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NHA Phlebotomy 2012

National Healthcare Association's Phlebotomy Certification Study Guide 2012

What are the 2 types of ciruclation in the heart? 1. Pulmonary Circulation 2. Systemic Circulation
What does Pulmonary Circulation do? Pulmonary Circulation carries DEOXYGENATED blood from the Right Ventricle to the lungs.
What does Systemic Circulation do? Systemic Circulation carries OXYGENATED blood from the Left Ventricle throughout the body.
What are the 2 RIGHT valves of the heart? 1. Tricuspid Valve: atrioventricular valve 2. Pulmonic Valve: semi-lunar valve
What are the 2 LEFT valves of the heart? 1. Mitral Valve: atrioventricular valve 2. Aortic Valve: semi-lunar valve
What are the 3 layers of the heart? 1. Endocardium 2. Myocardium 3. Epicardium
What are the 8 blood vessels? 1. Aorta 2. Arteries 3. Arterioles 4. Capillaries 5. Venules 6. Veins 7. Superior Vena Cava 8. Inferior Vena Cava
How many liters of blood are in the average adult body? 5-6 liters
Plasma is the ________________ portion of blood. liquid
Formed Elements is the ___________ portion of blood. cellular portion
What does the formed elements (celluar portion of blood) consist of? erythrocytes, leukocytes, thrombocytes
What is the lifespan for Erythrocytes? 120 Days
What are the 5 leukocytes (white blood cells)? 1. Neutrophils 2. Lymphocytes 3. Monocytes 4. Eosinophils 5. Basophils
What is another name for Leukocytes? White Blood Cells
Define Hemostasis. The process by which the blood vessels are repiared after injury.
What are the 4 stages of Hemostasis? 1. Vascular Stage 2. Platelet Phase 3. Coagulation Phase 4. Fibrinolysis
Explain the Vascular Phase of Hemostasis. 1st step in Hemostasis. Injury to blood vessels, causing it to constrict and slowing the blood flow.
Explain the Platelet Phase of Hemostasis. 2nd step in Hemostasis. Platelets adhere to injured endothelial lining. This forms aggregation (temporary platelet plug).
Define Aggregation. A temporary platelet plug formed during the platelet phase of hemostasis.
Explain the Coagulation Phase of Hemostasis. 3rd Step in Hemostasis. Converts temporary platelet plug into a stabin fibrin clot.
Explain Fibrinolysis in Hemostasis. 4th Step in Hemostasis. Breakdown and removal of the stabin fibrin clot.
What does APTT stand for? Activated Partial Thromboplastin Time
What is APTT used to monitor? APTT montiors Heparin Therapy and intrinsic pathways.
What does PT stand for? Prothrombin Time
What is PT used to monitor? PT monitors Coumadin Therapy, as well as extrinsic pathways.
What are the 3 major beins located in the antecubital fossa that are acceptable to use for a VP? 1. Median Cubital Vein 2. Cephalic Vein 3. Basilic Vein
Explain the Median Cubital Vein. Vein of choice for a VP. A large vein that tends not to move.
Explain the Cephalic Vein. 2nd vein of choice for a VP. This vein has tendency to move. It is often the only vein that can be palpated in an obese patient.
Explain the Basilic Vein. 3rd vein of choice for a VP. Tends to move.
What are 3 unsuitable veins for a VP? 1. Sclerosed Veins 2. Thrombotic Veins 3. Tortuous Veins
Define Hematoma. Blood accumlates in the tissue surrounding the vein. Caused by either the needle going through the vein or insufficient pressure being applied.
What are 2 causes of a Hematoma? 1. Insufficient pressure applied to the site. 2. Needle going through the vein
Define Hemoconcentration. Increase of proportion of plasma due to tourniquet being left on too long.
What can cause Hemoconcentration? The tourniquet being left on too long.
What is the longest a tourniquet should be left on? 2 minutes
Define Phlebitis. Inflammation of a vein due to repeated VP.
What can cause Phlebitis? Repeated VP to a site
Define Petechiae. Tiny, non-raised red spots that appear on/around the site due to a tournqiuet being left on too long and capillaries burst.
