Lesson 1

Question 1

Sample for any hematologic test

Answer 1

blood

Question 2

methods of blood collection

Answer 2

venipuncture (ETS & syringe), skin puncture

Question 3

The collection of blood from the capillaries or arterioles

Answer 3

Skin puncture

Question 4

Areas for skin puncture

Answer 4

plantar surfaces of middle finger/ forefinger, heel, big toe, earlobe

Question 5

Collected sample is known as

Answer 5

capillary, arteriolar, peripheral blood

Question 6

Puncturing devices

Answer 6

lancets
Gowers and Hagedorn needles
Bard Parker Blade no. 11
glass capillary pricker
pin & cork pricker

Question 7

Kinds of lancets

Answer 7

Stern
Hemolet
BB
Redi-lance
Sera Sharp

Question 8

What is less painful due to the lesser nerve endings compared to the fingers, toe and heel?

Answer 8

Earlobe puncture

Question 9

What area would have less tissue juice contamination?

Answer 9

Earlobe

Question 10

Why is there less tissue juice in the earlobe?

Answer 10

Due to less muscles and more free flow of blood due to the thin skin and more histocytes (macrophages in tissues) may be present

Question 11

Which are are less intimidating, easier and more accessible compared to the earlobe puncture?

Answer 11

Finger, heel and toe

Question 12

What are the sites to be avoided that may cause erroneous results or false negative results?

Answer 12

Edematous & congested areas
Inflamed & pallor areas
Extremities with intravenous line

Question 13

What areas must be avoided due to the difficulty of collection by the phlebotomist?

Answer 13

Heavily calloused, scarred and burned areas

Question 14

What is the ideal depth of skin puncture ranges in order to reach the capillary beds of the dermis?

Answer 14

2.5 to 3 millimeters

Question 15

What may be used to enhance blood flow ?

Answer 15

Gentle massage or a warm towel

Question 16

What must be avoided in order to avoid clotting?

Answer 16

Too much pressure or squeezing

Question 17

Why is the first drop discarded?

Answer 17

In order to eliminate tissue juices which may cause false negative results and to remove extraneous materials from the sites of collection

Question 18

What does not require such step of discarding the first drop?

Answer 18

Platelet Count

Question 19

What is the skin puncture sample used for?

Answer 19

CBC, fasting or random plasma glucose tests

Question 20

What is included in a Manual CBC?

Answer 20

Hematocrit
Hemoglobin
RBC count
WBC count
Differential count

Question 21

What is included Automated CBC?

Answer 21

Hematocrit
Hemoglobin
RBC count
WBC count
Differential count
Platelet count
RBC indices

Question 22

Hematocrit may be determined by?

Answer 22

Micromethod or Macromethod

Question 23

Micromethod is:

Answer 23

Requires capillary tube, centrifuge and microhematocrit reader

Question 24

Macromethod is:

Answer 24

Requires Wintrobe tube and centrifuge

Question 25

Required rpm in micromethod:

Answer 25

10,000-13,000 for 5 minutes

Question 26

Required rpm for macromethod:

Answer 26

2,500-3.000 for 10-15 minutes

Question 27

What are used for hemoglobin determination?

Answer 27

Sahli-Hellige tube hemometer spectrophotometer

Question 28

What is used for RBC, WBC and platelets counts?

Answer 28

Thoma pipets

Question 29

What are used for the differential count of stained blood smear?

Answer 29

Glass slide and spreader

Question 30

The collection of blood from the veins

Answer 30

Venipuncture

Question 31

What is the obtained specimen from venipuncture?

Answer 31

Venous blood

Question 32

Color of venous blood compared to arterial blood

Answer 32

Darker

Question 33

"primum non nocere"

Answer 33

the first thing is not to inflict damage

Question 34

What is an ideal phlebotomist?

