Phlebotomy 2 Flashcards

red blood cells
Terms Definitions
UA
URINALYSIS
EDTA.
Lavender.
sclerosed
hardened
Pt
patient
PSYCH/O
BRAIN
Anemia test
hemoglobin
Lavender (additive)
K,EDTA
Voluntary
Conscious contraction.
ATP
ADENOSINE TRIPHOSPHATE
NPO
NOTHING BY MOUTH
Professional negligence is:
malpractice
plain tube (dept.)
chemistry
lipemic serum
cloudy serum
Capillaries
Microscopic blood vessels.
ABO
BLOOD GROUP SYSTEM
Moral standards of behavior
ethics
EDTA
Ethylenediaminetetraacetate. A calcium chelating (binding) agent that is used as an anticoagulant for laboratory blood specimens.
Light Blue (dept)
Special Hematology
phagocytes
attack and digest bacteria
Adrenal Cortex
Mineralocorticoids, Glucocorticoids, Gonadocorticoids
altitude
RBC level is elevated
Parenteral.
Other than the digestive tract.
Agranulocytes that function in antibody production are called:
lymphocytes
The HemoCue beta-hemoglobin analyzer is used to assist in the diagnosis and evaluation of:
anemia.
Winged infusion sets.
aka Butterfly needles.
PT
(Prothombin Time)
Blue
Coagulation Dept
(For extrinsic coag. function)
PPE stands for
Personal Protective Equipment
4 basic types of tissue
epithelial
muscle
nerve
connective
Gold-Top Tube
Clot Activator/Separator Gel

Most Serum Testing
Parkinson's Disease
A progressive-degenerative disease characterized by tremors.
Yellow-Top Tube (1)
Sodium Polyanetholesulfonate (SPS)

Blood Cultures
SED RATE
SEDIMATION RATE OF ERYTHROCYTES
Dark Green (additive)
Li Heparin, Na Heparin
What evacuated tube additive prevents platelets from clumping?
EDTA
Human cells have how many chromosomes?
46
Human cells have how many chromosomes?
26,36,46,56
Anticoagulant used to prevent blood from clotting:
heparin
What evacuated tube additives inhibits complement?
SPS
What evacuated tube conventional stopper color indicates the tube contains silica particles to facilitate blood clotting?
red SST
Light blue tube top.
APTT and PTT
Aliquot
Portion of specimen used for testing
Hemolysis
destruction of RBC's and the liberation of hemoglobin into fluid portion of specimen causing sermum or plasma to be pink to red in color
Plasma
clear, yellowish fluid composing the major portion of the blood
Pathogenic
Possessing the ability to produce disease
contact transmission
direct contact~directly touching the affected area

indirect contact~ touching something that an infected person touched
what is hemolyzed serum
pink tinged serum
11 Major Organ Systems
"MRS. NEIL CURD"

Muscular
Skeletal
Respiratory
Nervous
Endocrine
Integumentary
Lymphatic
Cardiovascular
Urinary
Reproductive
Digestive
Gray collection tube
Oxalate, sodium fluoride additive
prevents blood from clotting-produces plasma
Tests: glucose levels, Blood alcohol levels, Lactate, Bicarbonate
A phlebotomist explains to an inpatient that he has come to collect a blood specimen. The patient extends his arm and pushes up his sleeve. This is an example of:
Implied consent.
A phlebotomist explains to an inpatient that he has come to collect a blood specimen. The patient extends his arm and pushes up his sleeve. This is an example of:
Implied consent.
Airborne precautions require the phlebotomist to wear:
An N95 respirator.
PKU must dry a minimum of:
3 hours
Phase of the laboratory testing where phlebotomist has the greatest impact on the quality of the specimen:
preanalytical
A test that will detect borderline abnormalities in a patient is said to be:
sensitive
A test that will detect borderline abnormalities in a patient is said to be:
reproducible, reliable, specific, sensitive
The glandular system that secretes hormones directly into the bloodstream is the:
endocrine system
Blood from a routine venipuncture should have what color?
dark red
Outer layer of the skin is the:
epidermis
Gloves
Must me worn when collecting blood specimen
Tourniquets
preven the venous outflow of blood from the arm causing the veins to bulge thereby making it easier to locate the veins.
