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# ADV Pract Final

# ADV Practice Final

QuestionAnswer
The organization that enforces workplace safety rules is: OSHA (Occupational Safety and HealthAdministration.
Airborne infections can exit from the carrier by cough, sneeze
An N95 respirator is required to prevent exposure to: airborne pathogens
Septic is infected or contaminated
Phlebotomy technique must be aseptic
The most common BBP that can be acquired from a needle stick accident in the hospital is HBV
A BBP is A disease causing microorganism
Communicable diseases are studied by the ________. They then make recommendations to prevent the spread of the diseasse. CDC
CDC stands for Center for Disease Control.
HIV stands for Human Immunodeficiency Virus
The term "acquired" In communicable disease this means that someone got infected The source of the infection can be from vectors, fomites, vehicles, and carriers.
A person who can infect others but does not show signs of disease is called a carrier
Nosocomial infections are: New infections acquired in the hospital. These are infections that patient did not have before entering the hospital.
Communicable disease can spread by both direct and indirect means. TRUE
Droplet infections typically travel only... 3ft or less
Class B fires include substances like: paints, oils, grease
NFPA stands for National Fire Prevention Agency
The white square in the NFPA symbol represents chemical reactivity
The red square in the NFPA symbol represents flammable substance
Radiation hazard sign must be posted outside the area where Xrays are taken.
The Biohazard symbol must be on Sharps containers, specimen transport bags, biohazard (red) trash bags.
The easiest way to prevent the spread of infections is to WASH HANDS!
A phlebotomist should disinfect the hands. before and after each patient.
In the "chain of infection" susceptible host is: The person who can catch the disease
Normal "exit routes" for communicable dsease are: coughing, sneezing, bleeding, mucous membtranes
Normal "entry routes" for communicable disease are: inhaling, skin wounds and injury, sexual transmission through mucous membranes, direct contact of infected fomite, food and water and vector transmission
Does alcohol kill all germs on the skin? NO. But, when it evaporates, it inactivates the bacteria.
Chlorohexidine gluconate is a good substitute for Iodine and Alcohol. This is also called: Zephrin Chloride
Iodine is a more effective killer of germs than alcohol. TRUE.
Vectors include animals and insects
Vehicle transmission is through food and water
Reverse isolation is used to protect the patient
CO2 Carbon dioxide
O2 Oxygen
NaF Sodium Fluoride. An antiglycolytic used in the gray top tube.
antiglycolytic An agent that preserves glucose in the blood specimen.
Li heparin Lithium. A salt that may be used in the green top tube.
thixotropic gel A separation gel used in red top and green top tubes.
Plasma the liquid part of unclotted blood
Serum the liquid part of clotted blood
clot activator tiny glass beads on the walls of some red top tubes.
thrombin A clotting agent. The Orange top tube has thrombin which makes the blood clot quickly.
SPS Sodium Polyanethanolsulfonate. An additive in the yellow top tube for blood cultures.
EDTA Ethylenediaminotetraacetate!! Oh yeh. This is an anticoagulant used in the lavender, pink, and royal blue top tubes.
What additive is in the light blue top tube Sodium citrate
What additive is in the yellow top ACD tube Acidified Citrate Dextrose
You have only a PT,PTT ordered. What do you do if you must use a butterfly for the collection? Use a discard tube before you collect the PT,PTT tube.
Shaking blood tubes may cause hemolysis
hemolysis is the breaking of red blood cells
These cells increase if the child is stressed during a blood draw WBCs
The tourniquet can be applied for up to 2 minutes when... NOT EVEN! Never leave a tourniquet on for more than 60 seconds.
When should you remove the tourniquet during a phlebotomy when you see blood enter the blood tubes you should remove the tourniquet.
What happens when you leave a tourniquet on the patient for too long a time? Hemoconcentration occurs and is not an accurate representation of the patient's blood.
Opening and closing the hand (making a fist) is allowed when... It is not allowed. This is not to be done. The activity will increase potassium and ionized calcium in the specimen.
photosensitive specimens are destroyed by light
thermolabile specimens must... be transported at the proper temerature.
