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Phlebotomy
Study for NHA phlebotomy exam A&P guide
| Question | Answer |
|---|---|
| What is the proper way to dispose of a used/open needle? | Do not recap, activate safety device, put in sharps container |
| What is the Good Samaritan Law? | A law that encourages trained healthcare professionals to help in an emergency situation without fear of being sued for negligence |
| If a patient refuses the VP, what should you do? | Let them refuse, inform supervisor or requesting nurse |
| Microorganisms that cause disease are called... | pathogens |
| What is the primary preferred vein for VP? | Median cubital vein |
| What does post prandial mean? | After meal |
| What is the longest a tourniquet should be left on a patients arm? | 1 minute |
| What can result of overuse of a vein? | Phlebitis, hematoma, scar tissue... |
| What are the 6 components of the chain of infection? | infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host |
| what is mode of transmission and an example? | the way in which a germ can be spread...coughing, sneezing, touching dirty surfaces, the toilet... |
| how do you prevent a hematoma from forming after a successful vp? | holding pressure until it stops bleeding |
| What is the maximum depth of an infant lancet for microcapillary collection? | 2.0 mm |
| Common symptoms of shock are.. | rapid weak pulse, cold/clammy/pale skin, spacing out |
| What type of hazard do bacteria, viruses, fungus and parasites belong to? | biologic |
| What are some examples of standard PPE? | gloves, mask |
| What are some examples of extra precaution PPE? | Goggles/glasses, face shield, n95, gown, shoe covers |
| Airborne, droplet and contact are what? | types of isolation |
| What 2 components make up the vascular system? | pulmonary and systemic circulation |
| Explain pulmonary circulation | Deoxygenated blood is delivered to the lungs from the pulmonary artery to be re-oxygenated and returned to the heart through pulmonary veins. |
| Explain systemic circulation | Oxygenated blood is sent through the aorta to the arteries for distribution to the body and returned through the superior vena cava and inferior vena cava. |
| What AV valve is situation between the right atrium and right ventricle? | Tricuspid valve |
| What semilunar valve is situated between the right ventricle and pulmonary artery? | Pulmonic valve |
| Another name for the bicuspid valve is? | Mitral valve |
| The bicuspid valve is located between ____ and ____ in the heart. | left atrium and left ventricle |
| What are the 3 layers of the heart? | Endocardium (inside), Myocardium (middle), and Epicardium (outside). |
| Name the blood vessels | Aorta, arteries, arterioles, capillaries, venules, veins, superior/inferior vena cava |
| What 3 layers make up the blood vessels (except capillaries) | tunica intima (inside), tunica media (middle), and tunica adventitia (outside) |
| Aorta, arteries and arterioles carry what kind of blood? | Oxygenated |
| Veins, venules and the superior/inferior vena cava carry what kind of blood? | Deoxygenated |
| A mixture of arterial and venous blood can be found in what? | Capillaries |
| how much blood does the average adult have? | 5-6 liters |
| Capillaries thin walls allow exchange of... | oxygen, CO2, nutrients and waste products |
| What is a reticulocyte? | An immature erythrocyte (RBC) |
| how long does it take reticulocytes to mature to RBCs? | 1-2 days |
| The normal life span of an RBC is... | 120 days |
| An oxygen carrying protein contained in erythrocytes is called | hemoglobin |
| What formed elements are contained in blood? | Erythrocytes, leukocytes, and thrombocytes (platelets) |
| How many leukocytes are there? What are they? | 5- neutrophils, eosinophils, basophils, monocytes and lymphocytes |
| Which WBC kills bacteria, fungi and foreign debris? | Neutrophils |
| Which WBC cleans up damaged cells? | Monocytes |
| Which WBC kills parasites and cancer cells, and is part of the allergic reaction? | Eosinophils |
| Which WBC fights viruses and makes antibodies? | Lymphocytes |
| Which WBC is also involved in the allergic response? | Basophils |
| The second most numerous WBC, making up 20-40% is... | Lymphocytes |
| The largest WBC, making up 3-8% is called | monocytes |
