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PHLEB > CPT-1 > Flashcards

CPT-1 Flashcards

1
Q

where did the word phlebotomy originate from?

A

phlebo-vein

tomy-to make an incision

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2
Q

what is therapeutic phlebotomy commonly used for?

A

patients who have Polycythemia

Polycythemia-condition characterized by high RBC count

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3
Q

who performs phlebotomy? what is phlebotomy also called?

A
  • nurse or phlebotomist

- phlebotomy also called a venisection

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4
Q

where is a tourniquet tied? how long can it be left on?

A
  • 4-6 inches above draw site

- max. 1 minute

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5
Q

what is hemolysis?

A

destruction of red blood cells

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6
Q

how does hemoconcentration occur?

A

results from the tourniquet being left on the arm for too long

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7
Q

what is a right under the patient’s bill of rights?

A
  • patients always have the option to decline medical treatment
  • know what tests are being performed on them
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8
Q

can a phlebotomist give results to a patient?

A

no, because they are not medically qualified

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9
Q

patient consent

A

various forms of consent that are needed from the patient in order to do a procedure

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10
Q

informed consent

A
  • a competent person gives voluntary permission for a medical procedure
  • after receiving adequate info about the risk of, methods, and consequences
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11
Q

expressed consent

A

permission given by a patient verbally or in writing for a procedure

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12
Q

implied consent

A

-patients actions gives permission for the procedure without verbal or written consent
EX: going to the ER, or holding out arm for blood draw

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13
Q

HIV consent

A

-special permission need to administer a test which detects HIV

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14
Q

parental consent for minors

A
  • a parent or legal guardian must give permission for procedures administered to underage patients
  • range from 18-21 depending on state law
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15
Q

tort

A
  • an injury/wrong committed with or without force to the person/property of another
  • for which civil liability may be imposed
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16
Q

what is donning? what is doffing?

A

donning: putting on the tourniquet
doffing: taking off the tourniquet

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17
Q

What characterizes tests waived by CLIA?

A

employ methodologies

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18
Q

what is barrier protection?

A

-PPE that provides physical barrier against infection

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19
Q

5 types of barrier protection

A
  1. masks
  2. goggles
  3. face shields
  4. respirators
  5. gloves (must be worn at all times)
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20
Q

what are mucous membranes?

A

eyes, nose, mouth

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21
Q

3 reasons why gloves are worn:

A
  1. provide protective barrier, prevent cross contamination
  2. reduce likelihood that microorganisms present on hands will be transmitted to patients
  3. reduce likelihood that hands contaminated with micro organisms from one patient will transmit to another patient
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22
Q

needles should never be _______

A

recapped

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23
Q

when should sharps containers be emptied/disposed of?

A

contains should be locked and disposed of when they are 2/3 full

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24
Q

what are 2 liquids used for decontamination?

A
  1. solution if sodium hypochlorite (bleach)

2. lysol

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25
Q

what is the needle stick safety and prevention act?

A

sharps injury log must contain:

  1. type and brand of device involved in incident
  2. department/work area where exposure incident occurred
  3. explanation of how the incident occurred
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26
Q

what are 4 things you must do if exposed to blood or any potentially infectious material?

A
  1. wash exposed area w/ soap and running water
  2. report exposure to supervisor
  3. refer to the MSDS
  4. full out an exposure report form
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27
Q

what is vein selection based on?

A

size and condition of the vein

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28
Q

you should always draw blood ________ Abd IV site

A

below

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29
Q

median cubical vein

A
  • vein most commonly used for venipuncture procedure

- large and usually anchored well

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30
Q

cephalic vein

A
  • can be more difficult to locate

- easiest vein to palate in an obese patient

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31
Q

basilica vein

A
  • least firmly anchored
  • located near brachial artery
  • if needle inserted too deep, risk puncturing brachial artery or an nerve
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32
Q

9 pieces of supplies for venipuncture

A
  1. laboratory requisition
  2. antiseptic
  3. tourniquet
  4. gloves
  5. vacutainer tubes
  6. vacutainer needles
  7. needle adapters
  8. winged infusion set
  9. needle disposal container
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33
Q

what do labels include?

A
  • accession number

- unique tracking number different for each sample

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34
Q

what is a tourniquet?

A
  • slows venous outflow of blood from arm

- causes veins to bulge

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35
Q

when must gloves be worn?