What can cause Petechiae. Tourniquet being left on too long and capillaries burst
Define Thrombus. A blood clot, usually consequence of insufficient pressure after a needle is withdrawn.
What can cause Thrombus. Insufficient pressure after a needle is withdrawn.
Define Thrombophlebitis. Inflammation of a vein with formation of a clot.
Define Septicemia. Systemic infection associated with the presence of a pathogenic organism introduced during VP.
Define Trauma. An injury to underlying tissues cause by probing the needle.
What can cause trauma. Probing the needle at the site.
Define Edema. Fluid retention in the tissue or inflammation.
Name 9 complications that can be caused by a VP. 1. Hematoma 2. Hemoconcentration 3. Phlebitis 4. Petechiae 5. Thrombus 6. Thrombophlebitis 7. Septicemia 8. Trauma 9. Edema
How far should you puncture when doing a capillary stick? No deeper then 2.0mm
Where to you puncture on the heel? Medial and lateral of the plantar surface of the heel.
What is the order of draw? Yellow, Lt. Blue, Red, Tiger Top, Green, Lavender, Gray
#1 in order of draw. Yellow Tube
#2 in order of draw. Lt. Blue Tube
#3 in order of draw. Red Tube
#4 in order of draw. Tiger Top Tube (Red/Gray)
#5 in order of draw. Green Tube
#6 in order of draw. Lavender Tube
#7 in order of draw. Gray Tube
Name the 3 parts of the chemistry section. 1. Electrophoresis 2. Toxicology 3. Immunochemistry
Explain Electrophoresis in relation to chemistry section. Analyzes chemical components of blood.
Explain Toxicology in relation to chemistry section. Analyzes plasma levels of drugs and poisons in the blood.
Explain Immunochemistry in relation to chemistry section. Detects and measures substances such as hormones, enzymes, and drugs.
Define Profile. A group of tests ordered by a physician.
Explain the Blood Bank Section. Where blood is collected, stored and prepared for blood transfusion.
Explain the Serology (immunology) section. Evaluates patients immune response through the production of antibodies.
Explain the Microbiology section. Detection of pathogenic microorgranisms in patient samples.
Explain the Urinalysis section. Detects infection of the kidney and urinary tract.
Explain the Hematology section. Formed elements of the blood are studied. Whole blood is the most common test.
What is the most common test of the Hematology section? Whole blood
Explain what to do for an External Hemorrage. Elevate the affected part above heart level and apply direct pressure to the wound.
Define Shock. Insufficient return of blood flow to the heart.
Define Agents in relation to the chain of infection. Infectious microorganisms that can be classified as viruses, bacteria, fungi and parasites.
Define Portal of Exit in relation to the chain of infection. How the infectious agent leaves it's reservoir.
Define Mode of Transmission in relation to the chain of infection. Specific ways in which the microorganisms travel.
Define Portal of Entry in relation to the chain of infection. What allows the infectious agent to access the susceptible host.
Define Susceptible Host in relation to the chain of infection. The person/host who is susceptible to the agent and is not resistant or immune.
What are the 5 steps to the chain of infection? 1. Agent 2. Portal of Exit 3. Mode of Transmission 4. Portal of Entry 5. Susceptible Host
Define Medical Asepsis. Destruction of pathogenic microogranisms after they leave the body.
What is the solution fraction for disinfection? 1:10 bleach to water
Define Negligence. Failure to exercise the standard of car that a responsible person would give.
What are the 4 D's of negligence? 1. Duty of care 2. Derelict: Breach of duty of care 3. Direct Cause: legally recognizable injury occurs as a result of breach of duty 4. Damage: wrongful activity must have cause the injury
Define Tort. Wrongful act that results in injury to a person.
What is it called if you touch a patient before they give you full consent? Battery
Define Invasion of Privacy. Release of medical records without the patients permisson.
Define Defamation of character. Injury to another persons reputation or name.
Explain Fasting Specimens. Collection of blood when the patient is in basil state - refrained from exercise, food, or drink for 12 hrs prior to drawing.
