CC (LAB)

Question 1

3 Major Phases of Testing

Answer 1

Pre-Analytic Phase
Analytic Phase
Post-Analytic Phase

Question 2

occurs first in the laboratory process
involves steps such as the actual ordering of the tests by physicians, as well as sample collection

Answer 2

Pre-Analytic Phase

Question 3

This phase includes what is usually considered the “actual” laboratory testing or the diagnostic procedures, processes, and products that ultimately provide results.

Answer 3

Analytic Phase (Chemical Analyses)

Question 4

final phase of the laboratory process.
This phase culminates in the production of a final value or result

Answer 4

Post-analytic Phase (Data Management)

Question 5

is the act of obtaining a blood sample from a vein using a needle attached to a collection device or a stoppered evacuated tube

Answer 5

Phlebotomy or Venipuncture

Question 6

Comes from the Greek words “ Phleb”, which means ____, and “tomia”, which means ____

Answer 6

vein, cutting

Question 7

The most frequent site for venipuncture is the ____ (located in the anterior elbow at fold)

Answer 7

antecubital fossa

Question 8

have thick walls to withstand the pressure of ventricular contraction, which creates a pulse that can be felt, distinguishing them from veins.

Answer 8

Arteries

Question 9

THE VASCULAR SYSTEM

Answer 9

veins, arteries, capillaries

Question 10

When arterial blood is collected by syringe, the pressure normally causes blood to “pump” or pulse into the syringe under its own power.

Answer 10

Arteries

Question 11

Normal systemic arterial blood is bright red because it is oxygen rich.

Answer 11

Arteries

Question 12

have thinner walls than the same-size arteries because blood in them is under less pressure.

Answer 12

veins

Question 13

They collapse more easily.

Answer 13

veins

Question 14

Blood is kept moving through veins by _____ and the opening and closing of valves that line their inner walls.

Answer 14

skeletal muscle movement

Question 15

Normal systemic venous blood is dark bluish red because it is oxygen poor.

Answer 15

veins

Question 16

are only one cell thick to allow the exchange of gases and other substances between the tissues and the blood.

Answer 16

capillaries

Question 17

The capillary bed in the skin can easily be punctured with a lancet to provide blood specimens for testing

Answer 17

capillaries

Question 18

3 Main Veins in the Antecubital Fossa

Answer 18

median cubital vein
cephalic vein
basilic vein

Question 19

located near the center of the antecubital fossa.
It is the preferred vein for venipuncture in the H pattern because it is typically large, closer to the surface, and the most stationary, making it the easiest and least painful to puncture and the least likely to bruise.

Answer 19

median cubital vein

Question 20

located in the lateral aspect of the antecubital fossa.
It is the second-choice vein in the H pattern. Although often harder to palpate (feel) than the median cubital, it is fairly well anchored and often the only vein that can be felt in obese patients.

Answer 20

Cephalic vein

Question 21

located on the medial side of the antecubital fossa.

Answer 21

Basilic vein

Question 22

It is the last choice in either pattern.
Although normally large and easy to feel, it is not well anchored and rolls easily, increasing risk of puncturing a median cutaneous nerve branch or the brachial artery that is nearby.

Answer 22

Basilic vein

Question 23

CLSI recommends against using it unless no other vein in either arm is more prominent

Answer 23

Basilic vein

Question 24

• is normally uniform throughout the body.
• it is primarily reserved for blood gas evaluation and certain emergency situations and performed only by those with special training.

Answer 24

Arterial blood composition

Question 25

is affected by metabolic activity of the tissue it drains and varies by collection site.
-It differs most from arterial blood in its lower oxygen content, but chloride, glucose, pH, CO2, lactic acid, and ammonia levels may also differ.

Answer 25

Venous blood composition-

Question 26

contains arterial and venous blood plus tissue fluid.

Answer 26

Capillary blood-

Question 27

Because it enters capillaries under pressure, the arterial portion is highest. Warming the site increases it further.

Answer 27

Capillary blood-

Question 28

Blood is approximately

Answer 28

55% fluid and 45% blood cells

Question 29

is normally a clear, pale yellow fluid (nonfasting serum can be cloudy due to lipids) separated from clotted blood by centrifugation.