| 1-3% of WBCs that increase with parasitic and skin infections are | Eosinophils |
| Which WBC caries histamine and makes up 0-1%? | Basophils |
| 60-70% of leukocytes are | Neutrophils |
| Blood cells originate in | Bone marrow |
| Formed in bone marrow from megakaryocytes that are essential to coagulation is what | Thrombocytes (platelets) |
| How long is the platelets lifespan? | 9-12 days |
| Capillaries are composed of | Endothelial cells |
| Blood is made up of 2 portions, what are they? and what is their percentage? | Plasma 55% and formed elements 45% |
| What percentage of plasma is water? | 90% |
| What is 10% of plasma made up of? | Proteins, amino acids, gases, electrolytes, sugars, hormones, minerals, and vitamins |
| What is hemostasis? | The stopping of blood by way of coagulation. |
| What are the 4 stages of hemostasis? | Vasoconstriction, platelet plug formation, coagulation, and fibrinolysis |
| What is aggregation? | During plug formation, platelets stick to the injured site to form a temporary plug. |
| What is the preferred VP site called? | Anticubital Fossa or AC |
| What three major veins are located in the AC? | Median cubital, cephalic, and basilic |
| Where are the three veins located in the AC? | Median cubital - direct center, cephalic - outside, basilic - inside |
| What artery runs the inside of the arm? | Brachial artery |
| What are sclerosed veins? | Veins that are hard or cord like, caused by disease, inflammation, chemo, and repeated VP usage |
| What are tortuous veins? | winding, twisted veins |
| Where do you not draw blood from? | IV sites, side of mastectomy, PICC lines, burns and scars, inside wrist, arteries, artificial fistula site, |
| When tissue and blood has surrounded the vein during VP, what is it called? | Hematoma |
| if a tourniquet is left on longer than 2 minutes, or within 1 in of the site, what occurs? | Hemoconcentration |
| inflammation of a vein due to excessive VP use is called | phlebitis |
| What is petechia? | Tiny red dots under the skin |
| a blood clot due to insufficient pressure post VP is called | thrombus |
| inflammation of a vein w/ formation of a clot is called | thrombophlebitis |
| What is septicemia? | A blood infection caused by germs |
| What is fasting and the recommended time? | Not eating or drinking except water, 8-12 hours |
| Accumulation of fluid in the tissues is called | Edema |
| What is a permanent surgical connection between a artery and vein that cannot be used for VP? | Fistula |
| What special handling does an arterial blood gas require? (ABG) | Chilled after collection |
| What is the proper flow of blood through the heart starting with the superior/inferior vena cava? | SVC/IVC - right atrium - tricuspid valve - right ventricle- pulmonic valve - pulmonary artery - lungs - pulmonary veins - left atrium - mitral valve - left ventricle - aortic valve - aorta - body |
| What are the receiving chambers of the heart? | Right and left atrium |
| What are sending chambers of the heart? | Right and left ventricles |
| Where does blood become oxygenated? | In the lungs |
| Where does blood become deoxygenated? | Transfer between arterioles and venules in the capillary beds |
| What body part is associated with BUN (blood urea nitrogen)? | Kidneys |
| What body part is troponin associated with? | The heart |
| What does ESR stand for? | Erythrocyte sedimentation rate |
| How many blood vessels are there? What are they? | 8 - Aorta, arteries, arterioles, capillaries, venules, veins, SVC/IVC |
| What is fibrinolysis? | The breakdown of a blood clot |
| What are 9 complications that can be caused during routine VP? | Hematoma, hemoconcentration, phlebitis, petechia, thrombus, thrombophlebitis, septicemia, trauma, edema |
| What is a group of tests ordered by a physician called? | Panel or profile |
| What do you do when a personal has an external hemmorhage? | Apply pressure and elevate the wound |
| What is the definition of shock? | Insufficient blood flow to the heart |
| What is medical asepsis? | The destruction of pathogenic microorganisms |
| What is used for disinfection? | 1:10 bleach solution made daily |
| What is negligence? | Failure to exercise the standard of care that is expected |
| What is it called if you touch a patient without consent? | Battery |
