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Edumed Phlebotomy
All information from class and worksheets
| Question | Answer |
|---|---|
| Which prefix means "decreased"? | Hypo- |
| What is the meaning of the prefix phlebo-? | Vein |
| What prefix means "after"? | Post- |
| What suffix means "surgical removal"? | -ectomy |
| What suffix means "inflammation"? | -itis |
| What suffix means "blood condition"? | -emia |
| What is the medical term for "white blood cell"? | Leukocyte |
| What is the plural form of the word thrombus? | Thrombi |
| What does the abbreviation "CA" mean? | Cancer |
| What suffix means "disease"? | -pathy |
| What root means "kidney"? | Nephr- |
| What abbreviation means "immediately"? | STAT |
| What does the abbreviation "NPO" on a patient's door mean? | Nothing by Mouth |
| What does the root word Cardio- mean? | Heart |
| What does the root tox- mean? | Poison |
| What prefix means "black"? | Melano- |
| What prefix means "blue"? | Cyan- |
| What prefix means "increased"? | Hyper- |
| What does the abbreviation "PRN" mean? | As needed (as required) |
| What prefix means "inside"? | Endo- |
| CBC | Complete Blood Count |
| Hct | Hematocrit |
| Hgb | Hemoglobin |
| Abd | Anti-DNase-b Strep A Test |
| AFB | Acid Fast Bacili Active TB Infection |
| alb | Albumin Looks at how well kidney and liver are working |
| bid | "bis in die" Twice per day |
| bls | Basic Lifesaving Support ~ CPR |
| bm | Bone Marrow or Bowel Movement or Breast Milk |
| bx | Biopsy |
| C&S | culture and sensitivity (antibiogram) |
| CT | Computed Tomography or Calcitonin, Thyrocalcitonin |
| CCU | Critical Care Unit Coronary Care Unit |
| CHF | Congestive Heart Failure |
| chol | Cholesterol |
| COPD | Chronic Obstructive Pulmonary Disease |
| CPK | Creatine Phosphokinase |
| CPR | Cardiopulmonary Resuscitation |
| CSF | Cerebrospinal fluid or Colony Stimulating Factor |
| CXR | Chest X-Ray (radiograph) |
| DC | Discharge or Discontinuted |
| diff | Differiential |
| DMR | Direct Myocardial Revascularization |
| DOB | Date of Birth |
| Dx | Diagnosis |
| ED | Emergency Department or Every Day or Erectile Disfunction |
| ENT | Ear, nose, throat |
| EKG | Electrocardiograph |
| FBS | Fasting blood sugar |
| FSH | Follicle Stimulating Hormone |
| FUO | Fever of Unknown Origan |
| GB | Gall Bladder or Gastric Bypass |
| GI | Gastrointestinal Track or Glycemic Index or Growth Inhibitory |
| GTT | Glucose Tolerance Test |
| gyn | Gynecology |
| H&H | Hematocrit and Hemoglobin |
| HCG | Human Chorionic Gonadotropin |
| hct | Hematocrit value |
| HIV | Human Immunodeficiency Virus |
| ICU | Intensive Care Unit |
| INR | Insulin Receptor |
| IV | Intravenous Infusion or Intravenous catheter |
| K | Potassium |
| L&D | Labor and Delivery |
| lab | Laboratory |
| LDL | Low Density Lipoprote |
| STAT | Statim = immediately |
| LMP | Last Menstrual Period |
| MI | Myocardial Infarction |
| MRI | Magnetic Resonance Imaging |
| MVA | Motor Vehicle Accident or Modified Vaccine Virus Ankara |
| Na | Sodium or Not Applicable |
| neg | Negative |
| noc(t) | Nocturnal or At night |
| NPO | Nothing by mouth |
| O2 | Oxygen |
| pH | Hydrogen ion Concentration |
| PKU | Phenylketonuric = inability to metabolize phenylalanine(plant Amino Acid) left untreated can cause brain or nerve damage. |
| Plt Ct | Platelet Count |
| prn | "Pro Re Nata" or As needed |
| PT | Prothrombin time or Pregnancy Test or Physical Therapy |
| PTT | Partial Thromboplastin Time |
| RBC | Red Blood Cell |
| R/O | Rule Out or Risk Of |
| TH | Thyroid Hormone |
| TSH | Thyroid Stimulating Hormone |
| WBC | White Blood Cell |
| SPS and ACD | Sodium polyanethol sulfonate and Acid Citrate Dextrose - in sterile yellow top tubes. Maintains the red cell viability |
| Needles and lancets are which type of safety hazard? | Sharps |
| What is the term for an object that is contaminated by bacteria? | Fomite |
| Which of the following is the first action you should take if you have been stuck with a used needle that has been in contact with blood? | Flood the exposed area with water and clean the wound with soap and water or disinfectant |
| What bone is close to the surface and at risk of being damaged during a heel puncture? | Calcaneus |
| If the number on the requisition does not match the arm band, what should you do? | Return to the lab and tell your supervisor |
| When collecting blood from a vein in the back of the hand, where should the tourniquet be placed? | Just above the wrist |
| What is the term for the hollow tube inside a needle's shaft? | Lumen |
| What is the first step in routine blood collection? | Gather correct supplies needed for the draw |
| Which department within the laboratory performs complete blood counts? | Hematology |
| How far from the puncture site should the tourniquet be placed? | 3-4 inches above the puncture site |
| Which Laboratory department would normally perform a prothrombin time (PT) test? | Coagulation |
| What color tube should be collected for coagulation studies? | Light Blue Top Tube |
| What is the single most important means of preventing the spread of infection? | Hand washing |
| How should a needle be inserted for venipuncture? | Bevel up, in a smooth quick motion |
