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NHA Phlebotomy 2012
National Healthcare Association's Phlebotomy Certification Study Guide 2012
| Question | Answer |
|---|---|
| What are the 2 types of ciruclation in the heart? | 1. Pulmonary Circulation 2. Systemic Circulation |
| What does Pulmonary Circulation do? | Pulmonary Circulation carries DEOXYGENATED blood from the Right Ventricle to the lungs. |
| What does Systemic Circulation do? | Systemic Circulation carries OXYGENATED blood from the Left Ventricle throughout the body. |
| What are the 2 RIGHT valves of the heart? | 1. Tricuspid Valve: atrioventricular valve 2. Pulmonic Valve: semi-lunar valve |
| What are the 2 LEFT valves of the heart? | 1. Mitral Valve: atrioventricular valve 2. Aortic Valve: semi-lunar valve |
| What are the 3 layers of the heart? | 1. Endocardium 2. Myocardium 3. Epicardium |
| What are the 8 blood vessels? | 1. Aorta 2. Arteries 3. Arterioles 4. Capillaries 5. Venules 6. Veins 7. Superior Vena Cava 8. Inferior Vena Cava |
| How many liters of blood are in the average adult body? | 5-6 liters |
| Plasma is the ________________ portion of blood. | liquid |
| Formed Elements is the ___________ portion of blood. | cellular portion |
| What does the formed elements (celluar portion of blood) consist of? | erythrocytes, leukocytes, thrombocytes |
| What is the lifespan for Erythrocytes? | 120 Days |
| What are the 5 leukocytes (white blood cells)? | 1. Neutrophils 2. Lymphocytes 3. Monocytes 4. Eosinophils 5. Basophils |
| What is another name for Leukocytes? | White Blood Cells |
| Define Hemostasis. | The process by which the blood vessels are repiared after injury. |
| What are the 4 stages of Hemostasis? | 1. Vascular Stage 2. Platelet Phase 3. Coagulation Phase 4. Fibrinolysis |
| Explain the Vascular Phase of Hemostasis. | 1st step in Hemostasis. Injury to blood vessels, causing it to constrict and slowing the blood flow. |
| Explain the Platelet Phase of Hemostasis. | 2nd step in Hemostasis. Platelets adhere to injured endothelial lining. This forms aggregation (temporary platelet plug). |
| Define Aggregation. | A temporary platelet plug formed during the platelet phase of hemostasis. |
| Explain the Coagulation Phase of Hemostasis. | 3rd Step in Hemostasis. Converts temporary platelet plug into a stabin fibrin clot. |
| Explain Fibrinolysis in Hemostasis. | 4th Step in Hemostasis. Breakdown and removal of the stabin fibrin clot. |
| What does APTT stand for? | Activated Partial Thromboplastin Time |
| What is APTT used to monitor? | APTT montiors Heparin Therapy and intrinsic pathways. |
| What does PT stand for? | Prothrombin Time |
| What is PT used to monitor? | PT monitors Coumadin Therapy, as well as extrinsic pathways. |
| What are the 3 major beins located in the antecubital fossa that are acceptable to use for a VP? | 1. Median Cubital Vein 2. Cephalic Vein 3. Basilic Vein |
| Explain the Median Cubital Vein. | Vein of choice for a VP. A large vein that tends not to move. |
| Explain the Cephalic Vein. | 2nd vein of choice for a VP. This vein has tendency to move. It is often the only vein that can be palpated in an obese patient. |
| Explain the Basilic Vein. | 3rd vein of choice for a VP. Tends to move. |
| What are 3 unsuitable veins for a VP? | 1. Sclerosed Veins 2. Thrombotic Veins 3. Tortuous Veins |
| Define Hematoma. | Blood accumlates in the tissue surrounding the vein. Caused by either the needle going through the vein or insufficient pressure being applied. |
| What are 2 causes of a Hematoma? | 1. Insufficient pressure applied to the site. 2. Needle going through the vein |
| Define Hemoconcentration. | Increase of proportion of plasma due to tourniquet being left on too long. |
| What can cause Hemoconcentration? | The tourniquet being left on too long. |
| What is the longest a tourniquet should be left on? | 2 minutes |
| Define Phlebitis. | Inflammation of a vein due to repeated VP. |
| What can cause Phlebitis? | Repeated VP to a site |
| Define Petechiae. | Tiny, non-raised red spots that appear on/around the site due to a tournqiuet being left on too long and capillaries burst. |
| What can cause Petechiae. | Tourniquet being left on too long and capillaries burst |
| Define Thrombus. | A blood clot, usually consequence of insufficient pressure after a needle is withdrawn. |
