erudite Flashcards

1
Q

includes procedures such as laboratory handling
and identification, which take place prior to any laboratory testing. In this phase, proper
control measures are placed to avoid subsequent issues.

A

pre-analytical testing phase

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2
Q

pre-analytical testing phase starts when and ends when??

A

It starts when the doctor’s order is
given and ends when the laboratory testing has officially commenced.

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3
Q

During this phase, the phlebotomist must not only be able to draw blood from the patient, but must also be able to identify factors that affect the process and address them as
needed.

A

pre-analytical testing phase

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3
Q

The ___ is used by physicians to diagnose and monitor the presence of a
disease.

A

laboratory test

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4
Q

The physicians compare the results to a ________ or _________ This
range shows the high and low limits of result values as compared to healthy individuals.

A

reference range or reference interval.

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5
Q

This range shows the high and low limits of result values as compared to healthy individuals.

A

Reference range or reference interval.

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5
Q

This can be influenced by age, gender, and conditions of the body.

A

the basal state

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6
Q

ideal in establishing reference range since it represents
the condition of the metabolism of the body early in the morning or after approximately 12
hours of fasting.

A

the basal state

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6
Q

Red blood cells (RBC), white blood cells (WBC), creatinine clearance

A

Age

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7
Q

Variable

A

Age
Altitude
Dehydration
Diet
Diurnal Variation
Drug Therapy
Exercise/IM Injection
Fever
Gender
Jaundice
Intramuscular Injection
Position
Pregnancy
Smoking
Stress
Temperature and Humidity

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8
Q

Red blood cells (RBC)

A

Altitude

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9
Q

Hemoconcentration, red blood cells (RBC), enzymes, iron (Fe),
calcium (Ca), sodium (NA)

A

Dehydration

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9
Q

Glucose, lipids, electrolytes

A

Diet

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10
Q

Thyroid-stimulating hormone (TSH), cortisol, iron (Fe)

A

Diurnal Variation

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10
Q

Enzymes, hormones

A

Drug theraphy

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11
Q

Potential of hydrogen (pH), carbon dioxide partial pressure (PCO2),
creatine kinase (CK), lactic acid dehydrogenase (LDH), glucose

A

Exercise/IM Injection

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12
Q

Hormones, cortisol

A

fever

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13
Q

Red blood cells (RBC), hemoglobin (HgB), hematocrit (Hct)

A

gender

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14
Q

Yellow color interfaces due to increased biliburin

A

Jaundice

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14
Q

Creatine kinase (CK) and the skeletal muscle fraction of LDH

A

Intramuscular Injection

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15
Q

Protein, potassium (K)

A

position

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16
Q

Red blood cells (RBC)

A

pregnancy

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17
Q

Cholesterol, cortisol, glucose, growth hormones (GH), triglyceride, white
blood cells (WBC)

A

smoking

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18
Q

White blood cells (WBC), iron (Fe), adrenocorticotropic hormone (ACTH),
catecholamine, cortisol