| What color tube should be collected for a CBC? | Lavender |
| What is the term for invasion and growth of a disease-causing microorganism in the human body? | Infection |
| What is the term for destruction of red blood cells due to a too-tight tourniquet? | Hemolysis |
| According to the Bloodborne Pathogens Standards, who is responsible for providing PPE to an employee? | The employer must provide and pay for PPE |
| What is the first step that should be taken immediately after withdrawing the needle from a patient? | Ingauge the safety device and apply pressure to the puncture site |
| Correct order of steps when conducting routine blood draw... | Select equipment based on tests ordered, correctly identify patient, collect specimen, stop bleeding, label tubes. |
| The anticoagulant EDTA works by binding which substance needed for blood clotting? | Calcium |
| What doe the term multisample needle mean? | The needle has a retractable rubber sleeve that covers one end of the needle when a blood collection tube is not attached |
| Which needle size is most commonly used for routine venipuncture? | 21g |
| Which laboratory department performs blood typing? | Immunohematology |
| Which of the following acronyms refers to barriers used to protect skin, mucous membranes, and clothing from infectious agents? | PPE = Personal Protective Equipment |
| A tube containing thixotropic gel could be used to collect blood for which of the following tests? | Chemistry Screen |
| What does the term reservoir mean? | A person who carries a disease agent but is not sick |
| Before drawing blood, information found on a requisition form should be matched against ... | In-patient - patient's wrist band Out patient- ask the patient to state his/her name and DOB |
| What is the maximum acceptable depth for a heel puncture? | 2mm |
| Which anticoagulant is used for coagulation studies? | Sodium Citrate |
| Which of the following may cause a hematoma? | Going through the back side of the vein when inserting the needle |
| What is the maximum amount of time a tourniquet can be left on? | 1 minute |
| What is the term for a collection of blood under the skin at the site of a venipuncture? | Hematoma |
| Which of the following tubes should be drawn first? | Blood culture tubes |
| What color vacuum tube should be drawn for trace metal analysis? | Royal blue top tube |
| The pathogen West Nile virus is carried by mosquitos? What type of transmission is this? | Vector transmission |
| A patient has a seizure while you are performing a venipuncture. What should you do? | Remove the tourniquet and needle immediately and call the nurse for help |
| For a phlebotomist, what is the principal occupational risk for infection? | Infection from an accidental needle stick |
| The emergency department 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 (providone-iodine) and perform a routine venipuncture with a gray top tube |
| What is the single most important step of the blood collection procedure? | Patient Idenitfication |
| What is the term for infections contracted by patients during hospitalization? | Nosocomial infections |
| What is the preferred method of blood collection in newborns and infants? | Dermal puncture |
| When should blood collection tubes be labeled? | At the patient's bedside, after taking the blood |
| When you tell a patient that you need to draw blood, he says that he does not want to have his blood drawn. What is the appropriate action? | Explain the procedure and ask the patient if he will consent. If he still refuses, inform the ordering provider and document on the requisition |
| A double sided needle is used for what type of blood draw? | Venipucture |
| Stating a patient's name is an acceptable form of patient identification. True or False | FALSE - Ask the patient to state his/her name and DOB |
| What organization is responsible for minimizing workplace injuries? | OSHA |
| Various subspecialties exist within the laboratory. The one that studies blood blood-forming tissues is _______. | Hematology |
| Allison, age 4 months, needs to have a blood test performed. The phlebotomist will collect capillary blood from what site for this infant? | Heel |
| Sara, age 12, is about to have her blood drawn. She asks the phlebotomist, "will it hurt?" What would be an appropriate response? | "You will feel it, but if you keep still it will not take long" |
| You have just entered the laboratory and another team member requests that you label her remaining tubes with the labels on the counter. What would be an appropriate response? | "I do not feel comfortable labeling specimens I did not collect." |
| List the six steps of the chain of infection. | 1) Infectious agent 2) Reservoir 3) Portal of exit 4) Mode of transmission 5) portal of entry 6) susceptible host |
| The veins most commonly used for venipuncture are located in the middle of the arm: this area is referred to as the ______. | antecubital fossa |
| Coagulation studies have been ordered. Which tube would you choose to obtain a PT and PTT? | Light Blue Top Tube |
| To prevent puncturing a bone during dermal puncture, the depth should not exceed____. | 2mm |
| What additive is in the Lavender top tube and how does it work? | EDTA (Ethylene Diamine Triacetic Acid) Works by binding to Calcium molecules |
