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Phlebotomy > Order of Draw > Flashcards

Order of Draw Flashcards

1
Q

Blood Cultures additive

A

nutrient broth

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2
Q

Light blue tube additive

A

sodium citrate

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3
Q

red tube additive

A

none

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4
Q

gold/tiger tube additive

A

silica/thixotropic gel

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5
Q

mint green tube additive

A

lithium heparin

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6
Q

dark green tube additive

A

sodium heparin

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7
Q

lavender tube additive

A

EDTA

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8
Q

Royal Blue tube additive

A

EDTA

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9
Q

Pink tube additive

A

K-EDTA

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10
Q

Grey tub additive

A

sodium fluoride, potassium oxalate

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11
Q

which tube must be filled completely and must have a discard tube?

A

light blue

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12
Q

what are the two options for discard tubes?

A

red tube or royal blue tube with a red stripe

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13
Q

the light blue top tube yields serum or plasma?

A

plasma

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14
Q

sodium citrate is a liquid additive that requires specific blood to additive ratio of ___ blood to ___ additive.

A

9 parts blood

1 part additive

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15
Q

the light blue top must be filled ____ to avoid an inadequate ratio of additive to blood.

A

completely

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16
Q

The light blue top tube must be inverted how many times?

A

3-4

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17
Q

name three common tests for the light blue top

A

Prothrombin Time (PT)
Partial Thromboplastin Time (PTT)
Activated Partial Thromboplastin time (APTT)

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18
Q

Red tube top yields serum or plasma?

A

serum

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19
Q

Who is responsible for red tube top specimen testing?

A

chemistry

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20
Q

What 2 tubes can be used for a serum pregnancy test?

A

red or tiger

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21
Q

tiger, speckled or gold tube top yields serum or plasma?

A

serum

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22
Q

Who is responsible for tiger, speckled or gold tube top specimen testing?

A

chemistry

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23
Q

What test can a red top be used for? (4)

A

serum pregnancy test
cold agglutinins
digoxin
ethanol

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24
Q

What does SST stand for and which tube is it associated with?

A

Serum Separation Tube

Gold/tiger top

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25
Q

List 5 other names for the tiger top.

A 
gold top
speckled tube
marble top
red/gray speckled top
gel
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26
Q

____ tube additive found in tiger top tubes promotes rapid clot formation of the blood.

A

silica

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27
Q

how many times should a tiger top be inverted?

A

8

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28
Q

What does PST stand for and what tube is it associated with?

A

Plasma separation tube

Mint Green

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29
Q

Name 3 common tests associated with the tiger top tube.

A

Basic Metabolic Panel (BMP)
Complete/comprehensive metabolic panel/profile (CMP)
Serum (Pregnancy Test)

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30
Q

____ evaluates the extrinsic system of the coagulation cascade. Therapeutic Drug Monitoring requites this test to be drawn when a patient is on a Coumadin regimen.

What tube is it associated with?

A 
Prothrombin time (PT)
Light Blue
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31
Q

____ evaluates the intrinsic system of the coagulation cascade. Therapeutic Drug Monitoring requires this test to be drawn when a patient is on a Heparin regimen.

What tube is it associated with?

A

Partial Thromboplastin Time (PTT)

Light Blue

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32
Q

This group of tests provide general information about the patients’ metabolism, kidney function, electrolytes and fluid balance.

What tube is it associated with?

A

Basic Metabolic Panel (BMP)

tiger top

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33
Q

This test is similar to a BMP, it is a more comprehensive look at the patients’ metabolism of chemicals in the body, kidney function, electrolytes and fluid balance. It also provides information about liver function and performance.

What tube is it associated with?

A

Complete/comprehensive metabolic panel/profile (CMP)

tiger top

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34
Q

Name two common tests used with the Mint Green Tube top

A

STAT electrolytes “Lytes”

hCG (plasma) Pregnancy Test

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35
Q

Measurement of ____ is necessary for the diagnoses and treatment fo renal and endocrine conditions. Low _____ levels are associated with arrhythmia and tachycardia. High levels are associated with heart failure.

What tube is it associated with?

