final review ch 9-19 Flashcards
what should a phlebotomist not do to prevent moving of needle in patients arm
anchor hand on patients arm while pulling tube straight out of holder
what should you not do when collecting for a micro collection
squeeze and scrape to collect drop
features of dermal puncture devices do not include
uniform depth
for a dermal puncture, what order do you collect an H&H, BUN and creatinine
H&H, BUN, and creatinine
lavender and gold
for a BAC, what cleaning agent can you use when a patient is allergic to iodine
chlorhexidine gluconate
best area to draw for geriatric patients
antecubital fossa
what happens to geriatric patients veins
become more elastic
why do you discard first sample drawn from heparin or saline lock
potential dilution of sample
what fecal specimen is used to find presence of parasites and eggs
random fecal
what is a timed urine test
creatinine
“snapshot” of inner workings of body
urine specimen
how long does a red top tube take to clot
30-45 mins
max amount of time before specimen needs to be delivered to lab
45 mins
what can you not use to test for pregnancy
sputum (spit/ saliva)
what samples are collected for ACT testing
(activated clotting time)
sodium citrate, dermal puncture, whole blood
purpose of palpating vein
find placement, width/ depth, and position
purpose of flanges
to stabilize the pushing and pulling of tubes
when should safety device be activated
immediately after removing needle
when do you label blood collection tubes
immediately after removing needle
what does the width have t do with dermal punctures
wider cut = more capillaries cut- more blood
expected normal range for bleeding time test
2-10 mins
what happens if you squeeze/ milk capillary puncture site
contamination
what do you use when patient is allergic to iodine
chlorhexidine gluconate
barriers to blood flowing when attempting to draw blood
going too deep, not deep enough in vein, readjusting or missing vein
what can cause a hematoma
moving too slow, missing vein, fishing around, removing tourniquet after needle is removed
what collection method is primarily used in peds
dermal puncture
basal state
abstinence of eating/ drinking and exercise. steady state after 8 hours
what purpose will a doctor order a digoxin level and is it a times test
yes, timed- for therapeutic drug monitoring and to see peak and trough levels
what’s the difference between aerobic and anaerobic
anaerobic- can’t tolerate oxygen,
aerobic- can tolerate oxygen
(think aerobic first- sucks out oxygen to allow anaerobic to not be compromised)
what blood culture bottle is drawn first when using winged infusion set
aerobic
what time is best for urine sample to detect UTI
morning
can you use a random fecal specimen to test for parasites
yes
common times urine test
creatinine protein clearance (24 hours)
what can cause extreme hemolysis
shaken too much, extreme temps, traumatic collection
what is lipemia
fats in serum
purpose of barcode specimen label
to identify, track and catalog sample
pneumatic tube system
transport of specimen in sealed container within network of tubes
point of care
performance of test immediately after obtaining sample
what must match patients ID and requisition form prior to blood draw
name, DOB, patient ID, bed/ room #
what are some reasons you won’t use expired blood collection tube
lower vacuum in tube - lab will reject
microclots risk increase
what is assault in phlebotomy
unjustifiable attempt to touch another person or threat to do so
battery in phlebotomy
intentional touching of another person without consent
which vein lies next to brachial artery
bascilic
what parts of the heel are acceptable areas for heel sticks
medial and lateral borders of foot
what is altered in hemoconcentration
formed ratio of elements
what type of tests are ordered “timed”
TDM- therapeutic drug monitoring
what info might H&H provide for physician
hemoglobin and hematocrit, whole blood, dermal puncture and coagulation tube
quality control
quantitative methods to measure QUALITY OF PROCEDURE
ex: making sure equipment is calibrated
(think like chores)
quality assurance
methods used to guarantee QUALITY PATIENT CARE
(think like marking off chore chart)
what steps in patient testing fall under pre analytical
prep, requisitions, collection
examples of pre analytical variables
specimen collection, site placement, tourniquet, cleaning of site
why can’t you draw on the side of a mastectomy
it’s painful and higher risk of infection for patient
is it appropriate to set your tray on patients bed
no- breach of standard. you and patient at risk of accidental needle stick, it’s unsafe and unsanitary
purpose of requisition
identify patient name, DOB, what tests will be done and tool collection
definition of hemoconcentration
increased ratio of formed elements in blood
negligence
failure g preform action that’s consistent with the standard of care