| Excessive squeezing of the dermal puncture site often leads to specimen_____. | Hemolysis |
| You are called to obtain a dermal specimen from a patient after two other phlebotomist were unable to obtain it. What should you do to attempt to increase the blood flow of the capillary blood to the puncture site? | Apply warm compress to the preferred site |
| An agent that inhibits the growth of bacteria is _______ | bacteriostatic |
| Routine venipuncture needles are usually _____ | 21 to 23 gauge and 1 inch long. |
| The most common dietary restriction that affects specimen collection is ____ | fasting. |
| You are to obtain a serum potassium level from Mrs. J, a hospitalized patient. You enter her room and observe that she has an IV of potassium infusing in her left arm and a sign above the bed that says "NO VENIPUNCTURE IN RIGHT ARM". Following actions? | Collect the blood from a site below the IV line. |
| The physician has ordered a blood alcohol test. What is an important handling consideration for this test? | Do NOT use alcohol to clean site, use Betadine. |
| What laboratory test require the specimen to be protected from light during collection and shipping? | Vitamin B and Bilirubin |
| When collecting capillary specimens, what is the first thing you do before collecting the blood into the microcollection device? | wipe away the first drop of blood with a clean, dry gauze |
| Glucose testing aids the physician in diagnosing _____ | diabetes mellitus |
| The first component of the glucose tolerance test is to | collect fasting blood and urine specimens |
| A physician can supervise an individuals's drug or medication treatment by using ______ | therapeutic drug monitoring |
| The anitcoagulant is a gray-stoppered blood collection tube is : | potassium oxalate |
| A gray-stoppered evacuated tube prevents glycolysis and coagulation. What additives does this tube contain? | Sodium fluoride - glycolic inhibitor Potassium Oxalate - anticoagulant. |
| Which tubes are specially designed to be free from lead? | Tan/Royal blue tubes |
| Which tube is designed to be free from all trace metals? | Royal Blue tube |
| Capillary tubes are also referred to as: | microhematocrit tubes. |
| Alcohol pads contain what percent isopropyl alcohol? | 70% |
| Isopropyl alcohol is a bacterialstatic antiseptic. What does bacterialstatic antiseptic mean? | Inhibits the growth of bacteria |
| What tube color should be collected when a CBC (complete blood count) is ordered? | Lavender Top |
| Which agency writes the standards stating that a new tourniquet must be used for every patient? | CLSI |
| One type of needle used by a phlebotomist is a butterfly. What is another name for this butterfly needle? | Winged Infusion |
| Collecting blood into an evacuated SST tube before collection of the sodium citrate tube may cause: | Contamination of coagulation specimens |
| What is a hub used for? | Holding the needle and evacuated tubes during venipuncture |
| When selecting a vein in a patient's antecubital area, what action will help you to determine the size, depth, and direction of the vein? | Palpate the patient's antecubital area |
| You are assembling equipment for a venipuncture and notice that the date on the needle's sterility label has passes. How should you proceed? | Discard the needle because its sterility is in question |
| During a venipuncture, if the area surrounding the vein begins to swell, creating a hematoma, you should first: | Remove the tourniquet. |
| Underfilling an evacuated tubes is possible if the tube is removed from the assembly before it is completely filled. If the evacuated tubes is a Sodium Citrate tube, what could happend? | Too little blood will be drawn for the proper blood to anticoagulation ratio |
| What will happen if a tourniquet is left on too long? | Hemoconcentraiton |
| During a venipuncture, some blood flows into the evacuated tube and then stops. What are some reasons this could happen? | 1)The needle is too close to a valve 2) The needle might have slipped out of the vein 3) The tube may be expired |
| The basis for Standard Precautions during blood collection is that: | any patient may be a carrier of any infectious diease |
| If no acceptable vein can be found in the antecubital area of either arm, the phlebotomist should: | check the dorsal side of the patient's wrist or hand |
| The name of the blood condition that patients may develop if they have a large amount of blood removed over time is_____ | iatrogenic anemia |
| To dispose of the phlebotomy equipment after the procedure you: | snap the safety device on the needle and dispose of the entire unit in the sharps container |
| The formation of a mass under the skin is a result of a ______. | hematoma |
| A sudden increase in the ratio of blood components to plasma results from: | hemoconcentration |
| A large bruise is also known as_______ | hematoma |
| A hematoma may form if the tourniquet is ______ | tied too tightly |
| Identifying a specimen accurately and making sure that it has not been altered or replaced is called establishing a: | chain of custody. |
| Antecubtial Fossa | Bend at elbow in arm |
