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Phlebotomy > NHA Exam > Flashcards

NHA Exam Flashcards

1
Q

CDC

A
  • Center of disease control

- located in Atlanta Georgia

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2
Q

Which way does blood circulate

A

left to right

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3
Q

Basilic Vein

A
  • On the inner part (inner medial) of the arm
  • This is your last option (but irl we do not do this!!! Go to hand)
  • The skin above this vein is very thin -> make sure the skin is tight so you don’t damage blood cells
  • Next to the brachial artery
  • Rolls more easily and runs directly over an artery (brachial)
  • Painful
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4
Q

Median cubital vein

A
  • At the center of the antecubital space
  • Your first choice
  • Usually larger than the other veins and more stationary
  • Veins can move but this vein is well anchored which makes it easier and less likely that the pt. feels pain during the procedure, or develop a hematoma
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5
Q

Cephalic vein

A
  • Second choice vein
  • Outer part (lateral) of the arm (thumb side)
  • Fairly well anchored
  • Only vein that can be palpated in obese pts.
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6
Q

Plasma

A
  • Liquid portion of blood
  • 55% of blood
  • Golden color
  • Contains oxygen, Co2, waste, nutrients
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7
Q

Buffy coat

A

Leukocytes and Platelets

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8
Q

Formed elements

A
  • Solid cell portion of blood
  • Leukocytes and platelets <1% of blood
  • Erythrocytes- 45% of blood
  • Made in bone marrow
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9
Q

Hematocrit

A
  • Hct.

- measurement of hemoglobin (Hgb)

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10
Q

Straight needle

A
  • Used at the antecubital space
  • You cannot use butterfly needle on antecubital space because they’re tiny
  • 30-15 degree angle
  • If you try to use a butterfly needle at the antecubital it will cause the RBC to try to squeeze in through the tiny needle and burst -> contaminated blood 50% of the time -> hemolysis
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11
Q

Butterfly needle

A
  • Infusion set
  • Smallest needle
  • Have wings because you go into the metacarpal veins flush (0 degree angle) (hold the needle by the wings)
  • Use at metacarpal veins
  • Metacarpal vein- Very small, fine veins of the hand
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12
Q

Capillary puncture (dermal puncture)

A
  • Arterioles and venules are in our fingertips; therefore capillaries are present as well
  • There is a lot of information here because capillaries carry oxygenated and deoxygenated blood
  • use when veins are inaccessible due to IV’s, scarring, or burns
  • 3rd and fourth finger on nondominant is best
  • usually point of care test
  • can be used for people at risk of iatrogenic anemia
  • lancet is not bigger than 2mm
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13
Q

Red top tube

A
  • Does not contain an additive unless plastic
  • Tests only plasma (serum)
  • It only tests plasma bc if the WBC, platelets, and RBC where there they would clot normally, making it impossible to count -> blood parts will separate by density
  • tests serology, chemistry blood bank
  • Plasma contains chemistry
  • No need to invert because no additive -> invert 5x if in plastic
  • 60 minutes to clot then centrifuge
  • Tests for cholesterol levels, glucose levels, sodium levels, kidney, levels, liver enzymes, cardiac levels, pregnancy test, drug testing, thyroid, HIV, Covid-19, immunities
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14
Q

Gold top, tiger top, speckle top, etc.

A
  • SST (Serum Separator Tube)- Clot activator- makes clot happen faster
  • tests plasma (serum)
  • once you put the tube in the centrifuge (30 minutes after draw) the formed elements become separated from the plasma by wax so you can test the pure separated plasma
  • Testing for chemistries (same as red top tube (same tests))
  • More common
  • additive: polymer Gel, clot activator
  • Must invert at least 5x
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15
Q

Lavender top tube

A
  • Tests complete blood cell count (CBC), sedimentation rate, routine immunohematology testing
  • Analyzes whole blood
  • Contains the additive known as EDTA (ethylenediaminetetraacetic acid)
  • EDTA keeps blood whole (keeps it from clotting) making it possible to count
  • Count cells (CBC- complete blood count)
  • Checks Inflammation
  • invert 8-10x
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16
Q

