Final Flashcards
What is the needle gauge?
Related to the diameter of the lumen
What are different types of needles used for drawing blood?
Hypodermic, Multisample, Butterfly
What are the needle safety devices?
Resheathing device, Blunting device, and equipment with devices that retract the needle after use
What is an antiglycolytic?
Substance that prevets glycolysis
Which tube must be full to be accepted?
Light blue
How does heparin prevent clotting?
Inhibiting thrombin formation
What is the function of sodium citrate?
Prevents coagulation by binding to calcium & does the best job of preserving coagulation factors
How does EDTA prevent blood clotting?
Binding or chelating calcium
Why is EDTA used for hematology?
Preserves cell morphology and inhibits platelet aggregation better than any other anticoagulant
Define ACD
Acid Citrate Dextrose
Define additive
Substance such as an anticoagulant, antiglycolytic, separator gel, preservative, or clot activator placed within a tube or collection container
Define butterfly needle
Another term for a winged infusion set
Define clot activator
Substance that enhances the coagulation process
Define ETS
Closed system in which the patient’s blood flows directly into a collection tube through a needle inserted into a vein
Define evacuated tube
Type of tube in blood collection that has a premeasured vacuum and is color-coded to denote the additive inside
Define lumen
Inner space of a blood vessel, tube, or needle
Define PST
Plasma separator tube
Define shaft
Long cylindrical portion of a needle
Define sharps container
Special, puncture-resistant, leak-proof, disposable container used to dispose of used needles, lancets, and other sharp objects
Define silica
Glass particles used to enhance the coagulation process; clot activator
Define sodium fluoride
Additive that preserves glucose and inhibits the growth of bacteria
Define SPS
Sodium polyanethol sulfonate
Define SST
Serum separator tube
Define thixotropic gel
Inert, synthetic gel substance that forms a physical barrier between the cells and serum/plasma when the specimen is centrifuged
Define winged infustion set
Stainless steel needle permanently connected to tubing with either a Luer attachment for syringe use or a multisample Luer adapter for use with the evacuated tube
Define accession
Process of recording in the order received
Define anchor
To secure firmly, as in holding a vein in place by pulling the skin taut with the thumb
Define arm/wrist band
Other names for an identification band or bracelet
Define ASAP
As soon as possible
Define bar code
A series of black stripes and white spaces of varying widths that correspond to letters and numbers
Define concentric circle
Circles with a common center; starting from the center and moving outward in ever-widening arcs
Define DNR/DNAR
Do not resuscitate/Do not attempt resuscitation
Define fasting
No food or drink except water for approximately 12 hours
Define hospice
A type of care for patients who are terminally ill
Define ID band/bracelet
Identification band/bracelet
Define MR number
Hospital identification number
Define needle sheath
Needle cap or cover
Define NPO
Nothing by mouth
Define palpate
Examine by feel or touch
Define patency
State of being freely open, as in the normal condition of a vein
Define patient ID
The most important step in specimen collection
Define reflux
The backflow of blood into a patient’s vein from the collection tube during venipuncture
Define requisition
The form on which test orders are entered and sent to the laboratory
Define stat
Immediately
What are the 3 types of test requisitions?
Manual, Computer, Bar-Code
What requisition information is required?
Ordering physician’s name, Patient’s first and last names and middile initial, Patient’s medical record number, Patient’s date of birth or age, Room number and bed, Type of test to be performed, Date test is to be performed, Billing information and ICD-9 codes, Test status, Special precautions
What are 4 special situations for entering a patient’s room?
Physicians and clergy, Family and visitors, Unavailable patient, Identifying yourself
How do you mix additives in the tube? How many times?
Gently invert it 8-10 times
What should a tube label include?
Patient’s first and last names, Patient’s identification number or date of birth, Date and time of collection, Phlebotomist’s initials, Pertinent additional information such as fasting
Where is the tourniquet placed when drawing a hand vein?
Proximal to the wrist bone
Why do you anchor the vein?
Keeps it from rolling or moving to the side upon needle entry & A needle passes through taut skin more easily and with less pain
Why do patients need to fast?
Eliminates most dietary influences on testing
Define hemoconcentration
Decrease in the fluid content of the blood, with a subsequent increase in nonfilterable large molecule- or protein-based blood components such as RBCs
How is hemoconcentration caused?
Long tourniquet application, massaging or squeezing site, probing for veins, lont-term IV therapy, drawing blood from sclerosed of occluded veins, and vigorous hand pumping
What are 2 ways of causing hemolysis?
