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Phlebotomy review
NHA review notes
| Question | Answer |
|---|---|
| When drawing for a coagulation study, a phlebotomist should | fill a light blue tube to the top |
| The tourniquet should be left on the patient's arm | No longer tan 60 seconds |
| For this condition emergency first aid treatment include maintaining open airway, controlling bleeding and keeping the patient warm until help arrives | shock |
| WBC, RBC, glucose and electrolyte are ordered for a patient which is acceptable for skin puncture, which color tube should be drawn | Lavender/RED |
| The proper procedure after collecting an ammonia specimen | place tube in ice water slurry |
| Additive in gray tube | Potassium Oxalate |
| Vein easily found in obese patients | Cephalic |
| Test specimen requires protection from light | Bilirubin |
| EDTA is an additive in | Lavender, Pink, Pearl tube tops |
| Described as an a nuclear biconcave disk | Erythrocyte |
| Farthest from the center of the body or point of attachment | Distal |
| Nearest the center of the body | Proximal |
| What are the 3 layers of the heart | Endocardium, myocardium, epicardium |
| What is the protective clothing and other items worn by an individual to protect mucous membranes, airways, skin and clothing from contact with infectious substances | personal protective equipment |
| Major difference between plasma and serum is that plasma contains | fibrinogens |
| Processing for ending venipuncture | Remove tourniquet, remove the tube, remove needle, apply pressure |
| Test that may NOT be performed using blood capillary tubes | blood cultures |
| Contains sodium citrate | light blue tube top |
| Process where a pathogen or foreign matter is surrounded, engulfed and destroyed by the WBC | phagocytosis |
| The middle layer of a blood vessel made up of smooth muscle tissue and some elastic fibers | tunica media |
| In a successful venipuncture evacuated tubes fill automatically as soon as the tube stopper is pierced because of | premeasured vacuum in each tube |
| Before blood donation is made a donor should be tested for | Hematocrit/Hemoglobin |
| When making a blood smear what is the desired result | a feathered edge |
| They engulf and digest bacteria | neutrophils |
| When a finger is excessively milked during a skin capillary puncture collection the result is | contamination with tissue fluids |
| When testing for drug abuse this test is taken | urine sample |
| Blood cultures are routinely performed to diagnose or discover | microorganism/infections |
| What are the 8 vessels of blood | arota, venules, arteries, veins, arterioles, superior vena cava, capillaries, inferior vena cava |
| What does the formed elements (cellular portion) consist of? | erythrocytes, leukocytes, thrombocytes |
| Veins not suitable for venipuncture | sclerose, thrombotic and tortuous |
| Tiny, non-raised red spots that appear on or around the site due to the tourniquet being too tight or left too long | Petechiae |
| Inflammation of a vein due to repeated venipuncture | Phlebitis |
| Increase of proportion of plasma due to tourniquet being left on too long | Hemoconcentration |
| When preparing for transport, this specimen should be placed in an ice bath within 30 minutes of collection | Arterial Blood Gases |
| During a routine venipuncture, the patient becomes pale and diaphoretic, What condition is most likely to occur in this patient | Syncope |
| A patient comes to the clinic for erythrocyte (RBC) sedimentation rate test which tube would be used for this venipuncture | Lavender |
| The antiglycolytic agent that maintains glucose stability for 3 days is | Sodium Floride |
| Swelling due to accumulation of fluids in the tissues is | edema |
| Most gas exchange between blood and tissue occurs in | capillaries |
| In this tube is Heparin, which prevents clotting by inhibiting thrombin formation | Green tube topper |
| This antiseptic has been traditionally used to obtain the highest degree of skin antisepsis when blood cultures are being collected | providine iodine |
| Measurement of copper, trace elements require collection in this color tube top | Royal blue |
| This test is ordered to detect deficiency in infants and is done on blood or urine. It is a genetic disease that causes mental retardation and brain damage | PKU (phenylketonuria) |
| Referred to as a short draw | single collection tube |
| Described as loss of consciousness and postural tone resulting from insufficient blood flow to the brain. | Syncope |
| Trapping blood in an extremity by compression of veins | Venostasis or venous stasis |