| What veins do we draw from when drawing a patient's hand? | Dorsal veins |
| Small red rash/dots from leaving the tourniquet on too long is called | Petechia |
| Inflammation of a vein is called | Phelbitis |
| If a patient has more than 20% of his/her blood drawn in one day it can cause _______ | iactrogenic anemia |
| To feel for the vein is called______ | palpation or to palpate |
| A swollen area is called ________ and should be avoided | Edematous |
| Holding a vein in place is also know as _____ | anchoring the vein |
| Hardening of a vein is referred to as _____ | sclerosis of a vein |
| Another word for fainting is _______ | syncope |
| When you would need to perform CPR on a patient? | When the patient has no pulse |
| Bruising or skin discoloration is known as | Echymosis |
| When would a phlebotomist use a multiple draw needle? | Drawing multiple tubes |
| The additive in the red/gray speckled collection tube is? | Thixotropic gel |
| A group of test requested is called a? | Panel or profile |
| If a patient has an IV in the arm, the phlebotomist should? | Draw from the opposite arm |
| What step should a phlebotomist take if blood was drawn from the wrong patient? | Immediately report to supervisor |
| Blood in urine is called? | Hematuria |
| The antiglycolytic agent that maintains glucose stability for 3 days is? | Sodium Flouride |
| A patient is rushed to the ER because of dehydration due to severe vomiting. The ER physician orders a test for STAT electrolytes. What tube would the phlebotomist use to do the collection? | Green |
| Collection devices used in skin punctures are? | Capillary Tubes |
| What is the purpose of warming the site prior to a dermal puncture? | Increase blood flow |
| The first step in stopping bleeding is to ? | Apply pressure |
| What is the purpose of the Accession order? | Correct Order of Draw |
| When cleaning the collection site, the phlebotomist should: | Outward spiral movement |
| A "short draw" in blood collection refers to: | Singel tube collection |
| When the body has had adequate rest and no food for at least 12 hours, it is said to be in: | Basal State |
| What is the best sample for the determination of blood pH and blood gases? | Arterial Blood |
| What is the most common complication from phlebotomy? | Hematoma |
| Recent OSHA regulations requires that all health care personnel exposed to blood and other body fluids must receive a vaccination against? | Hepatitis B |
| Red-top tubes are also called "plain" tubes. Blood collected in these tubes are allowed to clot by normal coagulation process, which will likely will take how many minutes? | 15-30 minutes |
| The vacuum draw of the evacuated tube decreases with: | Age |
| The boundaries for the approved area in performing heel punctures are: | Medial line extending from great toe and lateral line extending from fourth and fifth toe. |
| What tube is used for PT and PTT? | Light Blue |
| The proper way to dispose of a needle is to? | Put in sharps without recapping |
| A patient has been taking aspirin for arthritis. Which of the following is most likely to be affected by it? | Bleeding time |
| The most common cause of blood culture contamination is ? | Improper cleaning of site |
| If a patient refuses a venipuncture procedure, what should the phlebotomist do? | Report it to the nurse, your supervisor and document it on the requisition. |
| A symptom of shock? | Expressionless face |
| An obese patient was sent to the lab for a CBC, which of the following veins is most likely to be the only one that the phlebotomist can palpate? | Cephalic |
| Which of the following analytical errors occurs during blood collection? | Wrong order of draw |
| The phlebotomist identifies a patient in the clinic laboratory facility by: | Asking the patient to state their name and DOB |
| What is the correct action for ending a venipuncture? | Remove the needle and apply pressure |
| Declining medical treatment is an example of what a patient can do under the: | Patient's Bill of Rights |
| This can occur if the tourniquet is left on too long: | Hemoconcentration |
| What should be used to chill a specimen as it is transported? | Ice water or ice slurry |
| How many tubes are drawn for a three hour glucose tolerance test (GTT)? | 5 |
| Before a blood donation is made, the phlebotomist must always check the blood donor's: | Hemoglobin |
| A hematoma can be prevented if: | Pressure is places on site |
| A specimen for a blood lead level is drawn in a : | Royal blue tube |
| If a patient has a syncopal episode during blood draw, which of the following should be phlebotomist do first: | Remove the tourniquet then needle |
| An unconscious, unidentified man is admitted to an emergency trauma center. What would be the system of choice to ensure patient identification? | Use temporary armband |
| Peak level and trough level are used in : | Therapeutic drug monitoring |
| The following is correct about nosocomial infections: | infections obtained in a health-care setting |
| The purpose of the tourniquet in the venipuncture procedure is: | Enlarge veins |
| The most important means of preventing the spread of infection is: | Handwashing |
| What criterion do you use to decide which needle gauge to use for venipuncture? | Size and condition of vein |