Light blue top tube

A
  • Sodium Citrate additive
  • Tests clotting
  • tests plasma
  • Coagulation test
  • BT- bleeding time
  • Testing platelets (if they are working)
  • Inverted 3-4x
  • must be tested within one hour
  • PTT
  • INR
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17
Q

Green top tube

A
  • additive- sodium Heparin, lithium heparin, ammonium heparin
  • potassium test
  • tests stat and routine chemistry tests, ammonia, electrolytes, arterial blood gases (ABG)
  • test chemical levels in the blood
  • sodium levels
  • Tests liver function
  • tests plasma
  • Heparin is an anticoagulant
  • Invert 8x
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18
Q

Gray top tube

A
  • Additive is glucose preservative AKA antiglycolytic agent (antiglycolytic agent)
  • tests plasma
  • FBS- fasting blood sugar (before you eat)
  • GTT- glucose tolerance test (after you eat)
  • tests lactic acid measurement, GTT, FBS, blood alcohol levels
  • In a diabetic they can’t break down glucose and it remains high glucose levels
  • Invert 8x
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19
Q

Yellow top tube

A
  • Used for blood culture
  • Additive is nutrient broth or thioglycolate broth or SPS
  • tests whole blood
  • Used to grow and identify microorganisms that might be growing in blood
  • The infection would be identified and the patient is diagnosed with septicemia- blood poisoning, especially caused by bacteria or their toxins
  • Blood cultures are done stat
  • should withdraw the blood into a sterile safety syringe after obtaining a blood culture specimen from an adult patient
  • When you draw blood for blood cultures you draw 20mL total -> 10ml for each two yellow top tubes- #1 for aerobic in one arm and #2 is anaerobic in the other arm or other vein –LABEL THEM #1 and #2
  • transfer into anarobic first then aerobic
  • Invert three times
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20
Q

Order of draw

A
  1. Yellow top tube- blood cultures: Nutrient Broth/thioglycolate
  2. Light blue top tube- test coagulation/blood clotting time: sodium citrate
  3. Red top tube- chemistries (blood bank): no additive
  4. Gold/SST- chemisties (kidney function, liver function, immunities, HIV, etc.): clot activator
  5. Green top tube- liver function: heparin
  6. Lavender top tube- CBC (complete blood count): EDTA
  7. Grey top tube- Glucose (GTT), fasting blood sugar (FBS): oxhemolyalate/fuoride
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21
Q

Fasting specimens

A
  • Requires collection of blood while the patient is in the basal state- patient has fasted and refrained from strenuous exercise for 12 hours prior to the drawing
  • It is the phlebotomists responsibility to verify if the patient has been fasting for the required time
  • NPO- nothing by mouth
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22
Q

Timed specimens

A
  • These tests are often used to monitor the level of a specific substance or condition in the patients blood at a certain time of day
  • The specimen is drawn at a specific time for different reasons:
  • To measure blood levels of hormones
  • To determine blood levels of medications
  • To monitor changes in the patient’s condition
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23
Q

Two hour postprandial

A
  • This test is used to evaluate diabetes
  • Fasting glucose levels is compared with the level 2 hours after eating a full meal or ingesting a measured amount of glucose (glucola)
  • 3 hour GTT- is used to test hyperglycemia (abnormally high blood sugar level) this will be needed to diagnose diabetes
  • draw fasting blood -> patient eats -> every hour for three hours draw a tube = 4 tubes total
  • 5 hour GTT- is used to evaluate hypoglycemia (abnormally low blood sugar level) for a possible disorder in metabolism
  • draw fasting blood -> person eats -> every hour for five hours draw a tube = 6 tubes
  • These tests are done as early as 7:00 AM- 9:00 AM. —-Bloods drawn later in the morning will be rejected by the laboratory
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24
Q

