Module 1: Phlebotomy Fundamentals Flashcards

1
Q

considerations when performing phlebotomy

A
  • collect only the amount necessary for testing
  • learn factors that affect blood clotting
  • communicate professionally and therapeutically
  • verify each pts identity
  • use accurate labeling
  • explore pts history
  • how to deal with challenges to communication
  • infection control
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2
Q

phlebotomist

A

professional who uses needles to puncture veins to collect blood for lab testing

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3
Q

what are lab results used for

A
  • the basis for treatments and care
  • assist in diagnosis
  • detect problems
  • determine if treatment is working
  • monitor pts over time
  • show need for further testing or treatment
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4
Q

things a phlebotomist does

A
  • collect blood specimens
  • collect nonblood specimens: urine, semen, etc.
  • point of care testing: glucose levels at bedside
  • transport specimens
  • clerical duties
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5
Q

desired traits of phlebotomist

A
  • professionalism
  • respect for pt and coworkers by adhering to policies
  • good listener and communicator
  • compassion
  • keep the workplace clean and organized
  • growth
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6
Q

personal hygiene for phlebotomist

A
  • no perfume or other scented things that could trigger allergic reactions, nausea, or migraines
  • use deodorant
  • conservative grooming
  • avoid excessive piercings and tattoos
  • minimal makeup
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7
Q

service

A
  • shift focus from self to those you serve
  • commitment to exemplary performance
  • demonstrate quality, accuracy, and efficiency
  • keep focus on pt
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8
Q

growth

A
  • expanding professional knowledge
  • seek continuing education opportunities
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9
Q

ethical standard

A
  • do no harm
  • respect pt rights
  • use skills to the best ability
  • ensure the accuracy of specimen collection
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10
Q

heart

A
  • pump at the center of the cardiovascular system
  • hollow, conical, muscular organ
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11
Q

roughly how big is the heart

A

size of pts fist

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12
Q

where is the heart located

A
  • center of the chest
  • vertically between second and sixth ribs
  • more of it just to the left of the sternum
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13
Q

pericardium

A

membrane that surrounds the heart and attached blood vessels

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14
Q

layers of the heart in order (outermost to innermost)

A
  • epicardium
  • myocardium
  • endocardium
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15
Q

order of blood flow

A
  • superior and inferior vena cava
  • right atrium
  • tricuspid valve
  • right ventricle
  • pulmonary semilunar valve
  • pulmonary artery
  • TO THE LUNGS
  • pulmonary veins
  • left atrium
  • bicuspid (mitral) valve
  • left ventricle
  • aortic semilunar valve
  • aorta
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16
Q

how many heartbeats is one cardiac cycle

A

1 beat

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17
Q

range for most adults heartbeat

A

60 to 80 bpm

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18
Q

cardiac cycle

A
  • pumps deoxygenated blood to lungs where it is reoxygenated and exchanges CO2 for O2
  • oxygenated blood returns to heart and it pumped to arteries to supply body tissues with oxygen
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19
Q

the command center of the cardiovascular system

A
  • medulla of the brain
  • sends messages to the sinoatrial (SA) node
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20
Q

conduction system of the heart

A
  • SA node
  • AV node
  • bundle of His
  • Purkinje fibers
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21
Q

when is the electrical signal of the heart transmitted to the bundle of His

A

following atrial contraction

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22
Q

what do the Purkinje fibers trigger

A

ventricular contraction

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23
Q

why does the AV node pause

A

to let blood empty from the atria

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24
Q

vascular structures

A
  • arteries: branching into arterioles and capillaries
  • veins: branching in venules and capillaries
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25
Q

what do arteries carry and which artery is the exception

A
  • oxygenated blood to the body
  • pulmonary arteries: carry deoxygenated blood to lungs
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26
Q

where do coronary arteries supply blood to

A

heart muscle

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27
Q

where do femoral arteries supply blood to

A

lower extremities

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28
Q

what do veins carry and which vein is the exception

A
  • deoxygenated blood from the body back to the heart
  • pulmonary veins: carry reoxygenated blood back from heart to lungs
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29
Q

