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PMLS > LEC MIDTERM > Flashcards

LEC MIDTERM Flashcards

1
Q

•Patients who have their blood drawn while in a
seated position

A

PHLEBOTOMY CHAIRS

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2
Q

•Most have adjustable arm rests to allow proper
positioning

A

PHLEBOTOMY CHAIRS

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3
Q

•Hold all necessary equipment for proper
sample collection.

A

HANDHELD CARRIERS

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4
Q

•In variety of styles and sizes designed to be easily
carried by the phlebotomist

A

HANDHELD CARRIERS

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5
Q

•Convenient for STAT or emergency, situations or
when relatively few patients need blood work

A

HANDHELD CARRIERS

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6
Q

•Made of stainless steel or synthetic material,
usually with swivel wheels that allows smooth
gliding

A

PHLEBOTOMY CARTS

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7
Q

•Has several shelves to carry adequate supplies

A

PHLEBOTOMY CARTS

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8
Q

Used to clean the site prior to blood collection

A

ANTISEPTICSh

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9
Q

•Prevent or inhibit the growth and development of
microorganisms but do not necessarily kill
them

A

ANTISEPTICS

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10
Q

•Considered safe to use on human skin

A

ANTISEPTICS

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11
Q

Used to remove or kill microorganisms on surfaces
and instruments.

A

DISINFECTANTS

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12
Q

•Stronger, more toxic, and typically more corrosive
than antiseptics and are not safe to use on human
skin

A

DISINFECTANTS

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13
Q

•At least _____ of contact time is required
for bleach-based

A

10 minutes

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14
Q

as a substitute for
handwashing

A

HAND SANITIZERS

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15
Q

hand sanitizer

A

•Should not be used when hands are visibly soiled

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16
Q

used to hold pressure over the site following
blood collection procedures

A

GAUZE PADS & COTTON

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17
Q

are used to cover a blood collection
site after the bleeding has stopped

A

•Bandages

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18
Q

are used to make blood films for
hematology determinations either plain or with a
frosted area at one end where the patient’s name
or other information

A

Precleaned 25 x 75-mm (1 x 3-in) glass
microscope slides

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19
Q

•can be written in pencil
•LABELING materials like pen with permanent,
non-smear ink is also needed

A

slides

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20
Q

Used needles, lancets, and other sharp objects
must be disposed of immediately in special
containers.

A

NEEDLE AND SHARPS DISPOSAL CONTAINERS

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21
Q

• Most are red for easy identification
• Must be marked with biohazard symbol

A

NEEDLE AND SHARPS DISPOSAL CONTAINERS

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22
Q

Needle and Sharps Disposal Containers Characteristics:

A

-Rigid
-Puncture resistant
-Leakproof
-Disposable
-Locking lids

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23
Q

•Leakproof plastic bags that are commonly used to
transport blood and other specimens
• Marked with a biohazard label
• Has an outside pocket where requisitions can be
placed.

A

BIOHAZARD BAGS

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24
Q

•Tend to be expensive
•Utilizes transillumination to make it easier to
locate veins that are difficult to see or feel

A

VEIN-LOCATING DEVICES

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25
Q

VEIN-LOCATING DEVICES ______ through the patient’s skin to highlight veins

A

shine high-intensity LED or infrared red light

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26
Q

the _____ in the blood within the veins
absorbs the light, causing the veins to stand out as
dark lines

A

hemoglobin

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27
Q

Applied or tied around a patient’s arm prior to
venipuncture

A

TOURNIQUET

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28
Q

tourniquet ______ veins to restrict blood flow

A

compresses

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29
Q

Restriction of venous flow _______ the
veins, making them larger and easier to find

A

distends or inflates

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30
Q

•Restriction of blood flow can change blood
components if the tourniquet is left in place for

A

more than 1 minute

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31
Q

Tourniquet Approx.