Therapeutic blood monitoring

A
  • Test is used to monitor blood levels of certain medications to ensure patient safety and also maintain a plasma level
  • Blood is drawn to coincide with the lowest level or the highest level
  • Lowest (trough) levels are collected 15 minutes before the scheduled dose
  • Highest level or peak time will vary depending on the medication, and the route of administration (I.V, oral or I.M (intramuscular injection) -> 1-2 hours after oral medication
  • communicate with attending nurse ab medication times
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25
Q

Chilled specimens

A
  • Some tests require that the specimen collected be chilled immediately after collecting in crushed ice or ice water mixture
  • The specimen must be immediately transported to the laboratory for processing
  • ammonia and lactic acid specimen should be placed in ice water slurry
  • arterial blood gas should be placed in ice bath
  • cold agglutinin must be at body temp (37C)
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26
Q

Light sensitive blood specimen

A
  • These specimens are to be protected from light by wrapping the tubes in aluminum after they are drawn
  • Exposure to light could alter the test results for; bilirubin, folate, vitamin A and B6
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27
Q

Battery

A

you may be charged with battery if you draw from a patient without requisition forms
-intentional touching or force in harmful manner

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28
Q

Consent

A
  • Patient must sign a form that says they cannot leave once they start a GTT because the patient might get hurt or eat something -> (patient comes in fasting and then takes in a lot of glucose -> they may fall and get hurt)
  • If patient insist on leaving then call the doctor and ask him to explain or ask him to reschedule
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29
Q

Good samaritan

A

You save someone’s life but break their rib in the process -> good samaritan law will not allow you to sue them even if they do not survive

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30
Q

Pre-analytical error

A
  • Error that occurs prior to drawing the blood that affects the blood results
  • Misidentification
  • Using the wrong tube
  • Effects the results before the drawing ever occurs
  • Improper fast or exercise
  • Improper time of collection
  • Patient posture
  • Improper site preparation- clean the site properly
  • Medication interference- if requisition said no morning medicine you must make sure
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31
Q

Analytical error

A

-Errors made during the collection of blood
-Extended tourniquet time- (band on arm) should not stay on for more than one minute or it will cause hematomas
-Not enough blood drawn, under filing tubes, vacutainers, must be at least ¾ full
-More addictive than blood in tube
-Not waiting 30 minutes to centrifuge after SST draw
Hemolysis
-Failure to invert tube

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32
Q

Post-analytical error

A
  • Failure to separate plasma from cells
  • Improper use of serum separator
  • Processing delays- timed collections
  • Improper storage conditions
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33
Q

Libel

A

written defamation

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34
Q

Slander

A

when you speak defamation

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35
Q

Sputum specimen

A

-phlebotomist should instruct to breathe deeply and cough up the specimen into container

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36
Q

Cleaning station with blood

A

use a 1:10 ratio of water and sodium hypochlorite (chlorine bleach) in order to clean station properly

  • let it sit for 20 mins
  • wear goggles and face mask if spill is large
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37
Q

use as antiseptic for the skin

A
  • hydrogen peroxide
  • isopropyl alcohol
  • benzalkonium chloride- use when allergic to isopropyl
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38
Q

Povidone iodine

A
  • do not use on potassium, bilirubin, uric acid, phosphorous test bc can affect test results
  • can cause false elevation of potassium in pt.
  • should be used to decontaminate the site for ABG and blood culture collection
  • use this to clean the site for blood alcohol levels test
  • can be used for blood culture
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39
Q

what temperature should semen samples be stored

A

36-38C

  1. 6F
    - pt abstains from ejaculation for 2-7 days
    - must be given to lab within one hour
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40
Q

implied consent

A
  • rolling up sleeve
  • putting arm out
  • patient can be unconscious and in an emergency situation
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41
Q

transporting specimens

A
  • put specimens in a locker container to avoid spills

- if it is hot transport samples in a box with cold packs and a biohazard label

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42
Q

capillary blood drops on filter paper

A
  • you should apply the blood drops to the printed side of the filter paper
  • must dry for min 4 hours
  • if the first blood circle is not full, create a separate second larger circle
  • puncture site should not touch the filter paper
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43
Q