where do the jugular veins return blood from

A

from head and neck to the heart

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30
Q

where do the saphenous veins return blood from

A

from the lower extremities to the heart

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31
Q

capillaries

A
  • permeable
  • exchange vessels
  • where O2 and nutrients move into body cells and CO2 moves in capillary
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32
Q

what processes facilitate the exchange of O2 and CO2 in capillaries

A
  • osmosis: diffusion of water through a semipermeable membrane
  • diffusion: movement of a substance from an area of high concentration to an area of low concentration
  • filtration: separating substances by forcing them through a membrane
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33
Q

what does blood carry to body tissues

A
  • nourishment, vitamins, electrolytes, hormones, antibodies, warmth, oxygen
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34
Q

what does blood transport to excretory organs

A
  • cell wastes
  • carbon dioxide
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35
Q

how much blood do adults have in circulation

A

4 to 6 liters

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36
Q

% of plasma in blood

A

55% to 50%

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37
Q

components of plasma with percentages

A
  • water: 92%
  • mix of proteins, glucose, fibrinogen: 8%
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38
Q

% of RBC, WBC, and platelets in blood

A

40% to 45%

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39
Q

hemoglobin

A
  • in RBC
  • iron-containing protein
  • carries O2
  • gives blood the red color
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40
Q

are RBC flexible or inflexible

A
  • flexible
  • can easily pass through circulatory system
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41
Q

how long do RBC circulate in bloodstream

A

120 days

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42
Q

what replaces RBCs

A

bone marrow

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43
Q

types of WBCs

A
  • monocytes
  • lymphocytes
  • granulocytes (neutrophils, eosinophils, basophils)
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44
Q

function of WBC

A
  • defend body against infection
  • destroy pathogens and produce antibodies
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45
Q

platelets

A
  • necessary for clotting
  • stick to lining of blood vessels
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46
Q

what determines blood type

A

presence or absence of the A and B antigens

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47
Q

type A blood has which antigen

A

A antigen

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48
Q

type B blood has which antigen

A

B antigen

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49
Q

type AB blood has which antigen

A

both A and B antigens

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50
Q

type O blood has which antigen

A

neither antigen

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51
Q

type A plasma has which antibodies

A

anti-B antibodies

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52
Q

type B plasma has which antibodies

A

anti-A antibodies

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53
Q

type AB plasma has which antibodies

A

no antibodies

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54
Q

type O plasma has which antibodies

A

both anti-A and anti-B antibodies

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55
Q

Rh-negative can donate to

A
  • Rh-positive
  • Rh-negative
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56
Q

Rh-positive can donate to

A
  • Rh-positive
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57
Q

Rh-negative can receive

A
  • Rh-negative
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58
Q

Rh-positive can receive

A
  • Rh-positive
  • Rh-negative
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59
Q

what blood type can anyone receive (universal donor)

A

type O blood

60
Q

what blood type can receive any blood type (universal recipient)

A

type AB blood

61
Q

what blood type can give plasma to all blood types

A

type AB blood

62
Q

most to least common blood types

A
  • type O
  • type A
  • type B
  • type AB
63
Q

hemostasis

A
  • steady state of blood
  • state of equilibrium
  • includes components of the clotting process
64
Q

five phases of coagulation

A
  • vascular phase: injured vessel narrows to reduce blood flow
  • platelet phase: platelets clump and attached to injured vessel to plug the leak
  • coagulation phase: fibrinogen, calcium, and clotting factors work together to form blood clot to seal portion of vessel
  • clot retraction: blood clot shrinks to bring edges of tear close together to heal
  • fibrinolysis: breaks up and dissolves clot as other cells complete repair
65
Q

what can you do to aid the coagulation process

A

direct pressure

66
Q

when does effective communication occur

A

both sender and receiver assign similar meanings to the message

67
Q

steps of the communication cycle

A
  • sender develops message
  • sender encodes message into transmittable format
  • sender transmits messgae
  • receiver decodes message
  • receiver converts message to understanding
  • feedback
68
Q

analytical communicators

A
  • prefer working with real numbers, facts, data
  • little emphasis on feelings or emotions
69
Q

