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NHA Phlebotomy Prep2
Phlebotomy Review
| Question | Answer |
|---|---|
| Ethical Behavior in terms of an phlebotomist is? | Standards of right and wrong called the "Code of Ethics" which provides personal and professional rules of performance and moral behavior that all phlebotomists are expected to follow |
| The circulatory system delivers? | Oxygen, Nutrients, Hormones, Enzymes to the cells |
| Exchange is done at the capillary level? | to transport cellular waste such as carbon dioxide and urea to the organs. |
| The heart works as a? | A Pump |
| What two circulatory systems are they? | The Pulmonary and Systemic |
| The Pulmonary circulation carries? | Deoxygenated Blood from the right ventricles to the Lungs which this happens at the alveoli.... Which returns the oxygenated blood from the lungs to the left atrium. |
| The Systemic Circulation carries? | Oxygenated Blood from the left ventricles throughout the body. |
| How many chambers does the heart have? | 4 chamber Parts |
| The right Side of the heart has two valves, which are? | The Tricuspid Valve and The Pulmonic Valve |
| The Tricuspid Valve is what? | Its a Atrioventricular Valve...Pretty much a pathway tube between the right atrium and the left ventricle. |
| The Pulmonic Valve is what? | It's a semi Lunar Valve situated between the right ventricle and the Pulmonary Artery. |
| The Left side has two valves, which are? | The Aortic and Mitral Valve |
| The Mitral Valve is? | Is known as the Bicuspid Valve, Which as known as another atrioventricular valve between the left atrium and the left ventricle |
| The aortic valve is? | Is a semi lunar valve situated between the left ventricle and the aorta |
| The heart has how many layers? | 3 Layers |
| Name the three Layers of the heart? | Endocardium, Myocardium, and Epicardium |
| Endocardium is the? | endothelial (INNER) layer o the heart |
| Myocadium is the? | The muscular layer of the heart, which contract the heart. |
| Epicardium is the? | The fibrous outer layer of the heart. |
| How many blood vessels are they? | 5 |
| The name of the 5 blood vessels? | Arteries, Arterioles, Capillaries, Venules, Veins |
| The blood vessels, EXCEPT the capillaries are composed of how many layers> | 3 Layers |
| Name the 3 layers are the blood vessels? | The outer layer is the "tunica adventitia", The second layer is the middle smooth layer which is the "tunica media", The third layer is the inner endothelial layer which is the "tunica intima". |
| The Venules, Veins, and the Superior and Inferior Vena Cavae carry ? | Deoxygenated blood back to the heart |
| The Aorta, Arteries, arterioles carry? | oxygenated blood from the heart to various parts of the body. |
| The average adult has how many liters of blood? | 5 to 6 liters of blood |
| What is the liquid portion of the blood called? | Plasma |
| Plasma comprise how much percentage of blood? | 55% |
| Circulating blood contains how many components? | 9 components |
| The 9 components are? | Proteins, Amino Acids, Gases, Electrolytes, Sugars, Hormones, Minerals, Vitamins, Water (92%). * Also it contains waste products in the Urea that are destined for excretion. |
| The formed elements contain how much percentage? | 45% |
| What is another name for RED BLOOD CELLS? | Erytrocytes |
| What is another name for WHITE BLOOD CELLS? | Leukocytes |
| What is another name for platelets? | Thrombocytes |
| Where does blood originate in the body? | Stem cells and bone marrow |
| What component of erythrocytes contain? | Hemoglobin, which are the oxygen-carrying Protein |
| What is the life span of RBC ? | 120 days |
| What is the function of Leukocytes? | To provide the body's protection against infection. |
| The normal amount of WBC's range from?? | 5,000 to 10,000 |
| What is the term of Leukopenia? | The decrease of White Blood Cells |
| There are 5 types of WBC's in the blood? NAME THEM!! | Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils, |
| Out of the 5 WBC's which one carries histamine? | Basophils |
| APTT: | Activated Partial Thromboplastin Time |
