exam 1 Flashcards
what organ is the first to receive oxygenated blood from the coronary arteries?
heart
carry blood AWAY from the heart…
arteries
carry blood TO the heart…
veins
do veins or arteries have valves?
veins
capillaries are located…
between the arteries and the veins
order of vein we take blood from usually
- median 2. cephalic 3. basilic
median vein is located where on the arm
middle
cephalic vein is located where on the arm
outside or in line with the thumb
basilic vein is located where on the arm
inside of the arm or inner elbow
2 main portions of blood in the body…
- formed elements like RBCs, WBCs, and platelets
- fluid called PLASMA
fibrin clots do what?
uses up coagulation factors and entraps formed elements (cells)
the fluid remaining after coagulation/clotting is called?
SERUM
if there’s a clot the liquid is **, if it’s just in the body it’s ***
serum, plasma
yes or no… do PST tubes have anticoagulant in them?
yes
TAT
turn around time
routine
bulk of hospital testing, and result availability may vary with test ordered (TAT- up to 24 hours)
STAT
collect, process, and test immediately (TAT - 1 hour)
critical values
life threatening results
fasting
refrain from eating or drinking for a set period of time of time
outpatient
not admitted to hospital aka ambulatory
inpatient
admitted to hospital
donning
- hand sanitizer
- gown
- face shield
- gloves
doffing
- gloves
- hand sanitizer
- face shield
- gown
- wash hands
what is the most important step in specimen collection?
patient identification
does serum contain coagulation factors
no
if no clot (anti coagulated) what does it mean
coagulation factors in the plasma
- doing checks before collection, see an error on the order, what should u do?
call the ordering physician for clarification
- what is hemoconcentration caused by?
leaving tourniquet on too long
- which urine specimen is optimal for a culture and sensitivity?
midstream urine
- why do we exercise the plunger on the syringe before collection?
to break the seal so the plunger won’t stick
- what is not a proper aliquoting technique?
recapping the aliquot tubes with the original tubes
- which anticoagulant does not act by chelating(removing) calcium?
lithium heparin (anti thrombin)
grey top tube has what additives in it
potassium oxalate and sodium fluoride
- what do we check for to ensure the patient has stopped bleeding?
oozing and mounding
- what is the last choice of vein in the antecubital area?
basilic
- what does ambulatory mean?
move on their own and outpatient
- what is not a sign that a tourniquet may be too tight?
tourniquet indents the patients skin
- Ischemia means?
temporary deficiency of blood to an area
when veins and arteries that are plugged with scar tissue is what
- schlorost
- inflammation of the wall of the vein is what?
phlebitis
- CLSI recommends that serum/plasma and cells be separated within…
within 2 hours
- spin down a clot tube from collection time (red or gold) for how long?
30-60 minutes
- what carries deoxygenated blood away form the heart?
pulmonary arterties
- speed of the centrifuge is referred to as?
RPM
- post centrifugation; an SST sample has fibrin strands what would cause this?
the specimen had an insufficient clotting time
- which unlabeled specimen would you try to fix/correct?
suprapubic urine collection because it’s the most invasive
- what formed elements would u expect to find in the blood?
erythrocyte and leukocyte and platelets(thrombocytes)
- tube collection draw in order:
blood cultures, NaCit, mint pst, lavender edta
- when is it ok to let the patient leave?
after you’ve checked the collection site and taped it
- what type of blood do phlebotomists typically collect?
venous blood
- you collect one tube but the vein collapses, you miss the 2nd attempt, what do u do next?
ask another phlebotomist to try or try again with a syringe if it was only ur first attempt
- what is in red plastic non additive tubes to aid platelet activation?
silica particles
- how are arteries different from veins?
arteries have no valves
- what specimen would be rejected by a MLA in accessioning?
a tube missing the patient PHN
- a patient must give written consent to have blood collected from their foot?
FALSE, doctor has to give consent
hand and foot veins may be used for venipuncture collection?
true
what veins are best when poking from the hand
dorsal hand veins
what vein is best for foot pokes?
saphenous grin is the preferred site
don’t take blood from the foot if the patient has?
diabetes
in a grey top tube what is sodium fluoride
antiglycolytic, stops metabolism of glucose by blood cells
in a grey top tube what is the sodium oxalate
anticoagulant
random urine
collected for general screen of physical health
first morning
most concentrated
midstream urine
used for routine microbiology culture and sensitivity
24 hour or timed urine
total column of urine voided in a 24 hour period
pediactric urine
aka bagged
catheterized urine
inserted into bladder via urethra
suprapubic urine
invasive!!! can’t be recollected
blood alcohol test is ordered what cleaning products can be used on their arm before collection?
chlorhexidine gluconate
compliance with diet restrictions should be checked…
after identifying the patient
prior to collection the arm should be cleansed with…
70% isopropanol
a tourniquet is left on for 4 mins before collection, this prolonged application has caused venous stasis which leads to
decreased plasma volume
where should the tourniquet be placed
3-4 inches above puncture site
when using a winged infusion set for venipuncture and a coagulation test has been ordered, you need to
draw a NaCit discard tube first
during venipuncture, vigorous pumping of the hand
may result in erroneous potassium results
immediately following a needle stick exposure the phlebotomist needs to
rinse, report to supervisor and go to ER
an evacuated tube draws +- 10% of the stated volume on the label. if a 6 ml EDTA tube is collected, what is the range of volume of blood in the tube?