Answer 29

Serum-

Question 30

• is normally a clear to slightly hazy, pale yellow fluid that separates from the cells when blood in an anticoagulant tube is centrifuged.

Answer 30

Plasma

Question 31

Stat and other tests requiring a fast turnaround time (TAT) are often collected in tubes containing ____ because they can be centrifuged immediately to obtain plasma.

Answer 31

heparin anticoagulant

Question 32

contains both cells and plasma

Answer 32

Whole blood -

Question 33

It must be collected in an anticoagulant tube to keep it from clotting.

Answer 33

Whole blood -

Question 34

is used for most hematology tests and many point-of-care tests (POCTs), especially in acute care and stat situations

Answer 34

It must be collected in an anticoagulant tube to keep it from clotting.

Question 35

is the preferred method because blood is collected directly from the vein into a tube, minimizing the risk of specimen contamination and exposure to the blood.

Answer 35

. Evacuated tube system (ETS)

Question 36

used on small, fragile, or damaged veins

Answer 36

Syringe Method -

Question 37

set can be used with the ETS or a syringe and is often used to draw blood from infants and children, from hand veins, and in other difficult-draw situations.

Answer 37

Winged infusion set (butterfly) -

Question 38

• prevent blood from clotting and include ethylenediaminetetraacetic acid (EDTA), citrates, heparin, and oxalates. Each is designed for use in certain types of testing, and it is important to use the correct one.

Answer 38

Anticoagulants

Question 39

prevent glycolysis, which can decrease glucose concentration by up to 10 mg/dL per hour.

Answer 39

Antiglycolytic agents -

Question 40

The most common antiglycolytic agent, ____, preserves glucose for up to 3 days and inhibits bacterial growth.

Answer 40

sodium fluoride

Question 41

is used to collect ethanol specimens to prevent an increase in alcohol due to fermentation by bacteria

Answer 41

sodium fluoride

Question 42

are coagulation factors such as thrombin and substances such as glass (silica) particles and inert clays like diatomite (Celite) that enhance clotting by providing more surface for platelet activation.

Answer 42

Clot activators -

Question 43

are inert substances contained in or near the bottom of certain tubes.

Answer 43

Thixotropic gel separators -

Question 44

is made of pliable non-latex rubber flat band or tubing
It is wrapped around the arm, causing cessation of blood flow and dilation of the veins, making for easier detection.

Answer 44

Tourniquet

Question 45

The gauge of the needle is inversely related to the size of the needle; the larger the number, the smaller the needle bore and length. Routine venipuncture uses a

Answer 45

23- or 21-gauge needle

Question 46

: scar buildup that can result from many venipunctures in the same area for an extended period, improper redirection of the needle, or probing and can impair vein patency and make it difficult to perform subsequent venipunctures.

Answer 46

Vein damage

Question 47

: backflow of blood from the tube into the patient’s vein that can occur if blood in the tube is in contact with the needle during a blood draw. To prevent reflux, the patient’s arm must be in a downward position so that the collection tube fills from the bottom up.

Answer 47

Reflux

Question 48

results from poor site selection, inserting the needle too deeply or quickly, patient movement on needle insertion, excessive or lateral needle redirection or blind probing. Extreme pain, a burning or electric shock sensation, arm numbness, or pain radiating up or down the arm are all signs of nerve involvement that require immediate removal of the needle.

Answer 48

Nerve injury:

Question 49

rapid swelling at or near the venipuncture site due to blood leaking into the tissues

Answer 49

Hematoma formation:

Question 50

anemia as a result of treatment (e.g., frequent blood draws or removing large quantities at a time). Only minimum amounts of blood should be drawn from infants.

Answer 50

Iatrogenic anemia:

Question 51

: accidentally sticking an artery; often the result of deep or blind probing or attempting to draw from the basilic vein. Venipuncture must be discontinued and pressure applied for 5 minutes. Identify specimen as arterial blood if submitted for testing.

Answer 51

■ Inadvertent arterial puncture

Question 52

adverse effects of bacterial multiplication. Infection risk can be minimized by using aseptic technique, including cleaning the site properly and not touching it again before needle insertion.

Answer 52

Infection of the site: