of plasma is what water
less than 9% of plasma is mostly made up of what proteins
the function of albumin is to provide cells nutrients
the function of fibrinogen is to stop bleeding
the main function of globublins are to provide immunity
what are the formed elements of blood RBCs WBCs and platelets
the main function of the RBC is to carry O2 and CO2
the white blood cells proved for what immunity
platelets are in the blood system to do what stop bleeding...
what is a thrombocyte a platelet
which cells move through the body on their own WBCs
what is a leukocyte WBC
what action does a leukocyte use to eliminate an infection Phagocytosis
the heart has how many chambers? 4
the top chambers are called atria
the bottom chambers are called ventricles
the left chambers of the heart pump blood to where body
the right chambers of the heart pump blood to where lungs
the veins carry blood to where to the right atria of the heart
the arteries are responsible for pumping blood away from the heart
what vessel carries blood to the lungs? pulmonary artery
which vessel carries blood from the lungs to the heart? pulmonary veins
the three kinds of blood vessels veins, arteries, capillaries
capillaries are made up of only one kind of vessel tissue called tunica intima
the blood vessel outer layer is called what tunica adventia
the middle layer of the blood vessel is called the tunica media
what are veniols and arteriols the small veins and arteries that branch into capillaries
what percentage of blood is plasma and formed elements? 45% plasma, 55% formed elements.
what should you do if a vein collapses when drawing a standard vacutainer tube? change to a smaller tube like pediatric size.
routine venipuncture procedure consist of verify the requisition for test, identify the PT, wash your hands, gloves, palpate the vein
cysts a closed sac in or under the skin lined with epithelium and containing fluid or semi solid material
analytical errors PT. miss id, wrong tube, improper time for collection inadequate fasting improper site preparation med interference
Quality Assurance (QA) program that guarantees quality PT. care by tracking outcome
NPO nothing by mouth
edema accumulation of fluid in tissues
fistula surgical connection between an artery and vein (opening)
Phlebitis inflammation of vein results from repeated puncture of the vein
Petechiae tiny non raised red spots on the skin from rupturing of capillaries due to tourniquet being left on too long or tight.
Thrombus aggregation of platelets fibrin clotting factors/ the cellular elements of blood attached to the interior wall of the vein or artery
thrombophlebitis inflammation of vein with clot
septicemia systemic infection
trauma injury to underlying tissues caused by probing of needle
hematoma blood accumulated in the tissue surrounding the vein
hema concentration caused by prolong application of the tourniquet
median cubical vein vein of choice large/ do not tend to move
cephalic vein second choice tend to move use in obese PT.
basilica vein third choice if needle is inserted too deep you may punctured the brachial
activated partial thromboplastic time APTT a test for detecting coagulation defects of the intrinsic system
prothrombin time PT factor @ a plasma protein that is converted to the active form
stage 1 of hemostasis vascular phase injury to blood vessel causes it to constrict slowing flow of blood
stage 2 hemostasis platelet phase injury to endothelial lining causes platelets to adhere to it
five types of WBC neutrophils, lymphocyte, monocytes, basophils, eosinophil's
thrombocytes platelets
leukocytes white blood cells (function provide protection against infection)
erythrocytes red blood cells
capillaries microscopic blood vessels
blood vessel network of tubes that carry blood
pulmonic valve prevent blood from flowing back into the right ventricle from the pulmonary trunk
toxicology analyzes plasma level of drug/ poisons
electrophoresis analyzes chemical components of blood
stage 3 of homeostasis coagulation phase cascade of interaction of coagulation factors that converts the platelet plug to a stable fibrin clot
biologic pertaining to organisms and their products
micro capillary collection dermal (skin) puncture
dermal punctures example are PKU, glucose (blood sugar)
order of blood draw 1st- lavender 2nd- tubes with additives 3rd- tubes without additives
hematology red and white blood cell counts
chemistry elevates status of organ, body system or general health
serology evaluate PT.s immune response
urinalysis test urine to detect disorder/ infection of kidney and urinary tract
microbiology detection of pathogenic microorganisms
stage 4 of hemostasis fibrinolysis breakdown/ removal of clot
microorganisms disease cause pathogenic
molecules two or more atoms that are covalently bonded
buffy coat grayish white layer of white blood cells
packed red blood cells preparation of blood cells separated from liquid plasma (given in severe anemia ) restore hemoglobin and red cells
plasma liquid portion of white blood / contains active clotting agents
capillary tube used to collect capillary blood samples
allosteric the site other than the active site of an enzyme that bind regulatory molecules
gylcohemoglobin glycosylated hemoglobin the average blood glucose level over the previous several weeks
erythropoiesis process of erythrocyte production in the bone marrow
hemoglobin (Hb) complex protein iron compound in the blood that carries oxygen to the cells from the lunges/ carbon dioxide away from the cells to the lungs.
