NHA Study Guide Flashcards
you must have the _______ _______ before even approaching the patient
requisition form
all information is on the __________ form
requisition form
when you introduce yourself and confirm the patient, you must use ____ identifiers
2
inpatient patients must have their _________ and _______ identify themselves
wristband
verbally
outpatient patients must have a ______ ID and _______ identify themselves
physical
verbally
after introducing and confirming the PT, you must ________ them about the procedure
educate
you have to evaluate the PT w/ their _______ & ________ to determine the best site/method collection
age & condition
you evaluate the PT w/ their age & condition to determine what is the best ______ & ________ collection
best site & method collection
before blood collection, you have to make sure the PT has met all ________ & ________ necessary for blood collection
E.X: if they fasted
requirements & preparations
with complications you need to know what _____ them & how to ______ them
causes
help
excessive bleeding happens when a PT is on ______ _________
you help by applying ________
blood thinners
pressure
examples anticoagulation medications are . . .
1.) __________
2.) __________
3.) __________
1.) heparin
2.) warfarin
3.) aspirin
severe pain should not last more than a few _________
minutes
to help with severe pain, you can apply ________
but if that doesn’t help they should get checked out
ice
lack of ________ should only last a few hours
sensation
lack of sensation could be from the ________ or that you hit a ________
tourniquet
nerve
if the PT feels lack of sensation during a draw, you should _______ the draw & apply ________
STOP
pressure
excessive bruising is considered when it’s bigger than the size of a _______ _____
gauze pad
to help with excessive bruising, you should _______ _______
apply pressure
signs of an infection are . . .
1.) _______
2.) _______
3.) _______
1.) red
2.) swollen
3.) pussy
STAT means you _____ everything and do it right there
drop
ASAP means . . .
as soon as possible
_______ consent is when it’s verbal or in writing
expressed
_______ consent is when the PT is provided with all the information
informed
_________ consent is when their actions imply they are giving consent
implied
when a PT refuses consent, you have to _______ the person ordering test of refusal
inform
if inpatient, the PT must always have a _________
wristband
the PT wristbands must always MATCH the ________ _______
requisition form
what are the 3 main veins in the antecubital fossa?
1.) __________
2.) __________
3.) __________
1.) median cubital
2.) basilic
3.) cephalic
what fingers are used during a capillary puncture?
1.) ______
2.) ______
1.) the ring finger
2.) the middle finger
when doing a capillary puncture, you should always _______ away the 1st drop
wipe
when selecting a site to draw, the ______ _______ is the 1st choice
antecubital fossa
when selecting a site to draw, the ______ is the 2nd choice
dorsal
when performing a dorsal hand draw, you should always use a _________ needle
butterfly
when selecting a site, the ____/_____ is always LAST and needs Dr. approval
ankle/foot
you would never draw from the _____/_____ with a diabetic PT
ankle/foot
you never perform a venipuncture _________ an IV line, only ________ it
above
under
when performing a venipuncture on a arm w/ a IV line, you need to ________ the IV for a few minutes before proceeding
STOP
in a arm w/ a dialysis shunt, you should _________ perform a venipuncture
NEVER
you should never perform a venipuncture on the _________ side as a mastectomy
same
edema means ______
swollen, swelling
comes from fluid
T or F?
you should perform a venipuncture on a edema.
FALSE
edema = bruise
T or F?
you should perform a venipuncture on scarred skin.
FALSE
very painful
hematoma means _______
bruised
drawing blood on a hematoma will cause ___________
hemolysis
_______ means when RBC burst, and can alter test results because of the hemoglobin released
hemolysis
T or F?
you should draw on someone who is incohere/confused.
FALSE
that’s battery
________ veins are hard, inflexible and narrow and should not be drawn from
schlerotic
schlerotic = grown rigid or unresponsive especially with age
sclerotic veins are _____, _____, and narrow and should not be drawn from
hard, inflexible
THINK: pen tube
________ veins are twisted
tortuous
THINK: twisted = torture
tortuous veins are ________ and should not be drawn from
twisted
THINK: twisted = torture
_________ veins are inflexible and tender to touch and should not be drawn from
thromobotic
thrombotic veins are ________ & _______ to touch and should not be drawn from
inflexible & tender
________ veins are very thin and should not be drawn from
fragile
fragile veins are quite __________ and should not be drawn from
thin
_________ veins are tender, warm, and can appear red, they should not be drawn from
phlebitic
phlebitic veins are _______, _____, and appear ______ and should not be drawn from
tender, warm, and appear red
REMEMBER: phleb - itis = inflamattion of vein
even though you feel the vein, it does not mean you should ______ from them
draw
________ _______ is our 1st antiseptic of choice
isopropyl alcohol
________ is our 2nd antiseptic of choice
chlorhexidine
when collecting a blood culture, you must clean ________ and ______ with an antiseptic
twice, scrub
how long should a PT fast for?
