Question | Answer |
osha? | occupational saftey and health administrations |
what vaccination does OSHA require all health care personnel get? | OSHA requires that all health care personnel exposed to blood and other bodily fluids must recieve a vaccination agaisnt Hepatitis B. |
Pulmonary Edema | fluid in the lungs. |
How much blood can a person donate in a session. | 500ML |
Patients have the right to what? | under the Patients Bill of Rights they always have the option to decline medical treatment and to know what tests are being performed on them. |
what can you NOT give a patient? | Results and a diagnoses. Because you are not medically qualified to do so. |
Negligence is? | failure to give appropriate care. DONT BE NEGLIGENT! |
PPe stands for | Personal Protective Equipment. |
One of the most important practices is? | Hand washing is one of the most important (and easiest) practices used to prevent transmission of blood borne pathogens. |
Needles should never be | Recapped. |
Sharps containers must be what? | Puncture-resistant, leak proof on the sides and bottom and must be labeled or color-coded. |
IN infection control, WHO is the agent? | Person |
In infection control, WHAT is the portal of exit? | Needle. |
in infection control WHAT can we control? | Mode of Transmission OR exit of infection. |
In infection control WHAT is a portal of entry? | Mucus membrane |
In infection control WHO is a susceptile host? | Person |
Mode of Transmission | Specific whats in which microorganisms travel from the reservoir to the susceptible host. |
ALLERGIC reaction* | latex sensitivity is a physical reaction to a health worker but a allergic reaction to the pt. |
types of hazards | biologic, chemical, physical, fire and explosive and sharps |
biologic | infectious agent that can cause bacterial, viral, fungal, and parasitic infections. |
chemical | toxin, carcinogenic, caustic |
fire and explosive | Bunsen burners oxygen and chemicals that can cause burns or dismemberments |
sharps | needle, lancets, broken glass anything that can cut, pierce, and or puncture causing blood borne pathogens exposure |
physical | wet floors, heavy lifting cause falls, sprains and strains. |
five main types or mode of transmission | contact, droplet, airborne, common vehicle and vector borne. |
Contact | direct and indirect (fomite) |
droplet | cold, flu, and sneezing |
airborne | viral- breath in |
common vehicle | person, fomite and not hand washing |
vector borne | illness that is transmitted through an invertebrate such as an insect |
mode of infection | the point in the infection chain where we aim at preventing the spread of infectious disease |
standard precautions do what? | infection control method designed to prevent direct contact with blood and other body fluids and tissues by using a barrier of protection and work control practices |
what do we assume all Pts to be? | Patients are presumed to be infective for blood borne pathogens |
standard precautions consists of what? | gloves, face shields, disposal and disinfectants |
medical asepsis | this condition is best defined as " the destruction of pathogenic microorganisms after they leave the body" it also involves environmental hygiene measures such as equipment cleaning and disinfection procedures. |
what are barrier protections? | masks, gloves, face shields, respirator gloves |
how do you remove PPE equipment? | 1st- gloves 2nd- gown 3rd- shields. |
what type of soap should be used? | non-abrasive, antibacterial soap |
what do you do if blood splashes in the eye or mucous membrane? | flush with warm water (hotter the better) for 15 mins report to supervisor asap. |
who cannot be identified in an incident report? | a minor |
bedside manner includes? | introduce yourself, verify pt. explain procedure, small talk, advise them when your ready to poke, and speak to them on a first name basis. |
what phase is best practice? | "pleasant with the pt, professional with the poke" |
if pt has an I.V where do you draw blood? | downstream from the I.V. |
double mastectomy pts should only have blood drawn from what? | hands. |
left mastectomy pts should have blood drawn from what side? | right. |
what is fistula? | artificial connections of veins. |
what is graft? | artificial artery connections of veins. |
sclerosis is? | hard and cord like veins. |
for obese pts what vein is used? | cephalic vein is most likely to be the one you can palpate and draw blood from. |
cephalic means? | head. |
most common complication in phlebotomy | hematoma |
to prevent a hematoma | prevented if pressure is placed on the venipuncture sire until bleeding stops |
if a pt faints what is the 1st thing to do ? | get the needle out of the arm |
vasovagal syncope is | fainting dizziness before, during or after venipuncture |
circulatory system function | is to deliver oxygen, nutrients, hormones and enzymes to the cells. transport cellular waste such as carbon dioxide and urea to the organs where they can be expelled from the body. |
circulatory exchange is done where? | capillary level |
45% of blood is | formed elements |