| Because the increase is caused by arterial flow into the area, a specimen obtained from a warm site is described as | arterialized |
| Test specimen that requires arterialized blood | CBGs (capillary blood gases) |
| The concentration of ... is higher in capillary blood than in venous blood is | Glucose |
| CLSI order of draw for capillary specimens | Blood gas (CBGs), EDTA specimens, other additives, serum specimens |
| Process by which a person donates blood for his/her own use | autologous donation |
| A portion of a specimen is used for testing | aliquot |
| The additive in the red/gray speckled collection tube | thixotropic gel for serum separation |
| Blood in the urine is | Hematuria |
| A patient was rushed to the ER because of dehydration due to severe vomiting. The ER physician orders a test for STAT electrolytes. Which tube would the Phlebotomist use to do the collection | Green tube top |
| The boundaries for the approved area in performing heel punctures | the medial line extending from the great toe and lateral line extending from the fourth and fifth digit |
| What tube is used for PT and PTT | Light Blue topper tube |
| Additive in green tube topper | Heparin: lithium, sodium, aluminum |
| How many tubes are drawn for a three hour glucose tolerance test (GTT) | 4 tubes |
| Which section of the Clinical laboratory will perform pregnancy test on blood specimens | Chemistry |
| Peak level and trough levels are used in | therapeutic drug monitoring |
| After the blood collected from a heel stick is placed on the neonatal screening card, the card must dry in a horizontal position for a minimum of | 4 hours |
| Contraction of the heart | systole |
| The occult blood analysis is frequently requested on | Fecal Samples |
| the HICPAC transmission-based precautions include | airborne, droplet and contact |
| Inhibits coagulation by binding to calcium present to the specimen and must be filled 2/3 full, inverted 8-10 times, Common tests: CBC, ESR, Sickle Cell screening | Lavender |
| Defines low, moderate, and high complexity testing and requires labs to meet certain guidelines in order to perform their tests | CLIA 88 |
| Giving patient adequate information concerning... and consequences is... | Informed Consent (is consent given by the patient who is made aware of any procedure to be performed, it risks; expected outcomes and alternatives. It refers to voluntary permission by a patient to allow touching, examination after they have been informed |
| Condition that results when pathogenic microbes invade your body | infection |
| disease or infection past from person to person | communicable |
| Gloves, mask, gown, N95 respirator, booties | PPE (Personal Protective Equipment) |
| carries DEOXYGENATED blood from the right ventricle to the lungs | Pulmonary Circulation |
| carries OXYGENATED blood from the left ventricle throughout the body | Systemic Circulation |
| A blood clot, usually consequence of insufficient pressure after a needle is withdrawn | Thrombus |
| What are the 4 stages of hemostasis | 1. Vascular Stage 2 Platelet Phase 3. Coagulation Phase 4. Fibrinolysis |
| A temporary platelet plug formed during the platelet phase of hemostasis | Aggregation |
| What are the steps to the chain of infection | 1. Agent 2.Reservoir 3.Exit path 4.means of transmission 5.entry path 6.susceptible host |
| Failure to exercise due care that a responsible person would give | negligence |
| Permanent surgical connection between an artery and a vein; they are used for dialysis procedures and must never be used for venipuncture due to possible infection | Fistula |
| Injury to underlying tissues caused by probing the needle | trauma |
| Lavender stopper tubes are most commonly used to collect | hematology tests |
| specimen requires routine (normal handling) | cholesterol |
| Multisample needles are typically available in these gauges | 20-22 |
| Process of recording the order received; this means taking steps to connect the specimen and the paperwork with a specific individual | accession |
| Following analytical error occurs during blood collection | wrong order of draw |
| Means of transmission are | airborne, droplet(membrane), vector(insect), vehicle(food contamination) |
| Blood vessel that carries blood away from the heart | arteries |
| What type of muscle lines the walls of the blood vessels | visceral |
| referred to as sweat glands | sudoriferous glands |
| Divides the body horizontally into upper and lower portions | transverse |
| divides the body vertically into front and back portions | frontal plane |
| Divides body vertically into even right/left portions | midsagittal plane |
