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Final Review

TermDefinition
Antiglycolytic An antiglycolytic agent is an additive category that inhibits glucose metabolism by blood cells
Which tube must be full to be accepted? Light Blue
How does Heparin stop blood from clotting? Heparin prevents clotting by inhibiting thrombin
What does Sodium Citrate do? Sodium Citrate preserves coagulation factors
Why is EDTA used for hematology? Used for hematology because it preserves blood cell morphology
How many times should each tube be inverted? 8-10 times
Patent freely open
Turgid distended from being filled with blood
2 reasons to anchor the vein Taut skin reduces pain, Anchoring prevents the vein from rolling
3 types of requisitions manual, computer, barcode
Define accession Accession is the process of recording in the order received. To accession a specimen means to take steps to unmistakably connect the specimen and the accompanying paperwork with a specific individual
3 types of info on the requisition ordering physician's name, patient's date of birth, patient full name
What does needle gauge measure? the diameter of the needle's lumen
2 different types of needles for drawing blood straight needle, butterfly needle
Which tubes can produce serum? Red, SST, Navy Blue
Gray top tube is used mostly for what? glucose testing
In what shape should a venipuncture site be cleaned? concentric circles
How long does it take for the site to dry naturally? 30s to 1 min
How to tell a vein from an artery? artery has a pulse
5 special situations a phlebotomist could encounter unconscious patient, sleeping patient, patient with Dr. or clergy, patient with family, patient not in room
Barcode series of black stripes and white spaces corresponding to letters and numbers
What info could a barcode contain? patient name, ID number, lab test
STAT statim = immediately
DNR do not resuscitate
ASAP as soon as possible
Fasting no food or drink (except water) for 8-12 hours prior to specimen collection
Geriatric relating to old age
Code a way to transmit a message, normally understood by healthcare personnel only, over the facility’s public address system
Most important step in specimen collection patient ID
Minimum info on a tube patient name, patient DOB or ID number, date and time of collection, phlebotomist initials, pertinent additional info
Common timed tests GTT, blood cultures, TDM
Common fasting tests glucose, hemoglobin, lipids
Test which could be fatal if misidentified type and crossmatch
What to do if patient ID band is missing? notify the nurse, and attempt to very patient ID with them
Informing the patient you are a student is part of... informed consent
What to do if patient refuses blood draw? Explain importance of procedure, if they still refuse abort and note on requisition
Ideal arm position for blood draw the arm should extend downward in a straight line from shoulder to wrist and not be bent at the elbow
When to use a butterfly needle? infants, small children, or difficult adult veins
Where is tourniquet placed when drawing a hand vein? just above the wrist bone
Before drawing blood on a child you should... earn the trust of the parent by displaying a calm, confident, and caring attitude
Maximum amount of blood drawn from children 10% of their blood volume
Why is the butterfly needle preferred for children? less likely to collapse a vein
Ways to immobilize children wrapped in a blanket, arm restrained by parent or additional phlebotomist
4 challenges of geriatric venipuncture skin changes, hearing impairment, visual impairment, mental impairment
Disease which causes tremors Parkinson's Disease
Can you draw blood from an arm with a fistula or graft? NO
Care given to terminally ill patients hospice care
Proper tourniquet location 3-4 inches above the intended venipuncture site
Maximum amount of time tourniquet should be left on 1 min
At what angle should you enter the vein? 15-30 degrees
Hemoconcentration condition in which blood components cannot easily leave the bloodstream become concentrated in the smaller plasma volume
What causes hemoconcentration? dehydration
Basal State the resting metabolic state of the body early in the morning after fasting for approx. 12 hours
Edema swelling caused by the abnormal accumulation of fluid in the tissues
Sclerosed hardened
Thrombosed clotted
Hematoma a swelling or mass of blood (often clotted), can be caused by a blood leaking from a blood vessel during or following venipuncture
Syncope fainting
Probe to search (for a vein)
Lipemic abnormally increased blood lipid content, causing the serum or plasma to appear milky, cloudy white, or turbid instead of light yellow.
Petechiae tiny, non-raised red, purple, or brownish colored spots that appear on the patient’s skin when a tourniquet is applied
PICC peripherally inserted central catheter
Hemolysis when RBCs are damaged or destroyed and the hgb they contain escapes into the fluid portion of the specimen, causing the serum or plasma to appear pink to dark red
Lipids fat soluble, used to describe certain fatty substances
Icteric relating to jaundice, an abnormal deep yellow to yellow-brown color due to high bilirubin
Factors that affect basal state age, gender, conditions of the body that cannot be eliminated
4 situations which may trigger a hematoma Needle has pierced through a vein, Needle has not been inserted fully into the vein, Blind or excessive probing, Adequate pressure was not applied following venipuncture
2 things which may cause hemolysis Drawing blood through a hematoma, Failure to wipe away first drop of blood in capillary puncture
Tests affected by altitude RBC counts, Hgb & Hct, CRP, Uric acid, Urinary creatinine, Plasma renin
Blood test affected by child crying before blood draw WBC counts
Where to draw blood from hematoma distal to the hematoma
Where to draw blood from arm with IV below the IV
What might make a patient bleed excessively? aspirin or anticoagulant therapy
Iatrogenic Anemia anemia brought on by blood loss as a result of testing
What to do if you accidentally collect an arterial specimen? terminate the procedure and apply forceful pressure to site for 3-5 min until bleeding stops
Symptoms resulting from hitting a nerve burning or electric shock sensation, numbness, pain that radiates up or down the arm
What might cause vein collapse? tourniquet too tight, tourniquet too close to site, tourniquet removed during difficult draw
Can a phlebotomist draw from a VAD? NO
2 areas of the body optimal for dermal puncture finger-stick, heel-stick
Blood smears used for which test? differential
Blood smears must be made from what color tube, and how quickly? purple, within one hour
Calcaneus heel bone
Differential a test in which the number type, and characteristics of blood cells are determined by examining a stained blood smear under a microscope
Osteomyelitis inflammation of the bone
PKU phenylketonuria, a genetic disorder
Neonate newborn
Lancet a sterile, disposable, sharp-pointed or bladed instrument that either punctures or makes an incision in the skin to obtain capillary blood specimens for testing.