A

STAT electrolytes “Lytes”

mint green

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36
Q

What does hCG stand for?

A

Human Chorionic Gonadotropin

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37
Q

What test is associated with the Dark Green Tube Top?

A

Ammonia

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38
Q

A high volume of ____ in the blood is an indication that the liver is not functioning properly. The liver is responsible for converting ____ into urea to be expelled from the body.

A

Ammonia

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39
Q

What laboratory is responsible for lavender or dark purple tube tops?

A

Hematology

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40
Q

How much must the lavender tube be filled?

A

2/3

completely for ESR

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41
Q

Name 3 tests associated with the lavender tube

A

Erythrocyte Sedimentation Rate (ESR)
Sickle Cell Screening
Complete blood count (CBC)

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42
Q

How full should the Erythrocyte Sedimentation Rate (ESR) test tube be filled? What color is it?

A

completely

lavender

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43
Q

True or false: the CBC can be tested using blood from a dermal puncture.

A

TRUE

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44
Q

Why should a CBC never be centrifuged?

A

It can cause hemolysis

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45
Q

Who is responsible for testing the pink tube top?

A

blood bank

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46
Q

Name two tests associated with the pink tube top.

A

type and screen ratio

cross match

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47
Q

This test provides a basic understanding of patients’ blood type. It screens for antibodies present in plasma and serum. It also determines the patients’ blood type and categorizes it into the one of the 4 blood types.

What color tube?

A

Type Screen Ratio (TSR)

pink

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48
Q

This test is required prior to blood transfusion. It is used to determine if donor blood is a compatible match for the recipient.

What color tube?

A

Cross match

pink

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49
Q

what is the preservative that prevents the breakdown of sugar? What tube is it in?

A

sodium fluoride

gray tube

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50
Q

How long will sodium fluoride preserve the integrity of glucose in the sample?

A

3 days

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51
Q

_____ and ____ are anticoagulants that prevents clotting by binding to calcium in the sample. In which tubes are the found?

A

potassium oxalate
gray

or

EDTA - lavender/RB

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52
Q

How many times do you invert a gray tube top?

A

8

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53
Q

What are the 3 common tests associated with the gray tube top?

A

oral glucose tolerance test (OGTT)
Lactic Acid
Alcohol

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54
Q

_____ is used to test hyperglycemia and diagnose diabetes mellitus. What color tube is used?

A

3-hour OGTT

gray

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55
Q

_____ is used to evaluate hypoglycemia for disorders of carbohydrate metabolism? What color tube is used?

A

5-hour OGTT

gray

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56
Q

when performing a 3 hour glucose test how many blood draws will you do? What color tube?

A

4 draws

gray tube

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57
Q

Abnormal _______ results are an indication that the body is not receiving proper oxygenation. What color tube?

A

lactic acid

gray tube

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58
Q

Should a lactic acid test be done with or without stasis?

A

without stasis

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59
Q

what 2 tubes can be used for ethanol levels?

A

red or gray

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60
Q

what should not be used to clean a site when doing an ethanol test.

A

do not clean the site with alcohol

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61
Q

What two common tests are done in with a royal blue tube and what lab is responsible?

A

lead (pb) poisoning, heavy metal

toxicology

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62
Q

When is the royal blue tube with the blue stripe drawn?

A

after lavender/purple

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63
Q

true or false. all royal blue tubes are the same

A

false: red stripe has no additive, royal blue has EDTA

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64
Q

Which panel/profile do the following belong to?
albumin, alkaline phosphatase, SGPT, SGOT, BUN, creatinine, glucose, potassium, sodium, total bilirubin, total protein, A/G ratio, BUN/creatinine ratio, calcium, CO2, Chloride

What tube is this test associated with?

A

comprehensive metabolic panel - CMP

tiger top

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65
Q

Which panel/profile do the following belong to?
glucose, BUN, creatinine, BUN/creatinine ratio, sodium, potassium, CO2, chloride, Calcium

What tube is this panel associated with?