formed elements | erythrocytes (red blood cells) = 99% of formed elements leukocytes (white blood cells) and thrombocytes (platelets) |
all blood cells originate from | stem cells in the bone marrow |
the heart acts as what | two pumps (right and left sides) |
left and right sides of heart are connected by | two circulations with each pump equipped with two valves the function of which is to maintain a one way flow of blood |
pulmonary circulations | carries deoxygenated blood from the right ventricle to the lunges (alveoli) and return oxygenated blood from the lunges to the left atrium |
oxygenation takes place | at the alveoli - sacks in the lunges |
systemic circulation | carries oxygenated blood from the left ventricle throughout the body |
tricuspid valve | an atrioventricular valve, being situated between the right atrium and the right ventricle |
pulmonic valve | semi lunar valve situated between the right ventricle and the pulmonary artery |
mitral valve | (bicuspid valve) is another atrioventricaular valve, being situated between the left atrium and the left ventricle |
aortic valve | semi lunar valve situated between the left ventricle and the aorta |
how long does it take for a full circulation? | one min |
the average person weighting 155 pds has | app. 5-6 liters of blood in their system |
blood composes of | 7-9% of total body weight of a person |
blood has how much plasma? | 55% is plasma |
plasma is what? | a clear, pale yellow fluid |
what does plasma do | it carries nutrients, lipids, glucose, sodium, magnesium, calcium, potassium, oxygen, carbon dioxide, nitrogen, antibodies as wells as vitamins and hormones ect. |
what is 45% of blood | RBC, WBC and platelets. known as the formed cellular elements. |
how long does your body take to regenerate RBC you lose during donation | 6-8 weeks if you donate the maximum of 500ml |
three layers of the heart | endocardium, myocardium, Epicardium |
Endocardium | the endothelial inner layer lining of the heart |
myocardium | the muscular layer, this is the contractile element of the heart |
Epicardium | the fibrous outer layer of the heart. the coronary arteries, which supply blood to the heart are found in this layer |
blood vessels are | aorta, arteries, arterioles, caplliaries, venules and veins, superior and inferior vena cava |
Erythrocytes | red blood cells (RBC) |
Erythocrytes contain | hemoglobin, the oxygen-carrying protein |
hemoglobin | enters the blood as an immature reticulocyte where in one to two days, it matures into erythrocyte |
how many RBS's per microliter | 4.2 to 6.2 million RBC's per microliter of blood. |
what is the normal lifespan of RBC's | is 120 days |
what is leukocytes function | provide the body protection against infection |
how many WBC's for adults per microliter | 5,000-10,000 |
leukocytosis is what? | an increase in WBC's is seen in the case of infection and leukemia |
Leukopenia is what? | a decrease in WBC's is seen with viral infection or chemotherapy |
how many types of WBC's are in the blood? | 5 |
a differential count does what? | determines the percentage of each type |
neutrophils are what? | phagocytic cells, meaning they engulf and digest bacteria. their number increase in bacterial infection |
neutrophils comprise how much of WBC's population | 40-60 percent of WBC's population |
lymphocytes do what? | their numbers increase in viral infection, they also play a role in immunity |
lymphocytes comprise how much of the WBC population | 20-40 percent of the WBC population |
monocytes do what? | increase in intracellular infection and tuberculosis |
monocytes comprise how much of the WBC population? | 3-8 percent and are the largest WBC's |
Eosinophils do what? | they are active against antibody-labeled foreign molecules |
Eosinophils increase | in allergies, skin infections, and parasite infections |
ensinophils come | first in allergic reactions. during an allergic reaction it would show and increase in Eosinophil count |
Basophils do what | release histamine |
Basophils count for what of the WBC's population | 0-1% in the blood |
thrombocytes are essential for what? | blood coagulation |
thrombocytes are also known as | platelets are small irregularly shaped packets of cytoplasm in bone marrow |
three major veins are located | in the antecubital fossa |
the three major veins are? | median cubital vein, cephalic vein, basilica vein |
1st order of draw | red topper tube |
red top also known as | plain vacuum tube and contains no additive or anticoagulant |
collected blood clots by normal coagulation process is | 30 minutes |
do you need to invert a red tube? | No |
common tests for red tubes are | serum chemistry, serology, blood bank, Lytes |
arterial blood gad (ABG) sample must be run within | 15 minutes of collection |
arterial blood is used to determine | blood gas levels and blood PH. usually collected by a nurse or respitory therapist |
basal state is | when the patient has fasted and not exercised is 12 hours. |
do you note if a patient has not fasted? | yes |
2nd order of draw? | light blue |
light blue has what additive? | sodium citrate different ratios |