WBC count point of care test

A
  • expected range is 4.4-11/mm^3

- anything outside this range must be immediately reported to provider

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44
Q

capillary blood draw

A
  • select the third or fourth finger
  • use the second drop of blood
  • position puncture device so its perpendicular to the fingerprint ridges
  • you should touch the slide to the blood at 1.3 to 2.5cm from the end of the slide
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45
Q

what needle do you use on an older adult with fragile, easy to collapse veins

A
  • syringe and butterfly assembly and transfer to an ETS tube
  • syringe minimizes pressure on fragile veins
  • using a regular ETS tube would cause too much pressure
  • using a pediatric tube may not provide enough blood
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46
Q

Glucometer

A

-quality control testing should be done every day it is used

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47
Q

Clinical and Laboratory Standards Institute (CLSI) clinical laboratory workflow pathway

A
  • pre examination phase- processing the specimen, provide post puncture care
  • examination phase- review and verify results
  • post examination phase- entering critical laboratory data
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48
Q

dermal samples

A
  • because hematology tests are most affected by clotting lavender should be used first
  • it minimizes platelet clumping and microclot formation
  • red top would be collected last bc it is necessary for it to clot
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49
Q

mastectomy

A

-if a pt has a mastectomy on one side you should draw from the arm on the opposite side to prevent lymphedema and infection

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50
Q

before leaving a pt room

A

-mark each specimen with the date, time and initials on each tube was drawn

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51
Q

health hazard

A

blue

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52
Q

heel

A

-site for any pt under 1 year old

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53
Q

cholesterol point of care test

A
  • expected ranges from 140 to 200 mg/dL

- anything outside of this is reported to provider

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54
Q

OSHA vaccine

A

-hepatitis B vaccine must be provider to employees for free at least 10 days after hire

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55
Q

fainting

A
  • pts prone to fainting should be laying in a reclined position
  • supine position
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56
Q

N95

A

worn with pts that have airbone conditions (tuberculosis, measles, vericella)
-a regular mask if worn for pts with droplet contagious conditions (rubella, meningitis, diphtheria, mumps, pertussis, influenza)

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57
Q

contact precautions

A
  • wear goggles, gloves and gown

- diphtheria, herpes, simplex, scabies, hepatitis A, respiratory syncytial virus, wound and skin infections

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58
Q

Petechiae

A
  • microcapillary bleeds that are associated with coagulation abnormalities
  • appear as small tiny red dots below the tourniquet
  • you do not have to stop
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59
Q

Hemoconcentration

A

elevated blood levels

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60
Q

Edema

A

accumulation of fluid in one area of the body

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61
Q

Urticaria

A

-raised welts, often called hives

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62
Q

nerve injury

A

-a sharp, painful, and tingling sensation that radiates down the patient’s arm.

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63
Q

Accession number

A
  • identifies specimens in the laboratory

- should not be on requisition form

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64
Q

chemical exposure

A
  • remove clothes

- wash for minimum 15 minutes

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65
Q

order of draw for capillaries

A
  • different that regular order of draw
  • increased rate of coagulation affects it
  • release of thromboplastin causes blood to clot quickly
    1. blood gas collection
    1. purple, lavender, pink, pearl tubes containing EDTA
    1. green
    1. any other additive
    1. serum
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66
Q

hemolysis

A

-to avoid hemolysis make sure the alcohol at the site is completely dried

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67
Q

EDTA

A
  • hematology

- yields only plasma

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68
Q

PT/PTT test

A

-anticoagulant sodium citrate is used

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69
Q

potassium oxalate

A

-additive used for chemistry tests

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70
Q

anticoagulants

A

EDTA, sodium fluoride, sodium citrate, heparin, potassium oxalate

71
Q

troponin T levels

A
  • expected range is 0 to .2 ng/mL

- anything outside this range is to be reported to the provider

72
Q

warming technique

A
  • wrap warm towel in plastic bag

- rising hand in warm water for maximum 1 minute

73
Q

heparin

A
  • anticoagulant
  • produces a plasma specimen for chromosome analysis
  • aids in determining sodium levels
74
Q