A

basic metabolic panel -BMP

tiger top

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66
Q

Which panel/profile do the following belong to?

cholesterol, triglycerides, HDL, LDL, VLDL

A

lipid panel

according to LabCorp website: Gel-barrier transport, green-top (heparin) tube, or lavender-top (EDTA) tube

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67
Q

To which panel/profile do the following belong?

albumin, total bilirubin, direct bilirubin, alkaline phosphatase, AST (SGOT), ALT (SGPT), total protein

A

hepatic function panel (liver)

according to LabCorp:
Red-top tube, gel-barrier tube, or green-top (heparin) tube

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68
Q

Which panel/profile do the following belong to?

albumin, calcium, carbon dioxide, chloride, creatinine, glucose, phosphorus, potassium, sodium, BUN

A

renal function panel (kidney)

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69
Q

what state should a patient be in for a lipid panel?

A

fasting

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70
Q

this is the largest and most automated section of the laboratory

A

chemistry

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71
Q

This section is responsible for the detection of pathogenic microorganisms in patient samples and for hospital infection control.

A

microbiology

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72
Q

microorganisms that caused disease are ____

A

pathogenic

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73
Q

this type of test is done on the urine to detect disorders and infection of the kidney, urinary tract, metabolic disorders and drug abuse.

A

urinalysis

74
Q

if a physician suspects drug abuse a ___ sample should be collected.

A

urine

75
Q

when collecting a 24 hour urine sample the patient should be voiding in a ____ml or ___ liter graduated collection cylinder.

A

2,000ml

2 liter

76
Q

when a sample has been mishandled or stored incorrectly it will be necessary to ____ the sample

A

recollect

77
Q

A ____ test looks for hidden (occult) blood in a sample.

A

stool guaiac test

78
Q

____ is a substance from a plant that is used to coat the FOBT test cards.

A

guaiac

79
Q

is sputum the same as saliva?

A

no

80
Q

___ is a type of thick mucus that is produced by the lungs when they are diseased or damaged.

A

Sputum

81
Q

mucous membranes line the respiratory tract and ____ helps protect this tract from infection.

A

Sputum

82
Q

Sputum specimens are usually collected when?

A

3 consecutive mornings

83
Q

what is the most common non-blood specimen in the clinical lab?

A

urine

84
Q

_____ specimen is the most common form of a urine specimen because you can collect the random specimen anytime.

A

random specimen

85
Q

what needs to be avoided for a 24 hour urine collection

A

bedpans, urinals and toilet paper

86
Q

what happens with the first specimen in a 24 hour urine collection?

A

discard the first specimen

87
Q

If the blood sample you are centrifuging has been allowed to clot (ie plain red top tube, tiger top tube) the fluid portion of the sample that you have centrifuged is called _____.

A

serum (no clotting agents remain)

88
Q

If you centrifuge a tube that contains an anti-coagulant (blood has not been allowed to clot) you have _____.

A

plasma (plasma still contains the clotting agents)

89
Q

The main thing you need to understand about centrifuging is making sure your sample is

A

balanced in the machine

90
Q

How do you balance a centrifuge machine?

A

place a tube of equal size and with an equal volume of fluid (blood or water) directly opposite each other in the centrifuge racks.

91
Q

True or false: urine sample are commonly centrifuged to separate the fluid from sediment.

A

TRUE
urine is centrifuged to separate the fluid from sediment (blood cells, skin cells, bacteria, yeast, and other contaminants)

92
Q

What is the most important thing when creating a blood smear?

A

feathered edge.

93
Q

when creating a blood smear, you draw a sample into what color tube?

A

lavender

94
Q

What seals the end of the capillary tube so that it can be placed in a centrifuge?

A

crit-o-seal

95
Q

How much should a capillary tube be filled?

A

2/3

96
Q

True or false: you can over and under invert a tube

A

FALSE

You can under invert but not over invert

97
Q

The following are examples of what?

  1. inadequate specimen volume
  2. inadequate inversion with anticoagulant
  3. icteric (jaundice) specimen
  4. Lipemic specimen
  5. hemolyzed specimen
A

variables in specimen quality

98
Q

What does a hemolyzed specimen look like?

A

serum/plasma having a pink or reddish tint, usually caused by the phlebotomist

99
Q

Who usually causes a hemolyzed specimen?