| After the blood collection from a heel stick is placed on the neonatal screening card, the card must dry in a horizontal position for a minimum of | 1 hour |
| Hormones are produced in which of the following body systems? | Endocrine |
| This has been shown to erroneously affect lab tests results, leading to falsely elevated results: | Violent crying |
| Adding too much blood to a sodium citrate tube can cause: | Shorter clotting times |
| Contraction of the heart | Systole |
| The Joint Commission is a(n) | Accrediting Body |
| Nails can grow at a rate of: | 0.1 mm/day |
| Diurnal rhythms are the same as: | Circadian Rhythm |
| The occult blood analysis is frequently requested on: | Feces |
| Process by which blood vessels are repaired after injury: | Hemostasis |
| Function to provide the body protection against infection | Leukocytes |
| Contains hemoglobin, the O2 carrying protein. | Erythrocytes |
| Essential for blood coagulation | Thrombocytes |
| Any object that can harbor infectious agents and/or transmit infection | Fomite |
| All specimens should be handled with caution, as if they were contaminated with a blood born pathogen. | Standard precautions |
| Tube containing anticoagulant. | Whole Blood |
| When is skin puncture useful? | Small amounts of blood |
| The most automated section in the laboratory : | Blood Bank |
| This is the section where the formed element of the blood are studied by enumerating and classifying the red blood cells, whole blood cells, and platelets. | Hematology |
| Contains anticoagulant SPS or sodium ployanetholuesulfanate | Yellow top tube |
| Thixotropic gel (serum separator) forms a barrier between the serum and fibrin clot. | Red/gray speckled top |
| Plain vacuum tube contains no additive or anticoagulant. No inversion required. | Plain red top |
| Common tests: Serum chemistry tests, serology tests, and blood bank require this tube: | Plain red top |
| Common tests: Fasting blood sugar (FBS), Glucose Tolerance Test (GTT), Blood Alcohol Levels (BAC), Lactic Acid measurements use this tube. | Gray Top Tube |
| Contains anticoagulant Heparin combined with lithium, sodium, or ammonium. | Green top tube |
| Inhibits thrombin in the coagulation cascade and is not used for Hematology because ti interferes with the Wright's Stain. | Green Top Tube |
| Carries deoxygenated blood from the right ventricle to the lungs. Oxygenation takes place at the alveoli and returns oxygenated blood from the lungs to the left atrium. | Pulmonary circulation |
| Carries oxygenated blood from the left ventricle throughout the body | Systemic circulation |
| Inhibits coagulation by binding to calcium present in the specimen and must be filled 2/3 full, inverted 8-10 times. | Lavender. |
| Used for coagulation studies because it preserves the coagulation factors. Must be inverted 3-4 times. | Light Blue top tube |
| Sclerosed veins, thrombic veins, and tortuous veins are examples of: | unsuitable veins to use |
| Arteries, capillaries and veins are examples of | blood vessels |
| Responsible for monitoring infectious disease. This includes health care worker exposure. | CDC |
| This act defines low, moderate, and high complexity testing and requires labs to meet certain guidelines in order to perform their tests. | CLIA 88 |
| The national accrediting body for hospital, performs periodic inspection of healthcare facilities to ensure that they are meeting appropriate standards, | JC |
| Regulates how health care information is transmitted and proved protection for certain types of health information | HIPAA |
| Microorganisms that cause disease are: | Pathogenic |
| This complication results from repeated venipuncture of the same vein: | Plhebitis |
| Latex sensitivity is a type of: | Allergy |
| What precaution would you take when drawing a Vitamin B6? | Wrap in foil |
| What is the maximum % of blood a phlebotomist can draw before a patient experiences iatrogenic anemia? | 20% |
| During a routine blood draw wha tis the first thing you do if someone begins to seizure and is on the floor? | Clear Area |
| Which of the following complications can a phlebotomist cause by under filling a gray top tube? | Hemolysis |
| Arteries | Carry blood away from the heart, all arteries except pulmonary arteries, contain oxygenated blood |
| Veins | Carry blood towards the heart. All veins, except pulmonary veins, carry deoxygenated blood |
| Caplillaries | Smallest and most numerous blood vessels in the human body |
| Veins have ______ to keep blood from flowing backwards. | Valves |
| Which veins do you choose first for anticubital venipuncture? | 1) Median cubital 2) Cephalic 3) Basilic |
| Blood is comprised of formed elements (?) a liquid component (?). | formed elements = 45% Liquid component = 55% |
| Formed elements include blood cells that originate mostly from the ______. | Bone Marrow |
| The liquid component is made up of water (?) and solutes (?). | Water= 90-92% Solutes = 8-10% |
| ______ include electrolytes, enzymes, glucose, hormones, lipids, proteins, and metabolic substances. | Soultes in blood |
| Red Blood Cells | Made in Bone Marrow Bioconcave in shape Live ~120 days = 3-4 months 4.5-5.0 million/cm Carry Oxygen |