| What is APTT used for? | Is used to evaluate the extrinsic pathway. It also is used to monitor heparin therapy. |
| PT: | Prothrombin Time |
| PT/Prothrombin Time test is for? | to evaluate extrinsic pathway. This test is used to monitor coumadin therapy. |
| What is Fibrinolysis? | The breakdown and removal of the clot. |
| Preferred site selection for venipuncture is? | The antecubital fossa of the upper extremities |
| True or False: The vein should be large enough to receive the shaft of the needle? | True |
| True or False: The vein should be visible or palpable after tourniquet placement? | True |
| What are the 3 major vein location in the antecubital fossa? | Median Cubital Vein, Cephalic Vein, Basilic Vein |
| Median Cubital Vein: | It's the vein of choice, because it tends not to roll and its large. |
| Cephalic Vein: | Is the second choice, its usually more difficult to locate near the brachial artery. Also, it's usually used more in a patient that obese. |
| Basilic Vein: | Is the third choice, if the needle is inserted too deep, this artery may be punctured. |
| Sclerosed Veins: | The veins feel cordlike or hard |
| Tortuous Veins: | These are winding or crooked veins |
| True or False: Do we draw blood from an arm with IV fluids running into it? | False: NO!!! Due to the fluid altering the test results. Select another site! |
| For blood collections that require more stringent infection control such as blood cultures and arterial punctures which antiseptic should you use? | Povidone-Iodine is commonly used |
| Antiseptic: for patients that are allergic to iodine? | Use chlorhexidine gluconate |
| Why arent needles that are 23 gauge not used for blood routine? | Because it can cause hemolysis |
| Winged infusion set are used on what patients? | Elderly or pediatric patients |
| What should always be used when collecting a blood venipuncture? | Gloves |
| Never recap a needle without an? | Safety device |
| What is the most common tourniquets used? | It's the Latex Strip |
| Yes Or No: Do you need to check for latex allergy? | Yes, Always! |
| What other two tourniquets are available? | Tourniquets with a BUCKLE and VELCRO Closures |
| Can you always used blood pressure cuffs in replacement for a tourniquet ? | Yes, inflate the cuff to 40mm |
| What is a Chux? | An impermeable pas used to protect the patients clothing and bedding. |
| Where must needle be placed after Blood routine? | Must be a clearly marked puncture resistant biohazard disposal container |
| What is a hematoma? | Its the most common complication in phlebotomy. Its indicates that blood has accumulated in the tissue surrounding the vein. |
| What is hemoconcentration? | Is the increase elements of plasma, which happens when the tourniquet is left on for too long |
| Phlebitis? | Inflammation of the vein |
| Thrombus? | A blood clot that forms inside if your veins |
| Thrombophlebitis? | Inflammation of the vein with a formation of a clot |
| Septicemia? | A systemic infection that has been introduced while doing venipuncture |
| Trauma? | This is an injury to underlying tissues caused by probing of the needle |
| Fasting? | For test such as those for glucose, cholesterol, triglycerides require for that patient to to abstain from eating for at least 12 hours. As a Phlebotomist, you must make sure that patient has gone through the fasting state prior to the test! |
| Edema? | Is the accumulation of fluid in the tissues, while collection from edematous tissue alters test results... |
| Fistula? | Is a permanent connection of the artery and vein. this is usually for patient who is dealing with dialysis and MUST NEVER use it for venipuncture for risk of infection |
| What does the QA stand for and what is it? | QA stands for Quality Assurance and its defined as a program to insure that healthcare professionals are meet ethical standards in the healthcare industry. |
| What is the main routine in order to collect a patient blood specimen? | identifying the patient |
| When checking for the identity for a patient, what 2 sources are you checking? | The patients ID number and have him/her confirm their name |