Drawing blood through a hematoma & Forceful aspiration of blood during a syringe draw
What are 4 situations that can trigger the formation of a hematoma?
Inadvertent arterial puncture, needle penetrates all the way through the vein, needle is removed while the tourniquet is still on, excessive or blind probing is used to locate the vein
Which factors can affect basal state?
Age, gender, and conditions of the body that can’t be eliminated
Which test are affected by altitude?
RBC count, hemoglobin, hematocrit, C-reactive protein, uric acid, urinary creatinine and plasma renin
Which blood test is affected when a child is crying before a draw?
WBC count
When you have to draw blood from a hematoma, where should you do it?
Dital to the hematoma
What should you do if a patient is predisposed to fainting?
Ask the patient to lie down for the procedure
What is iatrogenic anemia?
Blood loss as a result of removing blood on a regular basis or in large quantities for testing
What should you do if you collect an arterial specimen?
If acceptable for testing identify specimen as possible arterial blood
What are the symptoms of hitting a nerve?
Extreme pain, a burning or electric-shock sensation, numbness of the arm, and pain that radiates up or down the arm
Define bevel
Point of a needle that is cut on a slant for ease of skin entery
Define EDTA
Prevents coagulation by binding to calcium
Define sodium citrate
Anticoagulant that prevents clotting by binding calcium and is used for coagulation tests because it does the best job of preserving coagulation factors
Define AV shunt/fistula/graft
Surgical fusion or artificial connection of an artery and a vein; typicall created to provide access for dialysis
Define basal state
Resting metabolic state of the body early in the morning after fasting for a minimum of 12 hours
Define edema
Swelling due to abnormal accumulation of fluid in the tissues
Define exsanguination
Blood loss to a point where life cannot be sustained
Define hematoma
Swelling or mass of blood caused by blood leaking from a blood vessel during of following venipuncture
Define hemoconcentration
Decrease in the fluid content of blood with an increase in large, nonfilterable molecules like RBCs in the blood vessel
Define hemolysis
Damage or destruction of RBCs and release of hemoglobin into the fluid portion of the specimen, causing serum color to range from pink-red
Define hemolyzed
Condition of serum or plasma that contains hemoglobin from broken RBCs
Define iatrogenic
Adjective used to describe an adverse condition brought on by the effects of treatment
Define icteric
marked by jaundice’; describes serum, plasma, or urine specimens that have an abnormal deep-yellow to yellow-brown color due to high bilirubin levels
Define jaundice
Condition characterized by increased bilirubin (product of RBC breakdown) in the blood, leading to deposition of yellow bile pigment in the skin, mucous membranes, and sclera
Define lipemia
Increased lipid content in blood
Define lipemic
Describing serum or plasma that appears milky or turbid due to high lipid content
Define petechiae
Tiny, nonraised red spots that appear on a patient’s skin upon tourniquet application; drops of blood that escape capillaries
Define sclerosed
Hardened
Define syncope
Medical term for fainting; loss of consciousness and postural tone that results from insufficient blood flow to the brain
Define thrombosed
Clotted; refers to a blood vessel that is affected by clotting
Define differential
Test in which number, type, and characteristics of blood cells are determined by examining a stained blood smear under a microscope
Define interstitial fluid
Fluid in the tissue spaces between cells
Define microcollection containers
Small plastic tubes used to collect tiny amounts of blood obtained from capillary punctures
Define microhematocrit tubes
Disposable, narrow-bore plastic or plastic-clad glass capillary tubes that fill by capillary action
Define newborn/neonatal screening
Routine testing of newborns for the presence of certain metabolic and genetic disorders
Define PKU
Phenylketonuria; disorder that results from a defect in the enzyme that breaks down phenylalanin into tyrosine
Define plantar surface
Sole or bottom surface of the foot
Define whorls
Spiral pattern of the ridges and grooves that form a fingerprint
Define ACT
Activated clotting time; monitors heparin therapy
Define aerobic
With air
Define anaerobic
Without air
Define autologous
Blood donated for one’s own use
Define compatability
Ability to be mixed together with favorable results, as in blood transfusions
Define GTT
Glucose tolerance test; Test used to diagnose carbohydrate metabolism problems
Define peak level
Drug level collected when the highest serum concentration of the drug is anticipated
Define septicemia
Microorganisms or their toxins in the blood