A

1 inch wide by 15-18 inches long

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32
Q

tourniquet commonly used

A

Flat strip type

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33
Q

Should be non-latex to prevent latex allergy

A

tourniquet

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34
Q

tourniquet must be applied _____ above the puncture site

A

3-4 inches

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35
Q

Pumping of hands can result to

A

eleveated potassium levels

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36
Q

•Prolonged tourniquet causes

A

hemoconcentration

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37
Q

Sterile, disposable, and designed for a single use
only

A

needles

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38
Q

type of needles

A

• Multisample needles (ETS)
• Hypodermic needles (Syringe System)
Winged infusion (butterfly)

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39
Q

-End that pierces the vein
-Allows needle to easily slip into the skin and vein
w/o coring

A

Bevel

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40
Q

Long cylindrical portion

A

Shaft

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41
Q

End that attaches to the blood collection device

A

Hub

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42
Q

Internal space of the needle

A

Lumen

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43
Q

Indicated by a number that is related to the
diameter of the lumen

A

GAUGE

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44
Q

• Inversely proportional to the needle’s
diameter

A

Gauge

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45
Q

the higher the gauge number

A

the smaller the diameter of the needle

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46
Q

selected accordingly to the size
and condition of px’s vein

A

Needle gauge

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47
Q

standard and most routine

A

21-gauge

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48
Q

most needles come in (length)

A

1 or 1.5 in

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49
Q

butterfly needles length

A

0.5-0.75 in | 1/2 to 3/4 inch long

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50
Q

-Provide immediate permanent needle
containment
-Activated using one hand
-Resheathing devices, blunting devices,
retractable needles

A

NEEDLE SAFETY FEATURES

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51
Q

shields that cover the needle after use and are devices that retract the needle after use

A

Resheathing Devices

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52
Q

-alternative for patients with small or difficult veins.

A

SYRINGE SYSTEM

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53
Q

SYRINGE SYSTEM Consist of a

A

(1) hypodermic needle, (2) sterile
plastic syringe with a Luer-lock tip

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54
Q

-Used for collecting blood from small or difficult
veins such as hand veins and veins of elderly and
pediatric patients

A

INFUSION SETS

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55
Q

-Allow much more flexibility and precision

A

INFUSION SETS

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56
Q

-Most sets have removable Luer adapters that
allow them to be used with either ETS holders or
syringes

A

INFUSION SETS

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57
Q

commonly referred as
butterfly, which contains plastic extensions that
resemble butterfly wings

A

-WINGED INFUSION SET

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58
Q

Most common, efficient, and CLSI-preferred
system for collecting blood samples

A

EVACUATED TUBE SYSTEM

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59
Q

System allows numerous tubes to be collected
with a single venipuncture

A

EVACUATED TUBE SYSTEM

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60
Q

Allows multiple tubes of blood to be collected
during a single venipuncture

A

MULTISAMPLE NEEDLES

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61
Q

Threaded in the middle and have a beveled point
on each end

A

MULTISAMPLE NEEDLES

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62
Q

•Threaded portion screws into a tube holder
• Covered by a sleeve that retracts as the needle
goes through the tube stopper

A

MULTISAMPLE NEEDLES

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63
Q

•Clear, plastic, disposable cylinder with a small
threaded opening at one end

A

TUBE HOLDERS

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64
Q

Attaches to the needle and holds the tube for ETS
Needle and tube-holder devices are available
permanently attached as a single unit or as both
devices preassembled.

A

TUBE HOLDERS

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65
Q

Collection tubes for obtaining blood.

A

EVACUATED TUBES

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66
Q

• Allows automatic filling of blood due to the
negative pressure
• Amount of vacuum is measured precisely by
manufacturer
• Able to draw exact volume of blood indicated on
the label
• Tube that has prematurely lost all or part of its
vacuum will fail to properly fill blood

A

VACUUM

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67
Q

CAUSES OF PREMATURE LOSS OF VACUUM:

A

• Improper storage
• Opening the tube
• Dropping the tube
• Advancing the tube too far onto the needle before
puncture
• Bevel becomes partially out of the skin during
puncture

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68
Q

a result of premature loss of
vacuum resulting to under-filled tube.