2 collection devices for dermal puncture microcollection containers, microhematocrit tubes
Blood obtained from dermal puncture is a mixture of what 5 things? arterial blood from arterioles, venous blood from venules, capillary blood, interstitial fluid, and intracellular fluid.
Types of tests that CANNOT be done on blood from dermal punctures ESR, blood cultures, coagulation studies that require plasma, tests that require large volumes of serum or plasma
Where do you puncture an infant's foot? medial or lateral plantar heel
How deep should you puncture an infant's foot? 2mm or less
When collecting ETOH, what should you use to clean the site? iodine, BZK, soap and water
Why use amber-colored microcollection tube? to prevent light exposure (bilirubin)
Why warm infant foot before puncture? can increase blood flow 7x
Why wipe away 1st drop of blood for dermal puncture? typically contaminated with excess tissue fluid and may contain alcohol residue that can hemolyze the specimen.
Common tests on newborns Bilirubin, PKU, hypothyroidism, galactosemia, and cystic fibrosis
What tube for ETOH testing? glass gray-top sodium fluoride tube
GTT glucose tolerance test
Analyte substance being analyzed
Autologous Donation donating blood to be used for yourself
Septicemia microorganisms or their toxins in the blood
TDM Therapeutic Drug Monitoring, the testing if drug levels in the bloodstream at specific intervals
hCG Human Chorionic Gonadotropin, a hormone produced by the placenta that appears both in urine and serum
Postprandial after a meal
pH potential hydrogen, a scale of the relative acidity or alkalinity of a solution
ABG arterial blood gases (pH, pCO2, pO2, sO2)
Most important part of donation process? patient ID
Why perform a GTT? diagnose problems of glucose metabolism
Which specimen requires strict identification and labeling? blood bank specimens
Why draw 2 bottles for blood cultures? ASM states 2-4 are necessary to optimize detection of bacteremia and fungemia
How to clean skin when collecting blood cultures 30-60 sec friction scrub, tincture of iodine
Therapeutic Phlebotomy The withdrawal of large volumes of blood used as a treatment for certain medical conditions (ex: polycythemia or hemochromatosis)
Peak Level (TDM) max level for a drug to be beneficial
Trough Level (TDM) min level for a drug to remain within the therapeutic range
Where is POC testing done? at location of pt
3 types of POC testing ABG, PTT, CRP, Lipids, Glucose
Cardiac Troponin I proteins specific to heart muscle
Specimens which must be kept cold ammonia, ACTH, Lactic acid, parathyroid hormone, pyruvate
Specimens which must be protected from light bilirubin, Vit A, Vit B2, Vit B6, Vit C
4 reasons a specimen might be rejected wrong tube, wrong collection time, QNS, chilling requirement not met
When does proper specimen handling begin? when a test is ordered
How should tubes be transported? Vertically with the stopper up to reduce agitation that can cause RBC damage and lead to hemolysis.
How do you chill a specimen? Either by completely immersing it in a slurry of crushed ice and water, or putting it in a special cooling rack.
Specimens that do NOT get centrifuged CBCs and other hematology spec. in EDTA tubes, other whole-blood specimens
PPE worn when processing specimens full-length face shield
How long do clot tubes have to sit before centrifugation? until they clot
Aliquot portion of a specimen used for testing
UA urinalysis - physical, chemical, and microscopic analysis
C&S culture and sensitivity
CSF cerebrospinal fluid
Most frequently analyzed non-blood fluid urine
3 methods of urine collection midstream, clean-catch, suprapubic aspiration
Which urine specimen for routine testing? UA
Which type of screening prefers urine to blood? drug testing
Best urine collection method for C&S clean-catch
Should CSF be refrigerated? NO
What test analyzes sweat? sweat chloride
Where is synovial fluid found? movable joints
Biopsy requires what type of specimen? tissue sample
Where is bone marrow collected from? iliac crest or sternum
C-UBT C-Urea Breath Test - tests for H. Pylori
Stool sample which is not refrigerated ova and parasites (O&P)
Guaiac test detects what? blood in the feces
Analysis of what detects chronic drug abuse? hair
Rapid strep test is done using what? throat swab
Symptoms of anemia fatigue, skin pallor, shortness of breath, light-headedness, dizziness, fast heartbeat
What is anemia low RBC count
7 tests in Hepatic Function Panel ALT, AST, Alkaline Phosphatase, Albumin, Direct Bilirubin, Total Bilirubin, Total Protein
Immunology/Serology testing is done on what type of specimen? serum
What types of tests are done in microbiology? C&S
Busiest area of the lab? chemistry
Created by: Jasperonius