Week 2 Flashcards
If you raise the bed, drop the rails or make a change to the bed to protect your back how do you leave it?
The way you found it
Phlebotomy tray can be put down anywhere in the room
No, it cannot be put on any food or Pt surfaces
An outpatient drawing station should contain what
Clean private quiet environment
Supply table
Special phlebotomy chair
Had a table for heelsticks and other procedures
Can you draw from a chair without arms
No
Are most gloves sterile
No, and they do not need to be but they must be a good fit
Hand Sanitizers
CDC Guidelines recommend use of alcohol-based hand sanitizer routine decontamination of hands
What is a SEESIP
A needle or tube holder that has a safety device, it is an OSHA acronym for a sharps with engineered sharp injury protection
Light blue stopper
2 in draw order
The additive is sodium citrate
The department is coagulation
Red stopper glass tube
Sterile tube
3 in draw order
No additive
Department is chemistry, blood bank, immunology
Red stopper plastic tube
3 and draw order
Additive is clot activator
Department is chemistry
Red/light gray stopper
3
No additive
No department, discard tube only
Red/black or red/gray
And gold stoppers
4 and draw order
Additive is clot activator and gel separator. SST
Department is chemistry
light green stoppers
5 in draw order
Lithium heparin and gel separator are the additive
PST
Chemistry is the department
Dark green stopper
6 in draw order
Additive is lithium heparin or sodium heparin
Department is chemistry
Lavender stopper
7 in draw order
EDTA is the additive
Hematology is the department
Pink stopper
7 in draw order
EDTA is the additive
Blood bank is the department
Gray stopper
8 in draw order
The additives are potassium oxalate/sodium fluoride, EDTA/sodium fluoride, and sodium fluoride
Department is chemistry
Royal blue stopper
7 in draw order
Additives can be none, EDTA, sodium heparin
Department is chemistry
The order of the draw
Young lads really shouldn’t put gum in ladies garments
- blood culture tubes or vials (sterile yellow or blood culture bottles)
- coagulation tubes (light blue tops)
- Serum tube with or without clot activator or gel (Red, gold, or speckle topped tubes)
- Heparin tubes (light green and dark green tubes)
- EDTA tubes (lavender, tan, royal blue top tubes)
- Oxalate/fluoride tubes (Gray top tubes)
What must you always do before using a tube
Always check the expiration date, and never use a tube that has been expired or dropped
Which additive prevents glycolysis?
Sodium fluoride
Mixing an additive correctly involves turn in the wrist this many degrees back in again
90°
Antiseptics
Antiseptic’s are to be used prior to all skin punctures
- 70% isopropyl alcohol, usually individually wrapped
(Do not use if drawing and alcohol level)
- Povidone – iodine, can be a swab, bottle or ampule
Disinfectants
Bactericidal, kill bacteria
Used on surfaces to kill bacteria, not safe for skin
A dilution of 1:10 of household bleach is used to kill viruses on surfaces and clean blood
A Tuurniquetcan be what
A blood pressure cup pumped up to 40, or a normal tourniquet
What happens if you leave a tourniquet on for more than a minute?
You have to take it off and wait two minutes before you can use that arm again. Or go to the other arm
21 gauge needle is what color
Green, this is Laura’s favorite
22 gauge needle is what color
Black
Hemolysis
When blood cells rupture,
this is a problem because potassium is located inside RBC’s and when the blood cells rupture I can affect the potassium in the RBCs and give erroneous results
Normal range of potassium
3.2–5.0 is the normal range of potassium
What makes anything not sterile, needles, holders, tubes, hands, etc.
– If it gets wet
– If it falls below the waist
– If it touch a non-sterile object
– Droplet transmission occurs nearby (talking, laughing, coughing, sneezing, etc.)
PPT
Partial thrombosis time
EDTA
ETHYEN-DI-A-MINE-TET-RAA-CE-TIC
EDTA is increasingly being used for blood tests why
It preserves cell morphology (cell structure)
How does EDTA work as an anticoagulant
EDTA binds with Ca so the clotting cascade is interrupted
SST
Serum separator tube
Red/gray tube and gold hold SST
When does the peak level of cortisol occur
8 AM
A thrombosed vein feels like what
They feel hard and cord like one palpitated
Petechiae, tiny red spots that appear in a patient’s arm when the Turnock it is applied or signs that the site may?
Bleed excessively
Iatrogenic anemia
Removing blood on a regular basis or in large quantities can lead to iatrogenic anemia in some patients especially infants
Edema
When an appendage of the Pt is swollen with excessive fluid’s
A patient has several short links of IV type to being protruding from his chest. This is most likely a
CVC,
Central venous catheter
How long does it take for hemoconcentration to occur at the puncture site
Only one minute of the tourniquet being on.
A bariatric phlebotomy chair is designed for individuals who are
Overweight
And AV fistula is most commonly used for?
Dialysis access
AV fistula
Permanent surgical fusion of an artery and vein that is typically created to provide access for dialysis
Normal range percentages come from what
95% of adults in a healthy state create the normal range
Circadian variations can cause fluctuations throughout the day and play a role in results.
Aldosterone, Bilirubin, cortisol, hemoglobin, insulin, iron, potassium, testosterone, and RBCs may all be elevated in the morning
Creatine, glucose, growth hormone, triglycerides, and phosphate, are normally lowest in the morning.
A basal state is?
Resting metabolic state of the body
The best ideal time to draw blood
Lipemic specimens appear
Lipemic means a high fat content in the blood which one put in the centrifuge will look white & milky or turbid (Brown and chunky)
Hi altitude creates more RBC because
The oxygen level is lower and higher altitude so you need more RBC
What happens to blood elements when you’re dehydrated
Blood is more concentrated there for the elements within the blood are concentrated and can cause erroneous results
Hemoconcentration
Lymphedema
Swelling one lymph nodes are removed
Hematoma
Blood filled bump
Like a blood blister or and goose egg on your head
Mastectomy
You can never ever ever draw from an arm on the same side as the surgical removal of a brass unless done with the physicians permission.
This can cause lymphedema
There’s been a double Mesec to me you choose to draw from the arm with physicians approval where the mystic to me was done the longest time ago
One drawing blood always ask
OK to use this arm?
A – line
An arterial line also called and a- line
And arterial line as a catheter placement in an artery used to provide accurate and continuous measurement of the patient’s blood pressure also used to collect blood gases another blood specimens.
Do not perform a venipuncture on this arm or apply a tourniquet
