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PH101
Phlebotomy chapters 11-19
| Question | Answer |
|---|---|
| The emergency dept has requested that a blood alcohol level be drawn on a patient. What is the proper way to obtain the specimen? | Clean the site with Betadine (povidone iodine) and perform a routine venipuncture |
| What is the term for fainting | Syncope |
| What test is most seriously affected by hemolysis? | Potassium |
| What test is affected by the patients position? | Sodium |
| What may cause hematoma? | Going through the backside of the vein when inserting the needle |
| Collections for which dept require a special pt ID system in addition to the hospital bracelet | Blood Bank |
| A large amount of bleeding into the tissues surrounding a puncture site can cause what condition? | Compartment syndrome |
| What is the term used to describe a vein that is hardened due to repeated venipunctures? | Sclerosed |
| Removal of what percentage of a childs blood can cause cardiac arrest? | 10% |
| Infants should have no more that what percentage of their blood volume removed in a 24 hour period? | 5% |
| What is the max amount of a child's blood volume that can be removed over a 1 month period? | 10% |
| What is the preferred max amount of blood volume that can be removed from a child? | 3% |
| What is average blood volume per kg of a child's weight? | 80ml |
| What effect does hemolysis of the specimen have on bilirubin tests? | It decreases the bilirubin level |
| What 2 inherited conditions does US law require testing for ? | PKU and hypothyroidism |
| Why must neonatal PKU testing be performed by heel stick rather than venipuncture? | Phenylalanine levels are different between veins and capillaries |
| How are neonatal screening samples usually collected? | By dermal puncture absorbed onto filter paper |
| If a venipuncture is required on a child younger than 2 years what is the preferred site for a phlebotomist using a butterfly needle? | Dorsal hand vein |
| In the elderly what body change may have the most impact on the safety and effectiveness of venipunctures? | Less collagen in the skin |
| Which of the following is the most common type of vascular access device? | Central Venous Line |
| Which of the following is used for dialysis patients to connect to the dialysis machine? | Arteriovenous shunt (AV shunt) |
| Only specially trained individuals are permitted to collect from ... | Vascular access device |
| How long should the heel of a neonate be warmed for prior to a heel stick? | 3 to 5 minutes |
| Which artery is most commonly used for arterial blood gas collection? | Radial |
| What is the normal pH of blood? | 7.35 to 7.45 |
| Which pH value indicates acidosis? | Below 7.35 (7.25) |
| Which blood parameter measures the amount of oxygen in the blood? | PO2 |
| Which blood parameter measures the carbon dioxide levels in the blood? | PCO2 |
| What parameter measures the percentage of oxygen bound to hemoglobin? | O2 saturation |
| Which test measures the level of bicarbonate in the blood? | HCO3 |
| Which anticoagulant is used for arterial blood gas collection? | Heparin |
| Where is the tourniquet applied for ABG collection? | No tourniquet is needed |
| Where is the radial artery located? | Thumb side of the wrist |
| Which artery has the best collateral circulation? | Radial |
| What test is used to assess the collateral circulation of the radial artery? | Modified Allen test |
| Which of the following complications of arterial puncture can close the artery? | Arteriospasm |
| Which of the following arterial sampling errors lowers PH values? | Too much heparin |
| A blood gas specimen that is NOT iced must be transported to the lab within what time? | 5 to 10 minutes |
| A blood gas sample on ice cannot be used to test for what analyze due to the effect of lower temperature? | Potassium |
| Air bubbles in a blood gas sample will not only cause an error in the PO2 value but which other error? | Decreased PCO2 |
| What angle should the needle be inserted for an arterial puncture? | 45 - 60 degrees |
| How long should pressure be applied to an arterial collection site | 5 minutes |
| What state is the body said to be in after fasting for 12 hours? | Basal |
| Timed specimens are most likely to be requested for what? | Digoxin |
| what does post-prandial mean? | After eating |
| What test is used to diagnose hypoglycemia? | 5 hour oral GTT |
| What test is used to diagnose gestational diabetes? | 1 hour oral GTT |
| What shows significant diurnal variation? | Cortisol |
| What drug is typically drawn in timed pairs known as peaks and troughs? | Vancomycin |
| What does FUO mean? | Fever of unknown origin |
| What organizations set guidelines for blood donor collection procedures for blood banks? | AABB and FDA |
| How much volume is in a unit of donor blood? | 450ml |
| What gauge needle should be used for drawing a donor unit? | 16 |
| for blood donor collection the site is first cleaned with soap and water. What is the second cleaning agent used? | Iodine |
| What conditions may be treated with therapeutic phlebotomy? | Hemochromatosis and polycythemia |
| What is the common name for antibodies formed in response to an infection with mycoplasma pneumoniae | Cold agglutinins |
| For what test does a blood sample need to be collected in a pre-warmed tube and kept at body temperature until delivered to the lab? | Cold agglutinins |
| Which test requires the blood sample to be chilled immediately after collection and delivered to the lab on ice? | Ammonia |
| When preparing blood smears, at what degree should the spreader slide be? | 25 - 30 degrees |
| What causes the appearance of holes on a blood smear? | Dirty slide |
| What requires a sample of feces? | O&P |
| How soon after collection must a urine sample be delivered to the lab? | within 1 hour |
| What urine collection is used for routine testing of metabolic abnormalities? | Random |
