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Phlebotomy

Phlebotomy 115 Week 3

QuestionAnswer
Basal State The patient's condition in the early morning, approximately 12 hrs after last ingestion of food
Hemolysis Rupture or lysis of the blood cells
TDM Theraputic Drug Monitoring
Peak 1/2-1 hr post dose
Trough 1/2 hr pre dose
TDM's Peaks & Troughs
Timed Specimens TDM
Patient Variable Age & Gender - More difficult or fragile veins
Patient Variable Blood Type
Patient Variable Circadian & Seasonal Rythms
Patient Variable Diet & Exercise - Affects Coagulation Factors
Patient Variable Smoking & Alcohol Intake - Affects Coagulation Factors
Patient Variable Medications
Patient Variable Intravenous Lines or Vascular Access Devices
Patient Variable Menstrual Cycle, Pregnancy, Menopausal Status
Patient Variable Emotional Stress and Psychiatric Disorders
JCAHO 2 Patient Identifers
Supplies for Venipuncture Gloves, Tourniquet, Alcohol Pads or Other Skin Disinfectents, Bandages of Gauze Pads, Glass Microscpoe Slides, Needles With Evacuated Tube Holders, Winged Infusion Sets, Blood Collection Tubes, Laboratory Requsitions of Lables, Marking Pens
1st Venous Selection Median Cubital Vein
2nd Venous Selection Cephalic Vein
3rd Venous Selection Basilic Vein
Specimen ID & Labeling Patient's Name - Last, First & MI Date of Collection, Time, Health Care Workers Initials Patient's Date of Birth
3 D's Depth, Direction, Diameter
Syncope Fainting
Hgb (Hemoglobin) Hemotology - O2 Carrying capacity of the blood
Hct (Hematocrit) Hemotology - % of packed red blood cells in a specific volume of blood
WBC Differential Hematology - Infection, Leukemia
CBC Hemotology - Complete blood count which includes Hgb, Hct, & WBC Differential
ESR (Erythrocyte Sedimentation Rate) Hemotology - Inflammatory states, a very generalized test
PT (Protime) Coagulation - Used most frequently to monitor coumadin therapy
APTT or PPT (Partial Thromboplastin Time) Coagulation - Used most frequently to monitor heparin therapy
Fibrinogen Coagulation - Is a precursor of fibrin, which is what makes up a clot
Hemoconcentration Increased blood concentration such as proteins, cells, and coagulation factors, can be caused by excessive tourniquet application
Diurnal Rythms Variations in the body's functions or fluids that occur during daylight hours or ever 24 hours
Interfering Substances Anticoagulant Therapy
Interfering Substances Antibiotic Therapy
Interfering Substances Drugs of Abuse
Interfering Substances Analgesics such as Asprin
Interfering Substances Cardiac Drugs
Interfering Substances Heparin Locks
Interfering Substances IV Therapy
Hematoma can occur The needle has gone completey through the vein
Hematoma can occur The bevel opening is partially in the vein
Hematoma can occur Not enough pressure is applied to the site after puncture
Interfering Substances Sickle Cell Anemia
Interfering Substances DIC - Excessive Bleeding
Interfering Substances Hyperlipidemia
Interfering Substances Impaired or reduced kidney function
Interfering Substances Abnormal hematocrit - <20% or >60%
Interfering Substances Hemolosis
Interfering Substances Excessive tissue juice
Interfering Substances Blood drawn from above an IV site
Interfering Substances Site improperly cleaned
Interfering Substances Improper equipment selection, i.e., needle size or tube selection
Specimen Rejection Timed sample drawn at the wrong time or the time is recorded incorrectly
Specimen Rejection Contaminated specimen
Specimen Rejection Use of outdated equipment, supplies, or reagents
Specimen Rejection Anticoagulated specimens that contain blood clots
Specimen Rejection Discrepancies between requisition forms and labled tubes (names, dates, times)
Specimen Rejection Unlabled Tubes
Specimen Rejection Inadequate volume of blood
Specimen Rejection Hemolyzed specimens (except for tests in which hemolysis does not interfere)
Specimen Rejection Specimen in the wrong collection tubes
Specimen Rejection Specimens that were improperly transported (chilled or unchilled)
Order of the draw Yellow, Light Blue, Red or Gold, Green, Lavender or Pink, Gray
Gray Top Glucose Determinations, Blood Alcohol Testing
Pink Top Whole Blood Hemotology Determinations
Pink Top EDTA
Gray Top Potassium Oxalate, Sodium Flouride
Pink Top Blood Bank, ABO Grouping, Rh Typing, Antibody Screening
Lavender Top EDTA
Lavender Top Whole Blood Hematolotgy
Yellow Top SPS - Sodium Polyanethol Sulfonate
Yelow Top Blood Cultures
Yellow Top Microbiology
Light Blue Top Sodium Citrate
Light Blue Top Coagulation Determinations
Light Blue Top 9:1 Ratio
Red Top - Glass No Additive
Red Top - Plastic Clot Activator
Red Top Serum Determinations
Red Top Chemistry
Yellow Top ACD - Acid Citrate Dextrose
Yellow Top Blood Bank Studies, HLH, DNA, Phenotyping, Paternity Testing
Tiger or Gold Top Clot Activator & Gel for Serum Separation
Tiger or Gold Top Serum Determinations/Chemistry
Red Top Serum Determinations in Chemistry & Serology
Red Top Used for theraputic drug monitoring
Green Top Sodium Heparin & Lithium Heparin
Green Top Plasma Determinations/Chemistry
Green Top Used in STAT/NOW blood chemistries
Occluded Veins Closed or constricted veins
Petechie Minute, pinpoint hemmorrage spots that may be indicative of a coagulation abnormality
Differentials A laboratory test that categorizes blood cells and any abnormalities present
Created by: Adwa
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