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Phlebotomy
Possible Quiz 3 Questions
| Question | Answer |
|---|---|
| If a patient is asked to fast, what contents levels are they looking for? | Glucose, Cholesterol, lipids |
| What is the butterfly Procedure (AKA winged infusion ) used for | small veins |
| When do you use hand veins | - Extensive bruising (hematomas) in the antecubital area -Inability to "feel" a vein |
| If you ever have to unplug an IV how long should you wait to start procedure? | 2 minutes |
| Pediatric cases require? | Skill. compassion confidence |
| How many attempts can be done for a Pediatric Venipuncture | No more then 2 attempts |
| Patient who is a child | Introduce yourself. Be warm and friendly, establish eye conta |
| How do you correctly identify a pediatric patient? | Reference two patient Identifiers (parent /guardian) or Patient name and date of Birth |
| Ask parent how cooperative the child might be is an example of? | A patient who is a child |
| Do you only explain the procedure to the patient and not the child? | No. Explain the procedure to the child using simple terms. Also Explain to the child that its going to be a little pinch |
| How else can you explain to a child about the procedure | Explain that if the child holds still, you will more likely be successful. |
| What punture method should be used for pediatric patients | Dermal puncture if posible |
| What are possible diseases for Pediatric patients | - PKU (phenylketonuria) - Hypothyroidism - Galactosemia - Cystic Fibrosis |
| What are Geriatric Patients | Elderly |
| What kind of patient care should be provided to Geriatric patients | - Use small needles or winged blood collection sets - Place tourniquets over clothes to prevent bruising - Perform dermal puncture if possible |
| Special Handling Procedures (Warmed specimens (cold agglutinins)) | - Warmed tubes - Portable heat blocks |
| Special Handling Procedures (Light-sensitive specimens) | - Bilirubin, beta carotene, vitamins A, B6, and B12, folate, and porphyrins - Amber containers - Foil wrapping |
| If you are unable to draw blood twice, what do you do? | Call for another phlebotomist |
| Considerations prior to collection of Capillary punctures | Age of the patient Level of understanding of the patient Communication with the patient To restrain or not restrain the patient Never tell the procedure will not hurt |
| Patients for Whom Capillary Puncture May be Considered | - Children 2 years or younger - Geriatric patients Obese patients |
| When NOT to use Capillary | -blood cultures, -erythrocyte sedimentation rate (ESR), coagulation tests, -and tests requiring larger volumes of plasma or serum. |
| (Puncture Devices) Width: No longer than? | 2.5 millimeters |
| (Puncture Devices) Depths | Maximum depth: 2.0 millimeters for heel sticks |
| Heel Sticks MAXIMUM LENGTH IS | 2.0 millimeters |
| Can any larger needles that 2.0 millimeter stick harm an infant | Yes |
| Steps 1-5 for capillary puncture | - Receive, review requisition form - Greet and identify patient - Explain Procedure obtain consent - Verify collection requirement -Sanitize hands put on gloves |
| Step 6: Position the Patient | - arm supported on firm surface, hand extended & palm up |
| Step 7: Select the Puncture Site | If you hit the heel bone you can cause permanent damage to a patient (serious damage to child |
| Where are dermal punctures normally located? | Dermal puncture performed on the palmar surface near the fleshy center of the distal perpendicular to the whorls. |
| What is the spot on a heel of a baby you want to avoid at all cost | Calcaneus (heel bone |
| Dermal puncture in infants is performed on the heel of an infant where | medial and lateral borders only on the posterior of the foot |
| Step 8: Warm the Site if Applicable | increases blood flow up to sevenfold |
| Step 9: Clean and Air-Dry Site | Cleanse site with an antiseptic (70% isopropyl alcohol) |
| Step 10: Prepare Equipment | Open packages in view of patient |
| Step 11: Grasp the Finger or Heel Firmly | - Hold lancet between thumb and index fingers of your dominant hand - Fingersticks: Grasp patient’s middle or ring finger between your non dominant thumb and index finger - Heelsticks: Grasp foot gently with non dominant hand |
| Step 12: | Position Lancet, Puncture the Site, & Discard Lancet |
| Step 13: | Lower Finger or Heel, & Apply Gentle Pressure Until Blood Drop Forms |
| Step 14:Wipe Away First Blood Drop | First drop is typically contaminated with tissue fluid and may contain alcohol residue |
| where do you perform venipuncture on a newborn | heel of the foot |
| How are you trying to get blood flow with a dermal puncture | perpendicular to the middle of the finger |
| Test that are done in all 50 states except | Jaundice test |
| Can you put the scoop of a dermal puncture collection tube on the skin | No, it might get infected |
| What tubes would you regularly see in a hematology lab | lavender/purple tops |
| Hemostasis | Process of blood clot formation after injury, and Lysis of the clot following injury repair |
| Coagulation Key Players | - Blood vessels - Platelets - Coagulation factors |
| Four Stages of Hemostasis | - Vascular phase - Platelet phase - Coagulation phase - Fibrinolysis |
| Venous blood is... | - Deoxygenated blood that flows from tiny capillary blood vessels within the tissues into progressively larger veins to the right side of the heart. |
| capillary sample | - a blood sample collected by pricking the skin |
| Vascular Phase 1st phase of hemostasis | Rupture of a vein or artery causes an immediate vascular or contraction of the smooth muscle lining the vessel |
| Platelet Phase 2nd phase of hemostasis | Aggregating platelets become activated, releasing factors that promote fibrin accumulation in the next phase |
| What is the name of the combination of vascular phase and the platelet phase? | Primary hemostasis |
| Coagulation Phase 3rd phase of Coagulation | Coagulation is a cascade of enzymes and factors ultimately resulting in a blood clot |
| This phase is initiated by release of tissue factor (extrinsic pathway); other plasma coagulation factors contact the materials exposed when the blood vessel is damaged (intrinsic pathway) | Coagulation |
| Stages of Coagulation | Stage 1: Primary hemostasis Stage 2: Secondary hemostasis Stage 3: Stabilization Stage 4: Fibrinolysis |
| White Blood cells function | Immune system cells |
| Red blood cell function | oxygen and carbon dioxide, transport glucose, fats, and proteins |
| What moves waste from the tissues to the liver and kidneys? | Red blood cells |
| Normocytic | - use the nucleus of a small lymphocyte as a reference subject - The normocyte is about the area of that nucleus. |
| Lymphocyte | - Normal values: 20-40% -Function: antigen/antibody |
| Eosinophil | Function: phagocytic, increase with parasitic infections and allergic reactions |
| Basophil | Function: mediators in inflammatory response, especially in hypersensitivity reactions |
| Platelets are also known as? | Thrombocytes |
| Platelets (Thrombocytes | Function to maintain capillary integrity and aid in hemostasis |
| 2 different pathways for coagulation | - Extrinsic - Intrinsic |
| Coagulation Pathways: Extrinsic | Outside bloodstream - Initiates the coagulation process |
| Coagulation Pathways: Intrinsic | Inside bloodstream - Produces thrombin on the surface of activated platelets |
| What does CBC stand for | Complete blood count |
| Fibrinolysis | Dissolving of clot |
Created by:
ChristianAwuah1
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