| _______ are primarily responsible for destroying foreign substances and pathogens and can pass through the thin walls of capillaries to enter the tissues through a process called Diapedesis. | Leaukocytes = WBC |
| Diapedesis: | process of WBCs traveling through the thin wall of capillaries into the bodies tissues. |
| There are _____ WBC/cmm in the circulating blood. | 5,000-10,000 |
| WBCs are categorized as : | Granulocytes and Agranulocytes |
| Granulocytes: | Neutrophils Eosinophils Basophils |
| Agranulocytes: | Monocytes Lymphocytes |
| Neutrophils | Small dark granules Increase in bacterial infection |
| Eosinonphils | Large red granules Increase in allergy and parasitic infection |
| Basophils | Large dark granules Increase in extreme allergic reactions |
| Lymphocytes | Contain no granules Increase in viral infections |
| Monocytes | Largest of the circulating white blood cells increase in prolonged illnesses |
| Thrombocytes or platelets | not whole cells, fragments of megakaryocytes |
| ________ function in hemostasis by forming a platelet plug at the site of injury and secrete a substance to narrow blood vessels and assists in clot formation. | Platelets |
| Four stages of blood vessel repair: | 1)Vasoconstriction 2) Platelet plug formation 3) Blood clotting (coagulation) 4) Fibrinolysis = dissolving of the clot and return of the vessel to normal function |
| Hypoglycemia | Lowered glucose - could be caused by serum sitting too long before being centrifuged. |
| Hyperkalemia | Higher Potassium -could be caused by serum sitting too long before being centrifuged. |
| People who live in high altitudes have a higher _____ count and ____. Higher altitudes have lower levels of O2 in the air. | RBC count and Hemoglobin. |
| Test in a CBC | RBC, WBC, HGB, HCT, Platelet count |
| Sedimentation rate | Measures the rate at which red cells fall when placed in a tube and allowed to stand for one hour. |
| When drawing a light blue top tube and using a butterfly needle, what special procedure must you do? | When using a butterfly, first draw a discard tube (plain red) before drawing the blue top tube to insure the correct blood to additive ratio |
| During a glucose tolerance test, patients are NOT allowed to _____ until the entire procedure is complete. | Leave the facility Eat or drink (water is acceptable) smoke consume alcohol chew gum |
| Accuracy | How close |
| If you are trying to stop the bleeding from a needle stick, which of the following is the best technique? | Apply direct pressure |
| Which of the following is a test used to monitor heparin levels? | ACT or Activated Clotting Time |
| Which of the following is the deepest layer of the epidermis? | Stratum basale |
| The area of a blood smear that is tested is called the _____. | Feather |
| Which of the following matches the definition: excessive RBC production? | Polycythemia |
| Which of the following is identified by the acronym (CPD)? | Citrate Phosphate Dextrose |
| According to the Zone of Comfort, if you are standing 3 feet from a person you are within ____. | Personal Distance |
| The "lubb" or first sound of the heartbeat is caused by: | the closing of the AV valves |
| Major functions of this organ include glycogen storage, secretion of bile, and detoxification of harmful substances: | Liver |
| A hydrogen breath test can be used to detect which of the following conditions? | lactose intolerance |
| This blood bank test is used to check for unsuspected antibodies and antigens in the recipient's and donor's blood that could cause severe reactions during transfusion: | Compatibility testing |
| What do veins have that arteries don't? | Valves |
| What is the inside of an artery or a vein called? | Lumen |
| What are capillaries? | Microscopic, one cell-thick vessels that connect arterioles and venules |
| What is the purpose of a capillary? | Capillaries are the site of gas exchange between blood & bodily tissues |
| What is the preferred locations for venipuncture? | 1. Antecubital Fossa 2. Upper aspect of the forearm 3. Posterior aspect of the wrist 4. Dorsum (back) of the hand 5. Ankle and foot veins (Dorsalis Pedis) |
| What does the medical term "ante" mean? | Before |
| What does the medical term "cubital" mean? | Elbow |
| What are the three superficial veins located in the Antecubital Fossa? | 1. Median Cubital Vein: Large and fixed 2. Cephalic Vein: Preferred in obese 3. Basilic Vein: Close to the brachial artery and median nerve |
| What is plasma composed of? | 92% water, 7% proteins, the rest is all 1% (gases, minerals, carbs and lipids, waste products, vitamins, hormones and drugs) |
| What is the buffy coat composed of? | Leukocytes and platelets |
| What is the percentage of plasma in the blood by volume? | 55% |
| What is the percentage of formed elements? | 45% (Erythrocytes, Leukocytes, and Platelets) |
| What purpose does hemoglobin have? | Carries O2 on the RBC |
| What is the count of erythrocytes in a healthy adult? | 4 - 6 million (approximately 2.4 million produced in a second) (Red blood cells make up approximately 99% of the cells of plasma) |
| What is the life span of a leukocyte? | ~24 hours |