tourniquet

A
  • should be 7.5 to 10 cm (3 to 4 inch) above venipuncture

- tuck partial loop under the tourniquet

75
Q

glucose point of care test

A
  • external liquid controls for quality control should be done when a new lot number or kit is opened
  • expected fasting blood glucose range is 70 to 126 mg/dL
  • using too much blood can cause high results
  • using too little blood, the strips is left open, or the first drop is used it can cause low results
  • low results can cause fast heart rate
76
Q

hand immobilizer

A

-The technician should use a hand immobilizer to access difficult veins in the patient’s hand. A hand immobilizer uses straps to keep the patient’s hand still during the collection procedure.

77
Q

phlebotomy wedge

A

stabilizes the patients arm

78
Q

requisition

A
  • The technician should check the requisition form for duplicate test orders, discrepancies, and missing information prior to performing the venipuncture.
  • should not have the accession number
  • patients name, date of birth, sex, ID #, specific precautions
  • you must fill out date and time of puncture, billing info, diagnostic coding
79
Q

urine culture and sensitivity test

A
  • should use clean-catch midstream collection of urine
  • first morning is preferred for pregnancy tests
  • timed urine is preferred for hormone tests
  • random urine is preferred for routine testing
80
Q

chain of custody guidlines

A

-apply to drug screenings, forensic studies, blood alcohol tests, and paternity tests

81
Q

3kg newborn

A
  • 1% as maximum allowable volume
  • 3 x 100= 300mL
  • 300 x .01= 3mL
  • 3mL allowable amount of blood draw
82
Q

pre-employment drug testing

A
  • cannot flush toilet after to ensure there is no tampering
  • must contain at least 45mL of urine
  • take the temperature of the specimen within 4 min of collection to ensure the urine is within the expected temperature range and tampering has not occurred
  • The technician should ensure that the specimen is within a temperature range of 32° to 38° C (90° to 100° F).
83
Q

IV

A
  • if a pt has an IV in one arm and a masectomy on the other ask the nurse to shut off the IV flow and draw below the IV site
  • ask the nurse to turn off all IVs for 2 minutes before starting puncture
84
Q

order of PPE removal

A

-gloves, goggles, gown, mask

85
Q

chloramine

A

used to disinfect wounds

86
Q

informed consent

A
  • must be conscious to receive information about the procedure
  • often for high risk, invasive, surgical procedure
87
Q

expressed consent

A

-pt must be conscious to provide written or verbal consent

88
Q

explicit consent

A

-pt must be conscious to dictate how their personal information is disclosed

89
Q

blood cultures

A
  • Blood cultures are done stat
  • must swab the site twice once with isopropyl or chlorhexidine and once with povidone or chlorhexidine
  • scrub the site with isopropyl alcohol for 60 seconds with a back and forth motion in a 6.35cm diameter range
  • allow 30 seconds to dry when using povidone or chlorhexidine gluconate
  • do not use evacuated tube
  • should withdraw the blood into a sterile safety syringe after obtaining a blood culture specimen from an adult patient
  • When you draw blood for blood cultures you draw 20mL total -> 10ml for each two yellow top tubes- #1 for aerobic and #2 is anaerobic -LABEL THEM #1 and #2
  • transfer into anearobic first then aerobic
  • Invert three times
90
Q

sharps container

A

-replace once 2/3 full

91
Q

18-gauge

A

-18-gauge for collection of donor units of blood

92
Q

21-23-gauge

A

-for laboratory assays

93
Q

insufficient blood

A

-try a different tube first

94
Q

washing hands

A
  • use dry paper towel to turn off faucet
  • use enough soap to form a lather
  • rub hands together for at least 15 seconds
  • hold hands in downward position when rinsing
95
Q

chlorhexidine

A
  • antiseptic used for pts allergic to alcohol or latex
  • use for blood alcohol test
  • nitrile gloves are good for people with latex allergy
96
Q