A

the phlebotomist

100
Q

What is a Lipemic specimen and what does it look like?

A

a high amount of lipids in the blood

serum/plasma will appear milky or white

101
Q

What is a icteric (jaundice) specimen and what does it look like?

A

high amount of bilirubin in the blood, serum/plasma will look green/brownish in color

102
Q

When should inversion begin?

A

as soon as the blood is drawn

103
Q

How long does it take for for blood in the system to make a complete circulation in the body?

A

one minute

104
Q

The average person weighting 155 pounds has approximately ___ liters of blood in their system.

A

5-7

105
Q

name the three layers of the heart

A

endocardium, myocardium, epicardium

106
Q

What is the inner endothelial layer lining of the heart?

A

endocardium

107
Q

Which is the muscular middle layer of the heart? This portion is the contractile element of the heart.

A

myocardium

108
Q

Which part of the heart is the fibrous outer layer of the heart. The coronary arteries which supply blood to the heart are found in this layer.

A

epicardium

109
Q

What are the valves on the right side of the heart?

pulmonary valve
mitral valve
tricuspid valve
aortic valve

A

tricuspid valve

pulmonary valve

110
Q

What are the valves on the left side of the heart?

pulmonary valve
mitral valve
tricuspid valve
aortic valve

A

mitral valve

aortic valve

111
Q

What is another name for the mitral valve?

A

bicuspid valve

112
Q

Where is the mitral valve located?

A

between the left atrium and left ventricle

113
Q

The right atrium and right ventricle are directly connected by the ____.

A

tricuspid valve

114
Q

The primary function of the urinary system is to

A

maintain the volume and composition of body fluids within normal limits.

115
Q

the urinary system maintains an appropriate fluid volume by

A

regulating the amount of water that is excreted in the urine.

116
Q

The _____ system contains the largest organ of the human body, the skin.

A

integumentary system

117
Q

What are the blood vessels in the human body? (5)

A 
arteries
arterioles
capillaries
venules
veins
118
Q

_____ blood is a mixture of arterial and venous blood

arteries
arterioles
capillaries
venules
veins
A

capillaries

119
Q

____ and _____ carry deoxygenated blood back to the heart

arteries
arterioles
capillaries
venules
veins
A

venules and veins

120
Q

Formed elements include (3)

arteries
venules
leukocytes
thrombocytes
arterioles
erythrocytes
capillaries
veins
A

thrombocytes (platelets)
erythrocytes (red blood cells)
leukocytes (white blood cells)

121
Q

another term for thrombocytes

A

platelets

122
Q

_______ contains hemoglobin, the oxygen-carrying protein.

A

erythrocytes (red blood cells)

123
Q

what is the average life of RBCs?

A

120 days

124
Q

Another name for leukocytes

A

white blood cells

125
Q

_____ function to provide infection protection to the body.

A

leukocytes (white blood cells)

126
Q

What are the 5 types of white blood cells in the blood stream?

A 
Neutrophils
Lymphocytes 
Monocytes
Eosinophils
Basophils

(never let monkeys eat bananas)

127
Q

Which white blood cell increases in the presence of a bacterial infection?

Basophils
Eosinophils
Lymphocytes 
Monocytes
Neutrophils
A

Neutrophils

128
Q

Which kind of white blood cell plays a role in immunity, and increases during a viral infection?

Basophils
Eosinophils
Lymphocytes 
Monocytes
Neutrophils
A

Lymphocytes

129
Q

This white blood cell is the largest white blood cell; their numbers increase in intracellular infections and tuberculosis.

Basophils
Eosinophils
Lymphocytes 
Monocytes
Neutrophils
A

Monocytes

130
Q

Which kind of white blood cell increases in allergies, skin and parasitic infection. An increased ____ count would be apparent during an allergic reaction.

Basophils
Eosinophils
Lymphocytes 
Monocytes
Neutrophils
A

Eosinophils

131
Q

This white blood cell accounts for 0-1% of WBCs in the blood. They carry histamine which is released during an allergic reaction. They never increase in number, only the amount of histamine being released increases in response to an allergic reaction.