Lumen.
Internal space of a needle or vein.
Antiseptic
Solution used to clean skin before venipuncture
Plasma Seperator Tube (additives)
Na Heparin and gel
Hyperglycemia
blood sugar level which is too high
most common site for venipuncture
median anticubital fossa
Acetylcholine
Chemical necessary for impulse to jump from one neuron to another (from axon to dendrite).
Commonly used gauge of needles used for venipuncture...
20,21,22
secondary hemostasis involves the formation of a tougher fibrin clot formed of..(3)
RBC, platelets, fibrin
Negligence.
Failure to act in a reasonable and prudent manner.
The "Right to Know" law primarily deals with:
Hazardous materials information.
Coagulation tubes have which type of closure?
light blue
Which is not a factor considered in negligence cases?
contract
Which is not a factor considered in negligence cases?
duties, contract, proximate causation, damages
Hardening of the arteries due to build up of cholesterol and/or calcium deposits:
arteriosclerosis
Tx drug monitoring is used for pts taking:
lithium
Tx drug monitoring is used for pts taking:
dextran, lithium, streptokinase, mithramycin
What method of blood collection is preferred for infants?
skin puncture
During the Allen test, which artery is released FIRST?
ulnar
What additive is found in an evacuated tube with a yellow conventional stopper and used to inhibits complement?
SPS
One of the most important (and easiest) practices used to prevent transmissions of bloodborne pathogens.
Hand washing
The part of the evacuated tube holder that is meant to aid in smooth tube removal.
Flange.
Requisition
Form on which test orders are entered and sent to the lab
What Department do the green tubes go to?
Chemistry
Apathy
A visible lack of interest, feeling or emotion
diurnal variation
the normal daily fluctuations in body chemistry related to hormone cycles sleep awake cycles and other regular patterns of change
during the bleeding time test how high should the blood pressure cuff read
40
quality phlebotomy
set of procedures and policies designs to ensure the delivery of the highest quality patient care and consistent specimen analysis
Humoral Stimulus
Changing levels in the blood triggers release of hormones.
once you have cleaned arm with alcohol you must then clean with
iodine
The period within which an injured party may file a lawsuit is known as:
Statue of Limitation.
The component that turns the fire triangle into a fire tetrahedron is:
A chemical reaction.
Engineering Control.
Device that isolates or removes a BBp hazard.
What does BBP stand for?
bloodborne pathogens
What does BBP stand for?
bloodborne procedures or bloodborne pathogens
What condition may cause petechiae on a patients skin?
patient platelet defect
SPS additive in a yellow tube top is:
Sodium polyanetholesulfonate
Blood Clot
The conversion of blood from a liquid form to solid through the process of coagulation. A thrombus is a clot which forms inside of a blood vessel. Is that clot moves inside the vessel it is referred to as an embolus (embolism).
What is the additive for the red top tube?
It is important to fill oxalate tubes to the stated fill capacity because excess oxalate:
Causes Hemolysis.
hematome
a swelling or mass of blood caused by blood leaking from a blood vessel during or follwoning venipuncture or arterial puncture.
An example of a test that is commonly ordered fasting is:
Glucose.
Susceptible Person
Host not immune to disease because of age or weakened immune system
POCT

point of care testing
refers to the performance of analytical tests immediately after obtaining a sample
Which blood tube should be drawn first, green (Ammonia, bilirubin) or blue (coagulation studies)?
Blue (coagulation studies)
Performing one's duties in the same manner as any other reasonable and prudent person with the same experience and training is referred to as:
The standard of care.
What does the National Fire-Protection Association (NFPA) codeword Race mean?
Rescue, Alarm, Confine, and Extinguish.
What is a legal term referring to the failure to act or perform duties according to the standards of the profession?
