Final exam intro to mlt Flashcards by amanda gonzalez

What is the difference between serum and plasma?

serum-liquid portion of blood after clotting

plasma-liquid portion or blood without the cells after spin down in a anticoagulant tube

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What is the primary function of the anticoagulant sodium fluoride?

inhibits glycolisis

anti-glycolitic

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Hematology anitcoagulant

EDTA

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Coagulation anticoagulant

Sodium citrate

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Chemistry anticoagulant

Heparin

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Why is freezing whole blood not normally recommended to preseve a specimen?

lyse red cells

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What are the 2 primary reasons patients are placed in isolation rooms?

to protect healthcare workers and visitors from infection

- to protect immunocompromised patient

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How does EDTA prevent clotting?

by binding or chelating calcium in the form of potassium

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How does heparin prevent clotting?

inhibits the conversion of prothrombin to thrombin

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Sites for capillary puncture on an adult?

finger

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Where would you not want to perform capillary punture?

ear lobe

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What is the preferred area on a finger for puncture?

middle or ring finger

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What is a hematoma?

bruise/bleeding under the skin

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What causes a hematoma?(placement of needle senerios)

puncture through vein and partially inserting needle into vein

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State the consequences of pushing a tube onto the needle BEFORE entering the patients vein?

blows out the vacuum and contamination

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Why do you remove the tube from the needle prior to withdrawing from the patients arm?

to release the vacuum from the tube

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What are clot activators?

substances that inhibit or enhance coagulatio

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What are examples of clot activators?

glass and silica
thrombin
siliceous earth
celite

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What does a sclerosed vein feel like when palpated?

Should these veins be used?

hard and rope like

No do not use

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What is edema?

swelling

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What is fistula?

direct connection between and artery and vein

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Why is fistula important to consider when deciding on site selection for venipuncture?

cannot be used due to risk to infection and or damage …generally used for dialysis

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What is a bevel?

slanted tip on the hollow venipuncute needle that enters the vein.

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What abnormalities should you look for on a bevel before venipuncture is performed?

inspect for spurs, bent tip and damage

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Why are therapeutic drug monitoring tests often timed collect testing?

everyone metabolize drugs at a different rate | maximize its effectiveness and prevent toxicity

What is the correct anatomical term for the heel bone?

calcaneus

What does skin puncture blood most closely resemble?

arterial blood

Why is routine or strict isolation used?

patient isolated to prevent the spread of disease

What protective equipment must be used during routine and strict isolation?

Gown, gloves and mask

What is protective or reverse isolation?

patient is isolated to protect them from infection.

What is the purpose of protective or reverse isolation?

Usually immunocompromised patient

What patients go through protective or reverse isolation?

patients on radiation, leukemia patients and burn victims

What type of PPE should be worn with protective or reverse isolation patients?

gown, mask, gloves, hair net and shoe booties

What does an abnormal retraction of a blood vessel wall during venipuncture cause?

vein collapse

What is the MOST important thing you should do before performing any type of specimen collection on a patient?

ID the patient

what should you do if a patient refuses to let you collect a specimen on them?

Tell the nurse or DR

Why should you allow the alcohol on the skin to dry properly before inserting the needle?

painful to patients | lyse red cells

Specimens should always be labeled where and when?

immediately after collecting or before going anywhere else

Where would the bevel on the needle fall that it would NOT allow collection of a blood specimen?

not inserted all the way penetration through the vein alongside the vein

What are some possible techniques for transferring blood from a syringe into the proper collection tubes?

transfer device

What is the proper puncture sit on an infants heel for skin puncture?

lateral and medial side of plantar surface

when the red stopper tube in spun down what type of specimen does it yield?

serum and clotted red cells

How must a collection site be prepared for collecting blood cultures? Why?

cleansed with betadyne in a non-overlapping circular motion to ensure the site is sterile and prevent contamination with normal skin bacteria

In therapeutic drug monitoring, the highest concentration of the drug during a dosing interval is called what?

peak

How do you collect specimens for a glucose tolerance test?

fasting for 8-12 hours. Patient drinks glucose drink, mark the time and the specimen is drawn at 1 hour intervals from the end of drinking the solution

Does the order of draw change depending on the collection equipment you use? (straight needle, butterfly, syringe)

Why should the site be warmed before performing a skin puncture?

increase blood flow

Why is controlling the depth of your lancet important during skin puncture?

to avoid hitting the bone and prevent excess bleeding

What step must you take, when doing a skin puncture, to eliminate tissue fluid contamination?

wipe first drop

What is a possible consequence of mixing a tube to vigorously?

hemolysis

What are extra steps you should take on a child prior to venipuncture ? What should you not do?

Calm patient, gain their trust and be patient | Do NOT tell them it will not hurt

Why should a patient NOT pump their fist prior to a venipuncture?

hemoconcentration

What is the most critical error a phlebotomist can make?

ID error on patient

what indicator lets you know you are in the vein when doing a syringe draw?

flash

What is the longest amount of time a tourniquet should be tied on a patients arm prior to venipuncture?

1 min

The alcohol prep pads used for cleaning a puncture site are 70% or 90% isopropyl alcohol?

70% isopropyl alcohol

Give a couple examples of coagulation tests?

PT, PTT

What color tubes are coagulation tests collected in?

light blue

What is the anticoagulant used in coagulation test tubes?

Sodium citrate

What should you do if your patient does not have an ID band, but is also not conscious or able to identify themselves?

find a nurse or dr that can ID the patiend

How should you handle questions from a patient about what tests your're drawing and what they mean?

State that you are only there to get the blood and defer to the dr. Be vague but honest

Do you ever draw above and IV site?

What should you do if you cannot draw on a patients arms because of multiple IV's?

IV off for 15 mins or find a different site

Why is it so important to mix anticoagulant tubes thoroughly after filling them?

to ensure complete anticoagulation and to prevent micro-clot formation

If your needle gauge choices were 18,20,22,23 or 25 which of these would have the smallest and the largest bore?

25 smallest | 18 largest

Small veins on a patient will collapse when what occurs?

pulling syringe too fast and too much suction

What indication might alert you to the possibility that you have entered an artery and not a vein during a venipuncture?

bright red blood squirting into the tube

What is the number one cause of hemoconcentration during venipuncture?

tourniquet on too long

Is water considered an acceptable thing to drink before fasting sample is drawn? coffee? smoking?

water ok coffee no smoking no

apperance of normal serum

straw yellow or clear

appearance of normal plasma

straw yellow slightly opaque

appearance of hemolyzed serum

clear red

appearance of icteric serum

dark yellow/brown

appearance of lipemic serum

milky white

color stopper for heprin

green

color stopper for NO additive

red

color stopper for EDTA

lavender

color stopper for Sodium citrate

light blue

color stopper for silicon serum separation material

red-gray or gold

color stopper for sodium fluoride

light gray

SPS

yellow

Why does the order or draw exist?

to prevent cross over contamination of additives

Order of draw #1

blood cultures (yellow or yellow-black top)

Order of draw #2 or #1 if no blood cultures ordered

coagulation (light blue top, sodium citrate)

Order of draw # 3

no additive (red top)

Order of draw #4 in order

SST (red-grey or gold) Contains a gel seperator and clot activator Sodium Heparin ( green) PST (light green top) contains lithium heparin EDTA (lavender top) ACDA or ACDB (yellow top) contains acid citrate dextrose Oxalate/flouride (light gray)

order of draw acrynom

You, Bring, Really, Tangy, Grape ,Lollipops, Yodeling, Girl

Final exam intro to mlt Flashcards

(87 cards)