A

stress

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19
when selecting the venipuncture site. They could choose an alternative site, or perform the procedure under special conditions.
Burns, Scars, and Tattoos- Damaged Veins Edema Hematoma Masectomy Obesity
19
This is the condition in which the individual is grossly overweight.
Obesity
19
Hemoconcentration
Temperature and Humidity
20
Patients who are obese have veins that are deep and difficult to locate.
Obesity
21
A solution is using a longer tourniquet or locating the cephalic or cubital vein.
Obesity
22
This procedure, often done to breast cancer patients, refers to the removal of the breast through surgery.
Mastectomy
22
Blood drawing from patients who had undergone this procedure becomes a challenge since the lymph flow is obstructed, and there may beswelling and infection after thesurgery.
Mastectomy
23
tourniquet cannot be applied because it can cause injury. It could also change the blood composition.
Mastectomy
24
A solid swelling or mass of blood in the tissues caused by the leakage of blood from the vessels during venipuncture.
hematoma
25
The tissues become fragile, making the task of locating the veins harder.
edema
25
selecting a venipuncture site with ___will be painful for the patient because it will obstruct the blood flow. It could also lead to the contamination of blood sample.
hematoma
25
It could also lead to the contamination of blood sample.
hematoma
26
This condition may be due to reactions from medications, pregnancy, infections, and other medical problems.
edema
27
also known as oedema, is an abnormal swelling caused by the accumulation of fluid in the tissues.
edema
28
may also produce inaccurate results.
Damaged Veins
29
being difficult to perform,
Damaged Veins
30
Veins could be sclerosed or hardened or thrombosed or clotted.
Damaged Veins
31
It is not advisable to choose a site that has ______ because veins in the area may be difficult to examine and blood circulation may be impaired.
burns, scars, or tattoos
32
______ may be too painful to touch and ___ may also be susceptible to infection due to the dyes used that may interfere with the process.
Burns, tattoos
32
There are cases when vascular access devices (VADs) are needed for _________________ of a patient.
blood sampling, infusing medication, central venous pressure readings, blood transfusion
33
Vascular Access Sites and Devices
Arterial Line Arteriovenous Shunt or Fistula Blood-sampling Device Heparin or Saline Lock Intravenous (IV) Sites 6. Central Vascular Access Devices (CVADs)
34
To obtain samples for arterial blood gas and laboratory studies, critically ill patients require ______ where a thin catheter is inserted into an artery.
arterial lines
35
This is also used to monitor blood pressure continuously.
Arterial line.
35
Neither tourniquet nor venipuncture is allowed in the arm with an ____.
Arterial line.
36
is a passageway created through surgery, and is usually in the arms with the intention of connecting the artery and a vein directly.
Arteriovenous Shunt or Fistula
36
This may be created for hemodialysis treatment or pathological process such as erosion of arterial aneurysm.
Arteriovenous Shunt or Fistula
37
Arteriovenous Shunt or Fistula This may be created for ___ or pathological process such as ______
hemodialysis treatment; erosion of arterial aneurysm.
37
A blood-sampling device is used to avoid the use of needle-sticks, prevent infections, and reduce wastage from line draws.
Blood-sampling Device
38
The device collects blood from the arterial or central venous catheter where it isconnected.
Blood-sampling Device
39
is an intravenous (IV) catheter attached to a stopcock or cap with diaphragm.
Heparin or Saline Lock
39
which is commonly called a "hep-lock,"
Heparin or Saline Lock
40
Its basic function is to provide access for administering medicine or drawing blood from the patient.
Heparin or Saline Lock
41
It is usually flushed with heparin or saline (to prevent clogging) and capped for future use.
Heparin or Saline Lock
41
It is threaded in the peripheral vein, which is in the lower arm above the wrist for up to 48 hours.
Heparin or Saline Lock
42
also known as indwelling lines,
Central Vascular Access Devices (CVADs)
43
There are three (3) types of CVADs: __
the central venous catheter lines, implanted port, peripherally inserted central catheter.
43
are any of the tubings inserted to the main vein or artery used for blood collection, monitoring the patient's pressures, and administering medications and fluids.
Central Vascular Access Devices (CVADs)
44
a thin plastic tube or catheter inserted into a vein in the forearm to inject a volume of fluids into the bloodstream.
Intravenous
44
IV If blood collection is necessary, the collection site should be _____
below the IV.
45
The phlebotomist should avoid collecting blood from the arm with ___ because the blood collected could be contaminated with ___
IV; IV fluid.
46
IV Take note that collection of blood from previously known IV sites should be avoided for _____
24 to 48 hours.
47
is a surgically implanted disk-shaped chamber attached to the indwelling line.
Implanted port
47
also knownas a central line inserted into the large vein (subclavian) and advanced into the superior vena cava.
Central venous catheteris
48
This is usually placed on the upper chest just below the collarbone.
Implanted port
48
is a flexible tube inserted into the veins of extremities and the central veins.
Peripherally inserted central catheter (PICC)
49
Handling Patient Complications Associated with Blood Collection
Allergies to Equipment and Supplies Excessive Bleeding Fainting Nausea and Vomiting Pain Petechiae Seizures or Convulsions
49
Seizures or Convulsions When seizures or convulsions occur, the blood draw should be ___
discontinued quickly.
50
There must be pressure held over the site but it must be made certain that movement is not restricted; the mouth is free from any obstruction and the patient is protected from self-injury. The first-aid personnel must be notified immediately.
Seizures or Convulsions
50
This condition involves the appearance of small red or purple spots that look like rashes, which appear on the arm when tourniquet is applied.
Petechiae
50
The patient should be warned before the needle insertion, and the phlebotomist should avoid redirection of the needle.
Pain
51
Pain If the patient complains of extreme pain or numbness, _________ and _______ to the site because this could indicate nerve involvement.
Remove the needle and apply ice
51
The phlebotomist needs to document the incident if the condition persists.
Pain
52
An emesis basin or wastebasket should be provided, and a cold damp washcloth should be applied to the forehead.
Nausea and Vomiting
52
When the patient feels nauseous and has the tendency to vomit, the phlebotomist has to _____
discontinue the procedure until the patient feels better or until the feeling subsides.
53
temporary loss of consciousness which is caused by the insufficient flow of blood to the brain.
fainting
53