| During routine venipuncture: should you wash your hands first then put on gloves.... OR/ put on gloves then wash hands after? | wash hands, then put on gloves.. always wash hands right after routine is collected |
| Do we label tube after venipuncture is collected? | YES, never prior! |
| Names some reasons why venipuncture can not be collected? | A manufacturing defect, expired tube, and a very fine crack inside the tube, improperly anchoring or positioning of the needle, etc. |
| True or False: can pulling back the needle slowly redirect the anchoring of the needle. | True, pulling the needle slowly can revert the routine of collection possible to colllect. |
| Which blood test needs to be protected from light? | Bilirubin, beta-carotene, and porphyrins, etc |
| Which blood test need to be put on ice? | ACTH, Acetone, Angiostensin Converting Enzyme (ACE), Blood Ammonia, Catecholamines, Free Fatty Acids, Lactic Acid, Pyruvate, Renin Activity. |
| Timed Specimens? | They are often used to monitor the level of a specific substance or condition in the patient. |
| Two-Hour Postprandial Test? | This test is used to evaluate diabetes mellitus. Fasting glucose level is compared with the level 2 hours after eating a full meal or ingesting a measured amount of glucose. |
| Oral Glucose Tolerance Test (OGTT)? | This test is used to diagnose diabetes mellitus and evaluate patients with frequent low blood sugar. 3-hour OGTT is used to test hyperglycemia (abnormally high blood sugar level) and diagnose diabetes mellitus. |
| Therapeutic Drug Monitoring? | This test is used to monitor the blood levels of certain medication to ensure patient safety and also maintain a plasma level. Blood is drawn to coincide with the trough (lowest blood level) or the peak level (highest blood level). |
| Blood Cultures (BC)? | They are ordered to detect presence of microorganisms in the patient‟s blood. Blood cultures are usually ordered STAT or as timed specimen, and collection requires strict aseptic technique. |
| PKU? | This test is ordered for infants to detect phenylketonuria, a genetic disease that causes mental retardation and brain damage. Test is done on blood from newborn‟s heel or on urine. |
| Cold Agglutinins? | Cold agglutinins are antibodies produced in response to Mycoplasma pneumoniae infection (atypical pneumonia). Blood is collected in red-topped tubes pre-warmed in the incubator at 37 degrees Celsius for 30 minutes. |
| Chilled specimens? | Some tests require that the specimen collected be chilled immediately after collection in crushed ice or ice and water mixture |
| Chilled Specimens 2? | Some of the tests that require chilled specimen are: arterial blood gases, ammonia, lactic acid, pyruvate, ACTH, gastrin, and parathyroid hormone. |
| Light-sensitive specimens? | Specimens are protected from light by wrapping the tubes in aluminum foil immediately after they are drawn. : Bilirubin, beta-carotene, Vitamins A & B6, and porphyrins. |
| What can happen to light specimens if their exposed to light? | TEST RESULTS CAN ALTAR! |
| DERMAL PUNCTURES (Microcapillary collection) | When venipuncture is inadvisable, it is possible to perform a majority of laboratory tests on micro samples obtained by dermal (skin) puncture |
| Dermal Punctures 2? | Dermal puncture can be allowed on adults and pediatric patients. |
| what can be caused if puncture wound is to deep from a dermal puncture? | Osteomyelitis (inflammation of the bone and bone marrow) |
| how deep of range can a lancet go inside a puncture wound for adults? | 3.0 mm for adults |
| how deep of range can a lancet go inside a puncture wound for an infant? | 0.85 mm for infants |
| For infantss what site selection should be used for a dermal puncture? | The Heel |
| The heel is used for dermal punctures on infants less than what age? | Less than 1 year of age |
| Areas that are recommended for an infant puncture on the plantar surface of the foot? | The medial and lateral area of the plantar surface |
