Chapter 7-9 Terms to Know

Question 1

Chemicals that inhibit blood
clotting or “blood thinners.”

Answer 1

Anticoagulant

Question 2

Any substance placed within a tube other than the tube stopper or if the tube is glass, the silicone coating.

Answer 2

Additive

Question 3

Substances used to prevent sepsis, which is the presence of microorganisms or their toxic products within the bloodstream. ______________ prevent or inhibit the growth and development of microorganisms but do not necessarily kill them.

Answer 3

Antiseptics

Question 4

The end of the needle that pierces the vein. The _________ allows the needle to easily slip into the skin and vein without coring (removing a portion of the skin or vein).

Answer 4

Bevel

Question 5

Is the transfer of additive from one tube to the next. It can occur when blood in an additive tube touches the needle during ETS blood collection or when blood is transferred from a syringe into ETS tubes.

Answer 5

Carryover/cross-contamination

Question 6

A substance that enhances coagulation in tubes
used to collect serum specimens.

Answer 6

Clot Activator

Question 7

Chemical substances or solutions regulated by the
Environmental Protection Agency (EPA) that are used to remove or kill microorganisms on surfaces and instruments.

Answer 7

Disinfectant

Question 8

Ethylenediaminetetraacetic acid

Answer 8

EDTA

Question 9

Closed system in which the patient’s blood flows through a needle inserted into a vein directly into a collection tube without exposure to air or outside contaminants. Most common, efficient, and CLSI-preferred system for collecting blood samples.

Answer 9

ETS (Evacuated Tubes System)

Question 10

Used with both the ETS and the syringe method of obtaining blood specimens. (With the syringe method, blood is collected in a syringe and must be immediately transferred into the tubes.)

Answer 10

Evacuated Tubes

Question 11

Needle __________ is indicated by a number that is related to the diameter of the lumen.

Answer 11

Gauge

Question 12

The internal space of a blood vessel through which the blood flows.

Answer 12

Lumen

Question 13

Refers to the order in which tubes are collected during
a multiple-tube ETS draw, or filled with blood from a syringe.

Answer 13

Order of Draw

Question 14

Used needles, lancets, and other sharp objects must be disposed of immediately in special containers referred to as

Answer 14

Sharps Containers

Question 15

Used for coagulation tests. Tubes have light-
blue stoppers.

Answer 15

Sodium Citrate

Question 16

The most common antiglycolytic agent. It preserves glucose and also inhibits the growth of bacteria. Tubes have gray top.

Answer 16

Sodium Fluoride

Question 17

Securing a patients arm to find vein.

Answer 17

Anchor

Question 18

The behavior of a healthcare provider toward or as perceived by a patient.

Answer 18

Bedside manner

Question 19

The cover or cap of a needle

Answer 19

Needle Sheath

Question 20

To examine the vein by touch or feel

Answer 20

Palpate

Question 21

Skin is pulled tight without slack.

Answer 21

Taut

Question 22

Step 1: Receive, Review, and Accession Test Request
Step 2: Approach, Greet, and Identify the Patient
Step 3: Explain the Procedure and Obtain Consent
Step 4: Verify Collection Requirements, and Identify
Sensitivities and Potential Problems
Step 5: Sanitize Hands and Put on Gloves
Step 6: Position Patient, Apply Tourniquet, and Ask the
Patient to Make a Fist
Step 7: Select a Vein, Release the Tourniquet, and Ask
the Patient to Open the Fist
Step 8: Clean and Air-Dry the Site
Step 9: Prepare Collection Equipment
Step 10: Reapply the Tourniquet, and Uncap and Inspect
the Needle
Step 11: Ask the Patient to Remake a Fist, Anchor the
Vein, and Insert the Needle
Step 12: Establish Blood Flow, Release the Tourniquet,
and Ask the Patient to Open the Fist
Step 13: Fill, Remove, and Mix Tubes in Order of Draw,
or Fill Syringe
Step 14: Withdraw the Needle, Place Gauze, Activate the
Needle Safety Feature, and Apply Pressure
Step 15 (ETS): Discard Blood Collection Unit
Step 15 (Syringe System): Discard Needle, Attach
Transfer Device, Transfer Blood, and Discard Syringe
and Transfer Device Unit
Step 16: Label and Prepare Tubes for Handling and
Transport
Step 17: Check the Patient’s Arm, and Apply a Bandage
Step 18: Dispose of Used Materials, and Reposition
Moved Items
Step 19: Thank the Patient, Remove Gloves, and Sanitize
Hands
Step 20: Transport Specimen to the Lab Promptly

Answer 22

Venipuncture Steps

Question 23

This type of patient may object to being tested at first, but will often come around, especially if given a sense of control over the situation by a reminder that he or she has the right to refuse testing. Remain calm and professional and treat the patient in a caring manner under all circumstances.

Answer 23

Handling Difficult Patients

Question 24

Also called altered state of consciousness or state of mind. Conditions can cause problems with blood collection, including verifying patient identification, explaining procedures, obtaining informed consent for procedures, and trying to safely obtain specimens if the patient is combative or unaware of what is happening. Consent for specimen collection may need to be obtained from an authorized relative or guardian.

Answer 24

Handling Patients in Altered Mental Status

Question 25

Explain why you are there, and ask the
patient for permission to collect the specimen.

Answer 25

Obtaining Consent

Question 26

Apply the ______________ snugly but loose enough to avoid damaging the patient’s skin. A tourniquet that is too tight can cause the vein to collapse when it is released or the tube is engaged. It can also distend the vein so much that it splits open on needle entry, resulting in hematoma formation.

Answer 26

Tourniquet Application

Question 27

If both AC areas are bruised, select a needle entry point below the bruising. Be aware that some elderly patients may not be able to make a fist because of muscle weakness. If no suitable vein can be found, gently massage the arm from wrist to elbow to force blood into the area or wrap a warm, wet towel around the arm or hand for a few minutes to increase blood flow.

Answer 27

Selecting Vein

Question 28

Patient Identification
Equipment Selection
Tourniquet Application
Site Selection
Cleaning the Site
Performing the Venipuncture
Holding Pressure

Answer 28

Proper Venipuncture Steps

Question 29

Swelling or mass of blood (often clotted) that can be
caused by blood leaking from a blood vessel during or following venipuncture.

Answer 29

Hematoma

Question 30

Condition in which blood components that cannot easily leave the bloodstream become concentrated in the smaller plasma volume.

Answer 30

Hemoconcentration

Question 31

Results when RBCs are damaged or destroyed and the
hemoglobin they contain escapes into the fluid portion of the specimen.

Answer 31

Hemolysis

Question 32

Relating to or marked by jaundice and is used to describe serum, plasma, or urine specimens that have an abnormal deep yellow to yellow-brown color due to high bilirubin levels.

Answer 32

Icteric

Question 33

Described as a loss of consciousness and postural tone (ability to maintain an upright posture) resulting from insufficient blood flow to the brain. It can last for as little as a few seconds or as long as half an hour.

Answer 33

Syncope

Question 34

Starts as soon as test is ordered. Things to consider:

Reference Ranges/Intervals
Basal State
Age
Altitude
Dehydration
Diet
Diurnal/Circadian Variations

Answer 34

Preexamination/preanalytical