A

“SHORT DRAW”

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69
Q

• Any substance placed within a tube

A

ADDITIVE TUBES

70
Q

ADDITIVE TUBES
• Have one or more specific functions:

A

a. Preventing clotting
b. Preserving blood components
c. Clot activator

71
Q

Additive amount is

A

pre-calibrated

72
Q

Commonly used for clearing and
discarding purposes

A

NON-ADDITIVE TUBES

73
Q

Yield serum samples

A

NON-ADDITIVE TUBES

74
Q

NON-ADDITIVE TUBES Examples

A

Vacuette® gray top, BD clear top

75
Q

Tube caps, tops, or closures are made of a type
of rubber
• Some are covered by a plastic shield

A

STOPPERS

76
Q

STOPPERS are designed to

A

• Prevent blood drops
• Prevent aerosols (mists)
• Prevent blood on the stopper or rim
• Prevents removal of stopper using a
“thumb-roll” or “pop-off”

77
Q

• Identifies the type of additive placed in tube
• Indicates a special property of the tube

A

COLOR CODING

78
Q

is generally universal, although
there might be a slight variation by the
manufacturer

A

Color coding

79
Q

Guarantee reliability of additives and tube vacuum
until an

A

expiration date

80
Q

• Liquid, spray-dried, and powder forms

A

BLOOD COLLECTION ADDITIVES

81
Q

should be lightly tapped
prior to use

A

Powdered additive

82
Q

Must be inverted upon addition of blood
sample
• Number of inversions are dependent on type of
additive and manufacturer

A

BLOOD COLLECTION ADDITIVES

83
Q

Never shake or otherwise vigorously mix a
specimen as this can cause

A

hemolysis

84
Q

Substances that prevent blood from clotting
(coagulating)

A

ANTICOAGULANTS

85
Q

(anticoagulants) Must be mixed immediately after collection to prevent

A

microclot formation

86
Q

3.2% Sodium Citrate

A

citrate

87
Q

used for coagulation test (ex PT, aPTT)

A

Sodium Citrate

88
Q

citrate has a ration of

A

9:1 ratio of blood to anticoagulant

89
Q

used for Erythrocyte

A

Sodium Citrate

90
Q

• Principle: prevent coagulation by binding (or
chelating) calcium
• Sample: Whole-blood
Require immediate mixing after collection to
prevent activation of coagulation process

A

Sedimentation Rate (ESR)

91
Q

Vigorous mixing or excessive number of
inversions can

A

activate platelets

92
Q

sodium citrate (Na citrate)
forms calcium salts to remove calcium
Coagulation tests (PT,PTT,TCT), tube must. be filled 100%

A

light blue top

93
Q

Sodium citrate (buffered)
form calcium salts to remove calcium
westergren sedimentation rate; requires a full draw

A

Black top

94
Q

Green-top tubes
Green-top and light green-top gel tubes

A

heparin

95
Q

Red-banded and green-banded

A

microhematocrit
tubes

96
Q

Plasma separating tube (Na Heparin)
Anticoagulants with lithium heparin: plasma is separated with PST gel at the bottom of the tube
-Chemestries

A

Light green top

97
Q

sodium heparin or lithium heparin
inactivates thrombin and thromboplastin

A

dark green top

98
Q

most widely used
Added to tubes w/ antiglycolytic
agents

A

Potassium oxalate

99
Q

•Principle: remove calcium and prevent clotting by
binding and precipitating calcium in the form of an
insoluble salt
• Sample: Whole-blood

A

oxalate

100
Q

Substance that prevents glycolysis (breakdown
/metabolism of glucose)

A

ANTIGLYCOLYTIC AGENTS

101
Q

Glucose can have a decrease rate of

A

10mg/dL per
hour

102
Q

most common antiglycolytic agent
- not an anticoagulant
Utilized to collect ethanol specimens to prevent
either a decrease in alcohol concentration due to
glycolysis, or an increase due to fermentation by
bacteria.

A

sodium fluoride

103
Q

immunohematology, paternity tests, transplant
compatibility

A

Acid Citrate Dextrose (ACD)

104
Q

for blood transfusion

A

Citrate Phosphate Dextrose (CPD)

105
Q

phosphate stabilizes

A

pH

106
Q

provides cells with energy

A

Dextrose

107
Q

• for blood culture
• reduces the action of a protein called complement • slows down phagocytosis
• reduces the activity of certain antibiotics

A

Sodium Polyanethol Sulfonate (SPS)

108
Q

substance that enhances coagulation in tubes
-Include substances that provide surface for
platelet activation

A

CLOT ACTIVATORS

109
Q

CLOT ACTIVATORS

A
  • Glass (silica)
  • clot activators in SSTs (serum-separator tubes)
  • Plastic red top
    Thrombin
110
Q

•provide a physical barrier between the serum or
plasma in the tube and the cells

A

Serum or Plasma Separator Tubes

111
Q

•prevents the cells from continuing to metabolize
substances such as glucose in the serum or
plasma

A

Serum or Plasma Separator Tubes

112
Q

-inert (nonreacting) synthetic substance

A

Thixotropic Gel Separator

113
Q

-density of the gel is between that of the cells and
the serum or plasma

A

Thixotropic Gel Separator

114
Q

made of materials that are as free of trace element
contamination as possible

A

Trace Element-Free Tubes

115
Q

refers to the order in which tubes are collected during a multiple tube ETS draw

A

order of draw

116
Q

intended to prevent contamination of blood specimens by carryover of additives that can interfere with some tests

A

order of draw

117
Q

The antiseptic most commonly used for routine blood collection is

A

isopropyl alcohol (isopropanol)

118
Q

For a higher degree of antisepsis, the traditional antiseptic has been ______ in the form of swab sticks or sponge pads for blood culture collection

A

For a higher degree of antisepsis, the traditional antiseptic has been povidone-iodine in the form of swab sticks or sponge pads for blood culture collection

119
Q

is recommended for decontaminating nonporous surfaces after cleaning up blood or other body fluid spills in patient care settings.

A

1:100

120
Q

When spills involve large amounts of blood or other body fluids or occur in the laboratory, a ______dilution is applied prior to cleanup.

A

1:10

121
Q

At least ______ of contact time is required for bleach-based and some other disinfectants to be effective.

A

10 minutes

122
Q

Fresh bleach solutions should be made

A

daily

123
Q

should not be used on babies
younger than two years of age because of the danger of aspiration and suffocation.

A

adhesive bandages

124
Q

Evacuated tubes are available from a number of different manufacturers and come in various sizes and volumes ranging from

A

1.8 to 15 mL

125
Q

Tube selection is based on the

A

age of the patient, the amount of blood needed for the test, and the size and condition

126
Q

Tube additives have one or more specific functions, such as

A

preventing clotting or preserving certain blood components.

127
Q

If the additive prevents clotting, the result is

A

whole-blood specimen

128
Q

nonadditive plastic tubes (Fig. 7-20) available are used for

A

clearing or discarding purposes

129
Q

yield serum sample

A

nonadditive tubes

130
Q

used as a clear or discard tube.

A

Nonadditive tubes

131
Q

If a test requires whole blood or plasma, the specimen must be collected in a tube that contains an

A

anticoagulant

132
Q

Gentle mixing is essential to prevent

A

hemolysis

133
Q

The most common anticoagulants are

A

ethylenediaminetetraacetic acid, citrates, heparin, and oxalates.

134
Q

are preferable due to
their high solubility (ability to dissolve)

A

salts

135
Q

can cause a dilution of the blood.

A

Liquid EDTA

136
Q

EDTA additive inversion

A

8-10

137
Q

are detected in a hematology specimen, it cannot be used for testing and must be recollected

A

microclot

138
Q

preferred for most hematology tests because liquid EDTA dilutes the specimen and results in lower hemoglobin values, red blood cell (RBC) and white blood cell (WBC) counts, platelet counts, and packed-cell volumes.

A

Spray-dried EDTA

139
Q

which is used for coagulation tests (e.g., PT and aPTT) because it does the best job of preserving the coagulation factors

A

sodium citrate

140
Q

Sodium citrate tubes have color

A

light- blue stoppers

141
Q

is also the additive in special erythrocyte sedimentation rate (ESR) tubes with black stoppers.

A

sodium citrate

142
Q

Vigorous mixing or an excessive number of inversions

A

activate platelets and shorten clotting times.

143
Q

prevents clotting by inhibiting thrombin

A

heparin

144
Q

an enzyme needed to convert fibrinogen into the fibrin necessary for clot formation)

A

thrombin

145
Q

has traditionally been used for some chemistry tests (e.g., ammonia and plasma hemoglobin). It is now commonly used for STAT tests (e.g., electrolytes) and in other rapid-response situations when a fast turnaround time (TAT) for chemistry tests is needed.

