GCE Phlebotomy
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| What are the 3 major veins for venipuncture? | Median Cubital, Cephalic, Basilic
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| What 12 items are needed to perform venipuncture? | Gloves, tourniquet, antiseptic, vacutainer needle, vacutainer tube, needle adapter, butterfly needle (if needed), chux (gauze), specimen label, plastics container, requisition slip, tape
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| What is the most commonly used antiseptic? And name 2 more. | -70% isopropyl alcohol swabs
-iodine, or (for those that are allergic to iodine) chlorhexidine gluconate
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| The smaller the gauge... The bigger the gauge... | -the bigger the needle
-the smaller the needle
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| What must always be worn when performing venipuncture? | Gloves
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| Why should you never recap a needle? And what should you do before putting a USED needle in a plastics container? | -Possibility of fingerpricks
-Close with safety device
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| -This indicates that blood has accumulatd in the tissue surrounding the vein. -What are the 2 most common reasons for this complication? | -Hematoma
-1. the needle is too deep
2. failure to apply enough pressure
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| -The increase in proportion of formed elements to plasma -What causes this? | -Hemoconcentration
-Tourniquet being on too long
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| A tourniquet should not be left on no longer than... | 2 minutes
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| To palpate the veins in the antecubital fossa what finger should you use? | index finger
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| With the bevel facing upward, you insert the needle at what degree of angle? | 15-30 degrees
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| What is the motto to venipuncture? | Find it, pick it, and stick it!!!
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| What are some common reasons for failure to obtain blood? | -The tube has lost its vacuum
-Improperly positioned needle
-Collapsed vein
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| What are some reasons a vacutainer tube has lost its vacuum? | -Manufacturing defect
-A tiny crack in the tube
-Expired tube
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| What does BC stand for? And what is that test for? | -Blood cultures
-To test for microorganisms in the patient's blood
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| What is a PKU test for? This test is done on blood from... | -To detect phenylketonuria in infants
-Heel or on urine
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| What is PKU (phenylketonuria)? | A genetic disease that causes mental retardation and brain damage
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| Some tests require chilled specimens and they must be collected and chilled how? | -In chilled ice water
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| Name one test that requires to be chilled. | Ammonia
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| Name one light-sensitive specimen. | Bilirubin (Jaundice)
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| The American Academy of Pediatrics recommends that heel punctures for infants not exceed ____ mm. | 2.0
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| Butterfly needles are only to be used on what three kinds of patients? | -Elderly
-Infants
-People with small veins
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| What is the correct order of draw? *REMEMBER*: Because Better Specimens Generate Perfect Goals | Blood Cultures (BC)
Blue
Serum (Red)
Green
Purple (Lavender)
Gray
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| A red top tube contains: Common tests are? | -No additives or anticoagulants, just serum
-Serum chemistry tests, serology tests, blood bank
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| A red speckled top tube contains: Common tests are? | -Clot activators
-Most chemistry tests
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| A red speckled tube is also sometimes called... | Tiger-top tube or Serum Seperator tube (SST)
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| How many times should a Red speckled tube be inverted? | 5 times
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| A gray top tube contains: Common tests are? | -Sodium fluoride, potassium oxalate
-Fasting blood sugar (FBS), Glucose tolerance test (GTT)
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| A green top tube contains: Common tests are? | -Heparin
-Ammonia, STAT electrolytes
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| What is the rule of thumb when using a blue top tube? | The tube must be filled completely, and should be inverted 3 to 4 times
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| What is the blood ratio to maintain during venipuncture? | 9:1 nine parts blood to one part additive
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| A blue top tube contains: Common tests are? | -Sodium Citrate
-Prothrombin time (PT), Activated Partial Thromboplastin Time (APTT, PTT), Bleeding Time (BT), PT/INR
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| A lavender top tube contains: Common tests are? | -Ethylenediaminetetraacetic acid (EDTA)
-CBC (complete blood count), Hemoglobin and Hematocrit, ESR (Erythrocyte Sedimentation Rate)
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| (RED TOP TUBE) Collected blood, clots by normal coagulation process in ____ minutes. | 30 minutes
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| How many times do you invert the RED TOP TUBE after collection? | 0, there is no need
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| What happens when there is insufficent return of blood flow to the heart, because of inadequate supply of oxygen to all organs and tissues of the body? | Shock
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| What are some common symptoms of shock? (4) | -pale, cold, and clammy
