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Phlebotomy > Final Practice > Flashcards

Final Practice Flashcards

1
Q

What is the MSDS?

A

The Safety Data Sheet.
(Tecnhincally stands for Material Science Data Sheet)

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2
Q

Who is the MSDS provided by?

A

OSHA

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3
Q

What is the most important aspect of drawing blood?

A

Verifying the patient

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4
Q

How far away from the venipuncture site do you place the tourniquet?

A

3-4 inches

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5
Q

What is hemolysis?

A

The destruction of blood cells caused by extended use of tourniquet

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6
Q

What is aerobic vs. anaerobic?

A

Aerobic is WITH oxygen, and drawn first.
Anaerobic is WITHOUT oxygen, and drawn second

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7
Q

When verifying the patient, what can you use instead of the patient’s DOB?

A

Their patient ID #, which is the MRN. You would use this WITH their name.

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8
Q

What is the MRN?

A

The patient ID #

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9
Q

What is anemia?

A

Low RBCs or low Hemoglobin

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10
Q

Are assault and battery the same as negligence?

A

NO.
Assault and battery DOESN’T equal negligence.

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11
Q

What is the difference between assault/battery and negligence?

A

Assault/battery is when you do something harmful, don’t obtain consent, etc.
Negligence is when you know you’re doing something wrong, but don’t care and do it anyway.

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12
Q

What is the term for no food/water for 8-12 hours?

A

Fasting

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13
Q

What will happen if you hit an artery?

A

If you hit an artery, it will PULSE and spurt because arteries are coming directly from the heart.

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14
Q

What is the range of the angle at which you insert the needle?

A

15-30 degrees

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15
Q

What is the order of vein from best to least favorable?

A

Median
Cephalic
Basilic

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16
Q

Is 18 gauge or 23 gauge bigger?

A

18 gauge

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17
Q

Break down the word phlebotomy

A

“Phleb” = Vein
“Otomy” = To cut
Phlebotomy = To cut a vein

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18
Q

What does a urine pregnancy test detect?

A

hCG

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19
Q

How do you balance a centrifuge?

A

By having two tubes of equal mass/weight on opposite sides of each other.

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20
Q

Which system releases/secretes hormones?

A

The endocrine system

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21
Q

What 2 hormones are secreted by the thyroid?

A

T4
TSH (thyroid stimulating hormone)

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22
Q

When drawing blood into a yellow tube, is ACD or SPS filled first?

A

SPS is filled first

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23
Q

If you fill 2 tubes successfully, and the third only fills part way and stops, what is most likely the explanation?

A

The tube’s vacuum is compromised.

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24
Q

When is the sharps receptacle considered to be overfilled according to OSHA standards?

A

When it is more than 3/4 full

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25
Q

If you are filling two sets of blood culture bottles, are the sets taken from the same or different venipuncture site?

A

The sets must be filled from two different venipuncture sites.

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26
Q

If the patient has scars that cover their arms and hands, and cannot find any acceptable venipuncture on the arm or the hand, but finds that there are no scars on the fingertips, what should the PBT do?

A

The PBT can do a capillary draw and document where the blood was collected and why.

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27
Q

If an emergency room physician directs a PBT to draw blood from an unconscious patient of unknown identity, is this legal? What form of consent is it?

A

It is legal under the concept of implied consent.

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28
Q

What is distal?

A

Distant… Further away from the heart/torso.

29
Q

Define ETS

A

Evacuated tube system

30
Q

If a tourniquet is left on for too long, this can cause hemoconcentration/hemolysis. What can this affect?

A

This can affect the test results, and not produce accurate test results.

31
Q

What is the difference in the collection of donor blood as compared to routine venipuncture for diagnostic testing?

A

A larger needle is used and the patient is first given a brief medical exam for donor blood.

32
Q

Blood flow slows and then stops while a PBT is halfway through drawing a citrate tube. After adjusting the needle gently forward and backward, the PBT is not able to restore the flow. What should he do?

A

Try a second citrate tube; if the second tube does not fill, perform a second venipuncture at a new site.

33
Q

Why is using liquid controls to test point-of-care devices effective?

A

Because it tests the device using analytes of known composition

34
Q

The veins in both arms of a pt who is obese are difficult for a PBT to palpate and the pt is complaining of the pain from the standard disposable tourniquet. What should the PBT do to try and locate a vein and improve comfort for the patient?

A

Remove the tourniquet, ask the pt to dangle her arms for several minutes, and then use a blood pressure cuff inflated to just BELOW the pt’s DIASTOLIC blood.

35
Q

Microclotting of an anticoagulated specimen may occur if the PBT does not…
a. Vigorously mix the specimen with the tube additive immediately after it is collected.
b. Use gentle inversions to mix the specimen with the tube additive immediately after it is collected.
c. Centrifuge the specimen within an hour of collection.
d. Place the specimen in a heating block immediately after collection.

A

b. Use gentle inversions to mix the specimen with the tube additive immediately after it is collected.