| The American Association of Pediatrics recommends that the heel punctures for infants NOT exceed ? how much depth? | 2.0mm |
| True or False: do phlebotomist perform dermal punctures on previous puncture sites | Hell No! FALSE |
| True or False: Do phlebotomist use the back of the heel or arch of the foot for dermal punctures? | Falseeee: What kind of shit is that! |
| True or False: Do phlebotomists use the medial and lateral areas of the plantar surface of the heel? | True!!! |
| The distal segment of the _____ or ______ finger of the non - dominant hand is the recommended site | third and fourth fingers |
| warming the blood for a finger puncture can increase the arterial flow up to how much ? | 7X more |
| warming the dermal site up to the minimum of how many minutes? | 3 minutes minimum |
| what can alcohol residue result towards? | Hemolysis of the red blood cells and may interfere with glucose testing |
| Order of draw for capillary specimens? | Lavender tube, tube with/without additives. |
| Lavender tube? | EDTA, inhibits coagulation by biding to calcium in the specimen |
| With a lavender tube how much blood should be filled? | 2/3 (two-thirds) |
| With a lavender tube how many times does it need to be inverted? | 8 times |
| Common Test: For Lavender Tubes | CBC, RBC count, WBC count, Platelet count, Hemoglobin and hematocrit count, ESR, Sickle cell screening |
| Light Blue Tube: | Sodium Citrate: Prevents coagulation by binding to calcium in specimen, tube must be filled COMPLETELY, |
| Why do we fill the light blue tubes completely? | To maintain ratio of nine parts of blood to one part |
| How many times do you invert the light blue tube? | 3 - 4 times |
| Common Test: For Light Blue Tubes? | Coagulation Studies- Prothrombin Time (PT) –APTT, PTT, FDP, Thrombin Time TT, FDP FDP, bleeding time BT, |
| Green top tube? | Contains the anticoagulant combined with sodium, lithium, or ammonium ion. |
| Yes Or No? Does heparin samples get sent to Hematology departments? | NO! It is not used for hematology because heparin interferes with the Wright‟s stained blood smear. |
| How many times do you invert Green Top Tubes (Heparin) ? | 8 times |
| Common Test: Green Tube (Heparin): | Chemistry tests: performed on plasma such as Ammonia, carboxyhemoglobin & STAT electrolytes. |
| Gray Top tubes: | All gray top tubes contain glucose preservative, (antiglycolytic agent): sodium fluoride- preserves glucose for 3days; or lithium,iodoacetate- preserves glucose for 24 hrs. Contain the anticoagulant potassium oxalate, prevents clotting bind calcium. |
| Do the Gray top tube contain additives and Anticoagulants? Yes Or No? | Yes |
| Name the Anticoagulant for the gray top tube? | Potassium Oxalate |
| How many times should you invert they gray top tubes? | 8 Times |
| Common Test: Gray Top Tube | Fasting blood sugar (FBS); Glucose tolerance test (GTT); Blood alcohol levels; Lactic acid measurement |
| What is the two other names for the red/gray tube called? | Tiger-top tube and SST (Serum separator tube) |
| Red Top Tube? | Is a plain collection tube with NO ADDITIVES or ANTICOAGULANTS! |
| How long does it take blood to clot from a red top tube? | 30 minutes |
| Do you invert red top tubes? | No. Its just a blood collection ! |
| Common Test: | Serum chemistry tests; Serology tests; Blood bank |
| Yellow Top tube? | These are used to collect specimens to be cultured for the presence of microorganisms. The SPS aids in the recovery of microorganisms by inhibiting the actions of complement, phagocytes, and certain antibiotics. |
| What is the anticoagulant of the Yellow Top Tube? | Sodium Polyanethosulfonate: SPS |
| How many times do you invert a Yellow Top Tube? | 8 Times |
| When testing whole blood, what tube is it collected in? | Lavender Tube with the additive of EDTA |
| Hematology Section? | This is the section where the formed elements of the blood are studied by enumerating and classifying the RBC's. WBC's, and platelets. By studying and examining the cells, disorders and infections are detected and treatment instituted or monitored. |
Created by:
KIMMYCO
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