| There are two different types of white blood cells, what are they? | Granular or Agranular leukocytes (Granular Leukocytes - perform phagocytosis) (Agranular Leukocytes - produce antibodies) |
| _________ Leukocytes are polymorphonuclear Examples of them are: Neutrophils, Eosinophils, and Basophils Their job is to perform Phagocytosis They usually react to inflammation | Granular |
| Lymphocytes and monocytes are examples of Agranular Leukocytes They produce? | antibodies Examples are: T cells and B cells |
| Which lymphocyte will be destroyed by HIV/AIDS? | T cells |
| What are the differentials and their percentages? | Neutrophils: 40% - 60% - Never Lymphocytes: 20% - 40% - Let Monocytes: 2% - 8% - Monkey Eosinophils: 1% - 4% - Eat Basophils: 0.5% - 1% - Bad Band: 0% - 3% - Bananas |
| What is the life span of a thrombocyte? | 9-12 days |
| Number of thrombocytes per cubic millimeter? | 150,000 - 400,000 |
| Functions of additives are: | 1. Preventing clotting/anticoagulant 2. Preserves certain blood components 3. Clot activator/promotes clotting |
| Yellow Top Tube | sodium polyanetholsulfonate SPS or Acid Dextrose. it tests blood culture for aerobes and anaerobes/2 VIALS SPS aids in the recovery of microorganism by inhibiting the action of complement, phagocytosis and certain antibiotics AEROBE1st ANAEROBE 2nd |
| Light Blue Top Tube | Additive: Sodium Citrate *** Fill completely Purpose: PT, Extrinsic pathway and Coumadin therapy and aPTT ( Activated partial thromboplastin time) RATIO: 9:1 |
| Red Top Tube | Additive: None Purpose: Serum separator tube |
| Green Top Tube | Additive: Sodium, Lithium or Amonium Heparin Purpose: STAT electrolyte or ammonia |
| Lavender Top Tube | Additive: EDTA Purpose: CBC, ESR (erythrocyte sedimentation rate) and sickle-cell screening *** Tube has to be filled at least two thirds |
| Gray Top Tube | Additive: Antiglycolytic agent sodium fluoride Preserves glucose for 72 hours - lithium iodoacetate Preserves glucose for 24 hours - potassium oxalate / anticoagulant by binding with calcium |
| Dark royal blue tube top | Additive: EDTA or sodium heparin Purpose: Test toxicology and trace elements, zinc and copper and lead |
| What does SESIP stand for? | Sharps with Engineered Sharps Injury Protection |
| How many times should the light blue tube be inverted? | 3-4 times |
| How many times does the red tube have to be inverted? | 5 times (every other tube 8-10 times except light blue: 3-4) |
| What is the average number of how many times a tube has to be inverted? | 4-10 times |
| True or false: a patient who is fasting can smoke as much as they please | FALSE! SMOKING INCREASES GLUCOSE AND CORTISOL LEVELS! |
| What must you have in order to be able to take blood from a patient? | Patients name Date of birth ID number Name of physician making the request Type of test requested Test status |
| In what scenario does a specimen need recollection? | Unlabeled or mislabeled specimen Quantity not sufficient Defective tube Incorrect tube used for test ordered Hemolysis Clotted blood in an anticoagulated specimen Improper handling |
| What are some complication of venipuncture? | syncope - fainting Hematoma - resolves over time Pain Infection Tissue trauma |
| What is a Guthries card? | A filtered paper for capillary puncture (it is used for PKU test) |
| What kinds of tests have to be followed by chain of custody? | Drug and alcohol testing, DNA analysis or parentage testing |
| What is hemophilia? | Hemophilia is a bleeding disorder (missing factor VIII) Hereditary, sex-linked disorder |
| How many liters of blood circulate through a healthy body? | 5 liters of blood circulate in our body every minute |
| What does ESR (erythrocyte sedimentation rate) sometimes indicate? | General indication of inflammation |
| Two major antigen systems are? | ABO and Rh Person is either Rh positive or Rh negative |
| Blood compatibility: | Type O - No antigens; anti-A and Anti-B antibodies; universal donors Type A - Type A antigen; anti-B antibodies; O and A donors Type B - Type B antigen; anti-A |
| What is Glycosylated Hemoglobin? | Provides information about the average blood sugar level during the past 2 to 3 months Normal HbA1c levels between 4% and 6%; goal for diabetic patients are levels less than 7% taken in purple top tube |
| What is negligence? | Failure to exercise the standard care that a reasonable person would give under similar circumstances |
| What is battery? | touching patient without their consent |
| What if informed consent? | Giving the patient information about the procedure |
| What is patient confidentiality? | Means the patients right to authorize use of his/her own information |
| What is the age to be able to donate blood? | 17-66 years old patient has to weigh atleast 110 pounds |
| What is an autologous donation? | When a person donated blood for his/her own use. Minimum time between donation and surgery can be as little as 72 hours. To be eligible the patient must have order from physician. |
| CLSI guidelines set the max time limit for separating serum and plasma from the cells is _______. | 2 hours |
| What is normal body temperature in Celsius? | 36.4 - 37.6 Room temperature is usually 15-30 degree Celsius Refrigerated temperature 2-10 degree Celsius Frozen temperature -20 degree Celsius |
