Deck 1 Flashcards
(110 cards)
1
Q
Petechiae
A
Tiny non-raised red spots that appear on skin from rupturing capillaries due to tourniquet being left too long or too tight.
2
Q
Order of draw
A
Yellow, Light Blue, Red, Red Marble, Green, Light Green, Lavender, Pink/White/Royal Blue, Gray, Dark Blue
3
Q
Quality Assurance
A
Scheduled audits
4
Q
Negligence
A
Failure to exercise standards of care
5
Q
Providone-iodine
A
For collections that require more stringent infection control such as blood cultures and arterial punctures.
6
Q
Chlorhexidine gluconate
A
For pts allergic to iodine
7
Q
Antiseptic
A
70% isopropyl alcohol pads
8
Q
Osteomyelitis
A
Inflammation of bone and bone marrow
9
Q
Lancet
A
Safely delivers pre-determined depth ranging from 0.85mm for infants to 3.0mm for adults.
10
Q
Forearm veins for venipuncture
A
Baslic, Cephalic, Median Cubital, Accessory Cephalic, Intermediate Antebrachial, or Intermediate Basilic Veins.
11
Q
Cannula
A
Large needle
12
Q
Tortuos Veins
A
Winding or crooked veins susceptible to infection because blood flow is impaired
13
Q
Fistula
A
Permanent, surgical connection between artery and vein. Used for dialysis but never for venipuncture due to possibility of infection.
14
Q
Collapsed vein remedy
A
- Pop vacutainer off needle and let vein refill then replace tube back on needle and allow to fill more, repeat until tube is full. Hold needle in vein very still. 2. Move needle to one side then other and up and down very slightly to be sure it is not just that bevel is against the vein wall. 3. Use smaller vacuum tube. 4. Remove tourniquet, withdraw needle and select another vein. 5. Use syringe or butterfly.
15
Q
Missed 1st stick remedy
A
- Don’t pull needle out, look for vein, often you can make out purple color of vein on either side of needle, withdraw needle slightly and re-enter vein at different angle. 2. If draw needle back to re-direct and lose vacuum, don’t pull out completely, replace tube with new one and continue the draw.
16
Q
Vasovagal Syncope
A
Pt faints or experiences dizziness before, during or after venipuncture. Pts with low diastolic or high systolic BP.
17
Q
Septicemia
A
Systemic infection associated with presence of pathogenic microorganisms in blood stream
18
Q
Bleeding Time Test (BTT)
A
Medical test to assess platelet function, involves making pt bleed then timing how long takes to stop bleeding, thin paper placed over incision, how quickly blood reaches rings is timed to determine coagulation properties.
19
Q
Venipuncture problems
A
Failure to obtain blood, Inappropriate puncture site, Scarred/Sclerosed veins, Rolling veins, Collapsing veins, Hematoma, Premature needle withdrawal, Fainting.
20
Q
Venipuncture complications
A
Hematoma, Hemoconcentration, Petechiae, Phlebitis, Thrombus, Thrombophlebitis, Septicemia, Trauma.
21
Q
Hemostasis
A
Process by which blood vessels repair after injury, causes bleeding to stop.
22
Q
Hemostasis stages
A
- Vascular phase (injury) 2. Platelet phase (temporary platelet plug) 3. Coagulation phase (stable fribrin clot) 4. Fibrinolysis (plasmin enzyme breaks down clot promoting tissue repair)
23
Q
Fibrin Degradation Product (FDP)
A
Measure rate of fibrinolysis
24
Q
Most critical mistake Phlebotomist could make
A
Failing to properly ID pt
25
Vein most commonly used for venipuncture
Median cubital vein
26
Easiest vein to palpate on obese pt
Cephalic vein
27
Tourniquet tied how many inches above puncture
4" - 6"
28
Most important thing to do if pt faints during venipuncture
Withdraw the needle
29
What happens during vascular phase of hemostasis
Vein constricts and slows blood flow
30
Basal state
Fasting
31
Diurnal variation
Different during day vs night
32
Digoxin
For cardiovascular disease
33
Trough
Lowest chemical blood level
34
Peak
Highest chemical blood level
35
Cold agglutinins
Antibodies produced in response to mycoplasma pneumonia infection (atypical pneumonia)
36
Warmed specimens
Specimens required to be kept warm until serum is separated from cells to keep cold agglutinins from attaching to RBCs at temps below body temp, collected in red-top tube pre-warmed at 37 degrees Celsius for 30 mins.
