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Phlebotomy Exam > Deck 1 > Flashcards

Deck 1 Flashcards

1
Q

Petechiae

A

Tiny non-raised red spots that appear on skin from rupturing capillaries due to tourniquet being left too long or too tight.

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2
Q

Order of draw

A

Yellow, Light Blue, Red, Red Marble, Green, Light Green, Lavender, Pink/White/Royal Blue, Gray, Dark Blue

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3
Q

Quality Assurance

A

Scheduled audits

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4
Q

Negligence

A

Failure to exercise standards of care

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5
Q

Providone-iodine

A

For collections that require more stringent infection control such as blood cultures and arterial punctures.

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6
Q

Chlorhexidine gluconate

A

For pts allergic to iodine

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7
Q

Antiseptic

A

70% isopropyl alcohol pads

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8
Q

Osteomyelitis

A

Inflammation of bone and bone marrow

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9
Q

Lancet

A

Safely delivers pre-determined depth ranging from 0.85mm for infants to 3.0mm for adults.

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10
Q

Forearm veins for venipuncture

A

Baslic, Cephalic, Median Cubital, Accessory Cephalic, Intermediate Antebrachial, or Intermediate Basilic Veins.

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11
Q

Cannula

A

Large needle

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12
Q

Tortuos Veins

A

Winding or crooked veins susceptible to infection because blood flow is impaired

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13
Q

Fistula

A

Permanent, surgical connection between artery and vein. Used for dialysis but never for venipuncture due to possibility of infection.

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14
Q

Collapsed vein remedy

A
  1. Pop vacutainer off needle and let vein refill then replace tube back on needle and allow to fill more, repeat until tube is full. Hold needle in vein very still. 2. Move needle to one side then other and up and down very slightly to be sure it is not just that bevel is against the vein wall. 3. Use smaller vacuum tube. 4. Remove tourniquet, withdraw needle and select another vein. 5. Use syringe or butterfly.
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15
Q

Missed 1st stick remedy

A
  1. Don’t pull needle out, look for vein, often you can make out purple color of vein on either side of needle, withdraw needle slightly and re-enter vein at different angle. 2. If draw needle back to re-direct and lose vacuum, don’t pull out completely, replace tube with new one and continue the draw.
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16
Q

Vasovagal Syncope

A

Pt faints or experiences dizziness before, during or after venipuncture. Pts with low diastolic or high systolic BP.

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17
Q

Septicemia

A

Systemic infection associated with presence of pathogenic microorganisms in blood stream

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18
Q

Bleeding Time Test (BTT)

A

Medical test to assess platelet function, involves making pt bleed then timing how long takes to stop bleeding, thin paper placed over incision, how quickly blood reaches rings is timed to determine coagulation properties.

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19
Q

Venipuncture problems

A

Failure to obtain blood, Inappropriate puncture site, Scarred/Sclerosed veins, Rolling veins, Collapsing veins, Hematoma, Premature needle withdrawal, Fainting.

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20
Q

Venipuncture complications

A

Hematoma, Hemoconcentration, Petechiae, Phlebitis, Thrombus, Thrombophlebitis, Septicemia, Trauma.

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21
Q

Hemostasis

A

Process by which blood vessels repair after injury, causes bleeding to stop.

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22
Q

Hemostasis stages

A
  1. Vascular phase (injury) 2. Platelet phase (temporary platelet plug) 3. Coagulation phase (stable fribrin clot) 4. Fibrinolysis (plasmin enzyme breaks down clot promoting tissue repair)
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23
Q

Fibrin Degradation Product (FDP)

A

Measure rate of fibrinolysis

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24
Q

Most critical mistake Phlebotomist could make

A

Failing to properly ID pt

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25
Q

Vein most commonly used for venipuncture

A

Median cubital vein

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26
Q

Easiest vein to palpate on obese pt

A

Cephalic vein

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27
Q

Tourniquet tied how many inches above puncture

A

4” - 6”

