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Phlebotomy > exam > Flashcards

exam Flashcards

1
Q

how much blood volume should be collected in a short amount of time for infants? And how do you calculate?

A
  1. 10%
  2. multiply kg by 100 then multiply by the percent
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2
Q

how to clean site for blood cultures? which bottle first?

A
  1. clean with alcohol or chlorhexidine gluconate for 60 secs allow to dry completely then clean again with povidine iodine
  2. aerobic
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3
Q

how are routine screenings for newborns collected? how do you collect it?

A
  1. specific forms/cards that contain filter paper
  2. avoid touching the filter paper; puncture no deeper than 2mm; wipe off 1st drop of blood; touch; has to soak through completely in each circle
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4
Q

what urine test requires fasting?

A

glucose tolerance test

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5
Q

what urine test has you void and then eat?

A

postprandial

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6
Q

what urine test has you discard 1st morning urine then collect the rest?

A

24-hour

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7
Q

what urine test uses clean catch midstream?

A

culture and sensitivity

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8
Q

what immunization is available to all employees?

A

hep B

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9
Q

1st order of draw

A

additive: sodium polyanethol sulfonate(SPS)
color: yellow or bottles
inversions: 8-10
lab: blood cultures

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10
Q

2nd order of draw

A

additive: sodium citrate
color: light blue
inversions: 3-5
lab: PT, PTT, D-dimer, fibrinogen, factor assay

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11
Q

what do blood cultures test for?

A

bacterial infections etc

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12
Q

3rd order of draw

A

no additive
clot activator in plastic
color: red
inversions: 3-5 plastic none:glass
labs: Chemistry dept.
bilirubin, hepatitis, thyroid panel, vitamins, Cryoglobulins, cold agglutinins, troponins

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13
Q

4th order of draw

A

additive: serum separator gel (SST)
color: gold/mottled red
inversions: 3-5
lab: Chemistry dept(same as red tube) plus the following:
basic metabolic, electrolytes, hcg, comprehensive metabolic panel, renal/ kidney function, creatine

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14
Q

5th order of draw

A

additive: rapid serum separator
color: orange
inversions: 3-5
Same as SST tubes but for stat order

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15
Q

6th order of draw:

A

additive: heparin (prevents thrombin)
color: green
inversions: 8-10
lab: routine chemistry, chromosome, genetic studies

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16
Q

7th order of draw

A

additive: EDTA with or without separator gel
color: lavender/ pearly white
inversions: 8-10
lab: CBC, hemoglobin, hematocrit, platelet, estimated sedimentation rate, factor v, HBA1c, ammonia

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17
Q

8th order of draw

A

additive: EDTA
color: pink
lab: blood bank collections

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18
Q

9th order of draw:

A

additive: EDTA free of trace elements
color: royal blue
lab: trace element, toxicology, nutrition

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19
Q

10th order of draw

A

additive: EDTA lead free
color: tan
lab: lead levels

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20
Q

11th order of draw

A

additive: sodium fluoride, potassium oxalate (anticoagulant) (prevents deterioration of glucose)
color: grey
inversions: 8-10
lab: glucose, blood alcohol level, lactic acid

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21
Q

12th order of draw

A

additive: acid citrate dextrose(acd)
color: yellow
inversions: 8-10
lab: DNA analysis, paternal testing

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22
Q

what are standard precautions? what are some of them?

A
  1. precautions taken with all patient encounters
  2. washing hands, wearing gloves
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23
Q

what are transmission based precautions? what are some?

A
  1. additional precautions taken when a patient is sick
  2. wearing additional ppe
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24
Q

what are droplet precautions? what are some diseases? what additional precautions should you take?

A
  1. additional precautions taken when patients have infections that spread via droplets larger than 5 microns
  2. meningitis, rubella, diphtheria, mumps, pertussis(whooping cough), flu, kneumonia
  3. wear a mask
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25
Q

what are contact precautions? what are some diseases? what additional precautions should you take?

A
  1. required for patients with infections that spread via contact
  2. diptheria, herpes, scabies, hep a, would/skin infection, MRSA, c diff
  3. wear gown
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26
Q

what are airborne precautions? what are some diseases? what additional precautions should you take?

A
  1. required for patients with infections that spread via droplets smaller than 5 micron
  2. chickenpox, tuberculosis, measles
  3. wear N95/N99 respirator
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27
Q

what do you cleanse with when doing a blood alcohol test?

A

povidone iodine unless allergic

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28
Q

what sites aren’t used for venipuncture?

A
  1. above IV
  2. arm with arteriovenous shunt
  3. arm with central venous access device
  4. same side as mastectomy
  5. with edema
  6. site with scarring
  7. sitee with hematoma
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29
Q

what does requisition include?

