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Lecture tests > Week 3 > Flashcards

Week 3 Flashcards

1
Q

When doing a blood culture test you feel which tube first and which tube second?

A

Aerobic is number one

Anaerobic is number two

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2
Q

Can a pt order their own blood work?

A

No, a pt can not.

  1. The insurance companies will not pay for it if they do.
  2. pt also cannot dx the interpret the result
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3
Q

Tear drop or palm leaf in image over pt bed

A

The baby died

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4
Q

If pt is unconscious do you silently draw?

A

No, talk to them like they are awake. They may still hear you.

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5
Q

What if the pt is not able to communicate their name and DOB

A

Ask family member or nurse

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6
Q

What is the most important step of the entire procedure?

A

Patient identification

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7
Q

What if there are any discrepancy on info?

A

“I’m sorry it’s against labeling policy”

Don’t draw!!!

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8
Q

Is it your job to explain the reason for the test?

A

No. Do not explain purpose of test-refer to MD or nurses

“I’m not really sure, you can ask the Doc or nurse”

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9
Q

If pt refuses to allow you to draw

A

Don’t force draw unless, under 18, involuntary committed (pinked), mentally challenged, demented pt (Alzheimer’s)

“Ok, but you did know Dr. Smith ordered this?”

If they still refuse tell nurse

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10
Q

Proper arm position

A

Arm straight

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11
Q

Feet and ankle draw

A

Must have MD order/permission

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12
Q

Three fav vein

A

1 median cubital

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13
Q

What does a good vein feel like

A

When palpitating with index finger it should feel like it has a good bounce to it

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14
Q

How far do you insert a needle

A

Most of the time a 1 inch needles put a little under a half an inch into the vein

Determine direction of the needle by palpitating the vein

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15
Q

If you’re having a hard time locating a vein what should you do?

A

Warm the area with A warm compress.
(Warm heat pack for eight seconds in the microwave in on the site for about a minute and bada boom a vein)

Massage in an upward motion

Gently tap area unless it is a PT or a PTT then don’t tap

Ask a more experienced coworker

Check hand veins

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16
Q

When venipuncture in hand veins and wrist what spot can you not use

A

The veins on the underside of the rest must not be used, as nerves and tendons are close to the surface of the skin in this area

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17
Q

If using an alcohol antiseptic to clean the venipuncture site comes away from the skin dirty what do you do

A

Get a new pad and continue to sanitize the area until the alcohol pads come away clean

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18
Q

What alcohol on the skin causes what

A

Causes stinging when the needle is inserted if alcohol is still wet and also can cause hemolysis to the specimen

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19
Q

Anchoring the vein helps

A

Detract from the pain

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20
Q

Failure to obtain blood by going to deep what do you need to do?

A

Pull the needle back a little bit, don’t tell the patient it doesn’t hurt.

21
Q

Tell your to obtain blood because the needle is too shallow, what are you do?

A

Tell the patient, and push it in a little bit further. Pushing in hurts so patient needs to be warned

22
Q

Failure to obtain blood, the needle has gone beside the vein. What do you tell the patient

A

This might be a little Pinchy, do I have your permission to move the needle?

Do not re-position if you are using the basilic vein

23
Q

How to prevent hemolysis

A
  • allow alcohol to dry
  • use large needles versus small needles when possible
  • invert tubes gently, handle like a raw egg
  • do not squeeze fingertip sights too hard
  • never draw from a hematoma
24
Q

Accidental arterial puncture

A

Will probably cause one of the following,

  • rapidly forming hematoma, this can cause nerve damage
  • rapid filling of tube with a pulsating movement
  • A bright cherry red colored blood
25
Q

Can you draw from bruises?

A

If the patient is not feeling pain from the bruises, yes you can draw from it.

26
Q

Troubleshooting failed venipuncture

A

“I’m sorry, I didn’t get it. I’m gonna get someone else”

27
Q

What initiates the collection process of specimens in a test request

A

A MD’s order is the initiate

28
Q

I’ll results go to who and where with the test request

A

All results go to the medical doctor and on the patient’s chart

29
Q

A requisition is what

A

Test request

30
Q

Unit secretary or clerk enters what into the computer with the requisition

A

If OP, ordered is called into lab or patient is given a requisition

Requisition may be computer generated or handwritten – contains date of birth, chart number, name, blood two colors

Computer labels are usually printed

A barcode system may be used, will be on the requisition, this is almost completely eliminates errors

31
Q

Information needed on the requisition (req)

A

MD name

Pt name

Pt MR #

Pt address

Pt dx

Pt DOB

Room and bed, if IP

Test request, will be checked off

Date and time to be collected

32
Q

What should you bring into the room if PT is confused

A

If PT is confused in anyway such as a psych pt shouldn’t bring only needed equipment

33
Q

What is the percentage of wristbands with errors on them

A

An average 13% of all wristbands have errors on them.

Always double check and do not drive if there’s any discrepancy

34
Q

Before collecting a lipid profile, LP or a fasting blood sugar, FBS what do you need to do

A

Verify any dietary restrictions were followed by the Pt. If not do not draw

35
Q

Supplies needing to be within reach

A

Gloves, tourniquet, alcohol prep, cars, needle, tubes for test, sharps container, bandage or paper tape, marker or pen

36
Q

Apply the tourniquet where

A

Approximately 3 to 4 inches above the desired venipuncture site and over clothing if you can

37
Q

What is the most common site for venipuncture draw

A

The antecubicle space (Front of elbow)

38
Q

Hand veins

A

Use only as the last resort, save for IV sites

Tight anchoring is very important, as hand veins have a tendency to roll because there’s not much surrounding tissue to support the vein

Butterfly, winged needles are preferred

39
Q

Cleansing the site is necessary because

A

To prevent microbial contamination of specimen and Pt

The site is not sterile

40
Q

How to insert the needle

A

Insert at a 15 to 30° angle using one smooth motion.

41
Q

Reason that a specimen may be rejected by the lab

A

Label not attached to sample

Label missing information, like date time and initials

Specimen not in correct tube

Coagulation tube not 90% full

Specimens are hemolyzed

Results not consistent with previous results (need to be recollected)

42
Q

Which of the following is required requisition information

A

Type of test to be performed

Do not need ordering physician’s name

43
Q

Following tests have been ordered for different patients and you receive them at the same time. Which test would you collect first?

A fasting glucose
B stat glucose in the ER
C stat hemoglobin in ICU
D asap CBC in ICU

A

B stat glucose in ER

44
Q

If anyone is in the PT’s room and the order is not a stat what do you do

A

Come back later

45
Q

Arriving to draw from an IP within NOP order who is eating breakfast to draw a fasting glucose what’s the best thing to do

A

Consult with the patient’s nurse to see if the specimen should be collected

46
Q

Where is the tourniquet it applied when drawing a hand vein

A

Proximal to the wrist bone

47
Q

If you have a cold or are feeling ill how do you draw from an older patient

A

Wear a mask over frame from drawing altogether

48
Q

Proximal

A

situated nearer to the center of the body or the point of attachment.

Towards the center of the body or attachment point

49
Q

Distal

A

situated away from the center of the body or from the point of attachment.

Away from the body center

Lecture tests (11 decks)

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