36
Q

A new pt is seated at the drawing station before the PBT realizes he forgot to label and initial the collection tubes from the last pt. What would be his best course of action?

A

Excuse himself and try to catch the last patient before they leave the facility, then label and initial the tubes in their presence.

37
Q

During a blood draw on an elderly pt, the pt’s vein collapses when the first tube is inserted. What is the best option for completing the draw?

A

Try a tube with a smaller volume.

38
Q

Orders indicate a pt needs coagulation studies, a lipid panel, and a complete blood count. What 3 tubes are needed?

A

Citrate tube (light blue)
SST (Tiger top)
EDTA (Lavender)

39
Q

When performing venipuncture on a school-aged child, which needle gauge is the best choice?

A

The smallest needle - so the bigger gauge

40
Q

Most blood chemistry tests are performed on what 2 tubes?

A

Serum tubes or Heparin tubes

41
Q

Which of the following processes is part of appropriate medical asepsis in a lab?
a. Using sterile gloves during venipuncture procedures.
b. Placing used needles in an autoclave before disposal.
c. Thoroughly cleaning a venipuncture site with 70% isopropyl alcohol.
d. Performing hand hygiene after every third patient.

A

c. Thoroughly cleaning a venipuncture site with 70% isopropyl alcohol.

42
Q

A pt with measles is in an airborne infection isolation room. When drawing blood from this pt, a PBT will need to wear what?

A

An N95 respirator

43
Q

The Needlestick Safety and Prevention Act requires that employees what?

A

Involve staff in the selection of safer medical devices.

44
Q

A transfer device allows blood to be safely transferred from _____ to ______.

A

A syringe to evacuated tubes.

45
Q

Blood pulsing into a collection tube is an indication that what?

A

The needle has struck an artery

46
Q

A PBT needs to collect gold, pink, and green-topped tubes through venipuncture. What is the correct order?

A

Gold, Green, Pink.
SST, Heparin, EDTA.

47
Q

Collection tubes with _____ should NOT be used for therapeutic drug testing.

A

Tiger tops.
Separator gel

48
Q

A pt begins to experience a seizure during a blood draw. What should be the PBT’s first response?

A

To remove and sheath the needle.

49
Q

Just as a needle is removed from a pt’s arm, the pt has a coughing fit and the PBT is accidentally stuck with the needle. What should the PBT do after placing the needle in the sharps container?

A

Wash the injury with soap under running water for 15 minutes.

50
Q

The anticoagulant action of this tube additive can be reversed with the addition of calcium:

A

Sodium Citrate

51
Q

In addition to causing pain for the pt, probing for a vein can result in _____, which may affect analytes in a specimen.

A

hematoma

52
Q

The bloodborne illness that has most commonly affected healthcare workers is…

A

Hepatitis B from needlesticks

53
Q

What tubes are used for coagulation studies?

A

Citrate tubes (light blue)

54
Q

What age of a patient is most likely to require the use of a syringe and transfer device?

A

80-year old

55
Q

Hemolysis of a capillary specimen is most likely to have resulted from…

A

“Milking” the finger during collection

56
Q

What are two effects of warming a capillary puncture site?

A

Increased blood flow and arterialization of the blood

57
Q

What are the two types of additives in gray-topped tubes?

A

Sodium or potassium oxalate and sodium fluoride.
AKA an anticoagulant and antiglycolytic.

58
Q

When a pt is in an isolation room, where should the PBT doff any required PPE?

A

Inside the pt’s room right before exiting.

59
Q

Drawing a pt’s blood for routine testing after she has expressed that she does not wish to have the procedure performed may be considered….

A

assault and battery

60
Q

What set of adaptations are appropriate when drawing blood from a pediatric patient?

A

Using a higher gauge needle, removing any sharp or potentially dangerous objects from within the patient’s reach, and never leaving the patient alone at the drawing station.

61
Q

Drawing blood from ____ is usually considered to be beyond the scope of practice for entry-level PBTs

A

Arteries

62
Q

When is a bandage applied to a venipuncture site?

A

After bleeding has stopped

63
Q

A blade-style lancet should be held at a ____ angle to a pt’s fingerprint whorls when performing capillary collection.

A

90 degrees

64
Q

What two tubes can electrolytes be collected in?

A

Red-top or Heparin

65
Q

Electrolytes and complete blood counts are ordered for a pt who must have blood collected by capillary puncture. What is the correct order of the tubes to use?

A

EDTA, Serum

66
Q

When an order is marked STAT it should be collected within…

A

10 minutes

67
Q

Hemolysis can occur when a PBT…
a. Draws a syringe plunger back forcefully
b. Uses a low-gauge needle
c. Mixes specimens by inversion
d. Removes a tourniquet immediately after blood flow is established

A

a. Draws a syringe plunger back forcefully

68
Q

blood that is hidden in urine or stool is called…

A

occult blood

69
Q

what is occult blood?

A

blood that is hidden in urine or stool

Phlebotomy (12 decks)

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