A

always

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36
Q

the lower the gauge __________

A

the larger the needle

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37
Q

why are needles smaller than 23 gauge not recommended?

A

-they can cause hemolysis

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38
Q

what is a winged infusion set also called?

A

butterfly needle

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39
Q

what is the most commonly used butterfly needle size?

A

23 gauge

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40
Q

when can you recap a needle?

A

never

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41
Q

what are the 5 proper steps to end a blood draw?

A
  1. remove tourniquet
  2. remove the tube
  3. place cotton over site
  4. remove the needle
  5. activate safety
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42
Q

what is edema?

A

accumulation of fluid in the tissues /excessive swelling

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43
Q

what are 8 venipuncture problems?

A
  1. failure to obtain blood
  2. inappropriate puncture site
  3. scarred and sclerosed veins
  4. rolling veins
  5. collapsing veins
  6. hematoma
  7. premature needle withdrawal
  8. fainting
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44
Q

what is a hematoma?

A

this is the most common complication from phlebotomy

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45
Q

what is vasovagal syncope?

A

fainting

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46
Q

what is the first thing you do if your patient faints?

A

get the needle out of the arm

47
Q

what is a capillary?

A

a microscopic blood vessel

48
Q

what can cause hemolysis?

A
  • milking a finger too much

- using too small of a needle

49
Q

what is a finger stick?

A

-capillary puncture done on finger when patient is over the age of 2

50
Q

which finger do you choose for a fingerstick?

A

either 3rd or 4th finger of the non dominant hand

51
Q

what is important to remember about finger sticks in terms of collecting blood?

A

always wipe away the first drop of blood with gauze (never alcohol)

52
Q

What is a heel stick primarily used for? (What type of test)

A

bilirubin

53
Q

What is bilirubin associated with?

A
  • overproduction occurs when liver doesn’t break down/excreting RBC
  • jaundice
54
Q

How far should you puncture for a heel stick?

A

-do not exceed 2.0mm

55
Q

What age do you perform heelsticks?

A

-infants less than 1-2 years of age

56
Q

What is the recommended location for a heel stick?

A
  • medial + lateral portions of the plantar surface of foot

- between big toe + 3/4 toe

57
Q

What should be placed on the heel prior to a heel stick?

A

-heel-warmer to dilate the capillaries

58
Q

What kind of tubes are used to collect bilirubin samples?

A
  • amber colored containers

- minimize exposure to light

59
Q

What is hemostasis?

A

the healing process

60
Q

What are the 4 phases of hemostasis?

A
  1. vascular phase
  2. platelet phase
  3. coagulation phase
  4. fibrinolysis
61
Q

What is the vascular phase of hemostasis?

A
  • injury to blood vessel causes it to constrinct

- slowing flow of blood

62
Q

What is the platelet phase of hemostasis?

A
  • injury to endothelial lining causes platelets to stick to it
  • form temproary platelet plug (aggregation)
63
Q

What is a BTT?

A
  • bleeding time test

- used to evaluate primary stages of hemostasis

64
Q

What is the coagulation phase of hemostasis?

A
  • interactions between coagulation factors
  • convert temporary platelet plug to a stable fribin clot
  • intrinsic + extrinsic pathway
65
Q

What is a PT/INR?

A
  • Prothrombin Time test (light blue)
  • evaluate extrinsic pathway
  • monitors anticoagulant therapy
66
Q

What is a PTT?

A
  • Partial Thromboplastin Time

- evaluate intrinsic pathway

67
Q

What is fibrinolysis?

A

-breakdown and removal of the clot

68
Q

What are the 3 things needed for hemostasis to occur?

A
  1. blood vessels
  2. blood platelets
  3. coagulation factors
69
Q

What is the basal state?

A
  • fasting and refrain from strenuous exercise for 8012 hrs prior to draw
  • water is okay
70
Q

What is post-prandial?

A

-after a meal

71
Q

What type of panel should be drawn when a patient is fasting?

A

lipid panal

72
Q

what are 3 uses for timed specimens?

A
  1. measure blood levels of substances exhibiting diurnal variation (EX: monitor cortisol)
  2. monitor changes in a patient’s condition
  3. determine levels of medication in blood strema
73
Q

what is diurnal variation?

A

-different during the day and night

74
Q

What is therapeutic drug monitoring?

