Med Lab II Study Stack for CPT exam
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| What is the one of the roles of the phlebotomist | Collect routine capillary and venous specimens for testing as requested.
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| What is the one of the roles of the phlebotomist (2) | Prepare specimen for transport, ensuring it's stability
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| What is the one of the roles of the phlebotomist (3) | Transport specimens to the laboratory when needed
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| What is the one of the roles of the phlebotomist (4) | Promote good public relations with hospital staff and patients
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| What is the one of the roles of the phlebotomist (5) | Comply with new and revised procedures as described in the procedures manual
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| What is the one of the roles of the phlebotomist (6) | Asist in collecting and documenting monthly workload and recording data
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| What is the one of the roles of the phlebotomist (7) | Maintain safe working conditions
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| What is the one of the roles of the phlebotomist (8) | Perform laboratory computer operations
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| What is the one of the roles of the phlebotomist (9) | Participate in continuing education programs
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| What is the one of the roles of the phlebotomist(10) | Perform other tasks assigned by supervisory personnel
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| What Characteristics are needed to succeed as a phlebotomist | Dependability, Honesty, Integrity, Empathy & Compassion, Professional Appearance, Interpersonal Skills.
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| What is the "code" that phlebotomists are expected to follow? | Code of Ethics
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| Where may phlebotomists find work? | Physician's offices, Reference labs, Urgent care centers, Nursing home facilities, wellness clinics.
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| What is pulmonary circulation? | Carries deoxygenated blood from the right ventricle to the lungs and returns oxygenated blood from the lungs to the left atrium
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| What is Systemic Circulation? | Carries oxygenated blood formt he left ventricle throughout the body
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| What is the anatomy of the heart composed of | Each side is composed of an upper chamber, the atrium, and a lower chamber, the ventricle. The right and left sides have two valves
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| What are the two valves in the right side of the heart? | Tricuspid valve-Between the right atrium and the right ventricle
Pulmonic Valve-Semi Lunar valve between the right ventricle and the pulmonary artery
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| What are the two valves in the left side of the heart? | Mitral Valve- AKA the bicuspid valve between the left atrium and the left ventricle
Aortic Valve-Semi lunar valve between the left ventricle and the aorta
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| What are the three layers of the heart? | Endocardium-endothelial inner layer lining the heart
Myocardium-Muscular middle layer. This is the contractile element of the heart
Epicardium- Fibrous outer layer of the heart. The coronary arteries which supply blood to the heart are found in this lay
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| What are the types of blood vessels of the heart? | Aorta, arteries, arterioles, cappilaries, venules, veins, superior and inferior vena cavae.
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| What are the three layers of all blood vessels (except capillaries)? | Tunica advenitita-outer connective tissue layer
Tunica Media-middle smooth muscle layer
Tunica Intima-inner endothelial layer
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| Where does the oxygenated blood flow from the aorta, arteries, and arterioles? | From the heart to various parts of the body
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| Where does the deoxygenated blood flow from the venules, veins, and the superior and inferior vena cavae? | Back to the heart
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| What do the capillaries connect? | The Arterioles and venules
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| What type of blood is contained in capillaries? | Mixture of arterial and venous blood
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| How much blood does the average adult have circulating through their body? | 5 to 6 liters
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| What are the two major portions of blood? (liquid portion and a cellular portion) | Liquid portion-Plasma
Cellular portion- Formed elements
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| Plasma comprises 55% of circulating blood. What does it contain? | Proteins, amino acids, gases, electrolytes, sugars, hormones, minerals, vitamins, and water (92%). It also contains wast products such as urea that are destined for excretion.
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| The formed elements comprise the remaining 45% of the blood. What does it contain? | Erythrocytes (make up 99%) and leukocytes, and thrombocytes.
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| Where do all blood cells normally orginate? | From stem cells in the bone marrow.
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| What do the erythrocytes contain? | Hemoglobin- the oxygen carrying protein.
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| How many days does it take for hemoglobin to mature into an erythrocyte? | one to two days.
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| What is the normal value for RBC's for an adult? | 4.2 to 6.2 million per microliter of blood.
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| What is the normal lifespan of an RBC? | 120 days
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| What is the function of the leukocyte? | Provide the body protection against infection.
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| What is the normal value for WBC's for an adult? | 5000 to 10,000 per microliter.
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| What is leukocytosis | Increase in WBC's. commonly seen in cases of infections and leukemia
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| What is leukopenia | Decrease in WBC's. Commonly seen in cases of viral infection and chemotherapy.
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| What are the five types of WBC's in the blood? | Neutrophils, Lymphocytes, Monocytes, Eosinophils, and Basophils.