| What type of fecal testing is used to detect the amoeba Giardia? | O & P |
| The sweat electrolyte test is used to diagnose what? | Cystic Fibrosis |
| What is the procedure that induces sweating via application of a weak electronic current? | Iontophoresis |
| What drug is used to increase sweating for sweat collection studies? | Pilocarpine |
| What must an amniotic fluid specimen be protected from? | Light |
| According to CLSI, what is the maximum amount of time that may be allowed to elapse between collection of a blood sample and separation of cells from plasma or serum? | 2 hours |
| What is the maximum amount of time a glucose sample collected in a gray top tube can be held at room temperature without loss of viability? | 24 Hours |
| Within what time frame should a routine blood collection sample be delivered to the lab? | 45 minutes |
| What is the term for breakdown of sugar within cells? | Glycolysis |
| Which analyze is unaffected by glycolysis? | Hemoglobin |
| Whole blood specimens collected in EDTA are stable for how long? | 24 Hours |
| Blood smears from EDTA specimens must be made within what time period after collection to prevent distortion of cell morphology? | 1 Hour |
| What problem can extreme temperatures cause with a blood sample? | Hemolysis |
| What term is used to describe small portions of specimen transferred tint separate containers? | Aliquots |
| What is the unique identifying number used for cataloging samples in the lab called? | Accession |
| If the stopper is removed from the tube before centrifugation, what effect will this have on the carbon dioxide and pH levels in the sample? | A decrease in CO2 and an increase in pH |
| Which tube can be centrifuged immediately after collection? | Heparin Tube |
| Which organization decides whether a given test is CLIA waived? | FDA |
| What is important when drawing blood at a patients home? | Carry a cell phone for emergencies |
| What is monitored by the activated clotting time (ACT)? | Heparin |
| Coumadin (warfarin) therapy can be monitored using which test? | PT |
| What is the most common test performed vis POCT? | Glucose |
| Blood levels of what rise within 4 hours after an acute myocardial infarction? | Cardiac troponins |
| What increases in congestive heart failure? | BNP |
| which group of strep bacteria is detected using a rapid strep test? | A |
| The detection of HCG in a patient sample is useful to diagnose what? | Pregnancy |
| What state should a urine sample be in before being tested? | Room temperature and well mixed |
| What organization mandates quality assurance? | Joint Commission |
| What refers to the quantitative methods used to monitor the quality of procedures to ensure accurate test results? | QC (Quality Control) |
| What represents the major goal of total quality management (TQM)? | CQI (Continuous Quality Improvement) |
| What refers to the larger set of methods used to guarantee quality patient care, including patient preparation and specimen collection and transport? | QA (Quality Assurance) |
| What refers to the entire set of approaches used by the institution to provide patient satisfaction? | TQM (Total Quality Management) |
| What philosophy sees the potential for improvement in every area, no matter how high the current performance level? | TQM (Total Quality Management) |
| What document contains information about the principles underlying testing and other protocols? | Procedure manual |
| What document contains information about laboratory schedules, patient preparation and specimen handling? | Directory of services |
| A phlebotomist is most responsible for controlling which variables in test results? | Preanalytic |
| A delay in reporting test results is considered what type of variable? | Postanalytic |
| An error in machine calibration is what type of variable? | Analytic |
| Improper identification of the patient is considered what type of variable? | Preanalytic |
| What term refers to a QA procedure that helps spot identification errors by comparing previous results on the patient to current results? | Delta Check |
| A blood sample of a patient standing up will have higher levels of what? | Albumin |
| For a patient on anticoagulant therapy, pressure should be held on a venipuncture site longer than normal to prevent what complication? | Compartment syndrome |
| A sample drawn for what requires special timing due to diurnal variation in it's blood levels? | Cortisol |
| A blood sample drawn from a non-fasting patient may result in a plasma characteristic that is called what? | Lipemia |
| What values are higher in infants than in adults? | RBC and WBC counts |
| Patients living in high altitudes have higher levels of.... | Hematocrit and hemoglobin |
| What levels can increase with anxiety? | Cortisol |
| What can occur in a blood sample if a patient has been suffering with prolonged diarrhea and vomiting? | Hemoconcentration |
| How often should centrifuges be calibrated? | Every 3 years |
| What type of law is created by a legislative body? | Statutory law |
| What type of law is determined by court discussions through interpretation of existing law? | Case law |
| What type of law is created by an agency through written regulations? | Administrative law |
| The violation of which type of law leads to a criminal action? | Public law |
| An unjustifiable attempt to touch another person can lead to what charge? | Assault |
| The intentional touching of another person without consent can lead to what charge? | Battery |
| A violation of a private law may lead to what? | Civil action |
| What is the term that is used to describe an injury to one person for which another person, who caused the injury, is legally responsible? | A tort |
| What is the legal basis for most medical malpractice cases? | Unintentional tort |
| What is the term for medical information that is linked to a specific patient? | Protected health information |
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