ch.48-test 3 study guide
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| insertion of a needle or cannula into a vein for the purpose of withdrawing blood | phlebotomy
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| what is venipuncture | puncture of a _____ performed with a __________ and for the purpose of collecting blood
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| whole blood is | the total volume of plasma and formed elements
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| why is alcohol sometimes not used | because it can alter a test result, especially glucose, so the povidone-iodine swabs can be used in place of the alcohol for some tests
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| GGT-What is the glucose tolerance test | Checks for glucose levels it take a couple hours and it is always done with pregnancy
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| Confirming Pretest Prep: What should you instruct the pt. to eat for 3 days before test | instruction to the pt. for preparation for a GTT
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| formed elements | RBC, WBC, platelets
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| PPE for Phlebotomy especially use what ALWAYS | GLOVES
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| What are the most common sites? | median cubital and cephalic veins,
NOT femoral, inguinal, saphenous, seprior vena cava, popliteal, posterior tibial, radial nor ulnar veins
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| standard supplies for procedures | evacuation - vacutainer, double needle, blood test tubes, alcohol, cotton or gauze bandaid
butterfly- tubing with needle, syringe, alcohol, cotton, bandaid
capillary- lancet, alcohol, cotton, test machine
SHARPS container and gloves
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| 48-2 What is the vacutainer/evacuation system all about? | blood collection device used with interchangeable collection tubes that are calibrated to collect the exact amt. of blood
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| What is the butterfly system? 672 | used for small or fragile veins and with children more frequently. They have wings attached to the needle and it helps hold the needle steady in the vein
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| The holder adapter plastic part of the evac system is also called what "v" | vacutainer
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| What is the NIOSH | recommends that health care workers use needles only if no safe alternatives are available; never recap needles before putting in sharps
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| yellow top tube TEST TYPE | CMP
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| RED TOP TUBE- additive and test type | COLLECTION TUBE WITH NO ADDITIVES, it can clot if left alone OR if you centrifuge it will separate the plasma and keep the clot at the bottom, used for blood chemistries and HIV/AIDS tests
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| GREEN top tube Test Types | Electrolyte studies
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| RED/GRAY or gold - additive and test type | No additive,
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| GRAY top tube test type | blood glucose tests like FBS or HgbA1c and then tested every 3 months
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| If drawing Blood culture, then CBC, then Blood Chemistries,which tube is FIRST and last and why? | 1-blood culture-yellow, 2- blood chem-RED, 3- CBC-Lav, Fresher cleaner sample for CBC
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| What to do with a elderly patient when drawing blood | have the patient elevate their arm after removing the needle
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| which specimen collection technique collects the smallest amt and uses calibrated glass tubes (674) | capillary puncture
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| which fingers are preferred to be used first? (674) | 3rd and 4th
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| lancets are used when and what is definition 674 | disposable instruments with sharp points used to puncture the skin
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| how is a capillary puncture taken in a infant? | in the heel
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| characteristics of capillary puncture technique | used on the pt's dominant hand
used with a lancet
used when smaller amounts of blood are needed
NOT used in evacuation collection tubes nor syringes
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| pt. fears and concerns- PAIN what to tell a pt. and suggest (675) |
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| bruises or scars | do not inject into these areas
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| when does a hematoma occur? | going through the vein, or not putting enough of the needle in the vein..it happens sometimes
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| What to tell a pt. regarding getting the blood test it is the best way to what? (675) |
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| how to avoid a hematoma and read venipuncture complications p.677 |
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| anticoagulants and serum separators | anticoagulant- Heparin and EDTA
serum separator- separates the whole blood clots on the bottom and plasma on the top by serum separator, or yellow gel in tiger top tube and gold tube
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| KNOW TESTS: indications diseases and disorders-BUN and creatine kinase | BUN test -bllod urea nitrogen-kidney disorders
CREATINE kinase-heart disease
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| Total Cholesterol | blood test to identify coranary artery disease (CAD) and atherosclerosis
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| Erythrocyte count (RBC) | used to identify anemia
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| Glucose | gray top and capillary puncture
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| potassium and sodium blood tests | identifies fluid-electrolyte imbalances
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| Gout is identifies with which blood test | Uric acid
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| PT or prothrombin time normal ranges | 11-15seconds (how long it takes for the blood to clot)
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| calcium normal ranges | 8.6-10 mEq/L
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| potassium normal ranges | 3.5-5.1 mEq/L
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| glucose fasting blood sugar -FBS normal ranges | 74-120 mg/dL
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| Blood counts |
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| normal sodium blood level | 136-146 mEq/L
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| WBC count- or white blood cell count is in which test? | CBC
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| CBC contains what? | Hct., Hgb, WBC, RBC, erythrocytes, basophils, everything for the whole blood
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| hematocrit determination | identifies how much volume of a sample is made up of RBC's after the sample is spun in a centrifuge
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| What is the most common way to clean the sit for venipuncture? | with alcohol
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| why do you not put tourniquet on too tight? | it can cause hemolysis
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| what is hemolysis | lysing or rupturing of RBC's(red blood cells)
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| what are the blood formed elements | red blood cells, white blood cells, and platelets
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| what is whole blood | the total volume of plasma and formed elements
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| how far do you go into the vein wall when performing venipuncture with the evacuation system? | 1/4-1/2 inch
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| After how many unsuccessful attempts at obtaining a good blood sample should yu seek assistance from your supervisor or MD | 2
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| what is the blood disorder when the blood doesn't coagulate at a puncture site? | hemophilia
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| what is plasma | the clear yellow liquid in which formed elements of blood are suspended
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| After the blood has been spun in the centrifuge, what test determines how much volume of a sample is made up of red blood cells ? | Hematocrit
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| what is the ELISA and Western blot tests used to confirm? | HIV infection and ELISA is the ENZYME -linked immunosorbent assay test
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| What is Morphology | the study of the shape of form of objects.
(like those morph apps for pics- what did you morph into??)
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| steps before the collection of a blood specimen | Identify the pt. correctly, ask the pt. to tell you their name,
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| when drawing blood from the elderly patient | have the pt. elevate her arm after removing the needle
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| Be AWARE of any blood disorders BEFORE taking blood by asking pt. if they have a bleeding disorder or problems with their blood clotting AKA- | hemophilia, if so, hold for min 5 min with pressure on puncture site or wound
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| Ask if pt. is allergic to | latex, non-latex is safer - some pts. dont even know until the procedure. (NOT ON TEST-common with seasonal allergies to some trees)
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