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Phlebotomy Session 8
| Question | Answer |
|---|---|
| What are some communication strategies | Verbal communication Nonverbal communication Active Listening |
| What are the "Four Components Of Communication" | -THE SENDER(Person sending the message) -MESSAGE SENT(What the sender wants to convey) -SYMBOLS(How the sender communicates the message) -MESSAGE RECEIVED(How the message is perceived) |
| What is the measurement considered for "PERSONAL SPACE" | 18in.-4ft. (Interactions with friends and some patients) |
| What is the measurement considered for "SOCIAL SPACE" | 4ft.-12ft. (Most interactions of daily life) |
| What is the measurement considered for "PUBLIC SPACE" | >12ft. (lectures, speeches) |
| What is the "Zone of Comfort" | Area around patient that is private territory(CHILDREN may feel uncomfortable if you get to close) |
| What is the "GOLDEN RULE" | Treat patient as you would want yourself or a family member treated in a health care setting |
| What is "Culture Sensitivity" | System of values, beliefs and practices that stem from a person's concept to reality |
| Physical Impact of Stress can cause? | -Hypertension -Hyperglycemia -Stroke -Myocardial Infarction -Diabetes -Ulcers -Neck and back pain |
| What are the early signs of stress | Headaches/fatigue (due to burnout and overload) |
| Immediate physical signs of stress are? | -Cold -Nervousness -Tense -Sweaty Hands |
| What are some coping strategies for stress | -keep caffeine to a minimum -try not to use alcohol/nicotine(may increase level of stress) -exercise regularly -set aside time to relax each day |
| define ethics | Morales duty to determine right and wrong |
| define accountability | You are responsible for your actions |
| Define Hemophilia | Tendency to bleed |
| define Thrombophilia | tendency to clot |
| Define Hemostasis | Process of blood clotting and then the subsequent dissolution of the clot following repair of injured tissue |
| Define Fibrinolysis | Breaking of the fibrin |
| What are the 5 Steps of the hemostatic process | Vascular Phase .. Platelet Phase .. Coagulation Phase.. Clot Reaction.. Fibrinolysis |
| What is Primary Hemostasis | -Process of forming a platelet plug at the sit of vessel injury -Consists of a vasoconstriction of platelet adhesion |
| Define Vasoconstriction(Vascular Phase) | "tightening" of blood vessels to divert blood flow around the damaged vessel -enhances contact activation of platelets and coagulation factors |
| Define Platelet Adhesion( Platelet Phase) | Platelets become activated and aggregate at the site of injury, forming a temporary loose, platelet plug |
| What happens in Secondary Hemostasis | Stabilizes the initially loose platelet plug, a sequence of enzymatic reaction is initiated which culminates in fibrin strands forming at the platelet plug |
| What happens in the "Coagulation Phase" | -Coagulation factors interact with each other to form a fibrin clot (reinforces the platelet plug...ADP, thromboxon, PFB) "FIBRIN FORMING SYSTEM |
| What are "Coagulation Factors" | Proteins normally presented in the blood (most are produced by the liver) ...normally "turned off" (inactive)..."A" signals the factor in its "active" form of coagulation cascade |
| What happens in the "Extrinsic Pathway" | Activated when endothelial cells are injured and tissue factor is released -activated factor VII and tissue factor bind to form a complex.(this complex, plus calcium, activates factor XTissue Factor) |
| What happens in the "Intrinsic Pathway" | Initiation occurs when factor XII is exposed to a negatively charged surface(termed the contact phase) "REQUIRES CLOTTING FACTORS VIII-XII |
| What is the "COMMON PATHWAY" | When factor Xa bigs to the platelet surface, a complex is formed composed of platelet phospholipid, calcium and factor Va...-Complex converts prothrombin to thrombin which in turn converts fibrinogen to fibrin |
| Explain Fibrinolysis | Bodys ways of keeping coagulation from becoming excessive and occluding the blood vessels |