A

-monitor blood levels of certain medications to ensure patient safety + maintain a plasma level

75
Q

What is a trough? What is a peak?

A
  • trough: lowest chemical blood level

- peak: highest chemical blood level

76
Q

When are trough levels collected?

A

-30 min before the scheduled pharma dose

77
Q

How are warmed specimens collected?

A
  • blood is collected in tubes pre-warmed in incubator

- cold agglutinins are antibodies produced in response to mycoplasma

78
Q

What is a common test that requires chilled specimens?

A

-ammonia

79
Q

How are light-sensitive specimens proteted?

A

-aluminum foil or amber tubes

80
Q

What is a test drawn without stasis?

A

-without a tourniquet

81
Q

What does with stasis mean?

A

-with a tourniquet

82
Q

What type of test must be drawn without stasis?

A

-lactate test

83
Q

What is the most critical pre-analytical error that a phlebotomist can make?

A

-improperly identifying the patient prior to sample collection

84
Q

What is a glucose tolerance test?

A
  • used to diagnose diabetes mellitus + gestational diabetes

- fasting

85
Q

How many draws are there in a glucose tolerance test?

A

-baseline then 1 for every hour after the baseline

86
Q

What are blood cultures ordered for?

A
  • detect the presence of microorganisms in the patient’s blood
  • patient will usually have chills/fever of unknown origin
87
Q

What is septicemia?

A

-presence of pathogenic/infectious microoganisms in the blood

88
Q

How many approved methods are there to clean the skin for a blood culture?

A

2

89
Q

What are the 2 methods used for cleaning the skin for a blood culture?

A
  1. with alcohol then iodine

2. with chlorhexadine

90
Q

What is the most common cause of contamination when drawing blood cultures?

A

improper site preparation

91
Q

what is PKU?

A
  • test ordered for infants to detect phenylketonuria

- genetic disease that causes mental retardation + brain damage

92
Q

What kind of draw is used for a PKU?

A
  • dermal puncture

- heel or urine

93
Q

Who draws an arterial blood gas?

A

-respiratory therapist, nurse, or physician

94
Q

Where is an ABG sample taken from?

A
  • radial arter

- thumb side of wrist

95
Q

What is arterial blood used for?

A

-determine blood gas levels and blood pH/acidity

96
Q

What are the 4 primary tests performed on arterial samples?

A
  1. pH
  2. carbon dioxide
  3. oxgyen
  4. bicarbonate
97
Q

What is the angle for an ABG draw?

A

90 degrees

98
Q

What is plasma?

A
  • liquid portion of unclotted blood

- still contains clotting factors

99
Q

what is serum?

A
  • liquid portion of blood that has been allowed to clot

- does not contain clotting factors

100
Q

which tubes have anticoagulants?

A

-lavender
-green
-royal blue (lavender stripe)
-light blue
-gray
(plasma)

101
Q

which tubes are without anticoagulants?

A

-red
-tiger top/gold
-royal blue with red
(serum)

102
Q

what is the hematology section?

A
  • formed elements of blood are studied via RBCs, WBCs, platelets
  • disorders/infections are detected
  • coagulation section
103
Q

What is the chemistry section?

A

-largest and most automated

104
Q

what is the chemistry section divided into?

A
  1. electrophoresis
  2. toxicology
  3. immunochemistry
105
Q

What is the blood bank section?

A

-blood is collected, stored, prepared for transfusion

106
Q

What is the serology/immunology section?

A

-performs tests to evaluate a patient’s immune response through the production of antibodies

107
Q

What is the microbiology section?

A

-detection of pathogenic microorganisms in patient samples

108
Q

What does pathogenic mean?

A

microoganisms that cause disease

109
Q

What is a C&S (culture and sensitivity) test used for?

A

detect + identify microorganisms

110
Q

What is the urinalysis section?

A

-detect infection of kidney, urinary tract, metabolic disorders, drug abuse

111
Q

What type of sample should be collected if a physician suspects a drug abuse?

A
  • urine sample

- clean catch mid stream (used for chemistry evaluation of the urine)

112
Q

What are cytology studies?

A

-presense of abnormal cells from urinary tract

113
Q

What is a clean catch specimen?

A
  • involves cleaning of the genital area

- collecting urine into sterile container

114
Q

What are the 3 components of urinalysis?

A
  1. physical examination
  2. chemical examination
  3. microscopic examination

PHLEB (3 decks)

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