-rapid, weak pulse
-increased, shallow breathing
-expressionless face/ staring eyes
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| What is the most important means of preventing the spread of infection? | Hand washing
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| What are 5 pieces of personal protective equipment (PPE's)? | -Gloves
-Goggles
-Masks
-Face shields
-Respirators
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| What are the 2 most important things that need to be on a requisition slip? | -Dr. name
-Patient's name
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| What does palpate mean? | To look for a vein
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| Tourniquets should be ______ inches above the site. It should not be left on no longer than _____ minutes. | -3-4 inches
-2 minutes
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| Where are the 3 major veins located? | Antecutial Fossa
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| Why is the basilic vein the third vein of choice? | Because it is the least firm vein, and is located near the brachial artery
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| (SA) What is a Sino-atrial node? | pacemaker
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| What must be signed before any kind of procedure is performed? | Informed consent
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| What is HIPAA's main key concept? | Patient confidentiality
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| What vaccination is required to be a licensed phlebotomist? | Hepatitis B
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| In order from outer to inner, what are the layers of blood vessels? | 1.Tunica adventitia - outer layer
2.Tunica media - middle
3.Tunica intima - inner or lining layer
4.Lumen - the internal space of blood vessel (or hollow portion)
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| -recording of cardiac cycle (ECG) | electrocardiograph
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| What is another name for a heart attack? | Myocardial infarction
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| Name 2 Winged Infustion needles. | ETS (Evacuated Tube System), Syringes
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| Anticoagulants are to prevent what? | Blood from clotting
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| Name 3 centrifuging coagulants. | red cells: bottom
platelets/WBC (buffy coat) middle
plasma (pale yellow fluid) top
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| With a Dr's order, out of ASAP or STAT, which one is first priority? | STAT = Emergency (cardiac enzymes)
ASAP = As soon as possible
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| Early in the morning when the body is at rest (fasting 12 hrs) RBC an WBC influence this state: | Basal state
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| When a patient has had a Mastectomy (breast removal) which vein should be used and why? | -A vein in the arm opposite of the side of removal
-lymphostasis may cause injury or infection to patient or inaccurate test results
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| If anything ever goes wrong during venipuncture, for example: shock or syncope fainting, what is the number one rule? | NEVER LEAVE YOUR PATIENT, EVER!!!
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| In the event of a patient fainting what steps should be taken? (5) | -remove needle and tourniquet ASAP
-talk to patient to keep them alert
-lower head
-apply cold compress
-call for first aid help
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| In event of a patinet having a seizure what should you do? | remove needle and tourniquet quickly
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| Bilirubin = And what precaution should be taken? | =Jaundice
-protect from light
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| This measures valuable data about patient's oxygen, ventilation, and acid base balance (done by respiratory therapist) | ABG Arterial Blood Gases
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| Name on non-blood specimen test. | Clean catch urine-detects infection
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| The 2 circulations of the heart are? | Pulmonary circulation
Systemic circulation
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| -this carries deoxygenated blood form the right ventricle to the lungs and returns oxygenated blood from the lungs to the left atrium | Pulmonary circulation
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| this carries oxygenated blood from the left ventricle throughout the body | Systemic circulation
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| This is an atrioventricular valve, between the right atrium and right ventricle | tricuspid valve
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| A semi lunar valve between the right ventricle and the pulmonary artery | pulmonic valve
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| What must be signed before any kind of procedure is performed? | Informed Consent
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| APTT | Activated Partial Thromboplastin Time
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| PT | Prothrombin Time
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| OGTT | Oral Glucose Tolerance Test
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| FUO | Fever of Unknown Origin
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| BC | Blood Culture
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| The right side of the heart has two valves which are: | -tricuspid valve
-pulmonic valve
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| What is the location of the tricuspid valve? | between the right atrium and right ventricle
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| What is the location of the pulmonic valve? | between the right ventricle and pulmonary artery
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| What is the flow of the pulmonary circulation? | from right ventricle to the lungs and then from lungs to left atrium
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| What is the flow of the systemic circulation? | from the left ventricle throughout the body