light blue tubes must be inverted many times | 5-10 |
light blue tubes are used to test | coagulation determinations on plasma specimens, certain test require chilled specimens, always fill to max fill line |
3rd order of draw color is | tiger top/gold top |
tiger top/gold top have what additive | clot activator- or glass particles fix tropic gel |
blood coagulates with additive in | 15-30 minutes |
4th order of draw | green top, mint top, hash marks on label |
mint green top has what additive | PST-Plasma separator tube |
Green top has what additive | heparin combined with sodium and lithium and ammonium ion |
Hash marked tube has what additive | sodium heparin |
common tests for green tubes are | ammonia carboxyhemoglobin (HCG= human chorionic gonadotropin (hormone) test for pregnancy) STAT lytes |
Lytes are? | Electrolytes- potassium, sodium |
BMP Panel is | Basic, Metobolic, Panel |
A panel is | a group of tests ordered together |
sodium additive tubes test for | lithium |
5th order of draw tube color is | lavender |
lavender tube has what additive? | EDTA- Ethylenediaminetetraacetate |
BMP- Chem 8 tiger/gold tube | Basic Metatbolic panel |
CMP-chem 14 tiger/ gold tube | comprehensive metabolic panel |
Dark purple tube has | 7 ML of EDTA- calcium binding agent |
LT purple tube has | 3.6 ml of EDTA- calcium binding agent |
pink top tubes are used for | blood banks/ transfusion- for blood typing |
lavender top tubes are used for | CBC-complete blood count, CBCAN- complete blood count automatic differential, CBCDN- complete blood count manual differential |
ESR-lavender top tube | Erythrocytes sedimentation rate |
ESR test for | suckle cell screening |
EDTA | inhibits coagulation by binding to calcium in the specimen |
what tube is used for coagulation studies? | light Blue |
tubes must be filled | at least2/3 full |
tubes must be inverted | 8 times |
hematocrit measures | the percentage of the RBC's in a given volume of whole blood |
what test is always given before blood donation? | hematocrit |
1-blood enters the heart | superior and inferior Vena Cava |
2-goes to | Right Atrium |
3-from there to | tricuspid valve |
4-then onto | right ventricle |
5-and now out to the | pulmonary artery and lungs |
6-back into the | pulmonary viens |
7-then onto the | left atrium |
8-moves onto the | Bicuspid valve |
9-down to the | left ventricle |
10-fonall to your hot dob via the | aorta |
veins have | valves |
ABG (arterial Blood Gas) | analyses arterial blood for oxygen, carbon dioxide, and bicarbonate content in addition to blod PH and used to determine the effectiveness or respiration |
Aseptic | the absence of microorganisms or by contrast, something that just discourages the growth of microorgansims is antiseptice |
what are the three preferred veins of the arm for phlebotomy? | cephalic, median cubital, basalic. |
what artery is to be avoided for venipuncture? | brachial |
the integumentary system is | skin hair nails |
the outermost layer of the skin is | epidermis |
the layer that contains the touch receptor | dermis |
the fat layer is called | subcutaneous tissue |
what is the function of the outermost layer | epidermis is dead cells that protect the body. |
wwhat dermal layer regulates body heat? | the subcutaneous fat layer |
which layer holds the capillaries | dermis |
the cardiovascular system comprises | the heart vessels the blood |
what color is plasma | light yellow |
91% of plasma is what | water |
less than 9% of plasma is mostly made up of what | proteins |
the function of albumin is to | provide cells nutrients |
the function of fibrinogen is to | stop bleeding |
the main function of globublins are to provide | immunity |
what are the formed elements of blood | RBCs WBCs and platelets |
the main function of the RBC is to | carry O2 and CO2 |
the white blood cells proved for what | immunity |
platelets are in the blood system to do what | stop bleeding... |
what is a thrombocyte | a platelet |
which cells move through the body on their own | WBCs |
what is a leukocyte | WBC |
what action does a leukocyte use to eliminate an infection | Phagocytosis |
the heart has how many chambers? | 4 |
the top chambers are called | atria |
the bottom chambers are called | ventricles |
the left chambers of the heart pump blood to where | body |
the right chambers of the heart pump blood to where | lungs |
the veins carry blood to where | to the right atria of the heart |
the arteries are responsible for pumping blood | away from the heart |
what vessel carries blood to the lungs? | pulmonary artery |
which vessel carries blood from the lungs to the heart? | pulmonary veins |
the three kinds of blood vessels | veins, arteries, capillaries |
capillaries are made up of only one kind of vessel tissue called | tunica intima |
the blood vessel outer layer is called what | tunica adventia |
the middle layer of the blood vessel is called the | tunica media |
what are veniols and arteriols | the small veins and arteries that branch into capillaries |
what percentage of blood is plasma and formed elements? | 45% plasma, 55% formed elements. |