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| What is the purpose of the Neutrophil? | The most numerous WBC (40-60%). They are phagocytic (eat and digest bacteria). Their numbers increase in cases of bacterial infection.
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| What is the purpose of the Lymphocyte? | Second most numerous WBC. (20-40%). Their numbers increase with viral infection and they play a role in immunity.
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| What is the purpose of the Monocyte? | (3-8% of WBC population)They are the largest WBC. They are monocytes while circulating in the blood but turn into macrophages and become phagocytes when they pass into the tissues. They increase with intracellular infections and TB.
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| What is the purpose of the Eosinophil? | Represent 1-3% of WBC population. They are active against antibody labeled foreign molecules. Their numbers increase with allergies, skin infections, and parasitic infections.
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| What is the purpose of the Basophil? | Account for 0-1% of WBC's. They carry histamine and will elevate with allergic reactions.
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| What are thrombocytes? | Platelets. They are essential for blood coagulation.
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| What is the normal value of platelets for an adult? | 140,000 to 440,000 per microliter of blood
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| What is the lifespan of a platelet | 9 to 12 days
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| What is Hemostastis | the process by which blood vessels are repaired after injury.
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| What are the four stages of Hemostasis? | 1. Vascular Stage
2. Platelet Stage
3. Coagulation Phase
4. Fibrinolysis
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| What is Vascular phase during hemostasis? | The injury to a blood vessel causes it to constrict slowing the flow of blood
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| What is the platelet phase during hemostasis | Injury to the endothelial lining causes platelets to adhere to it.
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| What is "aggregation" during the platelet stage of hemostasis? | the process of Platelets sticking to the site finally forming a temporary platelet plug
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| What does Bleeding Time Test evaluate for? | Primary hemostasis (happens during vascular and platelet phases of hemostasis)
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| What is the coagulation phase during hemostasis? | Involves a cascade of interactions of coagulation factors that convert the temporary platelet plug to a stable fibrin clot.
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| What is intrinsic pathway ? (during the coagulation phase of hemostasis) | The coagulation cascade involves both an intrinsic system and extrinsic system which ultimately come together in a common pathway
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| What does the APTT (activated partial thromboplastin time) evaluate? | The intrinsic pathway during coagulation phase of hemostasis. Also used to monitor heparin therapy.
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| What does the PT (Prothrombin time) test evaluate? | The extrinsic pathway during the coagulation phase of hemostasis. Also used to monitor coumadin therapy.
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| What is Fibrinolysis during hemostasis? | The breakdown and removal of the clot. As tissue repair starts, plasmin starts breaking down the fibrin in the clot.
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| What are FDP's | Fibrin Degradation Products- measurement is used to monitor the rate of fibrinolysis
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| What is the preferred site for venipuncture? | The anticubital fossa of the upper extremities.
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| Should you perform a blind stick on a patient? | No, The vein should be large enough to receive the shaft of the needle and it should be visible or palpable after tourniquet placement.
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| What are the three major veins located in the anticubital fossa? | Median Cubital vein
Cephalic Vein
Basilic Vein
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| What is the first choice for venipuncture when choosing one of the veins in the anticubital fossa? | Median cubital vein. Because it is large and tends not to move when the vein is inserted.
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| What is the second choice for venipuncture when choosing one of the veins in the antecubital fossa? | Cephalic vein-Usually more difficult to locate and has a tendancy to move. Often the only vein that can be palpated in an obese patient.
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| What is the third choice for venipuncture when choosing one of the veins in the antecubital fossa? | Basilic Vein-It is the least firmly anchored and located near the brachial artery. If the needle is inserted too deep, the artery may be punctured.
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| What are three examples of unsuitable veins for venipuncture? | Sclerosed veins
Thrombotic veins
Tortuous veins(winding or crooked veins, more susceptible to infection and may produce erroneous test results.
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| Should you draw blood from an arm that has IV fluids running into it? | No, the fluid will alter the test results.
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| Should you draw blood from an arm with an artificial A/V fistula (such as those surgically implanted in dialysis patients) | No, will alter the test results or cause trauma to the already delicate veins.
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| What solution would you use to cleanse the skin prior to collecting Arterial blood gases or blood cultures? | Provodone-Iodine solution
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| What do you use to cleanse the skin prior to venipuncture or capillary puncture? | 70% isopropyl alcohol
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| What are vacutainer tubes? | Color coded tubes with negative pressure to draw blood.
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| Are vacutainer needles reusable? | No, they are always disposable but can be used to both single tube and multi tube draws.