8-12 hours
what is basal state?
the combination of . . .
- resting
- fasting
- and NO exercise
with children, what types of tubes do we use?
smaller tubes w/ less vaccum
with children, what type of needle is used?
butterfly needle to help veins not collaspe
what changes w/ capillary draws?
the order of draw
what is the order of draw w/ capillary sticks?
Lavender
Green
Red
what angle is the needle always held at?
15-30 degree angle
POC stands for . . .
point of care testing
what is POC?
bedside care, immediate results
examples of POC is . . .
glucometer blood sugar
pregnancy test
what is important to help ensure safety throughout the collection process?
communication
if the patient loses consciousness we must . . .
STOP the procedure
call for help
assess breathing
we use syringes on what type of veins?
fragile & collasping veins
we use butterfly needles on what type of vein?
small & rolling veins
who do we use a heel stick on?
infants ONLY
12 month or younger
we do a _______ stick on an infant that is NOT ___________
heel
walking
doing a heel stick on infant would only be _______ months or younger
(before they can walk)
12
can impede how they walk
what size lancet do you use on a infant heel stick?
2mm lancet
how long do you use a heel warmer on and infant heel stick?
3-5 mins
with ANY capillary punctures, you must . . .
wipe away 1st drop
what is a hematoma?
a bruise/bleeding under the skin
how to prevent a hematoma?
PRESSURE!
to prevent a hematoma during a venipuncture, how long should you apply pressure?
2 mins
to prevent a hematoma during a arterial puncture, how long should you apply pressure?
5 mins
what is phlebitis?
inflammation of the vein
phleb = vein
itis = inflamattion
how does phlebitis occur?
scrapping vein causing it to swell
how to treat phlebitis?
applying ice & pressure
what is a thrombus?
a clot!
what should you do w/ thrombus?
DO NOT DRAW
thrombus = blood clot
what is diaphoresis?
excessive sweating
what is petechiae?
red dots around tourniquet (not our fault)
caused by platelet malfunction
what should you do if pt has petechiae?
complete draw
add EXTRA PRESSURE
what is hemoconcentration?
when we leave the tourniquet on too long
how to prevent hemoconcentration?
don’t leave tourniquet on for over a minute
what is syncope?
fainting
lack of blood supply to brain
what to do with pt if syncope happens?
stop draw
call for help
never leave PT
what to do during seizure?
stop draw
do nothing
move furniture
what is shock in pt?
cold, clammy skin, rapid pulse
what to do if pt is in shock?
add blanket, raise legs
what is the order of draw?
Be Ready Your Getting Poked
blood culture tubes
blue
red
yellow/SST/tiger tube topes
green
lavender (pink)
& gray
what is the capillary order?
lavender
green
red
what is in the blue tube?
sodium citrate
what does the blue tube do?
everything coagulation!
sodium citrate helps clot
how many times should you invert the blue tube?
3-4 times
what does the lavender tube has?
EDTA
what does the lavender tube do?
it’s a hematology test that preserves the shape of cells
reduces platelet clumping
how many times should you invert a lavender tube?
8-10 times
what does the green tube have?
heparin
what does the green tube do?
it’s a chemistry test that PREVENTS clots
how many times should you invert a green tube?
8-10 times
what does the grey tube have?
potassium oxlate
what does the grey tube do?
it tests sugar to preserve glucose
how many times should you invert the grey tube?
8-10 times
how many times should you invert a yellow sps tube?
8-10 times
how many times should you invert a serum tube?
5 times
s looks like a 5
quality checks on equipment are performed __________
daily
why do we create blood smears?
for white blood cell differentials
we make it 1 cell thick to see infection
what tube do we use for a blood smear?
EDTA (lavender) tube
a blood smear has to be prepared within _______ hour of collection
1
what angle do you go into when collecting a blood smear?