The pressure should be applied to the site until the bleeding stops. The attention of the authorized personnel should be called when the bleeding continues after five minutes.
Excessive Bleeding
53
Patients prone to fainting during venipuncture are asked to _____________
lie down during the procedure.
53
Excessive Bleeding When a patient is on _____ or ______ the bleeding may take a longer time.
aspirin or anticoagulant,
53
When the patient has adhesive allergy, a _____ should be placed over the site and should be removed after ___
gauze; 15 min
53
Excessive Bleeding The attention of the authorized personnel should be called when the bleeding continues after ________
five minutes.
53
Handling Patient Complications Associated with Blood Collection The alternative is to ask the patient to apply pressure for ________
5 mins
54
When the patient has latex allergy,
look for a sign to indicate the allergy and use a non-latex alternative for gloves, tourniquet, and bandages.
54
When the patienthas antiseptic allergy, simply use _______
a different antiseptic.
54
Avoiding and Handling Procedural Error Risks and Failure to Draw Blood
Hematoma Formation latrogenic Anemia Inadvertent Arterial Puncture Infection Nerve Injury Relfux of Anticoagulant Vein Damage
55
Infection can be avoided by making sure that tapes or bandages are not opened ________
ahead of time;
55
needles are not _____ into the tube holders; insertion site of the needle is not ______
preloaded; touched after sterilization;
56
cap is removed just before venipuncture; and patients are advised to keep the bandage on the site for at least ______.
15 minutes
57
This results from blood loss due to blood draw.
latrogenic Anemia
57
This happens when blood is filling up the tube rapidly and there is a rapid formation of hematoma on the site.
Inadvertent Arterial Puncture
58
It is important to ensure that only the required specimen volume is collected because if 10% of the blood volume is removed at once from the body, the patient could face a threat.
latrogenic Anemia
59
The phlebotomist should hold pressure over the site immediately after discontinuing the draw.
Hematoma Formation
59
if ___ of the blood volume is removed at ___ from the body, the patient could face a threat.
10%; once
60
A cold compress or ice pack may be offered to help address the swelling.
Hematoma Formation
61
Blood that has already been drawn flowing back into the vein from the collection tube may cause adverse reaction because of the presence of tube additives. To avoid this, make sure that the arm of the patient is in a downward position and the tube is just below the venipuncture site.
Reflux of Anticoagulant
61
Nerve Injury If the initial attempt is unsuccessful, the phlebotomist should try to _______. The next step is to ________
redirect the needle by using a slightly forward or backward movement remove the needle and look for an alternative site.
61
conditions that trigger hematoma:
. There is excessive or blind probing. · There is inadvertent arterialpuncture. . The size of the vein is too small. . The needle penetration has gone all through the vein. . Needle is not completelyinserted. . Tourniquet is still on when the needle was removed. . The pressure is notadequate.
61
happen when there is improper site selection, rapid needle insertion, excessive redirection of the needle, and blind probing.
Nerve injuries
61
Reflux of Anticoagulant Blood that has already been drawn flowing back into the vein from the collection tube may cause _______ because of the ________
adverse reaction; presence of tube additives.
62
Reflux of Anticoagulant To avoid this, make sure that the arm of the patient is in a ______ and the tube is just ___
downward position ; below the venipuncture site.
63
Hemoconcentration is a decrease in the fluid content or plasma volume which is usually caused by tourniquet that stagnates the normal flow of blood leading to the increase in concentration of red blood cells and other non-filterable large molecules.
Specimen Quality
63
Hemolysis, which is also called haemolysis, refers to the rupture of the red blood cells. The hemoglobin is then released into the surrounding fluid.
Specimen Quality
64
Specimen contamination means that the specimen is compromised due to incorrect handling, which involves allowing alcohol, powder or other materials into the sample. Getting glove powder or perspiration into films and specimens; using the wrong antiseptic; or simply not following the proper antiseptic procedure could interfere with the results.
Specimen Quality
64
Partially filled tube or short draw, happens when the phlebotomist pulls a tube before reaching the required volume. This may lead to the incorrect blood-to-additive ratio.
Specimen Quality
64
Wrong or expired collection tube should not be used because the manufacturer could not warrant the quality of the seal and pressure after the expiration date indicated in the tube.
Specimen Quality
65
decrease in the fluid content or plasma volume which is usually caused by tourniquet that stagnates the normal flow of blood leading to the increase in concentration of red blood cells and other non-filterable large molecules.
Hemoconcentration
65
also called haemolysis, refers to the rupture of the red blood cells. The hemoglobin is then released into the surrounding fluid.
2. Hemolysis,
66
happens when the phlebotomist pulls a tube before reaching the required volume. This may lead to the incorrect blood-to-additiveratio.
Partially filled tube or short draw,
67
the specimen is compromised due to incorrect handling, which involves allowing alcohol, powder or other materials into the sample. Getting glove powder or perspiration into films and specimens; using the wrong antiseptic; or simply not following the proper antiseptic procedure could interfere with the results.
Specimen contamination
67
Troubleshooting Failed Venipuncture
Needle not inserted far enough Bevel partially out of skin Bevel partially into vein Bevel partially through vein Bevel completely through vein Bevel against vein wall Needle beside vein Undetermined position
68
The ___ is critical to the success of the venipuncture.
needle position
69
should not be used because the manufacturer could not warrant the quality of the seal and pressure after the expiration date indicated in the tube.
Wrong or expired collection tube
70
usually occur when conditions are less than ideal, which leads to the veins being blocked, resulting in insufficient blood flow.
Collapsed Veins
71
This happens when there is a strong pressure in the vacuum of the tube or plunger; the tourniquet is too close to the site or it is too tight; or when the tourniquet has been removed during the draw.
Collapsed Veins
72
To avoid failure due to loss of vacuum, the phlebotomist should make sure that the bevel is not partially out of skin and the tube itself is not damaged.
Tube Vacuum
73
To avoid failure due to loss of vacuum, the phlebotomist should make sure that the _____
bevel is not partially out of skin and the tube itself is not damaged.
74
Specimen Quality
Hemoconcentration Hemolysis Short Draw Contamination Expired