| Specimens to be protected from light are: | Bilirubin Carotene Red Cell Folate Serum Folate Vitamin B2, B6, B12 and vitamin C Urine Porphyrins Urine Porphobilinogen |
| Chill specimen in crushed ice are: | Adrenocorticotropic hormone ACTH Acetone Angio-tension-converting enzyme ACE Ammonia Catecholamins Free fatty acids Gastrin Homocystein Lactic acid Parathyroid hormone PH blood gas - ABG - Aterial blood gas Pyruvate Rening |
| 3 categories for Urinaylsis | Physical, Chemical, Microscopic |
| Physical properties reported for Urinalysis | What we can see with the naked eye Color - yellow to amber Turbidity- clear to cloudy Oder - sweet smelling, very ammonia smelling, normal, etc. |
| Chemical properties reported for Urinalysis(10) | Use a dip stick with reagents that cause a color change reaction 1)Blood 2)Proteins 3)Glucose 4)Bilirubin 5)Urobiligen 6)pH 7)Leukocytes 8)Nitrates 9)Ketones 10) Specific Gravity |
| Microscopic properties reported for Urinalysis | Must be reported by trained professional (MT, MLT, pathologist, ...) Look at urine under microscope |
| Different means of collecting urine | Random - most common First Morning - very 1st urination Clean Catch - specific way of cleaning genital - needed for UA and UC TImed - specific time or times throughout day 24 hour - collect all urine for 24 hours in collection jug. |
| When do you label urine cups? | Before the patient voids in cup |
| True or False: Phlebotomy is considered an invasive procedure. | True. |
| At all times, phlebotomist must demonstrate a mastery of the principles and techniques established by the _____. | Clinical and Laboratory Standards Institute. |
| The phlebotomist is responsible for the collection, processing, and transport of blood specimens to the laboratory for testing. This responsibility consist of ___________. | the Pre-examination phase of laboratory testing |
| What is POCT? | Point of Care Testing - testing that can be performed at the patient's bedside. i.e. glucose monitoring |
| In 1988 Clinical Laboratory Improvement Amendment (CLIA '88) was established to ensure: (2) | All laboratories receiving federal funds, regardless of size, type or location would meet the same standards and be certified by the government. It also standardized laboratories in quality control testing |
| __________ is a body that accredits and regulates. | The Joint Commission (TJC or JC) |
| _______ that have become resistant to antibiotics include Methicillin-resistant Staphylococcus aureus, vancomycim-resistant enterococci (WRE), Pseudomonas aeruginosa, and clostridium difficile (C-diff). | Microorganisms |
| The ______ has created the respiratory hygiene and cough etiquette standard, to which everyone is expected to adhere. Individuals should cover their cough or sneeze, use the flu salute, and clean their hands frequently. | CDC - Centers for Disease Control and Prevention |
| 4 common vehicles of transmission of infection: | 1)droplet transmission 2)airborne transmission 3) vehicle-borne transmission 4) vector-borne transmission |
| Properly using ____________ will reduce the risk of infection to healthcare workers and patients. | Personal Protective Equipment (PPE) |
| The cardiovascular system is responsible for ______. The heart, blood vessels, and blood that flows through these structures make up this system. | circulation |
| The heart is a large muscle that works to pump blood through the _____ and is divided into 4 chambers. 2 atria and 2 ventricles | Vascular system |
| Layers of the heart muscle include ________, _________, and _________. | endocardium, myocardium, epicardium |
| The sac that holds the heart is the | perietal pericardium |
| ____________ provides the blood supply to the heart. Oxygenated blood travels from the left ventricle, through the aorta and directly into the coronary artiers | Coronary circulation |
| ___________ occurs when the blood that has been used by the body's cells is returned to the heart and transported to the lungs to pick up oxygen. | Pulmonary Circulation |
| ____________ is responsible for delivering nutrient-rich, oxygenated blood to all other parts of the body and bringing back the blood to the heart. | Systemic Circulation |
| _______ carry oxygen-rich blood through capillaries, where gas exchange occurs. _______ carry deoxygenated blood back to the heart. | Arteries, veins |
| Arteries and veins consist of three layers:_____, ________, _________ | Tunica intima, tunica media, and tunica adventitia |
| Red blood cells contain many ____ (proteins) on their surface. | Antigens |
| The most common blood group systems are the ____ blood group and the ___blood group. | ABO and Rh |
| Which organization requires patient's name, DOB, identification #, specimen collection date/time and phlebotomist initials. | CLSI = Clinical and Laboratory Standards Institute |
| What type of needles are used with syringes? | Hypodermic Needles |
| _______ errors can occur during patient identification, specimen collection and specimen handling. | Pre-examination |
| Specimen collection and handling are _______ variables that only those collecting and transporting the specimen can control. | pre-examination |
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