what should you do if a vein collapses when drawing a standard vacutainer tube? | change to a smaller tube like pediatric size. |
routine venipuncture procedure consist of | verify the requisition for test, identify the PT, wash your hands, gloves, palpate the vein |
cysts | a closed sac in or under the skin lined with epithelium and containing fluid or semi solid material |
analytical errors | PT. miss id, wrong tube, improper time for collection inadequate fasting improper site preparation med interference |
Quality Assurance (QA) | program that guarantees quality PT. care by tracking outcome |
NPO | nothing by mouth |
edema | accumulation of fluid in tissues |
fistula | surgical connection between an artery and vein (opening) |
Phlebitis | inflammation of vein results from repeated puncture of the vein |
Petechiae | tiny non raised red spots on the skin from rupturing of capillaries due to tourniquet being left on too long or tight. |
Thrombus | aggregation of platelets fibrin clotting factors/ the cellular elements of blood attached to the interior wall of the vein or artery |
thrombophlebitis | inflammation of vein with clot |
septicemia | systemic infection |
trauma | injury to underlying tissues caused by probing of needle |
hematoma | blood accumulated in the tissue surrounding the vein |
hema concentration | caused by prolong application of the tourniquet |
median cubical vein | vein of choice large/ do not tend to move |
cephalic vein | second choice tend to move use in obese PT. |
basilica vein | third choice if needle is inserted too deep you may punctured the brachial |
activated partial thromboplastic time | APTT a test for detecting coagulation defects of the intrinsic system |
prothrombin time | PT factor @ a plasma protein that is converted to the active form |
stage 1 of hemostasis vascular phase | injury to blood vessel causes it to constrict slowing flow of blood |
stage 2 hemostasis platelet phase | injury to endothelial lining causes platelets to adhere to it |
five types of WBC | neutrophils, lymphocyte, monocytes, basophils, eosinophil's |
thrombocytes | platelets |
leukocytes | white blood cells (function provide protection against infection) |
erythrocytes | red blood cells |
capillaries | microscopic blood vessels |
blood vessel | network of tubes that carry blood |
pulmonic valve | prevent blood from flowing back into the right ventricle from the pulmonary trunk |
toxicology | analyzes plasma level of drug/ poisons |
electrophoresis | analyzes chemical components of blood |
stage 3 of homeostasis coagulation phase | cascade of interaction of coagulation factors that converts the platelet plug to a stable fibrin clot |
biologic | pertaining to organisms and their products |
micro capillary collection dermal | (skin) puncture |
dermal punctures | example are PKU, glucose (blood sugar) |
order of blood draw | 1st- lavender 2nd- tubes with additives 3rd- tubes without additives |
hematology | red and white blood cell counts |
chemistry | elevates status of organ, body system or general health |
serology | evaluate PT.s immune response |
urinalysis | test urine to detect disorder/ infection of kidney and urinary tract |
microbiology | detection of pathogenic microorganisms |
stage 4 of hemostasis fibrinolysis | breakdown/ removal of clot |
microorganisms | disease cause pathogenic |
molecules | two or more atoms that are covalently bonded |
buffy coat | grayish white layer of white blood cells |
packed red blood cells | preparation of blood cells separated from liquid plasma (given in severe anemia ) restore hemoglobin and red cells |
plasma | liquid portion of white blood / contains active clotting agents |
capillary tube | used to collect capillary blood samples |
allosteric | the site other than the active site of an enzyme that bind regulatory molecules |
gylcohemoglobin | glycosylated hemoglobin the average blood glucose level over the previous several weeks |
erythropoiesis | process of erythrocyte production in the bone marrow |
hemoglobin | (Hb) complex protein iron compound in the blood that carries oxygen to the cells from the lunges/ carbon dioxide away from the cells to the lungs. |
elasticity | ability of tissue to regain it original shape/ size after being stretched |
gauge | caliber of dimension |
meniscus | curved fibrous cartilage in the knees / other joints |
glucose | simple sugar found in certain foods (fruits) major source of energy in the blood / animal body fluids |
morphology | study of physical shape/ size of a specimen |
metabolism | break down of chemical in food resulting in grouter generation of energy elimination of wastes and other body functions |
lancet | sharp pointed blade used to obtain a drop of blood for a capillary sample |
reagent | chemical substance known to react in a specific way |
emia | mean blood |
needles are color coded to indicate their | gauge |
when a lipid panel is ordered | the PT should be fasting for at least 12 hours with water allowed |
antisepsis | is a technique used on skin for cleaning of germ |
color tube stopper indicates a blood collection tube containing sodium heparin | Green |
