study guide Flashcards
heel sticks are done on neonates for what screening?
PKU
when doing a venipuncture on a child, whom should you explain the procedure to?
parents/caregiver & the child
what is the deepest length of a lancet for a newborn heel?
2.0 mm
what test specimen should be protected from light?
bilirubin concentration
dorsal veins blood collection uses a vein in a patient’s?
hand
after cleaning the site with antiseptic, what should you do?
let air dry
what color tube would be best for a bilirubin on an infant?
amber
what test would be collected in a lavender tube?
HGa1c
what is the amount of times a phlebotomist can stick a patient?
twice
what type of antiseptic should the phlebotomist use when collecting a capillary specimen on a patient?
70% isopropyl alcohol
what pair of blood test is most infected by fasting
glucose and triglycerides
what is the anticoagulant for hematology?
EDTA
the phlebotomist is asked to draw a CMP, glucose, A1C, CBC, PT/PTT. what is the correct order of draw?
light blue, gold, lavender, grey
where is the safe area for a heel stick on an infant?
medial or lateral portion of the plantar surface
the phlebotomist is using a venipuncture collection method, what is the order of draw?
sodium citrate, SST, sodium heparin, EDTA
what test specimen would be required to go on ice?
ammonia
what is a form of consent from a patient?
patient offers their arm to the phlebotomist
the phlebotomist is drawing blood out of a cephalic vein, where is this vein located?
outer edge, thumb side
what is the yield of a mint green tube top?
plasma
what will occur if you squeeze too vigorously during a capillary puncture?
hemolysis
after drawing a light blue tube top, how many times should it be inverted?
3-4 times
what is the most critical step in phlebotomy?
patient identification
what are the minimum requirements when labeling patient specimen?
phlebotomist initials
what color tube should you draw if you need serum?
red
what will happen if the tourniquet is left on for too long?
hemoconcentration
what type of angle and way does the needle face for a venipuncture draw?
bevel up, 15-30 degree angle
what would be tested in a blood culture?
Septicemia (bateria) & fungi
what is a hospital acquired infection called?
nosocomial infection
what is the most single important way to prevent the spread of infection?
washing your hands frequently
a phlebotomist has a requisition form for a 70-year old female patient with diabetes who has had a mastectomy of the left breast. which side should the phlebotomist draw on?
right arm
which container should all used needles be disposed in?
sharps container
what is not an infection control method? a. handwashing. b. protective clothing. c. biohazard container. d. sphygmomanometer
d. sphygmomanometer
a blood bank tube that contains ___ is ____?
a blood bank tube that contains EDTA is PINK
lancets are used to collect what types of blood samples?
capillary or skin puncture
adult capillary punctures most often involve use of the ____ finger(s)
third and fourth (middle and ring)
what is known as the blood clotting process?
hemostasis
what test needs to be placed on ice?
ammonia
before entering a designated isolation room, phlebotomist should always do what?
check requirements on signs
forcing venipuncture on a patient who has refused would be considered what?
battery
if a patient has fainted, and the phlebotomist is not attending the patient, it would be considered what?
negligence
broken glassware that may be contaminated should be picked up by?
mechanical mean (broom/dustpan)
what is basal state?
patient has fasted for 12 hours
light blue tops (always filled to top) are used for what?
coagulation
name 3 examples of a HIPPA violation
- giving out patients information without their permission
- disposing test tube with patient information in regular trash
- disposing health/medical records in incorrect bins
a patient has received their lab results and asks the phlebotomist with help for interpretation, what should the phlebotomist do?
refer the patient to the physician for interpretation of all results
a CMP is ordered for an adult whose veins continues to collapse despite drinking water. what needle is the best collection method for this patient?
23 gauge butterfly needles
what regulation set the minimum standards for medical laboratory practice and quality?
CLIA
what organization makes on-site visits to inspect laboratories?
CLIA
what standards are being violated when a phlebotomist fails to use proper hand washing precautions?
OSHA
when disposing of hazardous material, the phlebotomist must adhere to the guidelines and standards set forth by who?
OSHA
to clean up a blood spill, the phlebotomist must use?
10% bleach solution
what of the following is done first when ending a phlebotomy procedure?
remove the tourniquet with one hand
a collapsed vein is caused by?
too much vacuum
use your index to ___ for a vein
use your index to PALPATE for a vein
what is the correct way to collect a blood culture
aerobic (first), anaerobic (second)
what test would you NOT use alcohol?
alcohol
anticoagulant must be mixed by inversion, how many times?
8-10 times
what is a hematoma
bruise
what tube will be a short draw when put on first, when drawing with a winged infusion set (butterfly needle)? and why?
light blue tube, you must clear air in butterfly needle with discard tube (red top) because light blue must be filled to top
when performing a blood smear, what should a phlebotomist take to ensure a quality result?
- hold slides at 30 degrees to each other when performing the smear
- draw sample using lavender tube
- create a feathered edge
a 30 year old male patient has measles and is on airborne precaution, what is required to enter the room?