| divides the body vertically into right and left portions | sagittal |
| Inanimate objects that can harbor infections transmit disease | fomites |
| Internal space of a blood vessel through which the blood flows | lumen |
| Average blood volume | 5 Liters |
| Blood volume | 55% plasma, 45% formed elements |
| Lymph originates from | tissue fluids |
| Heart disorder characterized by fluid buildup in the lungs | congestive heart failure |
| The longest vein and the largest artery in the body in that order are | great saphenous and arota |
| the thick muscle layer of the heart | myocardium |
| Complete obstruction or prolonged ischemia leads to | myocardial infarction (MI) "heart attach" |
| Partial obstruction of a coronary artery or one of its branches can reduce blood flow to a point where it is not adequate to meet oxygen needs of the heart | myocardial ischemia |
| valves at the entrance to the ventricles | atrioventicular |
| upper chambers on each side of the heart - receiving chambers | atria (singular, atrium) |
| lower chambers of the heart - pumping/delivering chambers | ventricles |
| outer layer of a blood vessel made up of connective tissue and is thicker in arteries than in veins | tunica adventitia |
| inner layer or lining of a blood vessel, made up of endothelial cells with an underlying basement membrane | tunica intima |
| (Ordinary) - Distinguish with soda, acid, H20 | Class A |
| (Flammable) - Distinguish with dry chemical, carbon dioxide | Class B |
| (Electric) - Distinguish with dry chemical, halon carbon dioxide or non conductive material | Class C |
| (Metals) - Distinguish with dry powder | Class D |
| (Kitchens) - Distinguish with potassium based alkaline | Class K |
| Multipurpose and can be used on A, B, C class fires | Class ABC |
| Blood cultures, Aerobic and Anaerobic | Sterile Yellow/Blood culture |
| Lithium, Rubella Screen, ANA, Herpes | Red |
| PT, APTT, PTT, PT/INR, DDIMER, Fibrinogen, BT | Light Blue (full) |
| CMP, BMP, Lipid profile, Calcium, ALK (alkaline), Thyroid Panel, BUN | SST |
| Blood gas | Green |
| Ammonia, Stat Electrolytes | PST |
| CBC, ESR, HH, Hemoglobin, Hematocrit, Sickle cell, | Lavender |
| Blood alcohol, GT, GTT | Gray |
| STD/AIDS | pink |
| Blood bank | red |
| Trace Metal | Royal blue |
| The ___ top evacuated tube for collection of blood for CBC test | Lavender |
| When preparing a blood smear directly from a skin puncture it is best to ____ | wipe away first drop of blood |
| A centrifuge is used in a clinical laboratory setting to ___ | separate liquid from cells in blood |
| The common name for thrombocyte is | platelet |
| the sebaceous glans, skin, hair and nails are in the ____ system | integumentary |
| the trachea, nose, lungs and pharynx are in the ____ system | respiratory |
| The bladder, kidneys, uretha and ureters are in the ___ system | urinary |
| Most important step to ensure accuracy in sample collection is | identifying the patient properly |
| When should codes on glucose covettes or strips be compared to the code on the glucose meter | When patient is tested |
| used in the process of bloodletting | venesection or phlebotomy |
| Over production of red blood cells | polycythemia |
| a federal law passed requiring all healthcare providers to obtain a patient's consent in writing before disclosing medical information such as a patient's test results, treatment and condition to any unauthorized person | Health Insurance Portability and Accountability Act of 1996 (HIPAA) |
| study of nonverbal communication | kinesics |
| study of an individual's concept and use of space | proxemics |
| Bloods ability to form and dissolve clots | Coagulation |
| Microbiology department in the laboratory performs | culture and sensitivity testing |
| Compares current results of a lab test with previous results for the same test on the same patient | delta check |
| Distance, time and shielding are principles of | Radiation safety |
| Surfaces in the specimen collection and processing area should be cleaned with | 1:10 bleach solution |
| In the event of a body fluid splash to the eyes, the victim should immediately | flush eyes with water for 10 minutes |
| Injury to a blood vessel causes it to constrict slowing the flow of blood | Vascular phase |
| Injury to the endothelial lining causes platelets to adhere to it | Platelet phase |
| platelets stick to the site forming a temporary platelet plug in a process called | aggregation |
| This is a systemic infection associated with the presence of pathogenic organism introduced during a venipuncture | Septicemia |