Professional negligence
What is a disinfectant used in health care?
chlorophenol
What is a disinfectant used in health care?
chlorophenol or hexachlorophene
A health care-acquired infection occurs when:
the chain of infection is complete.
During an Ivy Bleeding Time procedure, the blood pressure cuff should be positioned:
above the antecubital crease
During an Ivy Bleeding Time procedure, the blood pressure cuff should be positioned:
above the antecubital crease, below the antecubital crease, around the patient's calf, around the patient's wrist
Why are syringes no longer commonly used for routine venipuncture?
safety and cross-contamination concerns
Red top tube
Also known as plain vacuum tube and contains no additive or anitcoagulant. Collected blood clots by normal coagulation process in 30 minutes.
Serum Separator Tube. (SST)
Tube containing a gel separator and silica to activate clotting.
k, EDTA (tests)
type and cross match, type and screen, antibody screen, Rhogram, CBC, Sed rate, Retic count, platelet count, Hemogram (H&H) , Diff.
3 Classifications of the Muscular System
Skeletal Muscles
Visceral or Smooth Muscles
Cardiac Muscles
name 3 main veins of antecubital fossa and give their location
cephalic-lateral, basilica-medial, median cubital-middle
An example of employee screening for infection control is:
Purified Protein Derivative (PPD) testing.
What age do kids like roll play, afraid of injury:
3-5 yrs of age
What is a required characteristic of a sharps container?
Leak-proof and puncture-resistant, locking lid, and marked with a biohazard symbol.
what is included in the digestive system
mouth, esophagus, intestines, rectum, anus, liver, gallbladder, and pancreas
The abbreviation for an agency that sets standards for phlebotomy procedures.
The National Committee for Clinical Laboratory Standards. (NCCLS)
What actions may result in a false positive blood culture result?
repalpating the site causes contamination
How large are capillaries?
about the size of the diameter of one cell
How large are capillaries?
about 1 centimeter in diameter or about the size of the diameter of one cell
What is a syringe transfer device
Allows safe transfer of blood into tubes without using syringe needle or removing tube stopper
What does the term "tort" mean?
A wrongful act for which damages may be awarded.
What are healthy ways to deal with stress:
Exercising on a regular basis, learning how to relax, and taking time to plan your day.
At least how long should a warmer be applied to a skin puncture site prior to making a skin puncture?
3 minutes
At least how long should a warmer be applied to a skin puncture site prior to making a skin puncture?
3, 4, 5, 6 minutes
What does POCT stand for and what benefits does it offer?
Point of care testing- Portable testing device; convenience to patient, short turnaround time
What steps should be taken when a blood sample cannot be obtained?
Advance, withdraw, rotate, try another tube.
What is the means of breaking the chain of infection?
Hand washing and glove use, isolation procedures, and stress reduction and proper nutrition.
How is bone marrow samples usually removed?
By aspiration from the iliac crest of the hip
If a patient is fainting, what is the first thing to do.
Get the needle of the arm.
list BD order of draw for glass color(open book)
white, red, blue, gold/red and black, green, light green,purple.pink,silver
Why are smaller than __ are not used for drawing blood because they can cause ___.
23. Hemolysis (The breaking , or Iycing, or Red Blood Cells.) These are called Hemolysed Red Blood Cells, or a Hemolyzed sample.
If a patient is on ginko biloba, aspirin, and/or Coumadin, you must...
Apply pressure to the site after a venipuncture for 2-3 minutes
If the patient asks you if the procedure will hurt, you should say that it:
May hurt a little but only for a short time.
