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Final Review
| Term | Definition |
|---|---|
| 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
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