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| What test is used to evaluate the intrinsic pathway? (Also used to monitor Heparin therapy) | APTT
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| What test is used to evaluate the extrinsic pathway? (Also used to monitor Coumadin therapy) | PT
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| The most common size for a winged infusion set (butterfly) is a | 23 gauge, 1/2 to 3/4 inches long
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| -This prevents the venous outflow of blood from the arm causing the veins to bulge, then making it easier to locate the vein. | tourniquet
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| The most commonly used tourniquet is: | the latex strip
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| What does fasting mean? | To abstain from eating for at least 12 hrs prior to the testing
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| What is the most critical error a phlebotomist can make? | Patient mididentification
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| Cleaning a site should be done how before a procedure? | using a circular outward motion
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| The formed elements are: | WBC
RBC
Platelets
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| In order from outer to inner what are the 4 layers of blood vessels? | 1.Tunica adventitia
2.Tunica media
3.Tunica intima
4.Lumen
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| What non-blood specimen test can be used to detect infection? | clean catch urine
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| APTT | Activated Partial Thromboplastin Time
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| PT | Prothrombin Time
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| BC | Blood Culture
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| Phenylketonuria | PKU
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| RBC | Red Blood Cell
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| WBC | White Blood Cell
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| CBC | Complete Blood Count
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| Ethylenediaminetraacetic Acid | EDTA
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| H & H | Hemoglobin and Hematocrit
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| ESR | Erthrocyte Sedimentation Rate
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| BT | Bleeding Time
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| FBS | Fasting Blood Sugar
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| GTT | Glucose Tolerance Test
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| SST | Serum Seperator Tube
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| PPE | Personal Protection Equipment
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| BBP | Bloodborne Pathogen
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| SA | Sino atial node (pacemaker)
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| ECG | Electrocardiogram
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| ETS | Evacuated Tube System
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| 2HPP | Timed Test
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| ABG | Arterial Blood Gases
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| The extrinsic pathway is associated with anticoagulant therapy known as? | Coumadin
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| A CBC consists of what 3 things? | WBC, RBC, Platelets
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| Failure to obtain sufficient amounts of blood is known as: | short draw
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| The four major anticoagulants are? | -coumadin
-heparin
-EDTA
-Oxalate
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| What is the medical term for blood in the urine? | Hematuria
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| Panels, profiles, and enzymes tests are generally drawn in which laboratory? | Chemistry
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| STAT electrolytes are performed on? | Plasma
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| Blue tubes must be filled to what ratio? | 9:1
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| ESR is done in what tube? | Lavender
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| Heparin is in what color tube? | Green
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| In what color tube is a CBC drawn? | Lavender
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| What is the additive in a lavender tube? | EDTA
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| What color is a PT/PTT test drawn? | Blue
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| What is the additive in the gray tube? | Sodium fluoride, oxalate
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| What color tube should STAT electrolyes be drawn? | Green
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| In phlebotomy, aspirin affects? | BT
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| Is a PT part of the extrinisic pathway or intrinsic pathway? | Extrinsic
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| What is the purpose of warming a site prior to venipuncture? | Increase blood flow
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| An anticoagulant tube that has been centrifuged has a buffy coat that is filled with? | Platelets and WBCs
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| What is the destruction of RBCs? | Hemolysis
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| The middle layer of the vein is the? | Tunica Intima
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| Is heparin associated for an intrinsic or extrinsic pathways? | Intrinsic
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| If a patient has an IV in both arms where should you draw blood? | Feet
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| What is the most common complication in phlebotomy? | Hematoma
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| The hollow portion of the vein is known as: | Lumen
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