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Phlebotomy Session 7

56% of lab errors occur during what phase During the Pre-Analytical Phase of testing
What is the most potentially fatal pre-analytical error Improper patient identification
An impatient should be asked to state his/her name, address, DOB and or unique ID number according to whos standards CLSI (Clinical Laboratory Standards Institute)
Fasting specimens should be collected around how many hours? 10-12 hours of complete fasting
How long do you pre-warm a site for capillary collection 3-5minutes (can cause increased blood flow to the area SEVENFOLD
The ORDER OF DRAW is suggested by CLSI
What happens if you under-fill a EDTA TUBE? you result with RBC SHRINKAGE
What happens if you under-fill blue top tubes You result with ELEVATED PT
What two analytes must be protected from the light? -BILIRUBIN -CAROTENE
aPTT should be tested within...? 4 HOURS
PT can remain stable for up to...? 48 HOURS (at room temperature)
Blood cultures are essential in the diagnosis of .. ENDOCARDITIS
Why are blood cultures done? To detect the presence of bacteria or yeast
What happens if a patient comes back with a positive blood culture? Physician might put the patient on broad-spectrum antibiotics, OFTEN I.V.
Septicemia may cause...? Fever, chills, shock, tachycardia, hypertension
50% of all positive blood cultures may be positive due to the process of CONTAMINANTS
Intravascular Organisms come from infected organs, cavities, fluids (CSF, synovial fluid, pericardial fluid), untreated superficial wounds, abscesses, U.T.I., or Respiratory infections
Extravascular Vascualr access devides(atrial lines, central venous catheters, etc.) urinary catheters, needles, etc
Define TRANSIENT BACTEREMIA Bacteria that exist momentarily in the bloodstream and then are engulfed by the cellular immune response
High risk contamination rates are an example of Vascular access devices, arterial lines, central venous catheters, and heparin locks
Define edema Swelling accumuation of fluid in the intercellular spaces of the body (FLUID IS INTRACELLULAR)
Hematoma (Bruise) ..Caused by the leakage of blood from veins and capillaries that collects the tissues (Blood accumulation)
Masectomies are usually accompanied by ... REMOVAL OF LYMPH NODES (high susceptibility to infections)
Sclerosed Veins Hardened Veins...due to inflammation, Disease, Repeated punctures (may be difficult to push the needle though)
If both arms have an IV, obtain the blood specimen ....? BELOW the insertion point ofthe IV LINE
PKU tests are done to..? rule out a hereditary metabolic disorder
If BILIRUBIN levels are too high babies are placed on...? UV LIGHT
EACH newborn is kept in an ISOLETTE
Newborns are extremely susceptible to ...? INFECTIONS
Always remove supplies from the isolette, ESPECIALLY ..? LANCETS
For children under two, ______puncture is the method of choice DERMAL
Heel Punctures are considered for Children under 1year/20pounds
Finger punctures are considered for Children from 1-2years
Children over 2 may have what type of puncture VENIPUNCTURE
Most elderly develop what type of anemia due to continuous phlebotomy LATROGENIC ANEMIA
EPA (environmental protective agency) recommends noise level in hospitals not to exceed ...? 40dB
Dialysis is performed on patients with END STAGE RENAL DISEASE
What happens during dialysis Waste products are removed from the blood
Venipunctures are prohibited from dialysis patients therefore you must perform..? a FINGER STICK
How many identifiers is recommended for an outpatient? 2 Identifiers
Its against "______regulations" to palpate a vein without gloves OSHA
Tourniquet must be applied how many inches apart from the antecubital fossa 3-4inches (restricts bloods flow, causes veins to distend)
Why should you allow chlorhexidine to dry completely before beginning a venipuncture To prevent Hemolysis
You should insert a needle at what angle 15-30 Degree angle (BEVEL UP)
All tubes with additives must be properly mixed as quickly as possible to prevent...? PLATELET CLUMPING AND COAGULATION
Examples of special handeling regarding "KEPT COLD SPECIMEN" include: Blood gases..ammonia
Examples of special handeling regarding "KEPT WARM SPECIMEN" include: Cold Agglutinins
Examples of special handeling regarding "KEPT IN THE DARK SPECIMEN" include Bilirubin...Carotene
What are some examples of Adverse Reaction Syncope...Nausea...Vomiting
If bleeding continues for more than 5minutes call PHYSICIAN
Created by: moralesm05



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