Final Flashcards
(56 cards)
1
Q
Explain the difference between serum and plasma.
A
- Plasma The liquid portion of the blood without the cells when blood is spun down in a tube with the anitcoagulants
- Serum the liquid portion of blood after clotting has occurred, fibrinogen is contained within the clot so therefore is NOT present in the serum
2
Q
What is the primary function of the anticoagulant sodium fluoride?
A
- it also inhibits Glycolysis
3
Q
State the anticoagulant of choice for the following types of tests:
a. Hematology:
b. Coagulation :
c. Chemistry:
A
a. Hematology: EDTA (Lavender Stopper Tubes)
b. Coagulation : Sodium Citrate (Light Blue Stopper Tubes)
c. Chemistry: Heparin (Green Top)
4
Q
Why is freezing whole blood not normally recommended to preserve a specimen?
A
-Cannot normally freeze RBC because they will Hemolyze
5
Q
What are the two primary reasons patients are placed in isolation rooms?
A
- To protect the health care staff, visitors and other PT from what the PT has
6
Q
How does EDTA prevent clotting? (Ethylenediaminetetraacetic acid)
A
- Prevents coagulation by binding or chelating calcium in the form of potassium or sodium salt
7
Q
How does heparin prevent clotting?
A
- Prevents coagulation by inhibiting the conversion of prothrombin to thrombin (anti-thrombin or neutralizes thrombin)
8
Q
- Describe the sites for capillary puncture on an adult. Where would you NOT want to perform capillary puncture? What is the preferred area on a finger for puncture?
A
- No thumb, index finger , pinky finger
- Perendicular to the finger print on the side
- NOT on the ear lobe
9
Q
- What is a hematoma and what causes it (give scenarios as far as placement of needle)?
A
- Hematoma is caused by blood leaking from the vein into the tissues resulting in the formation of a bruise, usually caused by puncturing through the vein, partially inserting
10
Q
- State the consequences of pushing a tube onto the needle BEFORE entering the patient’s vein.
A
- Could risk puncturing the stopper and releasing the vacuum from the tube
- Contamination
11
Q
- Explain the purpose of removing the tube from the needle prior to withdrawing from the patient’s vein.
A
-to release the vacuum in the tube
12
Q
- What are clot activators and what are some examples of these?
A
- substances that initiate or enhance coagulation
- Ex. Glass, silica, siliceous earth, thrombin
13
Q
- What does a sclerosed vein feel like when palpated? Should you use these veins?
A
- Sclerosed veins feel Hard, and should not be used (scarred)
- Do not use them, hard to the touch
14
Q
- What is edema?
A
- Swelling
15
Q
- What is a fistula? Why are these important to consider when deciding on site selection for venipuncture?
A
- Is a direct communication between an artery and a vein
- No blood pressure cuff or tourniquet can be applied to that arm
16
Q
- Explain what a bevel is and what abnormalities you need to look for on them before venipuncture is performed.
A
- Tip of the needle, looking for bent, spurs or blocked bevel before sticking
17
Q
- Why are therapeutic drug monitoring tests often timed collect testing?
A
peoples bodies metabolize drugs at different rates
- maximize its effectiveness of its dosing and prevent toxicity
18
Q
- What is the correct anatomical term for the heel bone?
A
CALCANEUS
19
Q
- What does skin puncture blood most closely resemble?
A
-arterial blood
20
Q
- Explain why routine or strict isolation is used. What protective equipment must be worn?
A
- To stop the spread of communiciple disease
- Wear Gloves, Mask, Lab Coat
21
Q
- Explain protective or reverse isolation. What is its purpose? What patients is this type isolation recommended for? What type of PPE is used when entering these rooms?
A
- Patient isolated to protect from infection
- Immune compromised, burn victims, leukemia patients, patients on radiation, patients on immune suppressant drugs
- PPE: gown, mask, gloves, booties, beard mask
22
Q
- What does an abnormal retraction of a blood vessel wall during venipuncture cause?
A
- Vein Collapse
23
Q
- What is the MOST IMPORTANT thing you should do before performing any type of specimen collection on a patient?
A
-ID PATIENT
24
Q
- What should you do if a patient refuses to let you collect a specimen on them?
A
-let the nurse and physician
25
25. Why should you allow the alcohol on the skin to dry properly before inserting the needle?
because it could give a false reading, also FUCKING HURTS
| - lyse red cells
26
26. Specimens should always be labeled where and when?
- On the Tube, immediately after completion of draw with patient still present
27
27. In regards to placement of the needle’s bevel in the vein, where would it fall that it would NOT allow collection of a blood specimen?