A
  1. dob
  2. full name
  3. sex
  4. specific identification numbers
    can include space to document, billing info, and diagnostic coding
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30
Q

peak of medication

A

2 hrs after administered
ask nurse when administered

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31
Q

through of medication

A

test 15 mins before next dose
ask nurse when administered

32
Q

fasting

A

usually 8-12 hrs with nothing to eat or drink besides water

33
Q

capillary order of draw

A
  1. blood gas
  2. EDTA
  3. heparin
  4. additive specimens
  5. serum
34
Q

glucose levels

A

70-110

35
Q

wbc levels

A

4.4-11

36
Q

cholesterol levels

A

140-200

37
Q

troponins t levels

A

0-0.2

38
Q

urine temp

A

32C- 38C

39
Q

warming technique

A

encase warm towel in plastic bag

40
Q

what do you do with arterial blood gas?

A

place in an ice bath

41
Q

what can cause hemolysis?

A
  1. not inverting tubes
  2. using too small of a needle
  3. oull to forceful on syringe
  4. handling roughly
  5. overtight tourniquet or leaving it longer than one min
    6.
42
Q

what can cause hemoconcentration?

A
  1. not removing tourniquet when blood flow is established
  2. if patient just sat up straight from supine position
  3. pumping fist during venipuncture
43
Q

how to doff ppe

A

gloves, goggles,gown, mask

44
Q

how to don ppe

A

gown, mask, goggles, gloves

45
Q

what are sclerotic veins?

A

hard, inflexible, narrow

46
Q

what are tortuous veins? varicose

A

twisted and lack elasticity

47
Q

what are thrombotic veins?

A

hard, inflexible, blood clot

48
Q

what are phlebitic veins?

A

tender warm and red area around it

49
Q

what does nerve damage feel like?

A

numbness, pins/needled, pain shooting down arm

50
Q

what’s phlebitis?

A

inflammation of blood vessel

51
Q

what’s thrombosis?

A

blood clot

52
Q

what’s petechiae?

A

small red dots below tourniquet

53
Q

symptoms of shock?

A

cold, clammy, pale skin, rapid pulse, shallow breathing

54
Q

how long do serum tubes need to clot before centrifugation?

A

30 mins

55
Q

how long do rapid serum tubes need to clot?

A

5mins

56
Q

what does heparin prevents?

A

clotting

57
Q

when your using a butterfly needle for light blue tubes…

A

you have to use a non additive tube to start blood flow

58
Q

how do you label every type of collection container immediately after collection?

A
  • patients name
  • date and time of collection
  • specimens type
59
Q

what do you send specimens to the lab in?

A

plastic biohazard bags with seals

60
Q

how to use filter paper?

A
  • apply blood to printed side
  • don’t add a second drop
  • wipe off 1st drop of blood
  • don’t touch puncture site to paper
  • allow to dry for at least 4 hrs
61
Q

is a medical record number an acceptable identifier?

A

yes

62
Q

when do you centrifuge serum tubes?

A

before transportation

63
Q

where do you drop blood for peripheral blood smear?

A

1mm of blood one half inch from edge of slide

64
Q

why is capillary order of draw different?

A

blood clots more quickly

65
Q

procedure for fecal occult?

A
  • avoid taking ibuprofen
  • collect for 3 days
  • consume high fiber diet
  • keep cards at room temp
66
Q

how much urine for a drug test?

A

45ml

67
Q

what do you do if a person is donating blood and bag fills halfway and vein collapses?

A

use a new collection bag to draw a new unit

68
Q

syncope

A

pale diaphoretic

69
Q

seizure

A

involuntary movement before hand

70
Q

what is a safety data sheet?

A

where chemicals must be clearly labeled and all possible hazards are clearly communicated

71
Q

what are the 4 categories of hazards in lab environment?

A
  • chemical (flammable)
  • biological (Bloodborne)
  • physical (ergonomics)
  • safety
72
Q

ergonomics definition

A

science of designing equipment, areas, and work tasks to make them safer

73
Q

how can hazards in the workplace be controlled?

A
  • safety devices
  • setting rules
  • work practices
  • ppe
74
Q

guidelines dealing with chemical hazrds

A
  • don’t use chemicals you aren’t trained to use
  • wear appropriate gloves when using disenfectant
  • don’t store food/drink near chemicals are used/stored
  • dont eat or drink anything you don’t know origin of
  • don’t keep food/drink in lab/drawing station
  • ## know where eyewash stations, sinks, showers etc are
75
Q

guidelines for physical hazrads

A
  • pay attention to ergonomics
  • standard precautions
  • pay attention to signs, lights, for xray/radiation exposure
  • use ear protection when working with loud machines
76
Q

how do you respond to a fire?

A

PASS
- pull pin
- aim at base of fire
- squeeze handle
- sweep back and forth at base
RACE
- remove anyone from danger
- activate alarm or call 911
- contain fire if possible by closing all doors/windows
- extinguish fire

Phlebotomy (3 decks)

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