Define TDM
Therapeutic drug monitoring; testing of drug levels at specific intervals to help establish a drug dosage, maintain dosage at a therapeutic level, and avoid drug toxicity
Define trough level
Drug level collected when the lowest serum concentration of the drug is expected
Define accession number
Number generated by the laboratory information system when the specimen request is entered into the computer
Define aliquot
Portion of a specimen used for testing
Define bar code
Series of black stripes and white spaces of varying widths that correspond to letters and numbers
Define central processing
Screening and prioritizing area where specimens are received and prepared for testing
Define mneumonic
Memory-aiding code or abbreviation
Define preanalytical
Prior to analysis
Define AFB
Alpha-fetoprotein; antigen present in human fetus that’s also found in amniotic fluid and maternal serum
Define C&S
Culture and sensitivity
Define clean catch
Method of obtaining a urine sample so that it is free of contamination from the external genitalia
Define CSF
Cerebrospinal fluid; clear, colorless liquid that circulates within cavities surrounding brain and spinal cord
Define H.Pylori
Heliobacter pylori; bacterial species secreting substances that damage the lining of the stomach and cause chronic gastritis, which can lead to peptic ulcers
Define O&P
Ova & parasites; test to detect the presence of intestinal parasites and their eggs in feces
Define occult blood
Hidden blood
Define serous fluid
Pale-yellow, watery fluid found between double-layer membranes that enclose the pleural, percardial, and peritoneal cavities
Define 24-hour urine
Pooled urine specimen collected over a period of 24 hours, usually beginning in the morning
Define UTI
Urinary tract infection; ailment caused by the presence of microorganisms in one or more structures of the urinary system
Why do you let the antiseptic dry completely?
Helps destroy microbes, Prevents specimen hemolysis from alcohol contamination, Avoids burning sensation when needle is inserted
Define geriatric
Relating to old age
What position should the arm be in for blood draw?
Extended downward in a straight line from shoulder to wrist
When do you use a butterfly needle?
Drawing blood from infants and small children, Difficult adult veins, Wrist or hand veins
Which disease causes tremors?
Parkinsons
Can you take blood from an arm with a fistula or graft?
No
Name some timed tests.
TDM, Blood culture, Cardiac enzymes
Name some fasting tests.
Glucose, Cholesterol, Triglycerides
How long should a tournique be applied?
No longer than 2 minutes
What might cause a vein to collapse?
Tourniquet tied too tightly or too close to venipuncture site, Vacuum draw of a tube or pressure of pulling on a syringe plunger is too much for vein, Tourniquet removed during draw
Can a phlebotomist draw from a CVAD?
No, but they can assist by transfering the specimen to the appropriate tube
Define PICC
Peripherally inserted central catheter; inserted into peripheral venous system and threaded into central venous system
Which test uses blood smears?
Differential
How quickly must a blood smear be made from the purple top tubes?
Within 1 hour of collection
Define lancet
Sterile, disposable, sharp-pointed or bladed instrument that either punctures or makes an incision in the skin
Where do you puncture an infants foot?
Medial or lateral plantar surface
Why do we warm the infant’s foot prior to skin puncture?
Increases blood flow as much as 7 times
Why do you wipe away the first drop of blood?
Contaminated with excess tissue fluid, Contains alcohol residue that can hemolyze the specimen, Keep blood from forming a well-rounded drop
Name common newborn test.
PKU, Hypothroidism, Galactosemia, Cystic fibrosis
Which tube is used for alcohol testing?
Glass gray-top sodium fluoride
Which antiseptic is used for blood alcohol tests?
Aqueous povidone-iodine & aqueous benzalkonium chloride (BZK)
Define postprandial
After a meal
Why are blood cultures ordered?
A patient may a bloodstream invasion
Why are 2 bottles drawn for blood cultures?
There’s an aerobic and an anaerobic
What is cardiac troponin I?
Proteins specific to cardiad muscle
What tube should a cardiac troponin I be drawn in?
SST/PST
Name 3 sources of preanalytical error.
Misidentified patient, Expired tube, Underfilled tube
Which specimen should not be centrifuged?
CBC in purple top tube
How long does it take clot tubes to clot?
Within 30 minutes
Define UA
Urinalysis; laboratory test that typically includes macroscopic, physical, chemical, and microscopic analysis of a urine specimen
What is the most frequently analyzed nonblood fluid?
Urine
Should CSF be refrigerated?
No, it should be kept at room temperature
Where is synovial fluid found?
Movable joints
What does the guaiac test detect?
Occult (hidden) blood