5.4-6.6mL
anticoagulants are
substances that prevent clotting
if you spin a PST tube for a chem test and the gel doesn’t migrate properly you should
quickly remove the plasma to another labeled tube
a heparin tube which contains a gel separator should sit for
15-30 mins at room temp for clotting
an order arrives for STAT bilirubin and CBC on a neonate in the NICU. what’s the correct order of draw
lavender and amber
evacuated tubes
withdraw a predetermined volume due to vacuum
can tubes be spun immediately upon arrival to lab
yes
how much volume is required in a tube according to CLSI
+- 10%
what is the ratio of light blue tubes
9:1
what is the ratio of light blue tubes
9:1
the order of draw for micro collection is
bilirubin, EDTA, Plasma
anticoagulant mode of action for NaCit is that it chelates calcium and therefore clot formation is inhibited T of F
true
the anticoagulant mode of action for heparin is interference with thrombin formation T of F
true
tubes containing heparin as an anticoagulant may also have either lithium or sodium in them T of F
true
a phlebotomist needs to collect a CBC and INR and a potassium on an inpatient. identify the tubes by colour and in the correct order of draw
light blue, green, lavender
which needle gauge indicates the smallest bore or lumen
22
tip: smaller gauge number, larger the lumen
the part of the syringe that shows measurements in mL or cc is called the
barrel
which additive can inhibit glucose metabolism in by red cells
sodium fluoride
after centrifugation which tubes final fluid portion will be plasma
any tube with an anticoagulant in it will produce plasma as the fluid portion after spinning
according to health canada, wearing gloves will protect the phlebotomist by reducing the column of blood from a needle stick injury by?
50%
a patient indicates “implied consent” when they
extend their arm when asked to do so
unidentified patients in the ER
may have blood draw ONLY if they have received a temporary identification band
if the phlebotomist has a STAT collection on a patient and they are currently with their doctor, the phlebotomist should
say excuse me and ask permission to proceed with collection
during the morning rounds the phlebotomist walks into patients room and they are sleeping. the phlebotomist needs to?
touch the side of the bed to gently wake the patient
when the phlebotomist realizes their patient is unconscious, what is the proper procedure to follow?
request help during the collection in case of any sudden movements
when collecting a good specimens from a small child, the approach that is NOT recommended is?
tell the child the procedure will not hurt
plasma
fluid portion of whole blood including the coagulation factors
serum
fluid portion of blood without coagulation factors, which were used up in making the clot
ven/o or phleb/o
vein
aort/o
aorta
arteriol/o
arteriole
vas/o or vascul/o
vessel or duct
angi/o
vessel
atri/o
atrium
atri/o
atrium
cardi/o
heart
tourniquet on too tight
petechiae
what angle should u enter the arm at
never enter >15 degrees of <30 degrees
plasma separator tubes (PST) contain what
heparin anticoagulant and a gel separator
serum separator tubes (SST) contain what
clot activator to activate coagulation also gel separator
when having a PST tube do you have to wait for blood to clot?
no.
EDTA, Heparins, Sodium Citrate, and Potassium oxalate are what
anticoagulants
order of draw
blood cultures
nacit tubes
serum (SST) (red)
heparin (PST) (mint)
EDTA (lav)
fluoride (grey)
Stop Buying Soup Goats Love Grass
S- sterile (blood cultures)
B- blue
S- serum
G- green
L- lavender
G- gray
is the order of fill the same as order of draw?
yes
timed means?
the scheduled or timed collection of an ordered specimen
ischemia means
deficiency of blood to an area
what’s allowed when fasting
water and prescription drugs
hemolysis
damaged RBCs
lipemic
appear cloudy, to much fat and lipids in blood
icteric
contains high levels of bilirubin usually range in colour from dark yellow/green to bright yellow
serum tubes need to be spun in centrifuge for how long?
10 mins at 1000-1300 RCF
PST tubes need to be in the centrifuge for how long?
10 mins at 1000-1300 RCF
NaCit tubes need to be spun in centrifuge for how long?
