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Phlebotomy
General Flashcards
| Question | Answer |
|---|---|
| Greek word for vein | phlebo |
| Greek word for incision | tomy |
| Phlebotomy is the ancient are of _______? | bloodletting |
| What is an ICD10 Code? | Diagnosis Code |
| What is an accession number ? | A unique tracking number different for each sample |
| If a patient faints what is the 1st thing to do? | Withdraw needle from their arm |
| what is another name for vasovagal syncope | fainting |
| What is a hematoma | when some blood releases into the tissues under the skin |
| What is the most common complication for phlebotomist | hemotoma |
| If a patient has iv where should you draw the blood | other arm or below the iv site |
| where are pediatric blood draws usually taken? | Median cubital |
| what is the last step of venipuncture | Inform patient that their physician will deliver results and do not leave patient until you checked to see the bleeding has stopped |
| How long should the tourniquet be left on for | no more than 1 minute |
| According to the CLSI when should the tourniquet be removed | as soon as blood flow is established |
| Why should you make sure the antiseptic is dry | Doesn't burn, doesn't hemolyze, and so it works properly |
| what does CLSI stand for | Clinical and laboratory standard institute |
| what is the first step of venipuncture procedure? | Verify requisition form for patients info |
| Requisition Form includes | Patients name and Dob Ordering physcians info test required special consideration diagnosis code |
| What should be noted on a requisition form | Date sample was drawn what time who did the draw |
| If patients complains about "arm falling asleep " what might have happened | aggravated nerve |
| What angle of entry should a hand vein butterfly needle be ? | 5 degrees |
| what is the most common needle size | 21 gauge |
| are needles smaller than 23 gauge recommended for drawing blood | no can cause hemolysis |
| what is hemolysis | breakdown of red blood cells |
| what can happen if the tourniquet is on too long? | Hemoconcentration and blood infiltration in tissues |
| What is a laboratory requisition | An order form that specifies what test are requested |
| What do you risk hitting with the basilic vein | Brachial artery or nerve |
| Which vein is commonly used on obese patients? | cephalic vein |
| What is the most common vein used | Median cubital |
| What are the three major veins | Median cubital cephalic Basilic |
| What are the typical site selections phlebotomist use? | Antecubital Fossa |
| What is an imminent danger inspection | when osha recieves a report that a condition of imminent danger exist at a workplace (least common inspection) |
| what is complaint inspection | occurs after an employee files a formal complaint with osha (most common type of inspection) |
| What are the 4 types of osha compliance inspection? | complaint fatality/accident programmed imminent |
| What does OSHA stand for | Occupational safety health association |
| If exposed to blood or infectious disease what should you do | Wash report refer to msds (material safety data sheet ) fill out an exposure report form |
| what should sharps injury log contain ? | type and brand of device involved the department of work area where the exposure incident occurred an explanation of how incident occurred |
| What do you use to decontaminate | Sodium hypochlorite solution (household bleach) |
| How full is a sharps container that ready to be disposed of | 2/3 full |
| T or F Needles should be recapped | false |
| What does PPE stand for | Personal Protective equipment |
| what can clarify patients information | patients id band |
| whats the first thing you do with patients | id them |
| Parental consent for minors | a Parent of legal guardian must permit procedures administered to underage patients (state age range 18-21) |
| Implied consent | The patients action permits the procedure without verbal or written consent |
| informed consent | A competent person gives voluntary permission for medical procedure after receiving info about the risk |
| What are CLSI standard proper identification? | Patients Id band |
| what are early tools were used? | suction devices with lancets and application of leeches to an incision |
| what was the concept behind bloodletting? | to rid the body of excess fluids and infection |
| Doffing | Gloves, goggles, gown, mask |
| Donning | Gown, mask, goggles, gloves |
| Reverse (or protective) isolation | Designed to keep susceptible patients isolated as not to infect them with disease or infection we have or may be carrying from the outside |
| Droplet precations | Droplets ususally travel short distances ( 3 ft or less) |
| Airborne precautions | reduce the risk of airborne transmission of infectious agents |
| What are the 1st piece of ppe that tech should remove? | Gloves |
| indirect contact transmission | Diptheria, lice, rsv |
| Universal precautions | Treating all potentially infectious materials as infected |
| What does a tachometer ensure | that the centrifuge spins at the recommended RPMs |
| Hematocrit testing | blood must be 2/3 full and seal with Crti-o-seal |
| what angle do you slide the smear | 30 degrees |
| T or F Fistulas tend to last many years longer than any other type of vascular access | true |