A

heparinized plasma

146
Q

is preferred over serum for potassium tests because when blood clots, potassium is released from the cells into the serum which falsely elevates test results.

A

heparinized plasma

147
Q

Heparin is the additive in:

A

Green-top tubes
• Green-top and light green-top gel tubes (see Fig. 7-18)
• Mottled green and gray-top tubes
• Royal blue-top tubes with green color coding on the label
• Green-top and light green-top microtubes
• Red-banded and green-banded microhematocrit tubes

148
Q

EDTA is the additive in:

A

Lavender (or purple)-top tubes (see Fig. 7-18).
• Microcollection containers with lavender tops.
• Pink plastic-top tubes with a special blood bank patient ID label.
• Royal blue-top tubes with lavender color coding on the label.
• Tan-top tubes used for lead analysis.
• White/pearl-top tubes with thixotropic gel separator.

149
Q

There are three heparin formulations:

A

ammonium, lithium, and sodium heparin

150
Q

causes the least interference in chemistry testing and is the most widely used anticoagulant for both
plasma and whole-blood chemistry tests.

A

Lithium Heparin

151
Q

heparin inversion

A

5-10

152
Q

remove calcium and prevent clotting by binding and precipitating calcium in the form of an insoluble salt

A

oxalate

153
Q

oxalate inversion

A

8-10

154
Q

destruction of red blood cells)

A

hemolysis

155
Q

acts as an RBC nutrient and preservative by maintaining RBC viability

A

Dextrose

156
Q

have yellow tops and require eight inversions immediately after collection to prevent clotting.

A

ACD tubes

157
Q

used in collecting units of blood for transfusion. Citrate prevents clotting by chelating calcium, phosphate stabilizes pH, and dextrose provides cells with energy and helps keep them alive.

A

Citrate phosphate dextrose (CPD)

158
Q

prevents coagulation by binding calcium. It is used for blood culture collection because in addition to being an anticoagulant, it reduces the action of a protein called complement that destroys bacteria.

A

Sodium polyanethol sulfonate (SPS)

159
Q

ingestion of bacteria by leukocytes

A

phagocytosis

160
Q

It also slows down phagocytosis (ingestion of bacteria by leukocytes) and reduces the activity of certain antibiotics

A

Sodium Polyanethol Sulfonate

161
Q

have yellow stoppers and require eight inversions to prevent clotting.

A

sps tube

162
Q

are the clot activators in serum-separator tubes (SSTs) and plastic red-top tubes

A

Silica particles

163
Q

Blood collected in ______ such as the BD orange stopper Rapid Serum TubeTM (RST) (Fig. 7-32) normally clots within five minutes.

A

Blood collected in thrombin tubes such as the BD orange stopper Rapid Serum TubeTM (RST) (Fig. 7-32) normally clots within five minutes.

164
Q

Minimizes chance of microbial contamination

A

blood culture

165
Q

The first additive tube in the order because all other additive tubes affect _____ tests

A

Coagulation tubes

166
Q

Prevents contamination by additives in other tubes

A

Glass nonadditive tubes

167
Q

Filled after coagulation tests because silica particles activate clotting and affect coagulation tests (carryover of silica into subsequent tubes can be overridden by anticoagulant in them)

A

Plastic clot activator tubes

168
Q

Serum-separator tubes (SSTs) colors

A

Red and gray rubber Gold plastic

169
Q

affects coagulation tests and interferes in collection of serum specimens; it causes the least interference in tests other than coagulation tests

A

Heparin tubes with gel/plasma-separator tubes (PSTs)
Heparin tubes

170
Q

Responsible for more carryover problems than any other additive: Elevates Na and K levels, chelates and decreases calcium and iron levels, elevates PT and PTT results

A

EDTA tubes
EDTA tubes with gel/plasma- preparation (PPTs)

171
Q

affect sodium and potassium levels, respectively. Filled after hematology tubes because oxalate damages cell membranes and causes abnormal RBC morphology. Oxalate interferes in enzyme reactions

A

Oxalate/fluoride tubes

PMLS (10 decks)

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