elasticity ability of tissue to regain it original shape/ size after being stretched
gauge caliber of dimension
meniscus curved fibrous cartilage in the knees / other joints
glucose simple sugar found in certain foods (fruits) major source of energy in the blood / animal body fluids
morphology study of physical shape/ size of a specimen
metabolism break down of chemical in food resulting in grouter generation of energy elimination of wastes and other body functions
lancet sharp pointed blade used to obtain a drop of blood for a capillary sample
reagent chemical substance known to react in a specific way
emia mean blood
needles are color coded to indicate their gauge
when a lipid panel is ordered the PT should be fasting for at least 12 hours with water allowed
antisepsis is a technique used on skin for cleaning of germ
color tube stopper indicates a blood collection tube containing sodium heparin Green
pre-analytical means variables affecting the specimen before lab testing
blood borne diseases that is most likely to be transmitted by needle-stick is hepatitis c
situation that is unacceptable to use an alcohol-based hand rub is before eating
if you get blood on the outside of the tube you have just filled with blood wipe the outside of the tube with disinfectant
primary cause of a collapsed vein during venipuncture is blood withdrawn too quickly/ forcefully
considering PT safety, the most dangerous phlebotomy practice is labeling the empty collection tubes before collection
Per CLSI the # of unsuccessful venipuncture attempts by an individual phlebotomist should be no more than 2
when performing a micro-collection procedure the best way to increase blood flow is to pre-warm the site
if you need to collect 5ml of blood on an 18 month old use the veins on the dorsal hand
to identify and verify that the Pt is correct ask them to state their name and DOB and match it to the requisition
antibiotics destroy or kill bacteria that cause disease
cerebrospinal fluid (CSF) fluid that flows through/ protects the four ventricle of the brain subarachnoid spaces the spinal canal
anticoagulants prevent blood from clotting
red blood cell is most numerous in the circulating blood
the rubber sleeve (at the end opposite the beveled needle tip) on an evacuated tub needle make it possible for use multiple tubes.
type and crossmatch (T&C) identify blood that is compatibility
lip emic serum or plasma that has a white milky appearance
remember that hep A is not a blood borne pathogen
phlebotomists are trained in pre analytical phases in laboratory testing
antiseptic to use when cleaning the arm to collect a blood alcohol is soap and water
venipuncture site should be cleaned in a circular motion from the center to the periphery
if your pt does not have a armband on (for identification) tell the nurse and you cannot collect the blood until the armband is placed on the PT.
a chain of custody procedure is required for specimen where the test result may have legal consequences
PHI (protected health information) per HIPAA is pt name, diagnosis, and phone number
if a pt develops a hematoma during the venipuncture procedure stop, apply pressure to site, raise the arm above the level of the heart and apply a pressure bandage
standard precautions is a two step infection control guideline for hospitalized pt that combines universal precautions and body substance isolation
OSHA is the organization that mandates safe working condition for employees
fasting lab test are order to eliminate the effects of diet on the test result
when using evacuated tubes for blood collection it is crucial to remember to never under fill tubes that contain anticoagulant, use tube past their stated expiration dates immediately invert tubes that contain additives
lab test requires serum use red color topped tub
blue stopper contain the additive sodium citrate
capillary blood sampling require very little blood
if your tub adapter become contaminated with blood disposed of it in a biohazard waste container
middle finger is recommended site for performing a skin puncture in an older child or adult
informed consent PT voluntarily permits touching, examination and or treatment
dependability is example of an ethical work characteristic
good way to earn a PT trust is act knowledgeable convey sincerity and look professional
brachial veins is your last choice from which to collect a blood specimen
aspect of professionalism is communication skills ethical behavior and time management
venous access devices (VAD)
if a pt has clotting disorder pressure should be applied to site for at least 5mins.
purpose for doing blood cultures is to detect septicemia
post prandial after meal
anticoagulants prevents formation of fibrin (blood clotting)
anticoagulants EDTA works by binding calcium
hand washing is the most important means of preventing the spread of infection
AIDS is caused by HIV virus
you have a statistically greater chance of contracting hepatitis in a work related incident than you do contracting AIDS
most prevalent type of nosocomial infections are those of the urinary tract
tourniquets prevents venous outflow of blood causing the veins to bulge
tourniquets may be left on 1 min
yellow top tube (sterile) contains anticoagulant sodium polyanetholesulfonate (SPS) use for cultured specimens invert 8 times
Red/gray (speckled) top called tiger top serum separator common test- serum chemistry test/ serology test/ blood bank
proper way to dispose of a needle is to put it into a sharps container with out recapping STAT. after withdrawing it
homeostasis process by which blood vessels are repaired after injury
ethical behavior standard of right and wrong
pulmonary circulation carries deoxygenated blood from right ventricle
systemic circulation carries oxygenated blood from left ventricle
Created by: sno413