30 degree angle
new borns are screened for ______
PKU (phenylketonuria)
new borns go through screening _____-______ hours after birth
24-72 hours
when collecting blood for newborns, you do a . . .
heel stick
wipe away 1st drop
you have to let the absorbing circle card dry for _______ hours
4
what is therapeutic phlebtotomy?
a fancy word for blood letting
what type of pt do we perform therapeutic phlebotomy on?
on pt who suffer from polycythemia vera
what is polycythemia vera?
overproducing of blood cells
how far apart can someone donate blood?
8 weeks apart
how old do you have to be to donate blood?
18+
how many lbs do you have to weigh to donate blood?
over 110 lbs
what is the age cap on donating blood?
there isn’t any
what do you have to do before collecting a pt’s blood for donation?
collect a complete medical history
what is ampheresis?
removing a blood element during blood collection by a special equipment
E.X: plasmapheresis (separating plasma)
what is autologous?
Donation of blood for their own future use
E.X: upcoming surgery
what is Iatrogenic anemia?
Blood loss due to repeated venipunctures
you always ________ specimen in front of pt before they leave the room to reduce the chance of errors
label
what is CLIA?
about test quality
Establishes guidelines for certain tests performed @ home or in facility
Required minimal judgement & interpretation
what are examples of CLIA?
E.X: reading dipstick, glucometer
what are the tests that go immediality on ice after drawing?
ammonia
lactic acid
ABG
ACTH
gastrin (stomach)
pyruvate
cold aggulutiins must be kept @ what temp?
warm
THINK: opposite
what is the special requirement for billirum?
has to be protected from light
what does billirum test for?
liver function
E.X: jaundice
how do you protect billirum from light?
using tin foil or amber colored tube
what does postprandial mean?
2 hours after eating
what is the rule when collecting stool?
you cannot mix urine w/ it
what is the most common non-blood sample?
urine
the perservatives when collecting urine keep the specimen good for _______ hours
72
what should a menustrating women do when collecting a urine?
wait for cycle to be completed instead
random urine test is used for . . .
drug test
clean catch midstreams are best for . . . .
cultures
prevents cross contaminations
w/ timed urine specimen you must . . .
refridge until delivered to physician’s office
a 24 hour urine specimen requirements are . . .
kept on ice
do not collect 1st void of the day
a 1st void urine specimen is used to test for. . . .
pregnancy
what are the requirements for semen collection? (3)
Do not expose to light or extreme temp
Keep close as body temp as possible
Must reach lab within 2 hours of collection
what is sputum?
Mucus or phlegm
For microbiology specimen
what is the requirement for testing for BAC?
using chlorhexidine instead of alcohol wipe
what is required from each person that had possession of specimen for any amount of time during chain of custody?
signature & date
what type of bags are used to send specimens?
biohazard bags
what are in biohazard bags w/ the sample?
copy of requisition form & absorbent material
what is POC testing?
done at bedside w/ immediate results
what do you do when a critical value is detected during POC testing?
report results immediately to ordering provider
what is OSHA?
for us, ensuring workers are safe
reduces incident expores
what is MSDS?
Material Safety Data Sheets
anything chemical related
chemical spills/incidents
what is NIOSH?
anything sharps related
what is JCAHO?
joint commission
Focuses on continual improvement of pt safety & quality care
what is CLSI?
Clinical & Laboratory Standards Institute (CLSI)
Guidelines for standards & operations
Order of draw
what is PHI?
protected health information
what are erythrocytes?
RBC
what are leukocytes?
WBC
what are thrombocytes?
platelets
what is hemostasis?
when blood vessels are repaired after injury
what is the purpose of timed specimens?
used to measure blood levels of substances (cortisol, medication)
also measures pt condition
what are 2 hour postprandial test for?
used to evaluate diabetes
fasting glucose level compared w/ 2 hours after eating
what does OGTT stand for?
oral glucose tolerance test
what is OGTT used for?
diagnose diabetes
evaluates low blood
what is therapeutric drug monitoring?
montioring blood level of medication
blood drawn to coincide w/ trough (lowest blood level) or peak level (highest blood level)
what is trough?
lowest blood level
what is peak?
highest blood level
what are blood cultures used for?
used to detect microorganisms in blood
E.X: pt w/ unknown fever
what technique is used for blood cultures?
aseptic technique
what color tubes are cold agglutinins collected in?
red topped tubes
what is ABG?
arterial blood gas
measures levels of gas
what is ACTH?
adrenocorticotropic hormone
diagnose disorders of the pituitary or adrenal glands
what do you do with a ABG collection?
you must chill it (ice)
what do you do w/ a bilirubin collection?
it’s light sensitive
amber colored tube or wrapped in tin foil, protect from light
what do you do w/ lactid acid specimen?
you chill it (ice)
THINK: milk goes into fridge
what do you do beta-carotene?
it’s light sensitive
amber colored tube or wrapped in tin foil, protect from light
THINK: carotene = pigment = UV
what do you do w/ a pyruvate specimen?
you chill it (ice)
what do you with a ACTH collection?
you chill it (ice)
what do you do w/ Vitamin A & B6?