N95
what needle gauge is the most commonly used in phlebotomy?
21g
what are the causes of hemolysis?
- alcohol used to clean, not allowed to dry
- finger or heel squeezed to vigorously
- blood scraped off, instead of allowing to flow into microcollection container
OSHA requires training and educational info be given to phlebotomists on all but what topic?
preventing identification errors
according to standard precautions, blood and body fluid from which groups are considered biohazardous?
- IV drug users
- chemo patients
- patients who are HIV positive
under standard precaution, all used needles are to be disposed of how?
discarded intact
what color tube should a SST be collected in?
red/tiger top
what is the difference between plasma and serum?
plasma contains fibrinogen; serum does not
what precaution should be used with a patient that has tuberculosis?
airborne precaution
the destruction of red blood cells is known as what?
hemolysis
a green stoppered evacuated tube contains what kinds of anticoagulant?
sodium heparin
the tourniquet should be applied how many inches above the propped venipuncture?
3 to 4 inches
if a phlebotomist has questions about disposing of outdated hazardous chemicals, where should they look to find this information?
MSDS
what would be considered a hospital acquired infection?
- a patient who contracts MRSA infection from a venipuncture
- urinary tract infection from a catheter
- sepsis from I.V. lines
what standards are being violated when a phlebotomist fails to use proper handwashing technique?
OSHA
a physician orders a HCG, CMP, type & screen, CBC, D-dimer. what is the correct order of draw?
light blue, gold, mint green, lavender, pink
the phlebotomists will be drawing a set of blood culture bottles. the tops of the bottles MUST be cleaned with:
70% isopropyl alcohol
a 19 year old patient comes in and offers her arm to the phlebotomist when she comes in with a venipuncture tray. this is an example of
implied consent
the phlebotomist has chosen to draw from the vein on a bariatric patient that is located on the outer thumb side of the arm. what is this name of this vein called?
cephalic
after blood collection, the phlebotomist labels the patient’s specimen, what information does the phlebotomist need to make sure is on the label?
patients numeric ID & phlebotomists initials
what piece of equipment is needed, in addition to standard precaution, when seeing a patient who is on airborne precautions?
N95
in order for hemostasis to occur, what is needed?
thromocytes
when handling a urine specimen that a patient collected, what should the phlebotomist use for protection
face shield
what is the medical term for red blood cells (RBC)?
erythrocytes
when performing a blood smear, A ___ tube with ____ is used
when performing a blood smear, a LAVENDER tube with EDTA is used
what would cause a hemolyzed specimen
excessively shaking the tubes & not allowing antiseptic to dry
what is used with collecting a sputum collection
phlegm
what additional information is required on the requisition form?
date & time of collection
the patient is on a medication called acetaminophen, what panel would this affect?
lipid
which of the following needs to be drawn first: ASAP, STAT, fasting, timed.
STAT
which laboratory employee has the most education?
pathologist
the medical assistant should instruct the patient obtaining a 24 hr urine collection to do what?
discard the first morning sample
when a medical assistant is speaking with a patient, making direct eye contact encourages what?
open communication
what is the chain of custody?
documentation process that protects evidence from contamination and tampering
what test is ordered to confirm hyper or hypoglycemia
OGTT
what test would be used for coagulations studies
PT/APTT
what needs to be on a requisition form
- ordering physicians info
- patients DOB
- patients first & last name
what color top tubes will the phlebotomist need to perform D-dimer, CBC, and CMP
light blue, gold, lavender
when performing a 3hr glucose tolerance test, it is a phlebotomist responsibility to verify that the patient has fasted for what amount of required length of time
8-12 hours
a phlebotomist should comply with HIPPA for what?
a patients information
the thinnest area of a blood smear, where the testing is actually done
feathered edge
12 hour fast is required for testing this
triglicerides
the use of gloves is mandated by who?
OSHA
what is the color tube that contains heparin
green
what is the color tube used for CBC’s (complete blood count)
lavender
reference values are higher for this test in capillary specimens
glucose
this is acceptable to drink when fasting for labwork
water
what is the specimen from an unclotted tube after being spun in the centrifuge and what does it contain?
the yields plasma and contains an anticoagulant
what is the medical term for fainting
syncope
the complication of a heel puncture that is too deep
osteomyelitis
pink top tubes are primarily used for?
blood bank
the sharp pointed device used for finger and heel sticks
lancet
tube used for most serum specimens
SST (tiger top/gold)
the part of the syringe that shows measurements in cc or ml
barrel
the slanted tip of the needle
bevel
medical term for heel bone
calcaneus
the composition of capillary blood more closely resembles ____ blood
arterial
the color tube used for glucose tests
grey
to examine by touch or feel for a vein is to?
palpate
what is the stopper color for the tube used in coagulation studies
light blue
the name of the anticoagulant in a lavender tube top
EDTA
____ is an anticoagulant
oxalate
the blood automatically fills the tubes because of a premeasured what?
vacuum