- partially inserted
- penetration through the vein
- along side the vein
28
28. What are some possible techniques for transferring blood from a syringe into the proper collection tubes?
-transfer device
29
29. Describe the proper puncture site on an infant’s heel for skin puncture.
- Lateral and medial side of plantar surface
| - Not arch or center of the heel
30
30. Once a red stopper tube is spun down, what type of specimen does it yield (serum or plasma, anticoagulated red cells or clotted red cells)?
- Serum and clotted red cells
31
31. How must a collection site be prepared for collecting blood cultures? Why is it important to take these extra steps?
wiped with alcohol or iodine
| - to ensure a sterile site
32
32. In regards to therapeutic drug monitoring, the highest concentration of the drug during a dosing interval is called the _____________________.
PEAK
33
33. Explain the procedure for collecting specimens for a glucose tolerance test. Should the first specimen be first specimen after dosing the patient be drawn at one hour post the fasting specimen or one hour post finishing the glucose?
- Specimen drawn after patient has fasted over night
- Patient drinks glucose, mark time, speciments drawn at 1 hr intervals from the end of glucose solution ingestion up to 5hrs
34
34. Does the order of draw change depending on the collection equipment you use (straight needle vs. butterfly vs. syringe)?
- No
35
35. Why should the site be warmed before performing a skin puncture?
-Increases blood flow
36
36. Why is controlling the depth of your lancet important during skin puncture?
- Due to being close to the bone
37
37. What step must you take, when doing a skin puncture, to eliminate tissue fluid contamination?
- After puncture wipe away the first drop of blood to keep from contamination
38
38. What is a possible consequence of mixing a tube too vigorously?
-Hemolysis
39
39. When drawing blood on a child, what are some extra steps you should take prior to venipuncture because of the age of your patient? What should you not do?
- Calm patient and gain trust
| - Do NOT tell them that it wont hurt
40
Why should a patient NOT pump their fist prior to a venipuncture?
- Hemoconcentration
41
40. What is the most critical error a phlebotomist can make?
- Patient ID Error
42
41. What indicator lets you know you are in the vein when doing a syringe draw?
- Flash back
43
42. What is the longest amount of time a tourniquet should be tied on a patient’s arm prior to venipuncture?
- Less than 1 minute
44
43. The alcohol prep pads used for cleaning a puncture site are 70% or 95% isopropyl alcohol?
- 70%
45
44. Give a couple examples of coagulation tests. What color tube are they collected in? What is the anticoagulant used in those tubes?
- PTT, D-dimer, PT , Na citrate
46
45. What should you do if your patient does not have an ID band on but is not conscious or able to identify themselves?
- Ask the nurse or physician to positively ID PT
47
46. How should you handle questions from a patient about what tests you’re drawing and what they mean?
- State your only there to collect blood and defer to the Dr. be vague but truthful
48
47. Do you ever draw a specimen above an IV site? Why? What should you do if you cannot draw on a patient’s arms because of multiple IV’s?
-NO, it could mess up the test results, or take IV off for 15 min or find another site
49
48. Why is it so important to mix anticoagulant tubes thoroughly after filling them?
- To ensure that the anticoagulant agent is properly distributed though out the tube, and to prevent micro clot formation
50
49. If your needle gauge choices were 18, 20, 22, 23, or 25 which of these would have the smallest and the largest bore?
- 18=Largest
| - 25=Smallest
51
50. Small veins on a patient will collapse when what occurs?
- too much suction
- pulling syringe too fast
- blood collected too quickly
52
51. What indication might alert you to the possibility that you have entered an artery and not a vein during a venipuncture?
- Bright red pulsing blood
| - The blood will gush into the tube and out of the hole when the needle is removed
53
52. What is the number one cause of hemoconcentration during venipuncture?
- Tourniquet on too long
54
53. Is water considered an acceptable thing to drink before a fasting sample is drawn? What about coffee? Is smoking acceptable?
Water=Yes,
| - ANYTHING ELSE IN NOT ACCEPTABLE!
55
54. Describe the appearance of the following types of specimens:
a. Normal serum= Clear straw or pale yellow
b. Normal plasma= Slightly Opaque pale yellow
c. Hemolyzed serum=clear red in serum
d. Icteric serum=brownish-yellow tinge (increased bilirubin)
e. Lipemic serum=Milky-white (presence of lipids or fats in blood)
56
55. What color stopper do the following tube types have:
a. SPS= Yellow Top
b. Sodium citrate=Blue
c. No additive= Red Top
d. Silicon serum separation material (SST)=Red-Gray or Gold
e. Heparin= Dark Green
f. EDTA= Lavender Top/Tan
g. Sodium fluoride/=Light Gray Top
