(M) Lesson 2: Pre-Analytical Considerations in Phlebotomy Flashcards

1
Q

This word means “before analysis”

A

Pre-Analytical

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2
Q

T or F: Pre-analysis begins during testing and ends with a test order

A

False (begins when a test is ordered and ends when testing begins)

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3
Q

Refers to the resting metabolic state of the body early morning after 12 hours of fasting (influenced by variables such as age, gender, and body conditions that CANNOT be eliminated)

A

Basal State

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4
Q

T or F: Basal state results are used to establish the reference values used for test results to know what normal and abnormal numbers are

A

True

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5
Q

T or F: RBC and WBC values are lower in newborns

A

False (higher)

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6
Q

Refers to how fast the kidney can filter creatinine

A

Creatinine clearance

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7
Q

T or F: Kidney function decreases with age

A

True

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8
Q

T or F: RBC counts are elevated at places with lower altitudes

A

False (higher altitude = lower oxygen levels trigger more RBC production)

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9
Q

This triggers higher concentration in test results due to a lack in solvent (water)

A

Dehydration

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10
Q

These increase with ingestion of fatty foods

A

Lipids

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11
Q

These are altered by drinking excessive water

A

Electrolytes

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12
Q

These chemicals increase in patients on high-protein diets

A

Ammonia and Urea

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13
Q

This is a byproduct of protein metabolism

A

Urea

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14
Q

This occurs naturally in the body and undergoes detoxification in the liver to turn into urea

A

Ammonia

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15
Q

This increases with ingestion of carbohydrates and sugary food

A

Glucose

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16
Q

T or F: Melatonin increases at night and decreases during the day

A

True

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17
Q

When are Renin and TSH at peak levels?

A

Predawn hours of the morning during sleep

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18
Q

Also known as the stress hormone

A

Cortisol

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19
Q

What are the peak hours of cortisol production?

A

Later in the morning (around 8am)

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20
Q

T or F: Chemotherapy drugs can cause an increase in blood cells (WBCs and platelets)

A

False (decrease)

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21
Q

What test is IMMEDIATELY followed after chemotherapy to measure blood components?

A

CBC Test

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22
Q

What does increased level of liver enzymes mean?

A

Liver failure

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23
Q

These increase amylase and lipase

A

Steroids and diuretics

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24
Q

T or F: During exercise, arterial pH and PCO2 levels are reduced to an acidic level

A

True

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25
Q

T or F: Glucose decreases by moderate muscular activity

A

False (increases)

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26
Q

This metallic element increases in the plasma whenever we exercise

A

Potassium

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27
Q

These 2 skeletal muscle enzymes increase during exercise

A

Creatinine Kinase and Lactate Dehydrogenase

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28
Q

T or F: Fever decreases insulin and glucagon levels

A

False (increases)

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29
Q

This chemical allows glucose to enter the cell

A

Insulin

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30
Q

This substance promotes glucose production

A

Glucagon

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31
Q

T or F: Fevers can increase cortisol

A

True

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32
Q

T or F: Blood components are higher for males than females

A

True

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33
Q

T or F: RBCs, hemoglobin, and hematocrit are all directly proportional

A

True

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34
Q

T or F: Androgen plays a key role in stimulating RBC production

A

True (Testosterone)

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35
Q

During intramuscular injections, these 2 substances increase

A

CK and LDH

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36
Q

Refers to jaundiced specimen having a deep yellow to yellow-brown color of serum or plasma

A

Icteric Specimen

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37
Q

This is responsible for the yellow pigment of the skin for jaundiced patients

A

Bilirubin

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38
Q

T or F: Bilirubin can interfere with chemistry tests based on color reactions

A

True

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39
Q

T or F: Moving positions too quickly causes blood fluids to filter into the tissues, increasing plasma volume

A

False (decreasing)

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40
Q

T or F: It is advisable to extract samples from the initial position of the patient

A

True

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41
Q

T or F: Mild anemia is normal in pregnancy

A

True (RBC counts are lower)

42
Q

Characterized by decreased pulmonary function, increased RBC count, and hemoglobin level

A

Chronic Smoking

43
Q

T or F: Smoking can increase the concentration of immunoglobulins

A

False (decrease)

44
Q

T or F: WBCs increase with stress

A

True

45
Q

T or F: Stress can increase serum iron levels

A

False (decrease)

46
Q

T or F: Temperature plays a factor in triggering hemoconcentration

A

True

47
Q

What is the mortal sin of medical technologists?

A

Patient Misidentification

48
Q

T or F: Urea is photosensitive

A

False (Bilirubin)

49
Q

This cold temperature range describes improper transport conditions of samples

A

2-6 degrees celsius

50
Q

T or F: Glucose can decrease if RBCs come in contact with the serum due to the RBCs consuming them

A

True

51
Q

Healed burn sites and areas with extensive scarring are still not ideal locations for blood draw due to?