| What can cause Thrombus. | Insufficient pressure after a needle is withdrawn. |
| Define Thrombophlebitis. | Inflammation of a vein with formation of a clot. |
| Define Septicemia. | Systemic infection associated with the presence of a pathogenic organism introduced during VP. |
| Define Trauma. | An injury to underlying tissues cause by probing the needle. |
| What can cause trauma. | Probing the needle at the site. |
| Define Edema. | Fluid retention in the tissue or inflammation. |
| Name 9 complications that can be caused by a VP. | 1. Hematoma 2. Hemoconcentration 3. Phlebitis 4. Petechiae 5. Thrombus 6. Thrombophlebitis 7. Septicemia 8. Trauma 9. Edema |
| How far should you puncture when doing a capillary stick? | No deeper then 2.0mm |
| Where to you puncture on the heel? | Medial and lateral of the plantar surface of the heel. |
| What is the order of draw? | Yellow, Lt. Blue, Red, Tiger Top, Green, Lavender, Gray |
| #1 in order of draw. | Yellow Tube |
| #2 in order of draw. | Lt. Blue Tube |
| #3 in order of draw. | Red Tube |
| #4 in order of draw. | Tiger Top Tube (Red/Gray) |
| #5 in order of draw. | Green Tube |
| #6 in order of draw. | Lavender Tube |
| #7 in order of draw. | Gray Tube |
| Name the 3 parts of the chemistry section. | 1. Electrophoresis 2. Toxicology 3. Immunochemistry |
| Explain Electrophoresis in relation to chemistry section. | Analyzes chemical components of blood. |
| Explain Toxicology in relation to chemistry section. | Analyzes plasma levels of drugs and poisons in the blood. |
| Explain Immunochemistry in relation to chemistry section. | Detects and measures substances such as hormones, enzymes, and drugs. |
| Define Profile. | A group of tests ordered by a physician. |
| Explain the Blood Bank Section. | Where blood is collected, stored and prepared for blood transfusion. |
| Explain the Serology (immunology) section. | Evaluates patients immune response through the production of antibodies. |
| Explain the Microbiology section. | Detection of pathogenic microorgranisms in patient samples. |
| Explain the Urinalysis section. | Detects infection of the kidney and urinary tract. |
| Explain the Hematology section. | Formed elements of the blood are studied. Whole blood is the most common test. |
| What is the most common test of the Hematology section? | Whole blood |
| Explain what to do for an External Hemorrage. | Elevate the affected part above heart level and apply direct pressure to the wound. |
| Define Shock. | Insufficient return of blood flow to the heart. |
| Define Agents in relation to the chain of infection. | Infectious microorganisms that can be classified as viruses, bacteria, fungi and parasites. |
| Define Portal of Exit in relation to the chain of infection. | How the infectious agent leaves it's reservoir. |
| Define Mode of Transmission in relation to the chain of infection. | Specific ways in which the microorganisms travel. |
| Define Portal of Entry in relation to the chain of infection. | What allows the infectious agent to access the susceptible host. |
| Define Susceptible Host in relation to the chain of infection. | The person/host who is susceptible to the agent and is not resistant or immune. |
| What are the 5 steps to the chain of infection? | 1. Agent 2. Portal of Exit 3. Mode of Transmission 4. Portal of Entry 5. Susceptible Host |
| Define Medical Asepsis. | Destruction of pathogenic microogranisms after they leave the body. |
| What is the solution fraction for disinfection? | 1:10 bleach to water |
| Define Negligence. | Failure to exercise the standard of car that a responsible person would give. |
| What are the 4 D's of negligence? | 1. Duty of care 2. Derelict: Breach of duty of care 3. Direct Cause: legally recognizable injury occurs as a result of breach of duty 4. Damage: wrongful activity must have cause the injury |
| Define Tort. | Wrongful act that results in injury to a person. |
| What is it called if you touch a patient before they give you full consent? | Battery |
| Define Invasion of Privacy. | Release of medical records without the patients permisson. |
| Define Defamation of character. | Injury to another persons reputation or name. |
| Explain Fasting Specimens. | Collection of blood when the patient is in basil state - refrained from exercise, food, or drink for 12 hrs prior to drawing. |