15 mins at 1500 RCF
which artery is located near the basilica vein
brachial artery
pulmonary circulation carries deoxygenated blood to the lungs via pulmonary arteries T or F
true
the inner most layer of the heart is the
endocardium
the node in the heart that is referred to as the pacemaker is the
sinotrial node
plasma is the fluid of the blood that does NOT contain clotting factors T or F
false
the chamber of the heart that has the thickest muscled wall is the ?
left ventricle
approximately how much pericardial fluid is found in the pericardial cavity?
50 mL
into what chamber does oxygenated blood enter the heart?
left atrium
what area of the heart receives deoxygenated blood from the hearts venous system?
coronary sinus
all veins in the body carry deoxygenated blood except the?
pulmonary veins
the reason the heart is a deep purple colour is bc
presence of myoglobin
is a midwife legally allowed to request a lab test on a patients sample?
yes
only a physician can fill out a req
false
blood tube that is delivered to the hematology bench is
Whole EDTA
reject all grossly hemolzed specimens, they are unsuitable for testing T or F
false
most histology specimens arrive in the lab in what?
formalin
a sample that arrives in the lab unlabeled is always rejected T or F
false
a blood tube for an ammonia test requires?
to be spun immediately upon arrival in a refrigerated centrifuge
first morning urine is the recommended sample for *** testing
cytology
in the heart the base =
upper part
in the heart the apex =
pointed end
pericardium
helps protect from infection and trauma by a double walled outer sac
outer layer of the pericardium is called
fibrous pericardium
inner layer of the pericardium is the
serous pericardium
serous pericardium consists of two layers:
parietal layer: lines inside of fibrous
visceral layer: covers outer surface of heart muscle
the pericardial cavity or space divides the ** and ** pericardium
parietal and visceral
what does serous pericardial fluid do
lubricates the surfaces of the pericardial space and allows the heart to move easily while it pumps
what are the three tissue layers of the heart wall
endo, myo, and epicardium
endocardium is
innermost layer
myocardium is
thick middle layer that forms most of the heart wall
epicardium is
outer layer, also called the visceral layer
4 hollow chambers in the heart what are they
2 atria and 2 ventricles
the upper chambers include and do what
right atrium and left atrium
these chambers RECEIVE blood
the right atrium receives ** blood from the body
deoxygenated blood
the left atrium receives *** blood from the lungs
freshly oxygenated blood
the lower chambers include the
right and left ventricle
the thickest of the 4 chambers
the ventricles job is to
PUMP blood
the right ventricle pumps blood to the
lungs for oxygenation
the left ventricle pumps blood to
the body
the heart has 4 one way valves which include
2 atrioventricular valves and 2 semilunar valves
what do the heart valves do
allow blood to flow through the heart chambers in ONE direction only
AV valves separate
the atria from the ventricles
the 2 important tissues associated with the atrioventricular valves are the
chordae tendineae and the papillary muscles
chordae tendineae is
the connective tissue that serves as “strings” that are attached to the cusps of the AV valves
without these blood would re enter through atria when the ventricles are contracting
papillary muscles are
cardiac muscle that extend into the ventricles and attach to the ends of the chordae tendineae
SL valves
stop blood flowing back into ventricles from the aorta and pulmonary arteries
2 phases of the cardiac cycle are
systole phase and diastole phase
systole
contraction phase
diastole
relaxation phase
diastole
relaxation phase
superior vena cava
returns blood from upper portion of the body
inferior vena cava
returns blood from the lower portion of the body
coronary sinus is
collection of veins that collect and return deoxygenated blood from the heart
all arteries in the body carry ** blood except the **
oxygenated, pulmonary arteries
all veins in the body carry ** blood except the **
deoxygenated, pulmonary veins
the presence of myoglobin does what to the colour of the heart
deep purple colour
plasma is the fluid portion of whole blood….
including coag factors
serum is the fluid portion of blood…
without the coag factors
used up in making the clot
depolarization comes before repolarization? true or false
TRUE
SST contain a **** to activate ***
clot activator to activate coagulation
PST contain ** and a ***
heparin anticoagulant and a gel separator
advantage of collecting in a PST is that…
you don’t have to wait 30 mins for the specimen to clot before centrifugation
tubes with gel separator must be spun within *** of collection
2 hours
SBSGLG
sterile
blue
serum
green(mint)
lavender
gray (fluoride)
capillary collections what tube is always first
EDTA
petechiae
small red spots on skin surface caused by bleeding under the skin
edema
interstitial fluid trapped in tissues resulting in a puffy appearance
CVC
central venous catheter
PICC
peripherally inserted central catheter
implanted port
small chamber that is surgically inserted beneath the skin
heparin lock
device inserted into a VAD to enable access for administration of medication and blood collection
any tube with an anticoagulant in it will produce plasma as the fluid portion after spinning? t or f
TRUE
which additive can inhibit glucose metabolism in by red cells?
sodium fluoride