Basophils
Eosinophils
Lymphocytes 
Monocytes
Neutrophils
A

Basophils

132
Q

____ is the liquid portion of anti-coagulated blood, it contains clotting factors.

A

plasma

133
Q

____ is the liquid portion of coagulated blood, it does not contain clotting factors because they were used to make the blood clot.

A

serum

134
Q

what does pH stand for?

A

potential of hydrogen or power of hydrogen

135
Q

what does it mean if blood is agglutinated?

A

clumped

136
Q

Which blood type is the universal doner?

A

O-

137
Q

which blood type is the universal recipent?

A

AB+

138
Q

What is a nosocomial infection

A

any infection contracted in a health care setting

139
Q

What are 4 examples of a nosocomial infection?

A

MRSA
Staph
Pneumonia
flu

140
Q

_____ is the specific way in which microorganisms travel from the reservoir to the susceptible host.

airborne transmission
contact transmission
droplet transmission
indirect contact transmission
mode of transmission
parenteral transmission
vector borne transmission
vehicle transmission
A

mode of transmission

141
Q

___ occurs when a pathogen is transmitted directly from an infected individual to you, example skin to skin contact with infectious persons

airborne transmission
contact transmission
droplet transmission
indirect contact transmission
mode of transmission
parenteral transmission
vector borne transmission
vehicle transmission
A

contact transmission

142
Q

This kind of transmission occurs when a fomite serves as a temporary reservoir for the infectious agent. This can include using a doorknob, faucet or public telephone, putting a contaminated pencil in your mouth.

airborne transmission
contact transmission
droplet transmission
indirect contact transmission
mode of transmission
parenteral transmission
vector borne transmission
vehicle transmission
A

indirect contact transmission

note: the book uses many of these examples for vehicle transmission, however it is incorrect.
Sources:
https://courses.lumenlearning.com/microbiology/chapter/modes-of-disease-transmission/

https://www.encyclopedia.com/education/encyclopedias-almanacs-transcripts-and-maps/common-vehicle-spread

143
Q

____ is an inanimate object that carries disease

A

fomite

144
Q

give an example of droplet transmission

A

sneezing and coughing

145
Q

Tuberculosis, an intracellular infection contracted by infectious particles that remain suspended in the air is an example of what kind of mode of transmission?

airborne transmission
contact transmission
droplet transmission
indirect contact transmission
mode of transmission
parenteral transmission
vector borne transmission
vehicle transmission
A

airborne

146
Q

Transmission through water, food, air, or the blood supply used by a transfusion are what kind of transmission?

airborne transmission
contact transmission
droplet transmission
indirect contact transmission
mode of transmission
parenteral transmission
vector borne transmission
vehicle transmission
A

vehicle transmission

this is different than the book however the book is wrong

147
Q

This occurs when a pathogen is transmitted through an invertebrate such as an insect like malaria, lyme disease or dengue virus.

airborne transmission
contact transmission
droplet transmission
indirect contact transmission
mode of transmission
vector borne transmission
vehicle transmission
A

vector borne transmission

148
Q

A disease or infection transmitted other than by mouth like needle-stick, open wound, hangnail, eyes, etc

airborne transmission
contact transmission
droplet transmission
indirect contact transmission
mode of transmission
parenteral transmission
vector borne transmission
vehicle transmission
A

parenteral

149
Q

At what point do we aim to break the chain of transmission?

A

portal of entry

150
Q

What is the easiest and most effective way to break the chain of transmission?

A

washing your hands

151
Q

What are the most common kind of nosocomial infections?

Blood
Airborne
Respiratory
Contact

A

respiratory

152
Q

name two diseases specifically addressed by the OSHA Blood-borne pahthogen standard

A

HIV and HBV

153
Q

What is the most commonly occurring nosocomial infection for lab employees?

A

HBV

154
Q

OSHA requires that all health care personnel exposed to blood and other bodily fluids must receive the vaccination series against ____

A

HBV

this must occur within 10 days of employment

155
Q

Your employer is required by law to provide the HBV vaccination to you within ____ days of initial assignment to a position where occupational exposure exists.

A

10 days

156
Q

Removing one or both gloves before draw is complete would be an example of a violation of OSHA’s ____ pathogen standard.