| What tube do you draw blood smear samples from | lavender |
| What is the most important thing when creating blood smears? | creating a feathered edge to create a single layer of cells |
| Urine samples are commonly centrifuged to separate fluid from | sediments |
| QNS? | Quantity not sufficient |
| what serum/plasma will look green/brownish | icteric |
| What specimen will look mikly/white | lipemic |
| What does the red stripe symbolize? white? blue? | blood, bandages, vein |
| what is the main thing to know with centrifuging | make sure the sample is balanced in the machine |
| What can a phlebotomist do to bring more blood to skins surface during finger stick ? | slightly squeeze finger |
| Phlebotomy is aka? | venesection |
| How high is the tourniquet tied around the arm ? | 3/4 above the draw site |
| The skin is wiped with what antiseptic? | 70% isopropyl alcohol |
| What is polythemia vera ? | a condition characterized by high red blood cell count |
| Therapeutic phlebotomy is used when? | Patients have polythemia vera |
| Can a patient decline medical treatment ? | yes |
| What are the types of consent ? | informed expressed implied Hiv parental |
| 4 classes of fire breakdown | Class A= combustible materials Class B= flammable liquids Class C= electrical fires Class D= combustible metals |
| where do you sweep to put out fire? | At the base |
| What does R.A.C.E stand for | Rescue Alarm Contain extinguish |
| What does the fire triangle include | Fuel, oxygen, heat |
| what does the number range for N.F.P.A | 0= minimal hazard 4=max hazard |
| Blue represents in fire ? red? yellow? white? | health, Flammability, reactivity, special |
| what does N.F.P.A stand for ? | National fire protection association |
| What are the 7 types of hazards? | biologic sharps chemical electrical fire or explosive physical allergic reaction |
| Can HIV survive long outside the human body? | no |
| Does aids have a cure | no |
| What is the HBV vaccine made of? and when is it most effective? | yeast cultures, immediately after exposure |
| How many shots in HBV serious? | 3 series |
| As HBV progresses it turns into ? | jaundice |
| How long can HBV survive in dried blood? | 7 days |
| Is there a cure for HBV? | no but there are treatment options |
| T or F There are different kinds of hepatitis. Infection with HBV will not stop someon from getting another type. | true |
| What kind of blood comes from the heart | oxygenated blood |
| hepatitis means ? | inflammation of the liver |
| Susceptible host | Person who is not resistant or immune |
| Vehicle transmission? Vector-borne ? parenteral? | Doorknob insect needle-stick |
| Agents | infectious microorganisms classified in 4 groups |
| Nosocomial Infection | Any infection contracted in a health care setting |
| How long after blood donation does it take the body to regenerate lost red blood cells ? | 6-8 weeks |
| What are the hearts layers (outside to in) | epicardium, myocardium, endocardium |
| How long does it take blood to make a complete circulation in the body? | 1 Mintute |
| Does a graft and fistula need development | A graft does not need development |
| Airborne transmission | Tuberculosis- an intracellular infection contracted by infectious particles that remain suspended in the air |
| Droplet transmission | sneezing/ coughing |
| Indirect contact | contact with a contaminated objects such as clothing |
| Contact transmission | skin to skin with infectious persons |
| Semen collection | If using condoms it cant have spermicides Semen specimens are sensitive to light or extreme temperatures Sample must reach lab 1 hour of collection and as close to body temp |
| 24 hour urine specimen steps | Discard 1st specimen Urinate into small collection container and pour into larger container Clean small container with soap and water between collections Refrigerate urine before delivering it to physicians office |
| What is the most common from of urine collection | Random urine collection |
| Urine collection | Should be between 12mL and 50 mL Label each specimen container with patients name, date, and collection time |
| When is it ideal to collect sputum sample | Early in the morning before breakfast, to obtain overnight accumulation of secretions |
| What does Sputum do | Protect respiratory tract from inspection |
| What is guaic | A substance from a plant that is used to coat FOBT test cards |
| What does stool guaic test look for ? | Hidden occult blood in stool |
| Urinalysis three components | Physical chemical microscopic |
| Urinalysis | Test urine to detect disorders of the kidney, urinary tract, metabolic diseases, and drug abuse |
| Microbiology dept | Responsible for detecting pathogenic microorganisms in patient samples and hospital infection control Primary test culture and sensitivity |
| Serology (Immunology) | Perform tests to evaluate the patients immune response through production of antibiotics |
| Blood Bank | Blood is collected, stored, and prepared for transfusion Strict patient ID Blood collected may be separated into components |
| Electrophoresis | Analyzes chemical components of blood |
| Toxicology | Analyzes plasma levels of drugs and poisons |
| Immunochemistry | Uses RIA techniques and enzyme immunoassay to detect and measure substances such as hormones, enzymes, and drug |