37
Specimens requiring chilling
Ammonia, Lactic acid, Arterial blood gas (ABG), Gastrin, Glucagon, Parathyroid hormone (PH), Partial Thromboplastin Time (PTT), Prothrombin Time (PT)
38
Specimens requiring warming
Cryoglobulin, Cryofibrinogen, Cold Agglutinin
39
Specimens requiring protection from light
Bilirubin, Vitamin B12, Carotene, Red Cell Folate, Serum Folate
40
Purpose of chilling specimen
Prevents separation
41
Therapeutic drug monitoring
Monitoring trough and peak levels, chemical levels in blood
42
Plasma
Liquid portion of un-clotted blood still contains clotting factor
43
Serum
Liquid portion of blood allowed to clot, clotting factor no longer present, they've been used to clot blood
44
Tubes with anticoagulants
Plasma tubes=Lavender, Green, Blue, Light Blue, Gray
45
Tubes without anticoagulants
Serum tubes=Red, Tiger
46
Clinical Laboratory Standards Institute (CLSI)
Defines order of draw to minimize cross-contamination
47
FUO
Fever of unknown origin
48
Sterile bottles
Lab: Microbiology
Additive: Nutrient broth
Symptoms: Systemic infection, FUO
Test: Blood Culture (BCx), 2 aerobic & 2 anaerobic bottles, ordered STAT, site cleansed with iodine, butterfly needle, keep bottle upright
To determine presence of pathogenic or infectious microorganisms in blood
49
Light blue top
Lab: Hematology
Additive: Sodium Citrate, anticoagulant
Yields: Plasma
Test: Prothrombin Time (PT) evaluates extrinsic system of coagulation cascade for pts on Coumadin regimen, Partial Thromboplastin Time (PTT) evaluates intrinsic system of coagulation cascade for pt on Heparin regimen, Activated Prothrombin Time (APTT)
Light blue top filled completely, 9 parts blood to 1 part additive, inverted 3-4 times, draw red top prior even if requisition does not request it to prevent thromboplastin from entering tube
50
Red top
Lab: Chemistry
Additive: None
Yields: Serum
blood clots naturally within 30-60 mins, often used as "discard" tube to prevent sample contamination, no need to invert
51
Tiger top
Lab: Chemistry
Additive: Silica, clot activator & Thixotropic,separator gel
Yields: serum
SST (Serum Separation Tube), invert 8 times
Test: BMP (Basic Metabolic Panel)-general info of metabolism, kidney function, electrolytes & fluid balance. CMP (Complete Metabolic Panel)-more comprehensive BMP test with liver function & performance.
52
Mint Green top
Lab: Chemistry
Additive: Lithium Heparin, anticoagulant & Thixotropic, separator gel
Yields: Plasma
PST (Plasma Separation Tube), invert 8 times
Inhibiting thrombin in coagulation cascade
Test: STAT Electrolyte-renal & endocrine conditions, low electrolyte indicates arrhythmia & tachycardia, high level indicate heart failure. HCg (Human Chorionic Gonadotropin)
53
Dark Green top
Lab: Chemistry
Additive: Sodium Heparin, anticoagulant
Yields: Plasma
Inhibiting thrombin in coagulation cascade, no gel
Test: Ammonia-indicates liver malfunction, liver converts ammonia into urea to be expelled from body
54
Lavender top
Lab: Hematology
Additive: EDTA (Ethylenediaminetetraacetic Acid), anticoagulant
Yields: Plasma
inhibits coagulation by binding to calcium, must fill 2/3, invert 8 times
Test: ESR (Erythrocyte Sedimentation Rate. Sickle Cell Screening. CBC (Complete Blood Count)-evaluates formed cellular elements
55
CBC (Complete Blood Count)
Evaluates formed cellular elements: WBC count, WBC differential, Hematocrit, Hemoglobin, Platelets, Differential counts
56
Hematocrit
Measures volume % RBC in blood, done before whole blood donation
57
Hemoglobin
Measures amount O2 carrying protein in blood, done before whole blood donation
58
Pink top
Lab: Blood Bank
Additive: EDTA, anticoagulant
Yields: Plasma
Larger volume of blood required for blood banking
Test: TSR (Type & Screen)-blood typing. Cross-match-determine if donor blood compatible to recipient
59
Gray top
Lab: Chemistry
Additive: Sodium Fluoride, antiglycolytic agent & Potassium Oxalate, anticoagulant
Yields: Plasma
Sodium Fluoride prevents breakdown of sugar x3 days. Potassium Oxalate prevents clotting by binding to calcium. Invert 8 times.
Test: OGTT (Oral Glucose Tolerance Test)-evaluate blood sugar, 3 hr: hypergycemia, diabetes mellitus, 5 hr: hypoglycemia, carb metabolism, gestational diabetes. Lactic Acid-indicates improper oxygenation
60
OGTT (Oral Glucose Tolerance Test)
Evaluate blood sugar
3 hr: hypergycemia, diabetes mellitus, 4 draws: baseline, 1 hr, 2 hr, 3 hr past glucose administration
5 hr: hypoglycemia, carb metabolism, gestational diabetes
61
BAC
Blood Alcohol Concentration
62
Royal Blue top
Lab: Toxicology
Additive: None/EDTA
Yields: Serum/Plasma
Drawn in order of additive. Royal Blue with red stripe, no additive, yields serum, drawn after light blue tube before serum tube. Royal Blue with blue stripe, EDTA, yields plasma, drawn after lavender tube.
Test: Pb Lead poisoning. Heavy Metal Toxicology
63
ABG (Arterial Blood Gas)
Determine blood gas & pH, drawn by respiratory therapist, nurse or dr from radial artery on thumb side, must run within 15 mins of collection
Test: pH. CO2. O2. Bicarbonate.