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28
Q

Most important thing to do if pt faints during venipuncture

A

Withdraw the needle

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29
Q

What happens during vascular phase of hemostasis

A

Vein constricts and slows blood flow

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30
Q

Basal state

A

Fasting

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31
Q

Diurnal variation

A

Different during day vs night

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32
Q

Digoxin

A

For cardiovascular disease

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33
Q

Trough

A

Lowest chemical blood level

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34
Q

Peak

A

Highest chemical blood level

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35
Q

Cold agglutinins

A

Antibodies produced in response to mycoplasma pneumonia infection (atypical pneumonia)

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36
Q

Warmed specimens

A

Specimens required to be kept warm until serum is separated from cells to keep cold agglutinins from attaching to RBCs at temps below body temp, collected in red-top tube pre-warmed at 37 degrees Celsius for 30 mins.

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37
Q

Specimens requiring chilling

A

Ammonia, Lactic acid, Arterial blood gas (ABG), Gastrin, Glucagon, Parathyroid hormone (PH), Partial Thromboplastin Time (PTT), Prothrombin Time (PT)

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38
Q

Specimens requiring warming

A

Cryoglobulin, Cryofibrinogen, Cold Agglutinin

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39
Q

Specimens requiring protection from light

A

Bilirubin, Vitamin B12, Carotene, Red Cell Folate, Serum Folate

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40
Q

Purpose of chilling specimen

A

Prevents separation

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41
Q

Therapeutic drug monitoring

A

Monitoring trough and peak levels, chemical levels in blood

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42
Q

Plasma

A

Liquid portion of un-clotted blood still contains clotting factor

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43
Q

Serum

A

Liquid portion of blood allowed to clot, clotting factor no longer present, they’ve been used to clot blood

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44
Q

Tubes with anticoagulants

A

Plasma tubes=Lavender, Green, Blue, Light Blue, Gray

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45
Q

Tubes without anticoagulants

A

Serum tubes=Red, Tiger

46
Q

Clinical Laboratory Standards Institute (CLSI)

A

Defines order of draw to minimize cross-contamination

47
Q

FUO

A

Fever of unknown origin

48
Q

Sterile bottles

A

Lab: Microbiology
Additive: Nutrient broth
Symptoms: Systemic infection, FUO
Test: Blood Culture (BCx), 2 aerobic & 2 anaerobic bottles, ordered STAT, site cleansed with iodine, butterfly needle, keep bottle upright
To determine presence of pathogenic or infectious microorganisms in blood

49
Q

Light blue top

A

Lab: Hematology
Additive: Sodium Citrate, anticoagulant
Yields: Plasma
Test: Prothrombin Time (PT) evaluates extrinsic system of coagulation cascade for pts on Coumadin regimen, Partial Thromboplastin Time (PTT) evaluates intrinsic system of coagulation cascade for pt on Heparin regimen, Activated Prothrombin Time (APTT)
Light blue top filled completely, 9 parts blood to 1 part additive, inverted 3-4 times, draw red top prior even if requisition does not request it to prevent thromboplastin from entering tube

50
Q

Red top

A

Lab: Chemistry
Additive: None
Yields: Serum
blood clots naturally within 30-60 mins, often used as “discard” tube to prevent sample contamination, no need to invert

51
Q

Tiger top

A

Lab: Chemistry
Additive: Silica, clot activator & Thixotropic,separator gel
Yields: serum
SST (Serum Separation Tube), invert 8 times
Test: BMP (Basic Metabolic Panel)-general info of metabolism, kidney function, electrolytes & fluid balance. CMP (Complete Metabolic Panel)-more comprehensive BMP test with liver function & performance.

52
Q

Mint Green top

A

Lab: Chemistry
Additive: Lithium Heparin, anticoagulant & Thixotropic, separator gel
Yields: Plasma
PST (Plasma Separation Tube), invert 8 times
Inhibiting thrombin in coagulation cascade
Test: STAT Electrolyte-renal & endocrine conditions, low electrolyte indicates arrhythmia & tachycardia, high level indicate heart failure. HCg (Human Chorionic Gonadotropin)

53
Q

Dark Green top

A

Lab: Chemistry
Additive: Sodium Heparin, anticoagulant
Yields: Plasma
Inhibiting thrombin in coagulation cascade, no gel
Test: Ammonia-indicates liver malfunction, liver converts ammonia into urea to be expelled from body

