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GCE Phlebotomy
| Question | Answer |
|---|---|
| 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
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