What does a 2 hour postsprandial test evaluate? Diabetes Mellitus
What does OGTT stand for? Oral Glucose Tolerance Test
What is an OGTT used to diagnose? Diabetes Mellitus
When is an OGTT scheduled to start? 0700-0900
What are you testing for at the 3 hr OGTT? Hyperglycemia
What are you testing for at the 5 hr OGTT? Hypoglycemia
What is the purpose of Therapeutic Drug Monitoring? Monitor blood levels of certain medications.
What is the purpose of Blood Cultures? Detect presence of microorganisms in a patient's blood.
Explain PKU. Test that is ordered on infants to detect phenylketonuria - causes MR and brain damage
Explain Cold Aggulations. Blood collected in red tubes that have been pre-warmed to 37 degrees celsius for 30 min.
Explain Chilled Specimens. Specimens that must be chilled ASAP in crushed ice or ice/water mixture.
What type of tests would need to be chilled specimens? Arterial Blood Gasses & Lactic Acids
Explain Light Sensative Specimens? Protected from light - wrapped in aluminum foil.
What is the additive in the Tiger Top Tube (red/gray)? Thixotropic gel for serum separation.
What is the additive in a Gray Tube? Antiglycolytic Agent: Sodium Fluoride, Lithium Iodoacetate Anticoagulant: Potassium Oxalate
What is the additive in a Red Tube? Nothing - it is a plain tube
What is the additive in a Lt. Blue Tube? Sodium Citrate
What is the additive in a Yellow Tube? Sodium Polyanetholesulfonate (SPS)
What is the additive in a Green Tube? Heparin combined with sodium, lithium or ammonium ion.
What additive is in a Lavender Tube? EDTA
What is the purpose of the Thixotropic Gel (Serum Separator) in a Tiger Top Tube? Form a barrier between the serum and fibrin clot - seperate the serum.
Common Tests for a Red Tube. Serum Chemistry Tests. Serology Tests. Blood Bank.
Common Tests for a Tiger Top Tube. Most chemistry tests.
Common Tests for a Gray Tube. Fasting Blood Sugar (FBS). Glucose Tolerance Test (GTT). Blood Alcohol Levels (BAC). Lactic Acid Measurements.
Common Tests for a Green Tube. Chemistry Screens. STAT Electrolytes.
Common Tests for a Lavender Tube. CBC (included RBC, WBC, & Platelet Count). WBC Differenetial Count. Hemoglobin & Hematocrit Determinations. ESR. Sickle Cell Screening.
Common Tests for a Lt. Blue Tube. Prothrombin Time (PTT). Coumadin Therapy. Activated Partial Thromboplastin Time (APTT). Factor Assays. Bleeding Time (BT).
What does Post-Parandaial mean? After a Meal
Microorgaisms that cause disease are _______________. pathogenic
What is the antiglycolytic agent that maintains glucose stability for 3 days? Sodium Fluoride
Which tests requires the specimen to be protect from light prior to testing? Bilirubin
What is the purpose of warming the site prior to a dermal puncture? Increases the blood flow.
Arterial Blood is the best sample for determination of ____________ ______ and _____________ ______________. Blood pH. Blood Gases.
What is the most common complication from phlebotomy? Hematoma
"Butterfly" is another name for a ____________ _____________ __________. Winged Infusion Set.
How long should it take for a Red Top Tube to clot? 30-60 minutes
Define Hemolysis. Destruction of Red Blood Cells
Red Blood Cells are also called _________________. Erythrocytes
Should you recap a needle? NO
The most common cause of blood culture contamination is ____________ _____________ ____________. Improper Skin Preparation
What is the vein that is most easily palpated in an obese patient? Cephalic
Peak Level and Trough Level are used in ____________ ___________ ______________. Therapeutic Drug Monitoring
Nosocomial Infections are infections contracted in a __________ ________ __________. Health Care Setting
Contraction of the heart is ___________. Systole
Relaxation of the heart is ____________. Diastole
What is the function of a Leukocyte? To provide the body protection against infection.
What do Erythrocytes contain? Hemoglobin - the 02 carrying protein
Created by: jmccart
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