Blood gases are best transported on crushed ice TRUE
Preanalytical error occurs... before the specimen is tested
Analyltical errors occur... during specimen testing
Postanalytical errors occur... after the specimen test is completed. This is usually errors in filing or reporting the results.
Bilirubin is a specimen that must be protected from... light
cryo- cold
cold agglutinins and cryoglobulins must be transported at... body temperature
Body temperature is: 37 degrees centigrade (37C) or 98.6 degrees farenheit (98.6F)
You have to draw a PTT, electrolytes and a CBC. What is the order of draw? (1) light blue top tube, (2) red top, (3) EDTA lavender
hemo- blood
erythro- red
leuko- white
arterial blood is bright red
venous blood is dark red
arteries carry blood... to the body (away from the heart). Remember "a" for away.
veins carry blood... to the heart
the lymphatic system is involved with... filtering the liquid part of blood.
The best rule to follow for patients that have an IV is... Do not draw blood from the arm with the IV.
If ordered to draw blood on the IV arm, the phlebotomist should... ask the nurse to shut off the IV; wait 2 minutes; withdraw 5cc of blood for discard; then collect the blood.
If you squeeze a finger or heel too hard to get capillary blood you might... hemolyze the specimen.
Capillary blood is a mixture of.... arterial and venous blood.
The capillary bed that is punctured with the lancet is really breaking both... capillaries (the ends of arteries) and venules (the beginnings of veins)
A CBG is Capillary blood gas
The heel stick should be performed by puncturing the.... medial or lateral aspect of the baby's heel.
No finger stick should be performed until the baby is... 1 year old (if the finger is large enough)
The best guarantee of blood flow with skin punctures is to... warm the puncture site before puncturing
cardi/o heart
hemostasis is... blood clotting.
The deepest puncture you can make for an adult skin puncture is... 3mm
The neonate has a maximum depth of skin puncture. It is.. .65 to .85 mm
A skin puncture that is too deep can cause... osteomyelitis
osteochondritis is... bone and cartilage inflammation. This can also be caused by puncturing too deep on the infant heel.
thrombocytes are... cells that help begin the blood coagulation process. They are also called blood platelets.
blood coagulation or hemostasis creates... fibrin from a series of chemical reactions with: platelet factors, intrinsic factors, and extrinsic factors.
extrinsic factors include tissue thromboplastin
platelet factor is... coagulation chemicals from platelets
intrinsic factors are... clotting factors from the plasma
When you perform a finger puncture you will have ______ minutes before blood starts to coagulate 3 minutes tops!
After you draw blood you should make sure that the puncture site is cared for. This means you hold down on the site.... until the bleeding stops
What can cause prolonged bleeding in a patient? (1) patient took aspirin; (2) patient is taking heparing; (3) patient is taking coumarin or coumadin. Also thrombocytopenia can cause prolonged bleeding.
thrombocytopenia A shortage of blood platelets.
petechiae Small dots of hemorrhage due to thrombocytopenia. These usually occur after you apply the tourniquet. If you see this you must remove the tourniquet immediately.
hematoma (1) a bruise. This is caused by not holding down until the bleeding stops! This could cause serious damage to the surrounding nerves and even cause paralysis!
hematoma (2) a bruise. Caused by bleeding from the vein. Blood becomes trapped under the skin and forms the typical black and blue coloring.
The blood tube you need for a protime and PTT is light blue top
arteriosclerosis hardening of the artery's muscle wall
atherosclerosis hardening of the arteries due to cholesterol plaques
thrombus blood clot
hematopoiesis Production of blood cells. Occurs in the bone marrow. RBC, WBC and PLTS are produced.
CBC Complete Blood Count. A test that determines the numbers of RBC, WBC, and PLTS. It also determines the Hgb (Iron) and Hct (cell volume).
Hgb Hemoglobin. An iron containing molecule in the RBC
Hct A test that determines the % volume of RBC in the blood.
ESR Erythrocyte Sedimentation Rate. A blood test that is collected in a black top tube.
Differential count A test in which a clinical lab scientist counts the % of white blood cell types on a blood smear through a microscope.
medial in the middle
proximal close to
supine patient is laying down on their back.
lateral to the side
The order of vein selection is: median, cephalic, then the basilic
The basilic vein is close to... the brachial artery and median nerve.
