Phlebotomy test Flashcards
5 phases of coagulation
1) Vascular (vessel constricts)
2) Platelet (cells clump to plug leak)
3) Coagulation (blood clot forms)
4) Clot retraction (clot shrinks as tear heals)
5) Fibrinolysis (clot dissolves)
6 links in chain of infection
1) Infectious agent
2) Reservoir
3) Portal of exit
4) Mode of transmission
5) Portal of entry
6) Susceptible host
Standard precautions
For all patients
Use PPE when handling bodily fluids
Airborne precautions
For infections spread via droplets SMALLER THAN 5 MICRONS
Wear respiratory protection
Droplet precautions
For infections spread via droplets LARGER THAN 5 MICRONS
Wear mask
Ex: pneumonia, streptococcal pharyngitis
Contact precautions
For infections spread through contact
Wear gloves and gown
Steps of communication cycle
1) Sender develops 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
CLIA waived tests
Tests of least complexity to perform and with a low risk for error
Low risk for incorrect result
Exposure control plan
An OSHA compliant plan that explains ways to minimize or eliminate exposure to bloodborne pathogens
PHI
Protected Health Information
Informed consent
Patient signs a consent form after having received full information about the procedure in a language with understandable terminology
Expressed consent
Patient gives this orally or in writing on a consent form
Implied consent
Patient’s actions indicate that they are giving consent
Locations not to use for venipuncture
1) ABOVE an IV catheter
2) Arm that has a fistula, shunt for hemodialysis, central venous access device
3) Arm on same side of mastectomy
4) Site that has edema, scarring or hematoma
Semen specimen collection instructions
Protect from extreme heat or cold
Must be returned to lab within 1 hour after collection
Basal state
Condition of rest and fasting, usually for at least 12 hours
Usually in the morning after waking
Hematoma
Bruise
Collection of blood under skin
Phlebitis
inflammation of a blood vessel
Random urine
Urine specimen collected at any time of day
Sclerotic
Thickened or scarred vein caused by repeated venipuncture
EDTA
Anticoagulant
Hemoconcentration
Excessive accumulation of blood into an area of the body
Usually caused by a tourniquet left on too long or a patient pumping their fist
Hemostasis
Stopping of blood flow
Hemolysis
Destruction of RBCs
Causes falsely elevated potassium levels
Can result from a tourniquet being left on too long
Iatrogenic anemia
Anemia caused by collecting too much blood
Most susceptible: older adults, children, and patients who are underweight
Transfix
To puncture through both sides of the vein
What can be used if a tourniquet is not available
Blood pressure cuff pumped to 40mm/Hg
Angle used for venipuncture
15 to 30 degrees
Conditions that newborn screenings detect
CF Hypothyroidism Phenylketonuria (PKU) Galactosemia Biotinidase Deficiency Sickle Cell Human immunodeficiency virus Toxoplasmosis
Calculating infant blood volume
1) Convert weight to kg (divide lbs by 2.2)
2) Multiply kg by 100
3) Convert blood volume in mL to L
Apheresis
Removal of blood plasma without withdrawing blood itself
Autologous transfusion
When a patient donates blood to be used for their own needs for future use
Biotinidase
Enzyme that breaks down biotin
Galactosemia
Lack of enzyme that breaks down galactose into glucose
If untreated, the infant can slowly starve to death
Hemochromatosis
High iron count
Polycythemia vera
High RBC count
PKU
- Metabolic genetic disorder
- Deficiency in hepatic enzyme called phenylalanine hydroxylase
- Causes permanent intellectual disabilities, seizures, delayed development, behavioral problems, psychiatric disorders, lightening of skin and hair, and eczema
- *PHENYLALANINE CAN BE FOUND IN MOST FOODS- IF NOT BROKEN DOWN IT CAN RISE TO TOXIC LEVELS IN INFANTS
Postprandial
After a meal
Therapeutic phlebotomy
Form of phlebotomy prescribed as treatment for patients who have polycythemia vera or hemochromatosis
Critical value
Lab test result outside the expected range that can be life threatening
Diluent
A solution that reduces the concentration of a specimen
Ex: water, saline
Point of care (POC)
At or near the patient or at the patient’s bedside
Reference Laboratory
Lab that is outside a patient care facility which can perform many more types of testing than the hospital lab
Thermolabile
Sensitive to high temperatures
EDTA tube tests
WBC
CBC
Sodium citrate tube tests
Coagulation
PTT
SST tube tests
Pregnancy Random glucose test Bilirubin (protected from light) Cold agglutinin (must be kept warm) Lipid profile
What can cause a vein to collapse?
Applying tourniquet too tight
Tests that should be protected from light
Bilirubin
Vitamin B12
Things that can cause falsely elevated potassium levels
Hemolysis
Using providone iodine
PPE that should be worn while aliquoting a blood specimen
Face mask and gloves
Chemistry department
Tests related to body chemistry
Ex: cholesterol, troponin, HDL
Hematology department
Tests related to blood count
Pathology department
Tests related to tissue samples
What should be included on injury log when a needlestick occurs?
Department where injury occurred
Type and brand of device that caused it
Brief explanation of what happened
Procedure for CPR on infant
30 compressions, 2 inches deep (3.8cm)
2 rescue breaths
Order that contaminated PPE should be taken off
Most contaminated comes off first
1) Gloves
2) Goggles
3) Gown
4) Mask
What should be included in quality control record?
Date of battery change
Classes of fire
Class A: materials like wood, paper and cloth
Class B: liquids like paint, oil and gas
Class C: electrical equipment
Class D: metals like sodium, magnesium and titanium