what to do when you cant see a vein with the touniquet on

A

-ask the pt to dangle their arm for 1 to 2 min

97
Q

role of phlebotomist

A
  • cardiovascular anatomy and physiology

- fundamentals of communication and infection control

98
Q

5 phases of coagulation

A
    1. vascular phase- vessel constricts
      1. platelet phase- cells clump to plug leak
      2. coagulation phase- blood clot forms
      3. clot retraction- clot shrinks as tear heals
      4. fibrinolysis- clot dissolves
99
Q

six links in the chain of infection

A
  1. infectious agent
  2. reservior
  3. portal of exit
  4. mode of transmission
  5. portal of entry
  6. susceptible host
100
Q

analytical communicators

A

-prefer to work with numbers and data, very little emphasis on emotions and feelings

101
Q

Intuitive communicators

A
  • prefer to look at the big picture

- can result in more questions than answers when it is so broad

102
Q

functional communicators

A
  • prefer an organized approach with timelines and detailed plans
  • step by step method
  • can be overwhelming with details
103
Q

personal communicators

A

-focuses on the patients emotions and feelings

104
Q

steps of communication style

A
  1. sender develops the message
  2. sender encodes message into transmittable format
  3. sender transmits message
  4. receiver decodes the message
  5. receiver interprets the message
  6. receiver provides feedback
105
Q

conduction system of the heart

A
  • SA node and AV node transmit signal to the bundle of His cells following atrial contraction
  • nerves between atria and ventricles send signal to perkinje fibers in the ventricular muscle to trigger ventricular contraction
106
Q

antiplatelet

A
  • delay blood clotting

- different from anticoagulant because it affects arterial as well as venous blood

107
Q

what to do if patient shows signs of syncope

A
  • syncope- fainting
  • immediately remove tourniquet and needle
  • apply pressure
  • move patient to floor or reclining position
  • if they do pass out monitor breathing, note how long the patient was unconscious
108
Q

CPR on adult

A
  • place the heel of one hand on patients sternum (between nipples)
  • place other hand over the first, interlacing fingers
  • give at least 100 chest pumps per minute, at least 3.8 to 5 cm in depth
  • allow the chest to fully recoil between compression
  • on child- 5 cm on chest, 30 times at about 100-120 chest pumps per minute, allow time for two rescue breathes and repeat
109
Q

CPR on infant

A
  • use two fingers
  • 30 pumps on chest
  • 3.8 cm deep
  • 100-120 compression a minute
  • two rescue breaths
110
Q

Accidental needle poke procedure

A
  • immediately disinfect using antiseptic or soap and water
  • notify immediate supervisor
  • document information in sharps injury log and facility incident report- do not include names, do include location, type of device involved, and how it happened
  • get a medical exam
  • get tested for HIV, hepatitis B and C
111
Q

PHI

A

-protected health information

112
Q

quality assurance

A
  • makes sure the test is accurate as can be
  • adhering to standard operating procedures
  • conducting quality control testing- how well a instrument is working
  • ensuring equipment is receiving maintenance
113
Q

when do you perform quality control procedures

A
  • daily
  • when there are wide range errors
  • never reuse
  • record controls in log
  • if centrifuge is making noise balance it
  • CLIA-waived test
114
Q

cleansing the site

A
  • use antiseptic
  • allow to dry- could cause hemolysis
  • clean outward in circular motion
115
Q

fires

A

Class A- involves wood, paper, cloth
Class B- involves liquids like paint, oil, gasoline
Class C- involves electrical equipment
Class D- involves metals like sodium, magnesium`, titanium

116
Q

Hepatitis B

A
  • HBV
  • most common spread by needle stick injury
  • HIV is least
  • Hepatitis A is spread by food and water
117
Q

Hematology

A

-blood count

118
Q

Microbiology

A

-processes tests related to bacteria growth

119
Q

Pathology

A

-processes tests related to tissue samples

120
Q

aliquot

A
  • wear gloves, mask, and goggles

- use a disposable pipette to transfer serum into aliquot tube after centrifuging blood specimen