intuitive communicators

A
  • prefer to look at the big picture
  • may result in more questions than answers if too broad of an approach is used
70
Q

functional communicators

A
  • prefers an organized approach: timelines, detailed plans, step-by-step
  • effective if pt doesn’t become overwhelmed with details
71
Q

personal communicators

A
  • use emotional language and connections
  • care about what people think/feel in response to info
  • good and active listeners
  • resolve conflict easily
72
Q

most fundamental component of communication

A

listening

73
Q

active listening

A
  • actively hearing and attempting to comprehend the meaning of words
  • sounds or gestures to indicate attentiveness
  • give feedback through paraphrasing
  • conveying genuine interest, warmth, empathy
74
Q

verbal communication

A

sharing of info using spoken words

75
Q

nonverbal communication

A
  • behavior that complements, negates, or substitutes for spoken words
  • gestures, mannerisms, facial expressions, body posture, stance, eye contact, movements, touch, personal space, overall appearance
76
Q

therapeutic communication

A
  • interaction that aims to enhance the comfort, safety, trust, health, and well-being of the pt
  • communicate in ways the pt understands
  • convey understanding and respect
77
Q

accepting (therapeutic communication skill)

A
  • hear what pt says and follow the thoughts they express
  • I get what you’re saying
78
Q

clarifying (therapeutic communication skill)

A
  • ask for a clearer explanation when what pt says is vague
  • I’m not sure I’m following that
79
Q

encouraging communication (therapeutic communication skill)

A
  • ask pt to share what they’re feeling
  • tell me when you are getting more anxious
80
Q

exploring (therapeutic communication skill)

A
  • gently persuade pt to express thoughts in more detail, avoid probing or prying
  • would you tell me a little more about that
81
Q

focusing (therapeutic communication skill)

A
  • keep pts attention on the info they need to understand
  • I enjoy hearing about your vacation, but lets get back to what to do if this keeps bleeding
82
Q

giving a broad opening (therapeutic communication skill)

A
  • allow pt to direct discussion
  • what do you need to know about what we’re doing today
83
Q

giving recognition (therapeutic communication skill)

A
  • show pt recognition as individuals, address them by name
  • let’s get started, Mr. Ellis
84
Q

making observations (therapeutic communication skill)

A
  • share your perceptions with pt
  • you seem a bit nervous today
85
Q

mirroring (therapeutic communication skill)

A
  • restate pt statement to show understadning
  • you’re having trouble understanding the doctor
86
Q

offering self (therapeutic communication skill)

A
  • convey your availability to listen and help
  • I’m here for you, tell me what you need
87
Q

offering general leads (therapeutic communication skill)

A
  • encourage pt to keep expressing their thoughts
  • please continue
88
Q

reflecting (therapeutic communication skill)

A
  • repeat pt statement or question back to them to encourage them to value or accept their own opinions
  • what do you already know about your cholesterol levels
89
Q

remaining silent (therapeutic communication skill)

A
  • convey that pt can continue formulating thoughts they want to express without any pressure to converse
  • no dialogue
90
Q

summarizing (therapeutic communication skill)

A
  • demonstrate understanding of important parts of the conversation
  • you know to contact the office if you have any pain or the site keeps bleeding even after you apply some pressure with the gauze pads I gave you
91
Q

advising (nontherapeutic communication)

A
  • tell pt what to do about things outside the scope of phlebotomy
  • if I were you I wouldn’t take that medication
92
Q

agreeing/disagreeing (nontherapeutic communication)

A
  • imply the phlebotomist’s opinion is validating or overriding that of pt, exceeds the scope of practice
  • I agree that chemo is your best option
93
Q

defending (nontherapeutic communication)

A
  • attempt to protect the facility or provider
  • Dr. Lopez has been doing this for a long time so she knows what’s best for you
94
Q

disapproving (nontherapeutic communication)

A
  • pass judgment on pt thoughts or plans
  • you should have given that medication a chance to work before you stopped taking it
95
Q

giving approval (nontherapeutic communication)