| The difference between assault and battery? | Assault is the threat of violence, battery is the act of violence |
| What is the reason for a 2 hour postprandial glucose? | To test for diabetes melitus |
| What does OGTT stand for? | Oral glucose tolerance test |
| What are you testing for with a 3 hour OGTT and a 5 hour OGTT? | Hyperglycemia (3) and Hypoglycemia (5) |
| Why is a PKU done on infants? (heel stick dot paper) | To detect phenylketonuria which causes MR and brain damage |
| When is a PKU performed? | 1-2 days after the baby is born |
| What do you do with a light sensetive test? | Cover it, or obtain it in a gold light sensitive tube. |
| Whats the most common light sensitive test? | Bilirubin |
| Why is an infants foot warmed before the heel stick? | To increase blood flow |
| Butterfly is another name for _____ | Winged infusion set |
| What is the destruction of red blood cells | Hemolysis |
| When should you recap a needle? | NEVER |
| What is the most common cause of blood culture contamination? | Improper site preparation |
| Peak and trough are used for? | Drug monitoring |
| Nosocomial infections are | infections obtained in a healthcare setting |
| What is the contraction/relaxation of the heart called? | systole/diastole |
| At what degree do you insert a needle for regular VP? | 30 degrees for straight stick, 15-30 for butterfly |
| Should a tourniquet be applied as tight as possible? | No, only reasonably tight enough |
| What is used to cover the puncture when VP is finished? | gauze and Band-Aid or coban or medical tape |
| What are warfarin, heparin, and aspirin? | Blood thinners |
| Why should a patient NOT pump their fist during venipuncture? | It may cause a bad sample, hemolysis, hematoma or trauma |
| What is a common test that is chilled? | Ammonia |
| Should a specimen be indicated to have been collected by capillary puncture? | Yes, because normal ranges may be slightly different than when collected by VP |
| What is a urine C&S ordered for? | Determination for UTI |
| Why should a CBC not be collected from a screaming infant? | Because their WBC may be elevated |
| What is basal state? | early morning, usually 8-12 hours after eating |
| When performing capillary punctures, why are EDTA microtainers obtained first? | To minimize likelihood of clotted specimens |
| What is is the most important test for proper patient identification? | Type cross and match |
| If there is an IV in both arms, where do you draw from? Are there special requirements? | Below the IV after it has been off for 2 minutes |
| What is the most critical mistake a phlebotomist can take? | Misidentifying a patient |
| What can happen if you invert a specimen vigorously? | It may hemolyze |
| Name the parts of a needle | Bevel, lumen, shaft, safety device, threaded hub, rubber sleeve |
| What determines needle size (gauge) | the diameter of the lumen |
| Why is an Hcg test typically performed in the morning? | First morning urine is more concentrated |
| Mucus or phlegm from the lungs is called | sputum |
| blood type is determined by the presence or absence of what? | Antigens |
| What tube cannot be obtained through capillary puncture? | Light blue-coagulation |
| Can you draw from an unconscious patient? A sleeping patient? Why? | Unconscious yes because it is assumed they would give consent. Asleep no. |
| If a nonblood specimen is obtained, what additional information should be noted? | Specimen type and source |
| Is a student required to inform the patient they are a student? | Yes, always |
| What is the standard needle for VP? | 21 g straight stick |
| What is homeostasis? | The bodies ability to maintain equilibrium |
| What is hemostasis? | The stopping of blood - blood clotting |
| What is the first step for a phlebotomist if an accidental needlestick occurs? | Flush the area with warm water and soap for at least 15 minutes |
| What test requires documentation of chain of custody? | Drug screen |
| What organization develops the standards for specimen handling and processing? | CLSI - clinical laboratory standards institute |
| What is the purpose of wiping the first drop of blood during a capillary puncture? | The first drop contains tissue fluid |
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