NH3
AMMONIA
Glucose
(stat)
Green
Chemistry
Hgb
Hemoglobin
CARCIN/O
CANCEROUS
RR
RECOVERY ROOM
Comprehensive
Metabolic Panels
Green
Chemistry
LH
Lutenizing Hormone
Pancreas
Glucogon, Insulin
ACTH
Adrenocorticotropic Hormone
MYEL/O
SPINAL CORD
RBC
RED BLOOD CELLS
QNS
Quantity not sufficient
chyme
thick soupy mixture
hCG
Human Chorionic Gonadotropin
(pregnancy test)
-OSIS
AN ABNORMAL CONDITION
Light Blue (dept)
Special Hematology
what is pO2?
blood gas
Bevel
End that pierces skin
thoracic cavity
hold the heart
Pharynx
Divided into 3 sections:

Nasopharynx
Oropharynx
Laryngopharynx
What color for PPT
green
grey (additive)
Sodium fluoride, Potasium Oxalate
Components of Fire:
fuel, oxygen, heat
What condition sometimes occurs following a mastectomy that becomes a factor in venipuncture site selection?
lymphostasis
Multisample needles are typicallly available in these gauges.
20-22.
grey (additive)
Sodium fluoride, Potasium Oxalate
TDM stands for
Therapeutic Drug Monitoring
3 types of muscle tissue
skeletal
cardiac
smooth
Meninges
Protective covering around the CNS.
what additive is in purple
EDTA
Civil actions involve:
Actions betweeen private parties.
What mode of infection transmission involves transfer of an infective microbe to the mucous mebrances of a susceptible individual by means of a cough or sneeze?
Droplet.
Which agency evaluates the safety, clinical efficacy, and medical efficacy of the equipment and supplies used by blood collection?
FDA
Which agency evaluates the safety, clinical efficacy, and medical efficacy of the equipment and supplies used by blood collection?
FDA,EPA,OSHA,JCAHO
Bleeding time procedures are usually ordered:
presurgically
Bleeding time procedures are usually ordered:
as timed tests, in a series, not stat, presurgically
The clear, colorless fluid that functions in protecting and nourishing the brain and spinal cord is called:
CSF
Blood collection and dilution unit manufactured by BD
Unopette
Standard of Care is set by:
JCAHO
Standard of Care is set by:
FDA,HIPAA,OSHA,JCAHO
Germicide
An agent that kills pathogenic microorganisms.
What microcollection containers should be filled first if collected by skin puncture?
Lavender stopper.
Gauges
Standard for measuring diameter of needle’s lumen
intracellular fluid
fluid found within cell membrances
Artery
blood vessel carrying oxygenated blood from the heart
nerve tissue
intracellular communicating by the condition conduction of electrical impulses and release of chemical messages
Bronchitis
Inflammation of the bronchi and bronchioles.
Assault.
Involves the act or threat of harm.
Plasma Seperator Tube (PST)(tests)
electrolytes, Metabolic Panel, Hepatic Function panel, MISC STAT tests
Healthcare workers are considered immune to a disease if they have:
Had the disease.
Examination of witness before a trail is referred to as:
discover
Examination of witness before a trail is referred to as:
discovery, statue of limitations, respondent superior, implied consent
When lab results indicate a life-threatening state:
critical values
To prevent skin and mucous membrane exposure when contact with a patient's blood is anticipated, the following should be worn:
PPE.
What condition, caused by a hematoma surrounding a venipuncture site, may lead to erroneous results?
hemostasis
What color tube top contains sodium fluoride?
gray
What color tube top contains sodium fluoride?
yellow, gray, green , blue
During pregnancy, the increase of body fluids may cause a patient's RBC count to :
decrease
Heparin
An anticoagulant that acts to inhibit a number of coagulation factors, especially factor Xa. Heparin is formed in the liver.
Thrombus
This blood clot usually a consequence of insufficient pressure applied after the withdrawal of the needle.
A royal blue top with green color-coding on the label contains:
Heparin.
How many attempts does a phlebotomist have, when drawing blood
Twice
reflux
backwards flow of blood into the patients vein from the collection tube durning venipuncture procedure.
What individuals has legal authority to authorize patient testing?
Patient's physician.
Contusion
injuries which break blood vessels in the skin where blood mixes with skin causing bruising
hemostasis
the process which blood vessels are repaired after injury
Neural Stimulus
Nervous system triggers release of hormones (adrenalin).
the..... is the single most ordered blood test
CBC
Vicarious Liability.
Employers are liable for actions of their subcontractors.