A
  • tell pt they are doing the right thing, results in pt continuing to seek approval rather than focusing on progress
  • I’m proud of you for taking the initiative to check your thyroid levels
96
Q

making stereotypical comments (nontherapeutic communication)

A
  • use cliches and meaningless phrases that show no original thought
  • things are always darkest right before the dawn
97
Q

minimizing feelings (nontherapeutic communication)

A
  • make light of pt anxieties
  • everybody hates needles
98
Q

probing (nontherapeutic communication)

A
  • pursue topics pt doesn’t want to discuss or things that invade pt privacy
  • why didn’t your daughter drive you here today
99
Q

reassuring (nontherapeutic communication)

A
  • give false hope or devalue pt feelings
  • everything is going to be all right
100
Q

defense mechanisms

A
  • coping strategies people use to protect themselves from negative emotions
  • usually unaware that they are using them
  • can be used positively or negatively
101
Q

apathy

A
  • indifference, lack of interest or concern
  • I don’t care what the doctor says about my weight because I know I will stick to my diet
102
Q

compensation

A
  • balancing failure with accomplishment
  • I ate a lot of candy yesterday but I also ate a salad
103
Q

denial

A
  • avoiding unpleasant situations by rejecting them or ignoring their existence
  • there is no way I have cancer so I won’t get the tests
104
Q

displacement

A
  • redirection of emotions away from the original subject onto a less threatening subject
  • I had enough trouble dealing with my aging parents so I shouldn’t have to wait this long for a blood test
105
Q

dissociation

A
  • disconnecting emotional importance from ideas or events and compartmentalizing those emotions in different parts of awareness
  • I’m always getting into fights with my neighbors which is odd because I teach an online course in conflict resolution
106
Q

identification

A
  • attributing characteristics of someone else to oneself
  • I’m just as healthy as my sister is
107
Q

introjection

A
  • adopting the thoughts or feelings of others
  • my dad says I should stand up for myself so I am going to be more assertive
108
Q

physical avoidance

A
  • keeping away from any person, place, or object that evokes unpleasant memories
  • I can’t go back to that hospital because that’s where my father died
109
Q

projection

A
  • transferring a person’s unpleasant ideas and emotions into someone or something else
  • my wife eats way more junk food than I do so why is the doctor warning me about my cholesterol
110
Q

rationalization

A
  • an explanation that makes something negative seem justifiable
  • my partner drinks every night to make himself less anxious about work
111
Q

regression

A
  • reverting to earlier childlike developmental behavior
  • I can’t come back every month and you can’t make me
112
Q

repression

A
  • eliminating unpleasant emotions, desires, or problems from the conscious mind
  • they tell me I was hurt in that robbery but I don’t remember anything
113
Q

sarcasm

A
  • using words that have the opposite meaning, to be funny/insulting/irritating
  • you have a nice office if you don’t like fresh air and natural lght
114
Q

substitution

A
  • replacing unacceptable desires with more constructive ones
  • I used to pull wings off insects and now I’m a biology teacher
115
Q

suppression

A
  • voluntarily blocking unpleasant experiences from one’s awareness
  • the doctor said I need more tests but I’m going to take my vacation first
116
Q

barriers to communication

A
  • language
  • culture
  • cognitive level
  • developmental stage
  • sensory issues
  • physical challenges
117
Q

adjustments for working with pts who speak a different language

A
  • interpreter
  • written instructions
  • respect cultural or personal preferences
118
Q

adjustments for working with pts with vision loss

A
  • verbally explain everything taking place
  • do not ask questions or make stereotypical comments
  • be mindful of safety, comfort, and dignity
  • use bright colors and solid backgrounds
  • avoid clear obstructions
  • offer print material in large fonts or audio formats
119
Q

how much of the blind population read Braille

A

10%

120
Q

adjustments for working with pts with hearing loss

A
  • face pt directly
  • enunciate clearly
  • do not shout
  • low-pitch tones are usually easier for them to hear
  • reduce extraneous noise
  • written communication
  • sign language interpreter
121
Q

customer service

A
  • ensuring customer satisfaction
  • encourage pt to communicate feelings
  • listen to pt viewpoints
  • help solve pt problems
122
Q