| Chemistry Section | Most extensive and most automated section of lab |
| Hematology Section | Where bloods formed elements are studied Coagulation sect usually part of hematology Hemostasis is evaluated |
| What is CLSI formerly called | NCCLS |
| What are the 4 stages of hemostasis | Vascular Platelet Coagulation Fibrinolysis |
| What is hemostasis ? | The process by which blood vessels are repaired after injury |
| Are bilirubin specimens light sensitive | Yes procedure must be performed quickly to minimize exposure to light |
| What is the common treatment for bilirubin | Phototherapy (light therapy) |
| What is bilirubin | When the liver is not breaking down and excreting red blood cells |
| What does a heel warmer do to capillaries and vessels | It allows increased blood flow to that area |
| How long should heel warmer be placed on foot? | 2-5 min |
| Heel punctures should not exceed how much for infants? Preemies? | 2.0 mm 0.85 mm |
| What are is recommend for a heel stick ? | Medial and lateral portions of the plantar surface of the foot |
| T or F Always wipe away the first drop of blood with gauze | True |
| T or F a capillary puncture is done on a finger when a patient is over the age of 2 and also adults | True |
| Lancet depth for adult? Child? | 3.0 mm 0.85 mm |
| What is osteomyelitis? | inflammation of the bone and bone marrow |
| What can deep penetration into the skin cause | osteomyelitis |
| What can excessive milking of the finger result in? | Hemolysis and contamination |
| Which test wouldn't a capillary puncture work for? | ESR, PT, PTT, Blood cultures and any test that require lots of blood |
| what tube is sometimes called the gel tube | tiger top |
| When is a royal blue top with red stripe drawn | after light blue top tube |
| Etoh can be cleaned with alcohol? | no use chloraprep |
| Hypoglycemia | abnormally low blood sugar |
| 3 hour OGTT test, hyperglycemia, what is that? | Abnormally high blood sugar level |
| T or F Potassium oxalate is an anticoagulant that prevents clotting by binding to calcium in the sample | t |
| what does sodium fluoride prevent | breakdown of sugar |
| What does types and screen ratio test | find blood type |
| how full should a pink top be | 2/3 full |
| Do you centrifuge all tubes | never centrifuge cbc (lavendar) |
| Hemoglobin | measures the amount of oxygen carrying protein |
| Hematocrit measures? | measures the volume % of rbcs |
| What does complete blood count test ? | Evaluates the formed cellular elements of the blood |
| Can cbc be tested on blood from a dermal puncture? | yes |
| How full must lavender tubes be filled | 2/3 full |
| EDTA inhibits coagulation by binding to ____? | Calcium |
| What tubes don't you invert 8xs? | Iight blue red royal blue with red stripe |
| hcg quantitative measures? | how much HCG is present |
| HCG qualitative determines | If HCG is present |
| What is HCG | human chorionic gonadotropin |
| what does Lytes test do? | measures electrolytes is necessary for diagnosing and treating renal and endocrine conditions |
| how does heparin the anticoagulant work | Works by inhibiting thrombin in coagulation cascade |
| What tube is called the pst (plasma separation tube) | Mint green tube |
| Complete/ comprehensive metabolic panel/profile (CMP) | This group of test is more comprehensive look at the patients metabolism of chemicals in the body, kidney function, electrolytes, and fluid balance. Also provides info about liver function and performance |
| Basic metabolic test (BMP) | This group test provided general info about patients metabolism, kidney functions, electrolytes, and fluid balance |
| how long does silica promote rapid clot formation of the blood? | 15 minutes |
| What is a marble top most commonly referred to as? | sst (Serum seperation tube) |
| Red top tube (plain vaccum tube) can be used to test? | Serum pregnancy test |
| Blood will clot naturally within? | 30-60 min |
| Therapeutic Drug monitoring requires PTT time tp be drawn when a patient is on ______? | Heparin regimen |
| T or F You dont have to use a discard tube for a light blue top | false |
| How many times do you invert light blue top | 3-4 times |
| T or f Sodium Citrate needs additive ratios of 9 parts blood to 1 part additive | true |
| What does sodium citrate prevent coagulation binding to ? | Calcium |
| What does blood culture bottles contain ? | sodium polyanethol sulfonate |
| Why is blood culture performed | when fever of unknown origin is present or shows symptoms of systemic infection |
| What can cross contamination samples do ? | erroneous results |
| what tubes are without anticoagulants | tiger top red Royal blue with red stripe |
| what is serum ? | liquid portion of blood that has been allowed to clot |
| What is plasma ? | Liquid portion of unclotted blood and still contains the clotting factors |
| What color are plasma and serum? | yellow tinted fluid |
| what are the heavier formed cellular elements? | rbc wbc platelets |
| When are plasma and serum created | when centrifuged |
| T or F a strict aseptic technique is required when drawing blood cultures | true |
| What 4 primary test are performed on arterial samples? | Blood ph blood carbon dioxide blood oxygen blood bicarbonate |
| How long must an ABG test be run? | 15 min of collection |