The degree to which an organism is capable of causing disease is called:
Virulence.
Which of the following tests requires blood to be collected in a pink-topped tube?
Coombs' test
The body system that mechanically and chemically breaks down food into nurtients that can be absorbed and used by the body's cells is the:
digestive system
The process by which body cells use energy to make complex substances from simpler ones is called:
anabolism
What pathways is initiated by the release of tissue thromboplastin?
extrinsic pathway
What site for arterial puncture has the disadvantage of increased risk of infection?
femoral artery
Condition in which children have high sensitivity to latex:
spina bifida
What test is performed to assess collateral circulation of the patient's hand prior to arterial puncture?
Allen test
What is the fluid portion of unclotted blood?
Plasma
concentric circles
cleanse the area using a circular motion starting at the inside of the venipuncture site, these circles are called concentric circles. Which vein you choose should be based on the size and condition of the vein.
When a disposable latex tourniquet becomes soiled with blood, it is best to:
Thrown it away.
Basal sate
Resting metabolism state of the body in the morning after fasting for min. 12 hours
reference valves
normal valves for for lab tests usually established using basal state specimens
Beside Manner.
The way in which an individual conducts himself or herself when interacting with a patient.
Universal Precaution
An approach to infection control in which all blood and body fluids are treated as if they were infected with HIV,HBV, etc.
pituitary gland
master gland of hormone system because it sends and receives messages
Bronchioles
Smaller branches of the bronchi in the lungs.
Light blue tube
Sodium citrate additive binds to calcium, prevents clotting
PT, PTT, TT, Fibrinogen
the ....the number of needle gauge, the ..... the diameter
larger, smaller
What organization provides voluntary laboratory inspections and proficiency testing?
(CAP) College of American Pathologists)
When the chain of infection is broken:
Infection is prevented.
Health care institutions need to report accidental bloodborne exposure to:
CDC
Health care institutions need to report accidental bloodborne exposure to:
EPA, CDC, OSHA, CLIA
What colors are required for labeling sharps containers?
red or orange
Hemoconcentration
A decrease in the fluid content of the blood (plasma), resulting in an increase of concentration. This is determined by an increase in the hematocrit. Caused by a filtration of plasma into body tissue and often created by dehydration.
Universal precautions
The name used to describe a prevention strategy in which all blood and potentially infectious materials are treated as if they are, in face, infectious, regardless of the perceived status of the cource individual. In other words, wheter or not you think the blood/body fluid is infrected with bloodborne pathogensm you treat it as if it is. The approach is used in all situations where exposure to blood or potentially infectious materials is possible. This also means that certain engineering and work practice controls shall always be utilized in situations where exposure may occur.
Plasma Separator Tube. (PST)
Heparinized tube containing a gel separator.
Never leave a tourniquet on for more than:
1 minute.
Whole Blood
Blood containing plasma and all of its natural elements (whit blood cells, red blood cells and platelets)
centrifuge
spins a sample at a very high speed separating components based on density
Screening Tests for Syphilis
1. Rapid Plasma Reagent (RPR)
2. Serologic Test for Syphilis (STS)
3. Venereal Disease Research Laboratory (VDRL)
glucose is a measure of..... in your blood
sugar levels
Areas of phlebotomy subject to quality control (QA) procedures include:
Patient identification, phlebotomy techniques, and specimen labeling.
The main principles involved in radiation exposure are:
Exposure time, distance, and shielding.
What is the best angle for spreading a blood smear by using two glass slides?
30 degrees
What is the best angle for spreading a blood smear by using two glass slides?
completely flat, 0, 30, 90, 180 degrees
Two examples of bleeding time devices are:
Simplate TM, Surgicutt TM
Bar codes Represent:
The light and dark bands of varying widths, alphanumeric symbols, and specific codes for numbers and letters are represented by:
The following test were to be collected from a patient following skin puncture: platelet count, bilirubin, T3. What order should these tests be collected?
platelet count, bilirubin, T3
Battery
The basis of torn in this case is the unprivileged touching of one person by another. When a procedure is to be performed on a patient, the patient must give consent in full knowledge of the procedure and the risk it entails (informed consent). Intentional touching of a patient without out his or her consent.