| What does a 2 hour postsprandial test evaluate? | Diabetes Mellitus |
| What does OGTT stand for? | Oral Glucose Tolerance Test |
| What is an OGTT used to diagnose? | Diabetes Mellitus |
| When is an OGTT scheduled to start? | 0700-0900 |
| What are you testing for at the 3 hr OGTT? | Hyperglycemia |
| What are you testing for at the 5 hr OGTT? | Hypoglycemia |
| What is the purpose of Therapeutic Drug Monitoring? | Monitor blood levels of certain medications. |
| What is the purpose of Blood Cultures? | Detect presence of microorganisms in a patient's blood. |
| Explain PKU. | Test that is ordered on infants to detect phenylketonuria - causes MR and brain damage |
| Explain Cold Aggulations. | Blood collected in red tubes that have been pre-warmed to 37 degrees celsius for 30 min. |
| Explain Chilled Specimens. | Specimens that must be chilled ASAP in crushed ice or ice/water mixture. |
| What type of tests would need to be chilled specimens? | Arterial Blood Gasses & Lactic Acids |
| Explain Light Sensative Specimens? | Protected from light - wrapped in aluminum foil. |
| What is the additive in the Tiger Top Tube (red/gray)? | Thixotropic gel for serum separation. |
| What is the additive in a Gray Tube? | Antiglycolytic Agent: Sodium Fluoride, Lithium Iodoacetate Anticoagulant: Potassium Oxalate |
| What is the additive in a Red Tube? | Nothing - it is a plain tube |
| What is the additive in a Lt. Blue Tube? | Sodium Citrate |
| What is the additive in a Yellow Tube? | Sodium Polyanetholesulfonate (SPS) |
| What is the additive in a Green Tube? | Heparin combined with sodium, lithium or ammonium ion. |
| What additive is in a Lavender Tube? | EDTA |
| What is the purpose of the Thixotropic Gel (Serum Separator) in a Tiger Top Tube? | Form a barrier between the serum and fibrin clot - seperate the serum. |
| Common Tests for a Red Tube. | Serum Chemistry Tests. Serology Tests. Blood Bank. |
| Common Tests for a Tiger Top Tube. | Most chemistry tests. |
| Common Tests for a Gray Tube. | Fasting Blood Sugar (FBS). Glucose Tolerance Test (GTT). Blood Alcohol Levels (BAC). Lactic Acid Measurements. |
| Common Tests for a Green Tube. | Chemistry Screens. STAT Electrolytes. |
| Common Tests for a Lavender Tube. | CBC (included RBC, WBC, & Platelet Count). WBC Differenetial Count. Hemoglobin & Hematocrit Determinations. ESR. Sickle Cell Screening. |
| Common Tests for a Lt. Blue Tube. | Prothrombin Time (PTT). Coumadin Therapy. Activated Partial Thromboplastin Time (APTT). Factor Assays. Bleeding Time (BT). |
| What does Post-Parandaial mean? | After a Meal |
| Microorgaisms that cause disease are _______________. | pathogenic |
| What is the antiglycolytic agent that maintains glucose stability for 3 days? | Sodium Fluoride |
| Which tests requires the specimen to be protect from light prior to testing? | Bilirubin |
| What is the purpose of warming the site prior to a dermal puncture? | Increases the blood flow. |
| Arterial Blood is the best sample for determination of ____________ ______ and _____________ ______________. | Blood pH. Blood Gases. |
| What is the most common complication from phlebotomy? | Hematoma |
| "Butterfly" is another name for a ____________ _____________ __________. | Winged Infusion Set. |
| How long should it take for a Red Top Tube to clot? | 30-60 minutes |
| Define Hemolysis. | Destruction of Red Blood Cells |
| Red Blood Cells are also called _________________. | Erythrocytes |
| Should you recap a needle? | NO |
| The most common cause of blood culture contamination is ____________ _____________ ____________. | Improper Skin Preparation |
| What is the vein that is most easily palpated in an obese patient? | Cephalic |
| Peak Level and Trough Level are used in ____________ ___________ ______________. | Therapeutic Drug Monitoring |
| Nosocomial Infections are infections contracted in a __________ ________ __________. | Health Care Setting |
| Contraction of the heart is ___________. | Systole |
| Relaxation of the heart is ____________. | Diastole |
| What is the function of a Leukocyte? | To provide the body protection against infection. |
| What do Erythrocytes contain? | Hemoglobin - the 02 carrying protein |
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