64
PKU (Phenylketonuria)
Detect genetic disease causing mental retardation & brain damage
65
Plasma tubes
Light Blue, Mint Green, Dark Green, Lavender, Pink, Gray, Royal Blue (with EDTA)
66
Serum tubes
Red, Tiger, Royal Blue (w/o additive)
67
CBC requires 2 tests before whole blood donation
Hematocrit & Hemoglobin (H&H)
68
N95 respirator
PPE used to protect from liquid and airborne particles contaminating the face
69
What does Hematocrit and Hemoglobin test for?
Anemia
70
What does the presence of Tropinin and CK-MB indicate?
MI (Myocardial Infarction), heart attack
71
Body Systems
(12) Skeletal, Muscular, Nervous, Urinary, Reproductive, Circulatory, Respiratory, Cardiovascular, Lymphatic, Endocrine, Digestive, Integumentary
72
When would you not do a foot or leg blood draw?
On a cardiac or diabetic patient
73
What does it mean to follow Standard Precautions?
Consider all samples as hazardous or infectious
74
Name 3 laws that govern phlebotomy
OSHA, MSDS, JCAHO
75
JCAHO
Joint Commission Accreditation Healthcare Organization-outlines pt and employee safety
76
What tube top color is used for crossmatching?
Red or Pink
77
How does a cut heal?
Coagulation cascade: coagulation factors interact in sequence, platelets form plug, prothrombin to thrombin, activates fibrinogen to fibrin, forms permanent plug until cut heals, Ca needed
78
Pink top tubes are tested in what lab
Blood Bank
79
What is the function of Sodium Fluoride
Prevents breakdown of sugar
80
Hematology
Study of formed elements (RBC, WBC, platelets) by studying cells, disorders and infections.
81
Hemostasis
Healing process
82
Chemistry
Largest and most automated section of lab. Includes Electrophoresis, Toxicology, Immunochemistry.
83
Electrophoresis
Analyzes chemical components of blood such as hemoglobin, serum, urine and cerebrospinal fluid based on differences in electrical charge
84
Toxicology
Analyzes plasma levels of drugs and poisons
85
Immunochemistry
Uses techniques such as Radio Immunoassay (RIA) and enzyme immunoassay to detect and measure substances such as hormones, enzymes and drugs
86
Blood Bank
Where blood is collected, stored and prepared for transfusion.
87
Serology (Immunology)
Performs tests to evaluate pts immune response thru production of antibodies. Analyzes presence of antibodies to bacteria, viruses, fungi, parasites and autoimmunity.
88
Microbiology
Responsible for detection of pathogenic microorganisms in pt samples and for hospital infection control
89
Culture and Sensitivity (C&S)
Used to detect and identify microorganisms and determine most effective antibiotic therapy
90
Urinalysis section
Performs tests on urine to detect disorders and infection of kidney, urinary tract, metabolic disorders (DM) and drug abuse
91
What color tube top is used for blood smear
Lavender
92
Diff-Safe
Punctures tube stopper and dispenses blood drop instead of uncapping and recapping blood tube for smear preparation
93
Function of circulatory system
Delivers 02, nutrients, hormones and enzymes to cells and transport C02 and urea to lung and kidneys where they can be expelled from body
94
How long does it take blood to make complete circulation in body
1 minute
95
Average person weighing 155 lbs has how much blood
5-7 liters
96
When blood volume in right atrium reaches ____ the blood drops thru tricuspid valve into right ventricle.
40 mL
97
Only artery to carry deoxygenated blood
Pulmonary artery
98
Mitral valve
Bicuspid valve
99
Pulmonary circulation
Arteries carry deox blood away from heart and veins carry ox blood back to heart.
100
Systemic circulation
Arteries carry ox blood away from heart and veins carry deox blood back to heart.
101
Blood vessels
Aorta, arteries, arterioles, capillaries, venules, superior and inferior vena cava.
102
Blood vessels composed of 3 layers
Tunica Adventitia (outer connective), Tunica Media (middle smooth muscular), Tunica Intima (inner endothelial)
103
Capillaries
Microscopic blood vessels composed of 1 endothelial layer, connects arterioles and venules, allows rapid exchange of 02, C02, nutrients and waste between blood and tissue cells. Capillary blood mixture of arterial and venous blood.
104
Components of blood
Plasma 55%, RBC, platelets, WBC 45%
105
Plasma
Clear, pale yellow fluid carries nutrients, lipids, glucose, sodium, magnesium, calcium, potassium, 02, C02, nitrogen, antibodies, vitamins and hormones.
106
Blood cells originate from
Stem cells in bone marrow
107
Platelets (thrombocytes)
Small irregularly shaped packets of cytoplasm formed in bone marrow
108
There are ___ to ___ million RBCs per microliter of blood
4.2 to 6.2
109
Normal life span of a RBC
120 days
110
How long does it take for RBCs to regenerate after blood donation
6-8 weeks