Yellow Tube Additive
SPS - Blood Cultures
ACD - Genetic or Platelet Stud
Auto regulatory Blood Flow distress
Blood flow controlled by tissue needs
Steps of blood clotting:
1. Uncoagulated blood
2. Calcium is utilized
3. Prothrombin converts to thrombin
4. Fibrinogen converts to fibrin
5. Clot forms
A specimen was mislabeled on the floor. You are required to fill out an incident report form. What information is included on the form:
Description of the consequence, details of the corrective action taken, and explanation of the problem.
What is the proper neonatal intesive care unite blood drawing procedure?
Wear mask, gown, and gloves.
Blood collection vaccum tubes may contain silicon to:
decrease the possibility of hemolysis,
Blood collection vaccum tubes may contain silicon to:
decrease the possibility of hemolysis, decrease interfer between the red blood cells and the, create a barrier between the RBCs and serum, create a barrier between RBCs and plasma
Patient Bill of Rights
Under the patients bill of rights they always have the option to decline medical treatment and to know what tests are being performed on them. If they ask, you must tell them. You do not however, ever give them results as you are not medically qualified to do so.
Information on a test requistion must include the:
Ordering physician's name, patient's medical record number, and patient's name and date of birth.
list 7 requirements of a quality specimen
patient prepared properly, correct labeling, correct tubes used, not hemolyzed, fasting samples collected timely, time samples correctly timed and documented, transported to lab in time
What is the first action to take to help a victim in shock?
Maintain an open airway.
If a patient develops a hematoma during a venipuncture procedure, what should the phlebotomist do?
Remove the needle immediately and apply pressure.
What patient would a phlebotomist most likely choose a syringe to collect a blood specimen?
a man with a heparin lock
What patient would a phlebotomist most likely choose a syringe to collect a blood specimen?
woman who had a mastectomy, woman who just suffered a miscarriage, a man with heparin lock, man who just underwent angioplasty surgery
What come first in an allergic reaction?
Eosinophils come first in allergic reactions. Then, Basophils follow releasing histamine. During an allergic reaction, it would show an increased of Eosinophil count.
Main Function of the Urinary System
To form and excrete urine. Eliminates toxins.
An example of a quality assurance (QA) indictor is:
The contamination rate for blood cultures will not exceed the national contamination rate.
Changing a patient's position from supine to standing will cause which physiologic change?
water will filter from the plasma to the tissues
What are the formed elements in the circulatory system that constitute the remaining 45% of the blood?
Erythrocytes (red blood cells), which compromise 99% of the formed elements, the leukocytes (white blood cells) and the thrombocytes (platelets). All blood cells normally orginate from stem cells in the bone marrow.
What can be used to enhance the vein section process?
Lowering the arm,palpating the antecubital area, and using a warm towel to increase blood flow.
What must be present to claim negligence?
A breaking of a legal duty or obligation owed by one person to another, a legal duty or obligation owed by one person to another, and harm done as a result of breach of duty.
What test may require an extra step in patient identification?
type and crossmatch
What test may require an extra step in patient identification?
type and crossmatch, blood cultures, fibrin degradation products, glucose tolerance testing
Your inpatient is asleep when you arrive to draw blood. What do you do?
Call out the patient's name softly and shake the bed gently.
What is the best way to end all phlebotomy encounters?
By saying "thank you" to the patient.
Why is it sometimes best to assemble equipment after selecting and cleaning the blood collection site?
You will be more apt to allow sufficient time for the alcohol to dry, you will have a better idea of what equipment to use, and you will waste less equipment.
You arrive to collect a specimen on a patient named John Doe in 302b. How do you verify that the patient in 302b is indeed John Doe?
Ask the patient to please state his name and date of birth before proceeding.
What is the best thing to do if the vein can be felt but not seen, even with the tourniquet on?
Look for visual clues on the skin to help you remember where it is.
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