| Thromboplastin activates what factor? | FACTOR 7 |
| define the REGULATION STAGE | Balance between coagulation and fibrinolyctic process must be maintained otherwise excess clotting or fibrinolysis will occur |
| Thrombophilia causes what | D.V.T. (Deep Venouse Thrombosis) or P.E. (Pulmonary Embolism) |
| define THROMBOPHILIA | Hypercoagulable state due to inherited(heriditary/genetic) defects or acquired defects in one or several factors of the coagulation cascade |
| How many patiens in the US are diagnosed with DVT each year? ....(thrombotic alert #1 | MORE than 500,000 |
| How many pulmonary embolisms are diagnosed each year in the US? ...(thrombotic alert #2 | MORE than 630,000 |
| FACTOR 1(fibrinogen) ...define .AFIBRINOGENEMIA | Total absense of measurable fibrinogen (RARE CONGENITAL DISORDER) |
| FACTOR 1(fibrinogen)...define HYPOFIRINOGENEMIA | Below normal levels of fibrinogen -treated by cryoprecipitate or FFP |
| FACTOR 1(fibrinogen)...define DYSFIBRINOGENEMIA | altered structure of the fibrinogen molecule -usually asymptomatic but has been associated with both bleeding and thrombotic events |
| explain ...FACTOR V (proaccelerin)GENE DEFECT | (MOST COMMON CAUSE OF THROMBOPHILIA) coafactor in coagulation cascade..defieceny causes bleeding but factor V mutation causes thrombotic events due to impaired degradation of factor V resulting in continued thrombin generation |
| what does MTHFR do ? | Breaks down homo cysteine |
| deficiency of MTHFR causes ? | increase of homocysteine leading to thrombosis |
| Acquired Homo cysteine is due to | deficiency of vitamin B6 and B12 |
| What happens if Prothrombin does not break down | keeps on activating thrombin to convert fibrinogen into a fibrin clot |
| deficiency in vWF causes (FACTOR VIII) | vonWillebrand's Disease |
| Defect or absense of coagulant portion causes | Classic Hemophilia A |
| Acute Phase Reactant | Increase in inflammation, stress, pregnancy and infectin which can lead to clot formation |
| What is the purpose of Quality Assurance | Gathering/evaluating information and data about services/tests provided |
| Quality Assurance is also known for | QUALITY IMPROVEMENT QUALITY ASSESSMENT PROFICIENCY IMPROVEMENT PERFORMANCE IMPROVEMENT |
| define T.A.T. | TURN AROUND TIME |
| What is the purpose of P.I. | Implement an interdisciplinary approach to collection, analysis and reporting of performance measures |
| What is the overall goal of P.I. | Effect quality improvement including accuracy and precision |
| Where does P.I. begin in a hospital setting | Begins in the lab before specimen is collected |
| What are Logbooks | Logs examined in quality assurance meeting to determine problem areas (also document problem areas with incident reports) |
| Define INCIDENT REPORTS | a formal written description of an incident/unusual occurrence |
| What is the purpose of incident reports | To objectively document exactly what happened (GOAL is to prevent another episode) |
| Define DELTA TEST | comparison between current results of the lab test and previous test results for same patient (CLS) |
| What are FLOOR BOOKS | Containcs information that lists the name of each test/procedure (useful to aid in consistency of testing for quality control purposes "AKA PROCEDURE, REFERENCE or TEST MANUAL) |
| what does JCAHO stand for | Joint commission on accrediation of healthcare organization (PRIVATE NON-GOVERNMENT AGENCY) |
| What does JCAHO do | Establishes guidelines for healthcare agencies regarding quality of care |
| What is CQI | Continuous Quality Improvement |
| What does CQI do ? | Framework and management commitment to improve healthcare structure, processes, outcomes, and customer satisfaction |
| What is the ultimate goal for CQI | IMPROVE PATIENT OUTCOMES |
| what are the "Poor patient outcomes (5 D's)" | -DEATH -DISEASE -DISABILITY -DISCOMFORT -DISSATISFACTION |
| Define P.D.C.A. | Plan-Do-Check-Act |
| What is the purpose of PDCA | Cycle for assessing, making changes, then reassessing and putting in action |
Created by:
moralesm05
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