121
Q

refusal of blood draw

A
  • pt does not have to tell you why

- must get written proof refusal

122
Q

Patient interview

A
  • any allergies?
  • do you ever feel faint during blood collection? if yes lock the arm to the chair to prevent sliding
  • do they have a preferred spot to puncture?
123
Q

places you may not draw

A
  • above an IV
  • an arm with a arteriovenous fistula or shunt
  • an arm with a central venous access device
  • anticubital space on a arm that had a recent mastectomy
  • site that has edema
  • site that has scarring
  • site that has hematoma
  • avoid site with tattoos
  • sclerosed veins
124
Q

tortuous veins

A
  • aka varicose veins
  • twisted
  • dialated
  • lack elasticity
  • easy to go through
125
Q

thrombotic veins

A
  • vein with a blood blood clot
  • hard
  • not flexible
126
Q

fragile veins

A
  • common in old, newborn, pediacterics
  • thin
  • weak
  • difficult to puncture
127
Q

phlebitic veins

A
  • tender
  • warm
  • red area around them
  • can have clots
128
Q

sclerotic veins

A
  • as people age they get this
  • hard
  • inflexible
  • narrow
  • develops after repeated blood draw from here
129
Q

urine test: culture

A
  • prepare for growth and identification of microorganisms
  • sensitivity usually follows to see which antibotics will kill it
  • must be clean catch or from catheter
130
Q

random urine specimen

A
  • put label on after pee
  • do not put label on lid
  • can be done at home and kept in refrigerator
  • label date and time
131
Q

fasting urine specimen (first urine)

A
  • pt must pee before sleeping
  • more concentrated than random
  • first void of the morning
  • used for pregnancy, glucose
  • urine deteriorate after 30 mins without refrigeration
  • detects human chorionic gonadotropin (hCG)
132
Q

Clean catch urine specimen

A
  • midstream
  • wash hands before and after test
  • do not let anything touch the inside of cup and lid
  • tests for bacteria
  • genitalia should be washed before the test too
133
Q

timed urine specimen

A
  • pt pees and then records the time
  • everything after that for the next 24 hours must be collected
  • after each pee mix it a little
  • start collecting at the second void of the day
  • all specimens must be kept on ice or refrigerator
134
Q

urine reagent testing

A
  • CLIA-wasived test
  • point of care
  • placing strip into urine
  • note color, clarity, odor
  • use key
  • can test pH, specific gravity, WBC, hemoglobin, ketones, bilirubin, protein, nitrites, and glucose
135
Q

Fecal occult blood test (FOBT)

A
  • identifies nonvisable blood in stool
  • diagnoses gastrointestinal lesions (ulcers) and colorectal cancer
  • detects bacteria, virus, fungi, parasites
136
Q

sputum

A

-material coughed from lungs
-usually for people with terberculosis, pnemonia
-confirms microorganism
-best in morning before eating and drinking
-

137
Q

outpatient verification

A
  • must have name, DOB, and photo ID
  • billing information
  • test status
138
Q

lipemic

A
  • indicates the pt has eaten fatty foods

- will appear cloudy

139
Q

warfarin

A

anticoagulant

-will affect PT/INR results

140
Q

Fatty foods

A

-can affect LDL and HDL results

141
Q

levothyroxine

A

-can affect thyroid stimulating hormone TSH

142
Q

evacuated tube system (ETS)

A

includes

  • gloves
  • isoproyl alcohol swab
  • gauze
  • tape/bandaid
  • tourniquet
  • needles- double sided
  • hub
  • tube
143
Q

alternative to tourniquet

A

-blood pressure cuff at 40mmhg

144
Q

tube label

A
  • includes expiration date
  • additive
  • amount of blood it can hold
  • after draw you label pts name, DOB, date, time, medical number
145
Q

anticoagulant tubes

A
  • plasma tubes
  • blood culture
  • light yellow
  • light blue
  • green
  • lavendar
  • royal blue
  • gray
146
Q