The RBC carries... Oxygen (O2) to cells and picks up CO2 waste from cells.
The respiratory system function is to... Obtain oxygen from the air when you inhale and expel carbon dioxide when we exhale. It is the RBC that carries the oxygen and the carbon dioxide.
A blood test that measures the function of the respiratory system is... the arterial blood gas (ABG) , or capillary blood gas (CBG)
Alzheimer's disease Mental dementia that can occur in the elderly
Sensory loss in the elderly can include... seeing, hearing, sense of smell, taste, and touch.
lysis to break
Neonatal screening tests are... required by the State. Each State differs but these tests include diabetes, PKU, and other inherited diseases.
The most important step in phlebotomy is... Identify the patient.
After puncturing the skin in a dermal puncture you should... wipe away the first drop of blood
edema fluid collection in the skin.
cyanotic bluish coloring due to low level of oxygen in the blood.
The neonatal screening card should have the circle filled... with one drop of blood. Do not over fill. The blood must stay inside the circle.
patient variables (things that can alter blood tests) include: diurnal variations, diet, fasting, age, stress
"fasting" means... Nothing to eat or drink for 8 to 12 hours. Small amounts of water is allowed.
Fasting for 13 hours is... Not acceptable for blood tests. The patient begins to dehydrate at around 13 hours and lab values are altered.
QNS Quantity not sufficient.
When blood tubes are under filled you can... Hemolyze and/or alter the shape of the red blood cells.
blood tubes with additives should be filled... over 50% full. The exception is the light blue top tube which must be filled completely.
The specimen tube label must have... Patient name, ID#, time of collection, date of collection and the initials of the phlebotomist
lipemic milky color of blood due to eating before blood is collected. The whitish coloring is due to fats that are being transported in the body.
CLSI Clinical Laboratory Standards Institute. A private organization that researches the affects of phlebotomy collection techniques and testing techniques.
storing blood in the refrigerator should be between... 2C and 8C
Timed test must be drawn... No more than 10 minutes before or after the designated time. The best method is to draw at the designated time!
TDM is... Therapeutic drug monitoring. This requires you collect blood at designated time before drug administration and after drug administration.
A patient that cannot identify himself should be admitted to the hospital with a special ID. This ID is called... mater ID number.
To identify an outpatient (they don't have armbands) you should... Use a picture ID and have patient confirm their name and address.
SST and PST tubes have... thixotropic gel.
The chain of infection can be broken by... hand washing, patient isolation, good health, use of PPE
PPE Personal protective equipment
The most common disinfectant is... 10% bleach
blood tubes transported to the laboratory must be double bagged. TRUE
virulence A term used to indicate the degree of pathogenicity. A highly virulent microorganism is very dangerous. A low virulence organism is not as dangerous.
Immediately after experiencing a needle stick the phlebotomist must... allow the site to bleed for several minutes; notify the supervisor; and be evaluated at a medical facility.
prothrombin a protein formed in the clotting process. This is tested for to determine the patient's ability to stop bleeding.
thrombin A clotting protein that helps form fibrin from fibrinogen.
hemophilia A condition in which the patient cannot stop bleeding after injury.
Allen test Test used to determine collateral circulation before performing a radial arterial puncture for ABGs
femoral artery artery in the leg
brachial artery artery in the arm
radial artery artery on the thumb side of the wrist
ulna artery artery on the little finger side of the wrist
basal state lowest state of metabolism reached by fasting 8 to 12 hours before having blood drawn.
probing for a vein is allowable when... This is never allowed! If you don't get blood you should move the needle straight in or move backwards only. No side to side probing. Probing can cause nerve damage and hemolysis
Blood should never be collected from the same side as a mastectomy TRUE
CLIA'88 The law that set laboratory quality standards
The "chain of custody" is... A written record of who handled a specimen collected from a patient. This is also verification that the patient collected from is the correct person.
negligence leaving out an important step in the process of caring for a patient.
battery touching a patient without consent
informed consent notifying the patient who you are and what you are going to do. This is required before you draw the blood.
assault verbal or physical threat
malpractice improper care given to a patient.
implied consent consent given by action.
expressed consent this is written consent. the patient signs a written agreement for a procedure.
Created by: rjmtoss