PHLEBOTOMY Flashcards
What is RBC?
Red Blood Cells
What is WBC
White Blood Cells
What is the primary role of the phlebotomist?
the collection of blood samples for lab analysis to diagnose and monitor medical conditions
Verbal and listening skills make up _
20% of communication
Non-verbal skills contribute _
approximately 80%
Blood is analyzed in what 3 forms?
Whole blood, plasma and serum
Not all tubes are centrifuged (not spun), T or F
True
A good specimen serum/plasma will be _
pale yellow, straw like
What is Hemolyzed?
specimens that appear red because of the release of hemoglobin from RBC’s
What is Inversion?
Flipping the tube upside down
What are the causes of Hemolysis? (4 causes)
-Not allowing the alcohol to dry before drawing
-Leaving tourniquet on too long
-Not using proper gauge needle
-Not inverting tubes correctly
What is Icteric?
specimens that are yellow because of the presence of excess bilirubin
What is Lipemic?
specimens that are cloudy because of increased lipids
What is Clinical and Laboratory Standards Institute (CLSI)?
A nonprofit organization that publishes recommendations performance of lab testing, develops standard of care for lab procedures. develops laboratory standards worldwide
What is Joint Commission( JC)?
Accredits and Certifies more than 15,000 healthcare organizations and programs in the US.
What is College of American Pathologist (CAP)?
An organization of board certified pathologist advocates high quality and cost effective medical care provides lab accreditation and proficiency testing for labs, perform on site inspections
What is Health Insurance Portability and Accountability Act (HIPPA)?
It protects the privacy of your patients
What is Malpractice?
It is misconduct or lack of skill by a health care professional that results in injury to the patient
What is Negligence?
defined as failure to give reasonable care by the healthcare provider must be proved in malpractice suit
What are the 3 different forms of Consent?
Informed, Expressed and Implied
What is Informed consent?
Explain the medical procedure, possible risks and results. NON-JARGON. Patient believes HCP is competent to perform procedure
What is Expressed consent?
After HCP explains procedure patient either gives consent in writing or verbally
What is Implied consent?
gives consent to collect the blood sample by extending arm or rolling up sleeve
What is Infectious Agent?
1st stage- consist of bacteria, fungi, parasites and viruses
What is Reservoir?
2nd stage- place where the infectious agent can live and possibly multiply (human, animals and other objects)
What is Portal of Exit?
3rd stage- A way to exit the reservoir in order to continue the chain of infection (nose, mouth, or other mucous membranes)
What is Means of Transmission?
4th Stage- Once the infectious agent has left the reservoir it must have a way to reach the susceptible host (Direct, droplet, airborne, vehicle or vector)
What is Portal of Entry?
(same as portal of exit) infectious agent has been transmitted to a new reservoir it must have a means to enter the reservoir (nose, mouth, etc)
What is Susceptible Host?
This can be a patient or another health care provider, Patients have lower immune systems due to illness
What is Nosocomial?
Infection acquired by a patient during a hospital stay
What is Health Care Acquired Infections (HAI)?
An infection acquired by a patient as the result of a health care procedure that may or may not require a hospital stay
List the Departments in a hospital and what they mean (10)
-Labor & Delivery: Child Birth
-Nursery: Infants
-Pediatrics: Children
-Emergency Room: Immediate Care
-Operating Room: Surgical Procedures
-Recovery Room: Postoperative patients
-Oncology Center: Cancer Treatment
-Intensive Care Unit: Critically Ill patients
-Neonatal Intensive Care Nursery: Newborns experiencing difficulty
-Psychiatric Unit: Mentally disturbed patients
What is Assault?
threat
What is Battery?
the action
What are the 5 Isolations?
Droplet, Contact, Airborne, Vehicle and Vector
What is Droplet?
host inhales material from the reservoir such as aerosol droplets
What is Contact?
Direct contact, unprotected host touches or is touched by reservoir
What is Airborne?
Inhalation of dried aerosol nuclei circulating on air currents or attached to dust particles
What is Vehicle?
Ingestion of contaminated food or water
What is Vector?
Parasites such as malaria transmitted by mosquito bite
Negligence is bad practice, T or F
True
What are the 10 things on a phlebotomy tray?
-Needles
-Gauze
-Needle Holders
-Tubes
-Butterfly Needles( Winged Infusion Set)
-Tourniquets
-Paper Tape
-Alcohol Pads
-Transfer Devices
-Syringe: manipulate & controls the blood flow
Needles Gauges
Smaller the number the bigger the needle
Needle Gauges- 16 to 18 ___
Donor Units
Needles Gauges- 21 & 22 ___
Regular Draws
Needles Gauges- 23 & 25 ____
Butterfly needles hard sticks, often causes hemolysis
Never do what to a needle
Never re cap a needle
What is Syringe Method?