A

blood-borne pathogen standard

157
Q

_____ is responsible for the identification of various hazards present in the workplace and for the creation of rules and regulation to minimize exposure to such hazards.

A

OSHA

158
Q

____ sensitivity can cause allergic reactions raging from simple dermatitis to anaphylaxis. You may also see raised, red blotches form on the skin.

A

latex

159
Q

what do you do if you see raised, red blotches form on the skin after touching a patient with gloves or the tourniquet.

A

stop the blood-draw immediately and report the incident to your supervisor.

160
Q

______ is an approach to infection control to treat all human blood and certain human body fluids as if they were known to be infectious for HIV, HBV and other blood-borne pathogens

A

Universal precautions

161
Q

_____ are the minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where health care is delivered.

A

Standard Precautions

162
Q

The following are examples of what?

Hand hygiene.
Use of personal protective equipment (e.g., gloves, masks, eyewear).
Respiratory hygiene / cough etiquette.
Sharps safety (engineering and work practice controls).
Safe injection practices (i.e., aseptic technique for parenteral medications).
Sterile instruments and devices.
Clean and disinfected environmental surfaces.

A

Standard Precautions

163
Q

In the NFPA diamond what does blue represent?

Flammability
Reactivity
Special
Health

A

health

164
Q

In the NFPA diamond what does red represent?

Flammability
Reactivity
Special
Health

A

Flammability

165
Q

In the NFPA diamond what does white represent?

Flammability
Reactivity
Special
Health

A

Special

166
Q

In the NFPA diamond what does yellow represent?

Flammability
Reactivity
Special
Health

A

Reactivity

167
Q

In the NFPA diamond ___ represents minimal hazard and ___ represents maximum hazard.

A

0, 4

168
Q

In the NFPA diamond what does OX stand for?

A

oxidizer

169
Q

In the NFPA diamond what does ACID stand for?

A

acid

170
Q

In the NFPA diamond what does ALK stand for?

A

alkali

171
Q

In the NFPA diamond what does COR stand for?

A

corrosive

172
Q

RACE describes the steps for dealing with a fire. What does it stand for?

A

Rescue (patients and co-workers)
Alarm (sound the alarm and alert those around you)
Confine (confine a fire by closing the doors and windows)
Extinguish (use the nearest fire extinguisher to put out the fire)

173
Q

PASS describes how to use a fire extinguisher to put out a fire. What does it stand for?

A

Pin (pull the pin)
Aim (aim at the fire)
Squeeze (squeeze the trigger)
Sweep the base of the fire

174
Q

______ precautions are used when there is a possibility of contact with:

blood
body fluids
non-intact skin
mucous membranes

A

Standard Precautions

175
Q

The second tier of precautions is to be used when the patient is known or suspected of being infected with a contagious disease, they may be referred to as _____. This includes contact isolation, airborne precautions, droplet precautions, reverse (protective) isolation.

A

isolation or precaution techniques

Transmission-based precautions

176
Q

____ is designed to reduce the risk of transmission of microorganisms. Examples include: lice/scabies, RSV, diarrhea, herpes, impetigo

airborne precautions
contact isolation
droplet precautions
reverse or protective isolation

A

contact isolation

177
Q

____ are designed to reduce the risk of airborne transmission of infectious agents. Examples: TB, measles, chickenpox, shingles, norovirus

airborne precautions
contact isolation
droplet precautions
reverse or protective isolation

A

airborne precautions

178
Q

_____ precautions are designed to reduce the risk of _____ transmission of infectious agents. Examples: group A strep, Rubella, Pneumonic Plague, Mumps Influenza A and Pneumonia

airborne
contact
droplet
reverse

A

droplet precautions, droplet transmission

179
Q

_____ is designed to keep susceptible patients isolated as not to infect them with a disease or infection we have or may be carrying from the outside, such as burn victims.

airborne precautions
contact isolation
droplet precautions
reverse or protective isolation

A

reverse or protective isolation

180
Q

TB, measles, chickenpox, shingles, norovirus are contracted via _____ transmission

A

airborne transmission

Phlebotomy (4 decks)

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