| Common tests: CBC, RBC, WBC and Platelet count; WBC differential; Hemoglobin and Hematocrit determinations; ESR (Erythrocyte Sedimentation Rate) is what tube color: | Lavender |
| Common tests: PT, PTT, thrombin time, fibrinogen degradation products, factor assays, bleeding time (BT) | Light Blue |
| Chemistry tests: performed on plasma such as Ammonia, carboxyhemoglobin & Stat electrolytes | Green |
| FBS, GTT; blood alcohol; lactic acid measurement | Gray |
| Also know as a SST; common test - most chemistry tests | Reg/Gray speckled |
| Common tests - serum chemistry tests, serology test; blood banks. Clots by normal coagulation process in 30 minutes | Red |
| This section performs test on the urine to detect disorders and infection of the kidney and urinary tract and to detect metabolic disorders such as diabetes mellitus. | Urinalysis Section |
| Performs test to evaluate the patient's immune response through the production of antibodies. Uses serum to analyze the presence of antibodies to bacteria, viruses, fungi, parasites and antibodies against the body's own substances | Serology (immunology) section |
| Section responsible for the detection of pathogenic microorganisms in patient samples and for the hospital infection control. Primary test performed is culture and sensitivity | Microbiology Section |
| Section where blood is collected, stored and prepared for transmission. | Blood Bank |
| Consists of eletrophoresis, toxicology, immunochemistry also the following tests are performed here: liver profile: AlT/AST, Bilirubin and Coronary risk profile: Cholesterol, Triglycerides, HDL, LDL | Chemistry |
| Where formed elements of blood are studied by enumerating and classifying the RBC, WBC and plates. Whole blood is the most common specimen analyzed | Hematology |
| Involves contact with the conjunctivae or mucous membranes of the nose or mouth of a susceptible person with large particle droplets generated from the source during coughing, sneezing or talking | Droplet precautions |
| Microorganisms can be dispersed widely by air currents and may become inhaled by or deposited on a susceptible host within the same room or over a longer distance from the source patient | Airborne |
| This type of transmission involves skin to skin contact and physical transfer of microorganisms to a susceptible host from an infected or colonized person | Direct contact |
| Transmission involves contact with a contaminated intermediate object in the patient's environment | Indirect contact |
| Isolation is condensed into three categories | airborne, contact and droplet |
| Latex sensitivity is a type of | allergic reaction |
| This is considered a pre-analytical error | inadequate fasting |
| Bacteria, viruses, fungus or parasites belong to this type of hazard | Biologic |
| Arterial Blood requires special handling. What is the special handling requirement? | Specimen must be chilled after collection |
| The "Good Samaritan Law" encourages healthcare professionals to | Provide medical care within the scope of their training at the scene of an accident without fear of being sued for negligence |
| Microorganisms that cause disease are | Pathogenic |
| Post-prandial means | after a meal |
| State and Federally funded insurance is called | Medicaid |
| National organization that develops guidelines and sets standards for laboratory procedures is | CLSI |
| The statue of limitations timing can begin | on the day the negligent act took place |
| Most frequent occurring lab-acquired infection is | hepatitis B |
| This is an example of potential exposure to blood-borne pathogens that involve a parenteral route of transmission | Rubbing the eyes while processing specimens |
| Lymph originates from | tissue fluid |
| This tube can be used to collect a serum specimen | Red |
| NPO means | nothing by mouth |
| Blood collection tubes are labeled | immediately after specimen collection |
| A patient has several short lengths of IV type tubing protruding from this chest. This is most likely a/an | CVC (central venous catheter) |
| Removing a unit of blood from a patient and not replacing it is used as a treatment for | polycythemia |
| After obtaining a specimen for a cold agglutinin test, the blood must be transported | at body temperature |
| These blood specimens should be transported in an ice slurry | Homocystene and rennin |
| Perspiration contamination can falsely elevate | chloride |
| According to CLSI guidelines, serum for most tests should be removed from the cells within | 120 minutes |
| This specimen can be centrifuged immediately | Electrolytes collected in a PST |
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