Lesson 1A Flashcards
Phlebotomy became widely accepted during the time of _________
(460 - 377 BC) when health was believed to be dependent on the balance of the humors
Hippocrates
Earth
Blood and Brain
Air
Phlegm and Lungs
Fire
Black Bile and Spleen
Water
Yellow Bile and Gallbladder
To keep the balance, excess humor is removed by __________.
bloodletting
Laboratory testing of _____ specimens is vital to the correct diagnosis, treatment, and monitoring of a patient’s condition.
blood
Laboratory results constitute __% of the objective information used by health-care providers to manage patient care and resolve patient health problems.
70
reports from a ___________ specimen can result in treatment that can be potentially harmful to the patient by overmedicating or under-medicating the patient with death being the worse patient outcome.
suboptimal
failure to adhere to the ___________________________can compromise the integrity of a successfully collected specimen.
collection procedure
Approximately ___% of laboratory error occurs during the preanalytical phase (process that occurs before testing of the sample) of laboratory testing.
56
Influencing factors are the responsibilities of the blood collector and include:
• Monitoring of specimen ordering
• Correct patient identification
• Patient communication and safety
• Patient preparation
• Timing of collections
• Phlebotomy equipment
• Collection techniques
• Specimen labeling
• Specimen transportation to the laboratory
• Specimen processing
____________ are the forms on which test orders are entered and sent to the lab.
Requisitions
Types of Requisitions
i. Hand-written requisitions
ii. Computer-printed requisitions
iii. Barcode labels
The most important step in specimen collection.
Identify the patient.
In identifying the patient, ask the patient to state their
name and date of birth.
In identifying the patient, if admitted you must check their
Check the patient’s identification bracelet
Identification number
a. Medical record number
b. Visit number
Verify diet restrictions
Fasting
Prepare the patient for testing
a. Bedside manner
b. Explain the procedure
c. Obtain consent
Position patient
a. Seated patient
b. Supine patient
Seated patients
i. Patients arm should be supported firmly
ii. Arm should not be bent at the elbow
Supine patients
i. Arm extended
ii. Not bent at elbow
Veins become more prominent
Ask the patient to make a fist
Do not allow patient to ________ as this causes hemoconcentration and leads to erroneous results
pump fist
will generally have the most prominent veins
Dominant arm
Veins have a ______or ______
bounce/ resilience
are hard and lack resilience
Tendons
T or F | select vein that feels hard and cord-like or lacks resilience
False
T or F | Do not draw from above an IV
True
If collecting blood above an IV, have IV turned off for a minimum of __ minutes prior to collecting
2
What areas must be avoided when collecting blood
burn
scars
tattoos
Edema
Hematoma
If there is hematoma
Draw from below site if no alternative
Draw from the side _____ of mastectomy whenever possible
opposite
Why must mastectomy side be avoided?
Application of tourniquet may cause injury on mastectomy side
If patient has double mastectomy, what should be done?
physician should be consulted -
usually avoid the side of the most recent mastectomy
Check _______________ on both arms to find a suitable vein
antecubital region
Use _____________________ except as a last resort and after obtaining permission from patient’s physician
leg, ankle, or foot veins
Order of finding veins
Antecubital region
Hands/ wrist
Leg, foot, or ankle
Blood flow to the _______ may not be representative of general circulation producing erroneous results
extremities
Lower extremity venipuncture may cause
blood clot formation
How to clean the site
a. Clean with antiseptic - 70% isopropyl alcohol
b. Clean using circular, outward motion
c. Do not contaminate the site by drying the alcohol with unsterile gauze
d. Do not introduce airborne contaminants by fanning or blowing on it
e. Do not touch the site after cleaning
Verify equipment and tube selection
a. Remove syringe from package
b. Advance the plunger to the end of the syringe
c. Securely attach the needle to the system
How to inspect the needle?
Visually inspect the needle tip for obstructions, imperfections, or barbs
How to anchor the vein
a. Place your thumb 1-2 inches below the intended venipuncture site
b. Pull the skin toward the wrist
c. Use the fingers of your anchoring hand to support the back of the arm
Line up the needle in the direction of the vein - bevel ____
up
Insert the needle into the skin at ______ angle
15-30°
A “_____” or small amount of blood will appear in the hub of the needle when the needle is in the vein
flash
Hold the syringe ______, with the tip down and transfer device
at the bottom
vertically
Dispose of the transfer device into a______ container
sharps
Slant the needle to the side of the tube so the blood runs down
the side of the tube to prevent
hemolysis
Label the tubes
a. Name of Patient
b. Age and Gender of Patient
c. Date of collection
d. Time of collection
e. Phlebotomist’s initials
Putting on crushed ice
(i.e.: ammonia, BNP, lactic acid, blood gasses)
(i.e.: ammonia, BNP, lactic acid, blood gasses)
Put crushed ice
Keeping it warm
(i.e. cold agglutinin, cryoglobulin)
(i.e. cold agglutinin, cryoglobulin)
Keep it warm
Protecting from light
(i.e. bilirubin)
(i.e. bilirubin)
Protect from light
If you are unable to obtain a specimen:
- Evaluate the problem
- Try again below the first site, on the opposite arm, or hand or write vein
- Do not try on the 3rd time