Vitamin A & B6
THINK: vitamins light sensitive (vitamin c in skincare)
what do you do w/ gastrin collection?
you chill it (ice)
what do you do w/ porphyrin collection?
it’s light sensitive
amber colored tube or wrapped in tin foil, protect from light
THINK: porphyrin helps hemoglobin function
what do you do w/ parathryroid hormone test?
you chill it (ice)
THINK: hormones have to chill
what size lancet is used for a dermal puncture on infants?
no more than 2mm
where do you do a dermal puncture on infants?
medial & lateral areas of plantar surface of foot
where do you NOT do a dermal puncture on infants?
do not use back of heel or arch of foot
what does the lavender tube contain?
EDTA
what is EDTA?
what color tube?
a anticoagulant
lavender tube
how many times should lavender tube be inverted?
8-10 times
what tube would you use for a RBC count?
lavender
what tube would you use for a platelet count?
lavender
what tube would you use for a WBC differential?
lavender
what tube would you use for a hemocrit?
lavender
what tube would you use for a ESR?
lavender
erythrocyte sedimentation rate = blood test that can reveal inflammatory activity in your body
hematology test = lavender
what tube would you use for a sickle cell screening?
lavender
what is ESR?
erythrocyte sedimentation rate
what is in the light blue tube?
contains sodium citrate (anticoagulant)
what is the light blue tube used for?
coagulation studies b/c it preserves coagulation factors
how many times should the light blue tube be inverted?
3-4 times
what does aPTT stand for?
activated partial thromboplastin time
what does PTT stand for?
partial thromboplastin time
what does FDP stand for?
fibrinogen degradation products
(FDPs) are the substances left behind when clots dissolve in the blood
what does TT stand for?
thrombin time
what does BT stand for?
bleeding time
what does PT stand for?
prothrombin time (PT)
what color tube should be used for a PT?
light blue
PT = prothrombin time
what color tube should be used for a aPTT?
light blue
what color tube should be used for a PTT?
light blue
what color tube should be used for a FDP?
light blue
(FDPs) are the substances left behind when clots dissolve in the blood
what color tube should be used for a TT?
light blue
what color tube should be used for a BT?
light blue
BT = bleeding time
what is inside the green tube?
contains Heparin (anticoagulant)
green tubes are not used for __________ b/c it messes w/ blood smears
hematology
green tubes are inverted how many times?
8-10 times
green tubes are used for ______ tests
chemistry
ammonia test should use what colored tube?
green
carboxyhemoglobin test should use what colored tube?
green
carboxyhemoglobin test is used to diagnose carbon monoxide poisoning
STAT electrolytes test should use what colored tube?
green
what do gray tubes contain?
- additives & anticoagulants (glucose preservative)
- potassium oxalate
how many times are gray tubes inverted?
8-10 times
what does FBS mean?
fasting blood sugar
what does GTT mean?
glucose tolerance test
when collecting a FBS, what tube should be used?
gray
fasting blood sugar test (FBS
when collecting a GTT, what tube should be used?
gray
when collecting a blood alcohol level, what tube should be used?
gray
when collecting lactic acid measurement, what tube should be used?
gray
what are red & grey speckled top tubes also called?
tiger top tubes/serum separator tubes (SST)
what do red & grey speckled top tubes have?
clot activators to speed up clotting
what makes up clot activators in tiger topped tubes?
silicia & celite
how many times should red/gray speckled top tube should be inverted?
5 times
red/gray/tiger top/SST tubes are used for most ___________ tests
chemistry
THINK: chemistry, green comes after
what do red tubes have?
nothing?
how many times do you invert a red tube?
0 times, no need to invert
what do yellow tubes contain?
SPS sodium polyanethol sulfonate (anticogulatant)
THINK: used for blood cultures
yellow tubes are ___________
sterile
what are yellow tubes used for?
cultures to check for microorganisms
what tubes are used for thyroid studies?
speckled/tiger top tubes