Answer 34

Focus on the patient Manage thoughts and listens for feelings

Question 35

The three possible complications of venipuncture

Answer 35

Local immediate Local delayed General delayed

Question 36

Local immediate complications

Answer 36

Not hitting the vein Collapsed vein Hitting through and through

Question 37

Local delayed complications

Answer 37

Syncope or fainting Thrombosis Thrombophlebitis

Question 38

General delayed complications

Answer 38

Latex allergies Nausea Diabetic shock Convulsions or cardiac arrest Anemia Continued bleeding or hemorrhage

Question 39

It is the bluish discoloration of the skin which is caused by the physical trauma of the veins

Answer 39

Hematoma

Question 40

How do you aid hematoma?

Answer 40

Gentle massage to the site or use of hot compress

Question 41

What is the false increase of blood cells which can be caused by prolonged application of tourniquet or too much pressing of the fingers, toes, heel or earlobe during skin puncture?

Answer 41

Hemoconcentration

Question 42

Syncope or fainting is caused by:

Answer 42

Lack of oxygen in the brain

Question 43

What do you call the blood clot in the site cause by physical trauma?

Answer 43

Thrombosis

Question 44

What do you call the inflammation of the vein caused by physical trauma?

Answer 44

Thrombophlebitis

Question 45

What general delayed complication that require cold compress to be placed in the forehead of the patient?

Answer 45

Nausea

Question 46

What may occur due to hypoglycemia?

Answer 46

Diabetic shock

Question 47

What may be given to those who are hypoglycemic?

Answer 47

Juice, candy or any sweet food

Question 48

What to do when convulsions or cardiac arrest happen?

Answer 48

Must inform attending physician immediately and cardiopulmonary resucitation must be done

Question 49

What is a low blood cell count that may occur after frequent collections are done?

Answer 49

Attending physician, consultant or hematologist must be informed immediately

Question 50

Continued bleeding or hemorrhage of the site can be caused by:

Answer 50

Anticoagulant therapy of the patient or clotting factor deficiency

Question 51

What to do when there is continued bleeding or hemorrhage?

Answer 51

Apply pressure on the site using gauze or non-latex elastic wrap for 5-15 minutes. - attending physician, consultant or hematologist must be immediately informed

Question 52

What are the materials used when performing venipuncture via ETS?

Answer 52

ETS adapter Multi-sampler needle Evacuated tube Alcohol pads Gauze/cotton Micropore

Question 53

What are the materials used when performing venipuncture via syringe?

Answer 53

Syringe Evacuated tube Alcohol pads Gauze/cotton Micropore

Question 54

Approach, Greet & Identify Patient

Answer 54

Step 2

Question 55

Test Requisition

Answer 55

Step 1

Question 56

Explain procedure & obtain consent

Answer 56

Step 3

Question 57

Verify collection requirements & identify sensitivities and potential problems

Answer 57

Step 4

Question 58

Sanitize hands and put on gloves

Answer 58

Step 5

Question 59

Position patient, apply tourniquet & ask patient to make a fist

Answer 59

Step 6

Question 60

Select vein

Answer 60

Step 7

Question 61

Clean & airdry the site

Answer 61

Step 8

Question 62

Prepare collection equipment

Answer 62

Step 9

Question 63

Reapply tourniquet & uncap and inspect needle

Answer 63

Step 10

Question 64

Ask patient to make a fist, anchor and insert needle

Answer 64

Step 11

Question 65

Establish blood flow, release tourniquet & ask patient to open fist

Answer 65

Step 12

Question 66

Fill, remove, mix tubes in order of draw & fill syringe

Answer 66

Step 13

Question 67

Withdrawal of needle, place gauze & activate needle

Answer 67

Step 14

Question 68

Discard needle, attach transfer device, transfer blood and discard syringe & transfer device unit

Answer 68

Step 15

Question 69

Label tube in the presence of the patient

Answer 69

Step 16

Question 70

Check and apply bandage

Answer 70

Step 17

Question 71

Dispose materials & reposition moved items

Answer 71

Step 18

Question 72

Thank patient, remove gloves & sanitize hands

Answer 72

Step 19

Question 73

Transport specimen to the lab promptly

Answer 73

Step 20