54
Q

Lavender top

A

Lab: Hematology
Additive: EDTA (Ethylenediaminetetraacetic Acid), anticoagulant
Yields: Plasma
inhibits coagulation by binding to calcium, must fill 2/3, invert 8 times
Test: ESR (Erythrocyte Sedimentation Rate. Sickle Cell Screening. CBC (Complete Blood Count)-evaluates formed cellular elements

55
Q

CBC (Complete Blood Count)

A

Evaluates formed cellular elements: WBC count, WBC differential, Hematocrit, Hemoglobin, Platelets, Differential counts

56
Q

Hematocrit

A

Measures volume % RBC in blood, done before whole blood donation

57
Q

Hemoglobin

A

Measures amount O2 carrying protein in blood, done before whole blood donation

58
Q

Pink top

A

Lab: Blood Bank
Additive: EDTA, anticoagulant
Yields: Plasma
Larger volume of blood required for blood banking
Test: TSR (Type & Screen)-blood typing. Cross-match-determine if donor blood compatible to recipient

59
Q

Gray top

A

Lab: Chemistry
Additive: Sodium Fluoride, antiglycolytic agent & Potassium Oxalate, anticoagulant
Yields: Plasma
Sodium Fluoride prevents breakdown of sugar x3 days. Potassium Oxalate prevents clotting by binding to calcium. Invert 8 times.
Test: OGTT (Oral Glucose Tolerance Test)-evaluate blood sugar, 3 hr: hypergycemia, diabetes mellitus, 5 hr: hypoglycemia, carb metabolism, gestational diabetes. Lactic Acid-indicates improper oxygenation

60
Q

OGTT (Oral Glucose Tolerance Test)

A

Evaluate blood sugar
3 hr: hypergycemia, diabetes mellitus, 4 draws: baseline, 1 hr, 2 hr, 3 hr past glucose administration
5 hr: hypoglycemia, carb metabolism, gestational diabetes

61
Q

BAC

A

Blood Alcohol Concentration

62
Q

Royal Blue top

A

Lab: Toxicology
Additive: None/EDTA
Yields: Serum/Plasma
Drawn in order of additive. Royal Blue with red stripe, no additive, yields serum, drawn after light blue tube before serum tube. Royal Blue with blue stripe, EDTA, yields plasma, drawn after lavender tube.
Test: Pb Lead poisoning. Heavy Metal Toxicology

63
Q

ABG (Arterial Blood Gas)

A

Determine blood gas & pH, drawn by respiratory therapist, nurse or dr from radial artery on thumb side, must run within 15 mins of collection
Test: pH. CO2. O2. Bicarbonate.

64
Q

PKU (Phenylketonuria)

A

Detect genetic disease causing mental retardation & brain damage

65
Q

Plasma tubes

A

Light Blue, Mint Green, Dark Green, Lavender, Pink, Gray, Royal Blue (with EDTA)

66
Q

Serum tubes

A

Red, Tiger, Royal Blue (w/o additive)

67
Q

CBC requires 2 tests before whole blood donation

A

Hematocrit & Hemoglobin (H&H)

68
Q

N95 respirator

A

PPE used to protect from liquid and airborne particles contaminating the face

69
Q

What does Hematocrit and Hemoglobin test for?

A

Anemia

70
Q

What does the presence of Tropinin and CK-MB indicate?

A

MI (Myocardial Infarction), heart attack

71
Q

Body Systems

A

(12) Skeletal, Muscular, Nervous, Urinary, Reproductive, Circulatory, Respiratory, Cardiovascular, Lymphatic, Endocrine, Digestive, Integumentary

72
Q

When would you not do a foot or leg blood draw?

A

On a cardiac or diabetic patient

73
Q

What does it mean to follow Standard Precautions?

A

Consider all samples as hazardous or infectious

74
Q

Name 3 laws that govern phlebotomy

A

OSHA, MSDS, JCAHO

75
Q

JCAHO

A

Joint Commission Accreditation Healthcare Organization-outlines pt and employee safety

76
Q

What tube top color is used for crossmatching?