Syringe method is for fragile veins, phlebotomist can manipulate and control the blood flow. Can slowly retrieve the blood. When using syringe method always use a transfer device
When do you use Butterfly Needles? (8)
-Patients with small veins (hand or wrist)
-Pediatric patients
-Geriatric Patients
-Oncology Patients
-Restrictive Positions
-Severely Burned
-Fragile skin/veins
-Patients who specifically ask
What is Syncope?
When a patient faints
What do you first if a patient faints?
Firstly remove tourniquet
What do you do if a patient has an IV?
Draw from opposing arm if both arms have IV then have RN turn off IV (takes 15 mins) and then draw below
What are the 3 Major Veins?
Median Cubital (Vein of choice)- large and doesn’t move
Cephalic- thumb side harder to locate (lateral side of your arm)
Basilic- tendency to roll
How many times can you legally stick a patient?
Twice
In what order should patients be prioritized?
1st- STAT
2nd- TIME
3rd- Routine
What is Hematoma?
not applying enough pressure. hematoma is a bruise
What is Petechia?
Small red bumps
What is Basal State and what are 3 examples?
Ideal time to collect blood from patient, most reliable blood reading such as
- early morning (12 hours after food ingestion)
-fasting
-no exercise
What tests require the patient to be in a Basal Test?
Glucose, Cholesterol, triglycerides and electrolytes
What are the 7 areas to avoid during a blood draw?
1- Damaged veins: scar tissue
2- Hematoma: bruising
3- Edema: swelling of tissue (fluid)
4- Burns (tattoos, scar tissue)
5- Mastectomy: breast removal
6- IV: use opposing arm if on both call RN
7- Fistula: dialysis do not use that side
What is the order of draw?
-Yellow (SPS) or Blood Cultures
-Light Blue (sodium citrate)
-Serum: Red, Gold, SST & Speckled (Red/Gray)
-Green (Plasma separator tubes) Light Green (Heparin)
-Lavender (EDTA)
-Gray (Potassium Oxalate/ Sodium Fluoride)
-Yellow (ACD) Paternity
LITTLE BOY SAYS GRANDMA LETS GO
What is the order of draw for dermal puncture(finger stick)?
-Special: CBG, Blood Smear, PKU
-EDTA
-Green: Heparin
-Serum: Red, Gold
What is Thrombocytes?
Cells involved with clotting (Platelet)
What is centrifuged?
Spinning tubes
What tests are done with the light blue tube? (4)
-PT
-PTT
-Fibrinogen
-D-Dimer
What tests are done with the lavender tube? (5)
-CBC
-Hematocrit
-Hemoglobin
-Retic Count
-ESR ( sed rate)
What tests are done with pink tube? (3)
- Type of Screen
-Antibodies
-Cross Match
What tests are done with Red/Gold/Green/Gray tubes? (6)
-Glucose
-Drug Screen
-Toxicology
-Alcohol
-Cholesterol
-Cardiac enzymes
Babies should not get a heel stick 24-48 hours after birth to check for sepsis T or F?
False, they should get checked
What does FUO stand for?
Fever of Unknown Origin
What is Throught Level?
before given medication, immediately 30 mins before the next scheduled
What is Peak level?
draw right after given medication
What are ABG & CBG used for?
fundamental diagnostic tools used in the medical field to assess a patients respiratory and metabolic status
What is ABG?
measures the balance of oxygen and carbon dioxide in your blood to see how well your lungs are working.
What is CBG?
A test in which the number, type, and characteristics of blood cells are determined by examining a stained blood smear under a microscope. Normally it is a finger stick
What is GTT?
a procedure that determines whether a patient can use and store glucose normally
What is the Bleeding Time Test?
determining how long it takes for your blood to clot
What is Thrombocytopenia?
Low platelet count
What is PKU?
a blood test given to newborns one to three days after birth. usually a heel stick
What is Sepsis?
infection in blood
What is aerobic?
Oxygen (use first for syringe)
What is anaerobic?
no oxygen, usually first
What is Hemostasis?
Stoppage of blood flow from a damaged blood vessel
What is Hemochromatosis?
excessive accumulation of iron in the body
What is Hemoconcentration?
an abnormally high concentration of blood
What is Mucosal Lactose?
enzyme that breaks down lactose from milk
What is HCG?
hormone tested for pregnancy
What is Osteochrondritis?
inflammation of bone and cartilage
What is Osteomyelitis?
Inflammation of the bone caused by infection
What is Jaundiced?
Appearing Yellow
What is Iatrogenic Anemia?
a type of anemia caused by too many blood draws
If a baby is less than 1 year old they get a ____
heel stick
What is Suprapubic?
inserting a sterile needle directly into bladder
What are specimens shielded by light? (3)
-Bilirubin
-Beta-Carotene
-Folate
What are specimens placed on ice? (5)
-Ammonia
-Lactic Acid
-Acetone
-Gastrin
-Renin
What are Specimens placed on Warm Pack?
Anything with ‘Cryo-‘
-Cryofibrinogen
-Cryoglobulin
What is OSHA?
Occupational Safety Health Administration assures safe work conditions for workers by enforcing work place laws and standards