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| The ______ the gauge the bigger the diameter of the needle. | smaller
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| the ______ the gauge the smaller the diameter of the needle | bigger
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| Which guage is larger, 16 or 23 | 16
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| Why are needle gauges smaller than 23 not used to draw blood? | A smaller gauge will cause hemolysis
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| What is a needle adapter (tube holder)? | One end has a small opening that connects to the needle, the other end has a large opening to hold the collection tube.
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| What are winged infusion sets used for? | Venipuncture on small veins such as dorsal veins, pediatric patients, and the elderly.
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| What is the most common length of the needles used in venipuncture? | 1 inch and 1.5 inch
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| What is the most common size of the winged infusion sets used? | 23 gauge and 1/2 to 3/4 inch long.
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| What is an alternative when you cannot use the vacutainer tubes on your patient? | a 10 to 20 ml syringe
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| What is the purpose of the tourniquet? | Prevent the venous outflow of blood from the arm causing the veins to bulge thereby making it easier to locate the veins.
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| What types of tourniquets are available? | Latex, non latex (both disposable and non-disposable) and velcro and buckle closure
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| What is a chux pad? | impermeable pad used to protect the patient's clothing and bedding.
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| What is the purpose of a specimen label? | To identify the specimen to the appropriate patient and placed on each tube after venipuncture.
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| Do you have to wear gloves during venipuncture? | Yes, it is an OSHA requirement
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| What is a Hematoma? | The most common complication from phlebotomy procedure. The blood accumulates in the tissue surrounding the vein. (usually from the needle going through the vein or failure to apply enough pressure on the site after collection)
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| What is Hemoconcentration? | The increase in proportion of formed elements to plasma caused by the tourniquet being left on too long (more than 2 minutes)
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| What is Phlebitis? | Inflammation of the vein as a result of repeated venipuncture on that vein
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| What is Petechia? | tiny non-raised red spots that appear on the skin from rupturing of the capillaries due to the tourniquet being left on too long or too tightly
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| What is a thrombus? | A blood clot usually from insufficient pressure being applied after withdrawl of the needle.
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| What is Thrombophlebitis? | Inflammation of a vein with formation of a clot
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| What is septicemia | A systemic infecion associated with the presence of pathogenic organisms introduced during venipuncture
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| What is Trauma (related to venipuncture)? | an injury to underlying tissues caused by probing of the needle
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| What are three factors to consider prior to performing venipuncture? | Fasting
Edema
Fistula
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| What role does fasting play in venipuncture? | Some tests require that the patient abstain from eating for at least 12 hours. Phlebotomist must confirm that the pt. did not eat prior to the test
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| What types of tests must a patient fast for? | glucose, cholesterol, and triglycerides
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| What is edema and what can it do to test results? | The accumulation of fluid in the tissues. Collection from edematous tissues alters test results
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| What is a fistula and what are they used for? | Permanent surgical connection between an artery and a vein. They are used for dialysis and must never be used for venipuncture due to the possibility of infection
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| What is Quality Assurance? | A program that guarantees quality patient care by tracking outcomes through scheduled audits.
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| What is a fistula and what are they used for? | Permanent surgical connection between an artery and a vein. They are used for dialysis and must never be used for venipuncture due to the possibility of infection
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| What is Quality Assurance? | A program that guarantees quality patient care by tracking outcomes through scheduled audits.
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| What is monitored for Quality Assurance? | Appropriateness, applicability, and timliness of patient care.
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| Name Four errors in quality control that happen before collection: | Patient misidentification
Improper time of collection
Wrong tube
Inadequate fast
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| Name Five more errors in quality control that happen before collection: | Exercising prior to testing
Patient posture
Poor coordination with other treatments
Impromper site preparation
Medication interference
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| Name Three errors in quality control that happen during collection: | Extended tourniquet time
Hemolysis
Wrong order of draw
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| Name three more errors in quality control that happen during collection: | Failure to invert tubes
Faulty technique
Under filling tubes
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| Name three errors in quality control that happen after collection- | Failure to separate serum from cell material
Improper use of serum separator
Processing delays
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| Name three more errors in quality control that happen after collection: | Exposure to light
Improper storage conditions
Rimming clots
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| What should you use to verify what tests need to be completed during blood draw? | Requisition form
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| What information do you use to identify your patient? | Check the patient's ID number and have them state their name to you
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| After you give the patient your name, what other information should you give them? | Explain the procedure
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| Which finger do you use to palpate for veins and why? | Index finger: because it is the most sensitive
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| What must the phlebotomist do prior to touching the patient? | Wash your hands
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| Is it a requirement to wear gloves during venipuncture? | Yes, mandated by OSHA
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| How far above the antecubital fossa should your tourniquet rest? | 3-4 inches above the site
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| Should your patient rapidly open and close their fist to engorge their veins? | No, rapidly opening and closing can cause backflow and hemolysis of the blood
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