A

Red or Pink

77
Q

How does a cut heal?

A

Coagulation cascade: coagulation factors interact in sequence, platelets form plug, prothrombin to thrombin, activates fibrinogen to fibrin, forms permanent plug until cut heals, Ca needed

78
Q

Pink top tubes are tested in what lab

A

Blood Bank

79
Q

What is the function of Sodium Fluoride

A

Prevents breakdown of sugar

80
Q

Hematology

A

Study of formed elements (RBC, WBC, platelets) by studying cells, disorders and infections.

81
Q

Hemostasis

A

Healing process

82
Q

Chemistry

A

Largest and most automated section of lab. Includes Electrophoresis, Toxicology, Immunochemistry.

83
Q

Electrophoresis

A

Analyzes chemical components of blood such as hemoglobin, serum, urine and cerebrospinal fluid based on differences in electrical charge

84
Q

Toxicology

A

Analyzes plasma levels of drugs and poisons

85
Q

Immunochemistry

A

Uses techniques such as Radio Immunoassay (RIA) and enzyme immunoassay to detect and measure substances such as hormones, enzymes and drugs

86
Q

Blood Bank

A

Where blood is collected, stored and prepared for transfusion.

87
Q

Serology (Immunology)

A

Performs tests to evaluate pts immune response thru production of antibodies. Analyzes presence of antibodies to bacteria, viruses, fungi, parasites and autoimmunity.

88
Q

Microbiology

A

Responsible for detection of pathogenic microorganisms in pt samples and for hospital infection control

89
Q

Culture and Sensitivity (C&S)

A

Used to detect and identify microorganisms and determine most effective antibiotic therapy

90
Q

Urinalysis section

A

Performs tests on urine to detect disorders and infection of kidney, urinary tract, metabolic disorders (DM) and drug abuse

91
Q

What color tube top is used for blood smear

A

Lavender

92
Q

Diff-Safe

A

Punctures tube stopper and dispenses blood drop instead of uncapping and recapping blood tube for smear preparation

93
Q

Function of circulatory system

A

Delivers 02, nutrients, hormones and enzymes to cells and transport C02 and urea to lung and kidneys where they can be expelled from body

94
Q

How long does it take blood to make complete circulation in body

A

1 minute

95
Q

Average person weighing 155 lbs has how much blood

A

5-7 liters

96
Q

When blood volume in right atrium reaches ____ the blood drops thru tricuspid valve into right ventricle.

A

40 mL

97
Q

Only artery to carry deoxygenated blood

A

Pulmonary artery

98
Q

Mitral valve

A

Bicuspid valve

99
Q

Pulmonary circulation

A

Arteries carry deox blood away from heart and veins carry ox blood back to heart.

100
Q

Systemic circulation

A

Arteries carry ox blood away from heart and veins carry deox blood back to heart.

101
Q

Blood vessels

A

Aorta, arteries, arterioles, capillaries, venules, superior and inferior vena cava.

102
Q

Blood vessels composed of 3 layers

A

Tunica Adventitia (outer connective), Tunica Media (middle smooth muscular), Tunica Intima (inner endothelial)

103
Q

Capillaries

A

Microscopic blood vessels composed of 1 endothelial layer, connects arterioles and venules, allows rapid exchange of 02, C02, nutrients and waste between blood and tissue cells. Capillary blood mixture of arterial and venous blood.

104
Q

Components of blood

A

Plasma 55%, RBC, platelets, WBC 45%

105
Q

Plasma

A

Clear, pale yellow fluid carries nutrients, lipids, glucose, sodium, magnesium, calcium, potassium, 02, C02, nitrogen, antibodies, vitamins and hormones.

106
Q

Blood cells originate from

A

Stem cells in bone marrow

107
Q

Platelets (thrombocytes)

A

Small irregularly shaped packets of cytoplasm formed in bone marrow

108
Q

There are ___ to ___ million RBCs per microliter of blood

A

4.2 to 6.2

109
Q

Normal life span of a RBC

A

120 days

110
Q

How long does it take for RBCs to regenerate after blood donation

A

6-8 weeks

Phlebotomy Exam (1 decks)

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