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FINAL
MLT 118: PHLEBOTOMY AND SPECIMEN HANDLING
| Question | Answer |
|---|---|
| What effect will false positives, such as an improper cleansing prior to urine excretion, have on the patient sample? | it will result in the patient to be treated for conditions that they don't have |
| A false negative result will result in | delayed treatment, which can be fatal |
| Define fasting and how long is a patient supposed to fast? | it is testing done in the morning after an overnight fast, where the patient has no food for 10-12hrs |
| Which tests often require fasting? | glucose testing and triglyceride testing |
| Why would a patient's posture affect cortisol testing results? | a patient that moves from lying to sitting will increase BP, which would cause a spike in hormones |
| What tests would be affected by vigorous exercise (march anemia)? List some examples of substances that will increase | CPK, LDH, AST (due to increase in muscle/heart enzymes) bilirubin, creatinine, uric acid production |
| What circadian testing would require timed specimen to assess heme production in sleep? | Iron levels |
| Why do we assess circadian tests with timed specimens? | the analytes change within 24hrs |
| Which timed specimen is done to assess a patient's production an utilization of insulin? | post-prandial |
| When are Peak and Through tests conducted and why? | 30-60mins after drug dosage; done to determine whether or not a drug was toxic or therapeutic |
| When smaller gauge needles be utilized for a winged collection? | for fragile, superficial hand veins; to exert less pressure to burst the veins |
| What is the cleansing process of a blood culture? | OPTION 1: alcohol to remove dirt/oil, betadine to kill bacteria OPTION 2: duo iodine swab OPTION 3: Chlorohexidine |
| What is the order of draw for blood cultures? | Aerobic (allows the initial air to get in) Anaerobic (no exposure to air) |
| What is the dilution of blood to bacteria to grow bacteria? | 1:10 to 1:20 |
| Why do we do separate venipunctures from different sites? | determines whether or not an infection is systemic or due to contamination |
| What is the most common draw regimen for blood cultures? | 2 set blood cultures, drawn 30mins apart |
| Why do we need a sodium fluoride gray glass tube for legal blood draws? | the sodium fluoride prevents glycolysis to assess the true alcohol presence in a patient |
| Instead of alcohol wipes, what should we use to clean the site prior to a legal blood draw? | b2K or povidone iodine |
| What is the purpose of GTT? | assess a patient's glucose metabolism over time to use as diagnostic testing for diabetes |
| Potassium oxalate is an anticoagulant used in | gray stopper tubes |
| If an anaerobic bacteria is suspected to be causing a UTI, what form of urine collection would we use? | supra-pubic aspiration |
| What is the usage of boric acid for blood culture? | maintains colony counts in urine specimens |
| What differentiates boric acid urine vacutainers from sodium fluoride grey top? | urine vacutainers have yellow bands on them |
| SPS is most common anticoagulant used in | micro labs |
| Heparin is an anticoagulant used mostly for | viral cultures |
| What testing would be protected from light via amber-tinted aliquot holders or wrapped foil? | Bilirubin, Vitamin C/E/K |
| What testing requires specimen to be immersed in ice and water immediately after the draw? | ammonia, lactic acid, pH/blood gases |
| Cryoglobulin and cold agglutinins require warming of specimen to | maintain body temperature |
| For capillary sticks, what is the primary site for people over the age of two? | finger; middle |
| True or false: capillary blood is mainly comprised of arterial blood with a mix of venous blood | true |
| What are limitations of capillary blood draws? | - they are not aligned with venous blood due to tissue fluid that dilutes different analytes - increase pain for patient - quality of the sample can be easily comprimised |
| Are straight lancets without a safety deviced used for lab testing? | no! point-of-care testing only |
| What is the average depth of a spring-loaded lancet? Why can the depth not exceed 2mm, especially for newborns? | 1-1.5mm; it can damage nerves or bones |
| How long should you keep a heel warmer own for an infant? | 3-5 minutes |
| Why do we use alcohol instead of iodine for cleansing capillary sites? | iodine will contaminate the area by artificially inflating analytes |
| When doing a fingerstick, position the lancet (blank) to the lines of the fingerprint | perpendicular |
| Why would you wipe away the first drop of blood with gauze after puncturing the capillary site? | first drop contains interstitial fluid that would dilute the specimen |
| What are the clinical duties of a phlebotomist? | - pt identification/labeling - assessment of bleeding post procedure - assess pain level prior to and after the venipuncture - specimen collection in correct containers |
| What are the technical duties of a phlebotomist? | - maintain dexterity - assist in aliquoting, processing speicmen |
| What are the clerical duties of a phlebotomist? | - print/file lab requisitions - answer inquires and direct further explanation to the appropriate lab/medical staff |
| What is the goal of safety and infection control for phlebotomists? | reduce risk by limiting/reducing hazards in the workplace according to OSHA guidelines |
| Name some examples of common HAI? | C-diff, MRSA, norovirus, bloodborne pathogens like HBV/HCV |
| When disposing of needles into the sharps container, at which point should we empty the sharps container? | 2/3 full/70% full |
| Describe "Universal Precautions" | treating every patient specimen we encounter as if it will cause an infection |
| True or False: Systemic Circulation carries deoxygenated blood to organs and extremities | False; oxygenated. deoxygenated blood=pulmonary circulation |
| What part of the heart is responsible for controlling blood flow? | Pulmonary valves |
| Describe blood flow in the heart | Deoxygenated blood-right atrium, right ventricle, pulmonary arteries Oxygenated blood-pulmonary veins, left atrium, left ventricle |
| Arteries of the blood vessel carry (blank) blood away from the heart | oxygenated |
| Veins contain (blank) to prevent the back flow of blood back into the heart | valves |
| True or False: Vena Cava is the largest vein | true |
| Capillaries contain what type(s) of blood for gas exchange? | oxy. and deoxy. blood |
| Why would arteries have a thicker muscle layer? | to withstand the force of pumping heart from the blood |
| Why is the median cubital the primary selected site for venipunctures? | it is the most stable vein and superficial |
| Why would the basilic vein be the least selected site for venipuncture? | it has less tissue and is closer to nerves |
| Why would blood draws from the feet/ankle require physician permission, especially for diabetic patients? | there is a risk of tissue necrosis |
| Describe Serum | the liquid portion of blood present after clotting. it is created in vitro, and it contains no clotting factors |
| Describe Plasma | the liquid portion of blood in vivo/in vitro with anticoagulant added. it contains unconsumed clotting factors and preserves cellular elements; primarily made of water |
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