| where is PKU testing done? | newborns heel or urine |
| What does diurnal variation test happen ? | Blood samples require same blood test drawn multiple time throughout the day |
| What is anaerobic? aerobic? | Without oxygen with oxygen |
| what is the generic equivalent to chloraprep ? | chlorhexidine gluconate |
| how long must a patient finish their glucola | 5 min |
| do you fast for glucose tolerance test | yes |
| what is a specialty drink high in measured amounts of glucose called | glucola |
| What is the most critical error a phlebotomist can make? | improperly id the patients before sample collection |
| what is pre analytical | skills and procedures before a specimen is analyzed |
| Specimens that require protection from light? | bilirubin b12 b6 |
| Specimens that require warm collection ? | cryoglobulin (fatsting) cryofibrinogen cold agglutinin |
| specimens that require to be chilled? | Ammonia lactic acid abg |
| What is without stasis ? | with no tourniquet |
| Lactic acid test should be drawn without or with stasis? | without |
| What do you do to prevent light contamination | wrap tube in aluminum foil or transport in amber bag |
| What should ammonia test be placed on? | ice |
| what does an ice bath prevent? | seperation |
| what tube are warmed specimen collected in | red top tube |
| T or F antibodies formed may attach to red blood cells at temps below body temp | t |
| what are cold agglutinins? | antibodies produced in response to mycoplasma pneumonia infection |
| Peak level collection depends on what | meds metabolism route of administration |
| how many minutes before scheduled dose should trough levels be collected | 15 min |
| what is peak | highest chemical blood level |
| what is trough | Lowest chemical blood level |
| What tube should a lipid panel be drawn in | sst tube |
| post prandial means? | after a meal |
| What is basal state | fasting |
| what all must be working for hemostasis to occur | blood vessels blood platelets coagulation factors |
| what enzyme starts breaking down the fibrin clot? | plasmin |
| What happens during fibrinolysis stage | the breakdown and removal of the clot |
| what pathway does partial thromboplastin time use | intrinsic pathway |
| what does INR mean ? | no matter where you get your blood tested the ratios will be calculated to always correctly administer meds |
| what test is used to evaluate the extrinsic pathway | Prothrombin time test (PT/INR) |
| What is hemochron? | a device used for POCT regarding PT/INR |
| what does the coagulation cascade involve? | intrinsic pathway system and extrinsic pathway system |
| what phase involves a cascade of interactions between coagulation factors that converts the temp platelet plug to a stable fibrin clot? | coagulation phase |
| what test is used to evaluate the primary stages of hemostasis? | Bleeding time test (BTT) |
| What are the primary stages of hemostasis? | vascular and platelet phase |
| what is aggregation | additional platelets stick to the site forming a temporary platelet plug |
| what is platelet phase | injury to the endothelial lining causes platelets to adhere to it |
| what is the vascular phase | injury to a blood vessels causes it to constrict, slowing flow of blood |
| What does iodine do to potassium levels | increase them |
| T or F You can place a warm towel in bio bag | true |
| Can you transport specimen in a lockable container? | yes |
| What should you always use over the arm in infants? | heel |
| What should you never transport specimen in ? | bubble wrap |
| What is the max mL you can get from 6lbs? | 3 mL |
| What can help stabilize the arm? | phlebotomy wedge |
| What are normal cholesterol levels | 140-200 |
| How should you draw from a patient that always faints? | laying down |
| During donation what should the patient do with their hand ? | pump hand |
| How many g should be received during donations | 16g-18g |
| What should you do if bag stops filling during donations? | End draw and finish in new bag |
| What should you do if glucometer is 130 and above? | report to physician |
| Does thrombin increase clotting time? | yes |
| Chromosome analysis | heparin |
| What Troponin levels should you report to a physician | .3 and above |
| If patient runs to the lab how long should you have them rest? | 15 min |
| Why should you put ABG on ice? | To stop metabolic activity of RBCs |
| What are dorsal veins | hand veins |
| What was the joint commission 2016 national patient safety goal ? | Patient identification |
| What POCT WBC count is normal? | 4.4-11 |
| When do you test for a newborn screen blood shot | 72 hours of birth |
| What is the breath test called that does not allow the patients to talk or consume anything | h. pylori |
| What is the title for the 24 hour urine and serum test that is both a blood and urine collection? | creatinine clearance |
| These are tiny non-raised spots that appear on the skin from rupturing of the capillaries due to the tourniquet being on too long or too tight | petechiae |
| This test in drawn in a light blue tube. This test is used to help rule out the presence of thrombus | d-dimer |
| What is the breakdown and removal of a clot called? | fibrinolysis |
Created by:
MilanLewis21
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