pre-analytical | means variables affecting the specimen before lab testing |
blood borne diseases that is most likely to be transmitted by needle-stick is | hepatitis c |
situation that is unacceptable to use an alcohol-based hand rub | is before eating |
if you get blood on the outside of the tube you have just filled with blood | wipe the outside of the tube with disinfectant |
primary cause of a collapsed vein during venipuncture is | blood withdrawn too quickly/ forcefully |
considering PT safety, the most dangerous phlebotomy practice is | labeling the empty collection tubes before collection |
Per CLSI the # of unsuccessful venipuncture attempts by an individual phlebotomist should be | no more than 2 |
when performing a micro-collection procedure the best way to increase blood flow | is to pre-warm the site |
if you need to collect 5ml of blood on an 18 month old | use the veins on the dorsal hand |
to identify and verify that the Pt is correct | ask them to state their name and DOB and match it to the requisition |
antibiotics | destroy or kill bacteria that cause disease |
cerebrospinal fluid (CSF) | fluid that flows through/ protects the four ventricle of the brain subarachnoid spaces the spinal canal |
anticoagulants | prevent blood from clotting |
red blood cell | is most numerous in the circulating blood |
the rubber sleeve | (at the end opposite the beveled needle tip) on an evacuated tub needle make it possible for use multiple tubes. |
type and crossmatch (T&C) | identify blood that is compatibility |
lip emic | serum or plasma that has a white milky appearance |
remember that hep A | is not a blood borne pathogen |
phlebotomists are trained | in pre analytical phases in laboratory testing |
antiseptic to use when cleaning the arm to collect a blood alcohol | is soap and water |
venipuncture site | should be cleaned in a circular motion from the center to the periphery |
if your pt does not have a armband on (for identification) | tell the nurse and you cannot collect the blood until the armband is placed on the PT. |
a chain of custody procedure | is required for specimen where the test result may have legal consequences |
PHI (protected health information) per HIPAA | is pt name, diagnosis, and phone number |
if a pt develops a hematoma | during the venipuncture procedure stop, apply pressure to site, raise the arm above the level of the heart and apply a pressure bandage |
standard precautions | is a two step infection control guideline for hospitalized pt that combines universal precautions and body substance isolation |
OSHA is the organization | that mandates safe working condition for employees |
fasting lab test are order | to eliminate the effects of diet on the test result |
when using evacuated tubes for blood collection | it is crucial to remember to never under fill tubes that contain anticoagulant, use tube past their stated expiration dates immediately invert tubes that contain additives |
lab test requires serum use | red color topped tub |
blue stopper | contain the additive sodium citrate |
capillary blood sampling | require very little blood |
if your tub adapter become contaminated | with blood disposed of it in a biohazard waste container |
middle finger | is recommended site for performing a skin puncture in an older child or adult |
informed consent | PT voluntarily permits touching, examination and or treatment |
dependability | is example of an ethical work characteristic |
good way to earn a PT trust | is act knowledgeable convey sincerity and look professional |
brachial veins | is your last choice from which to collect a blood specimen |
aspect of professionalism | is communication skills ethical behavior and time management |
venous access devices | (VAD) |
if a pt has clotting disorder pressure should be applied to site for | at least 5mins. |
purpose for doing blood cultures | is to detect septicemia |
post prandial | after meal |
anticoagulants | prevents formation of fibrin (blood clotting) |
anticoagulants EDTA | works by binding calcium |
hand washing | is the most important means of preventing the spread of infection |
AIDS | is caused by HIV virus |
you have a statistically greater chance of contracting | hepatitis in a work related incident than you do contracting AIDS |
most prevalent type of nosocomial infections | are those of the urinary tract |
tourniquets | prevents venous outflow of blood causing the veins to bulge |
tourniquets may | be left on 1 min |
yellow top tube | (sterile) contains anticoagulant sodium polyanetholesulfonate (SPS) use for cultured specimens invert 8 times |
Red/gray | (speckled) top called tiger top serum separator common test- serum chemistry test/ serology test/ blood bank |
proper way to dispose of a needle is to | put it into a sharps container with out recapping STAT. after withdrawing it |
homeostasis | process by which blood vessels are repaired after injury |
ethical behavior | standard of right and wrong |
pulmonary circulation | carries deoxygenated blood from right ventricle |
systemic circulation | carries oxygenated blood from left ventricle |