royal blue top tube

A
  • clot activator or EDTA

- trace element testing

147
Q

light yellow top tube

A
  • acid citrate dextrose (ACD)
  • blood bank studies
  • DNA testing
  • invert 8-10x
148
Q

orange top tue

A
  • thrombin-based clot activator

- stat chemistries

149
Q

syringe

A
  • for pt with fragile easy to collapse veins
  • manually adjust the rate the blood is taken
  • evacuated tubes are not used in the blood collection
  • blood is first taken and transferred into tube using transfer device
150
Q

hub

A
  • adapter

- use only once

151
Q

vein preferance

A
  • median cubital
  • cephalic
  • hand
  • basilic
152
Q

anchoring veins

A
  • use nondominant
  • 2 inches below site
  • use thumb to pull down
153
Q

hand draw

A

-10 degree angle

154
Q

angle on needle

A
  • 10 degree on hands
  • 30-15 on arm
  • deeper the vein bigger the angle
155
Q

complication that can occur

A
  • nerve damage
  • hematoma
  • phlebitis- inflammation of blood vessle
  • thrombosis- clot that can block
  • petechiae
  • hemocencentration
  • syncope
  • diaphoresis- sweat
156
Q

leaving tourniquet on too long

A
  • may elevate the levels of potassium
  • causes hemolysis
  • can cause low CBC
  • can cause high iron level
157
Q

blood smear

A
  • can be venous or capillary blood
  • can be done by finger to slide
  • microscopically examine blood
  • must be prepared at least one hour after drawing
  • wedge method using two glass slides at 30-35 degree angle
  • frosted side up
158
Q

thermolabile specimens

A
  • use heat or a heat block to to regulate temperature
  • use ice slurries, refrigerator, or freezer for chilling purposes. do not use cold or ice packs
  • avoid fluctuating temperatures
159
Q

photosensitive

A

protect from light

160
Q

packaging and shipping

A
  • include patients identification, specimen identification, shipping paperwork, and test information
  • biohazard identification
  • pack with:
  • absorbent materials
  • watertight primary containers
  • watertight secondary containers
  • stronger outer packaging
  • coolants
161
Q

steps of packaging tube

A
  • first make sure the tube is labeling with patient ID, date and time of collection, source and type of specimen
  • place tube into biohazard bag
  • then place into primary container with absorbent material surrounding and any coolants if necessary
  • put this all in the secondary container and place specimen documentation above
  • then place these into shipping container
162
Q

steps in handling and transporting specimens

A
  • mixing the sample
  • aliquoting
  • adding dilutents
  • centrifuge
  • package
  • follow procedures
163
Q

transporting urine

A
  • use evacuated transport tubes with preservatives when sending urine to a reference lab
  • transfer sample into tube with disposable pipette
  • keep at room temp
  • must be tested within 72 hours
164
Q

what to include on the lab requisition form for transporting

A
  • patient name, ID #
  • date
  • type of test
  • ordering providers name
  • ICD-10-CM code for diagnosis
  • and a place for the provider to sign after getting results
165
Q

pneumatic tube system

A
  • sends tubes to departments
  • fast
  • inpatients
166
Q

chain of custody

A
  • maintains control and accountability of specimen from the draw to disposal
  • any who handles the specimen must document their name and identifying information of the patient, body, subject, or object the specimen came from
  • name of the person who obtained and processed the specimen
  • date, location, and signature of the person attesting the specimen is correct and matches the documentation
  • signature and date from anyone who handled the specimen for any amount of time
167
Q

informatics

A
  • QR code, radio frequency identification, bar codes

- these are to be scanned after receiving the specimen

168
Q

tamper-evident containers

A
  • drug testing

- forensics

169
Q

reference rage for hemoglobin

A

male- 13-18

female- 11.5-16.5

170
Q

how to access patients medical records

A

-patients ID number

171
Q

LH/FSH

A
  • hormone tests

- would be used for reproductive specialists

172
Q

LDL/HDL

A

cholesterol tests

173
Q

CRP/BNP

A

cardiac tests

Phlebotomy (1 decks)

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