chain of infection

A
  • infectious agent
  • reservoir
  • portal of exit
  • mode of transmission
  • portal of entry
  • susceptible host
123
Q

what makes the human body an ideal reservoir for microbial growth

A
  • nutrient
  • moisture
  • ideal temp
  • ideal pH
124
Q

what is effective infection control

A

breaking the chain of infection

125
Q

direct transmission

A

contact with infected person or body fluids carrying the pathogen

126
Q

indirect transmission

A
  • intermediate step between the portal of exit and portal of entry
  • fomites and vectors
127
Q

fomite

A
  • nonliving transmitter of infectious agent
  • medical equipment, doorknobs, pens
128
Q

vector

A
  • living transmitter of infectious agent
  • insects
129
Q

main way to break chain of infection

A

effective hand hygiene

130
Q

standard precautions

A
  • applies to every pt
  • PPE when handling body fluids, nonintact skin, mucous membranes
  • hand hygiene
  • safely disposing of equipment, needles, and other sharps
131
Q

airborne precautions

A
  • for infections that spread via droplets smaller than 5 microns in diameter
  • wear respiratory protection like N95 respirator or mask
  • varicella, tuberculosis, measles
132
Q

droplet precautions

A
  • for infections that spread via droplets larger than 5 microns in diameter
  • wear mask
  • rubella, meningitis, some respiratory infections
133
Q

contact precautions

A
  • infections that spread via direct contact or contact with the environment
  • wear gloves and gowns
  • herpes simplex, wound infections, scabies, some bacterial infections
134
Q

how does the body react after exposure to a pathogen

A

activates immune response

135
Q

classic symptoms of inflammation

A
  • erythema (redness)
  • edema (swelling)
  • pain
  • heat
136
Q

steps of the body’s response to pathogens

A
  • pathogen invades and damages cells
  • send mediators of inflammation to the site (histamines, kinins, prostaglandins) which bring WBC
  • WBC arrive to the site
  • blood vessels dilate causing erythema and heat
  • walls of vessels become more permeable so WBC can get to the site
  • plasma from blood enters site causing edema which exerts pressure on nerves causing pain
  • clotting factors stop bleeding and proteins help repair damage
  • chemotaxis brings more WBC to engage in phagocytosis
137
Q

chemotaxis

A

movement of cells or organisms in response to chemicals

138
Q

scenarios following inflammatory response

A
  • heal locally: inflammatory response did it’s job
  • spread to lymph nodes: invasion too strong, increase in WBC, lymphadenopathy
  • spread to bloodstream: septicemia, fatal without treatment
139
Q

acute infection

A
  • symptoms appear suddenly
  • begins gradually and worsens quickly
  • body can usually recover in a few weeks
  • common cold
140
Q

chronic infection

A
  • lingers, sometimes forever
  • symptoms may not last for long periods of time
  • person can still transmit to others
  • hepatitis B
141
Q

latent infection

A
  • periods of remission and relapse
  • herpes simplex
142
Q

opportunistic infection

A
  • person with weak immune system
  • may not cause disease in person with fully functional immune system
  • oral candidiasis common in pts with AIDS
143
Q

medical asepsis

A
  • removing microorganisms after they leave the body
  • reduce number, prohibit growth, prevent transmission
  • hand hygiene
  • does not eliminate pathogens
144
Q

handwashing steps

A
  • use warm water and friction for minimum of 20 seconds
  • rinse with fingers pointed downward
  • turn off faucet with paper towel
145
Q

surgical asepsis

A
  • mandatory for invasive procedures
  • eliminate microorganisms and prevent them from entering the body
  • sterile gloves, supplies, and equipment
  • antiseptic skin preparation
  • not typically used by phlebotomists
146
Q

CDC cough etiquette

A
  • cover mouth and nose
  • use facial tissue to contain respiratory secretions, dispose of in waste receptacle
  • hand hygiene after contact with respiratory secretions
  • offer mask to anyone coughing or sneezing
  • keep anyone coughing or sneezing 3 feet away from others