A

Impaired circulation

52
Q

T or F: Tattooed areas are acceptable places to draw blood from

A

False (impaired circulation, more susceptible to infection, and contains dyes that can interfere with testing)

53
Q

“Sclerosed” means what?

A

Hardened

54
Q

“Thrombosed” means what?

A

Clotted

55
Q

T or F: You must choose veins that are proximal to damaged ones

A

False (distal)

56
Q

T or F: Edema may yield inaccurate results due to tissue fluid contamination

A

True

57
Q

Refers to swelling or mass of blood caused by blood leaking from a blood vessel during or following venipuncture

A

Hematoma

58
Q

T or F: Lymph node removal causes lymphostasis

A

True (obstruction or stoppage of lymph flow)

59
Q

T or F: Lymphostasis does not change blood composition in the arm

A

False (it can if blood gets contaminated with lymph fluid)

60
Q

What is the most prominent vein for obese patients?

A

Cephalic Vein

61
Q

T or F: Patients taking aspirin have a less chance of excessive bleeding

A

False

62
Q

T or F: You can apply a pressure bandage instead of maintaining pressure

A

False (Never apply pressure bandages instead of maintaining pressure)

63
Q

Refers to temporary loss of consciousness due to insufficiency of blood flow to the brain

A

Syncope

64
Q

Refers to fainting due to a nervous system response to abrupt pain, stress, or trauma

A

Vasovagal Syncope

65
Q

Refers to the sensation of spinning as a symptom of syncope

A

Vertigo

66
Q

Refers to tiny, non-raised red (or purple) spots that appear on the patient’s skin when a tourniquet is applied due to minute drops of blood escaping the capillary wall resulting from a capillary defect or platelet abnormality

A

Petechiae

67
Q

→ tube inserted into a vein or artery
→ ready access to the patient’s circulation
→ eliminates the need for multiple draws
→ uses include:
- administering of fluids or medication
- drawing blood
- central venous pressure reading

A

Vascular Access Device

68
Q

T or F: You can apply a tourniquet or perform venipuncture on an arm with a VAD

A

False

69
Q

Refers to a catheter placed in an artery (most common in a radial artery)

A

Arterial Line (A-Line/Art-Line)

70
Q

Refers to a surgical procedure that fuses veins with arteries commonly used for hemodialysis treatment

A

Arteriovenous shunt/AV fistula

71
Q

→ used for administering medication and drawing blood
→ uses the vein in the lower arm above the wrist
→ can be left in place for up to 48 hours
→ flushed with heparin or saline to prevent clotting

A

Heparin or Saline Lock

72
Q

T or F: Drawing coagulation specimen is not recommended when a Hep-Lock is in place

A

True

73
Q

→ thin plastic tube/catheter
→ inserted in a vein to administer fluids

A

Intravenous (IV) Sites

74
Q

T or F: Blood specimen can be contaminated or diluted with IV fluid causing erroneous test results

A

True

75
Q

T or F: Draw blood above the IV site if both arms have one

A

False (below the IV)

76
Q

T or F: Blood can only be collected within 24 to 48 hours of the time the IV was discontinued

A

False (should not be collected within 24 to 48 hours of the time the IV was discontinued)

77
Q

Refers to a needle-less closed device that is sometimes connected to an arterial or central venous catheter

A

Blood Sampling Device

78
Q

→ indwelling line that consists of tubes inserted into main vessels
→ used for administering fluids and medications, monitoring pressures, and drawing blood

A

Central Vascular Access Device (CVAD)

79
Q

Device wherein the line is inserted into large veins (subclavian advancing into the superior vena cava)

A

Central Venous Catheter (CVC) or Central Line

80
Q

Surgically-implanted disk-shaped chamber attached to the indwelling line placed on the upper chest just below the collar bone

A

Implanted Port

81
Q

Line is inserted into a vein (in an extremity) and threaded into a main vein leading to the heart

A

Peripherally Inserted Central Catheter (PICC)

82
Q

This is the most common complication in venipuncture

A

Hematoma

83
Q

What is the color of arterial blood?

A

Bright red

84
Q

Refers to blood loss due to blood draw

A

Iatrogenic Anemia

85
Q

Refers to an adverse condition brought by the effects of treatment/procedure

A

Iatrogenic

86
Q

T or F: Life is threatened if more than 5% of blood volume is removed at one time

A

False (10%)

87
Q

What artery is near the basilic vein?

A

Brachial Artery

88
Q

Refers to back flow of additive into the patient’s vein from the tube during the venipuncture procedure

A

Reflux

89
Q

→ decrease in fluid content or plasma volume
→ caused by stagnation of the normal venous blood flow because of tourniquet application
→ increased concentration of RBCs and other non-filterable large molecules

A

Hemoconcentration

90
Q

Complication wherein RBCs are damaged and hemoglobin escapes into the fluid portion of the specimen

A

Hemolysis

91
Q

Slight hemolysis is indicated by what hue of red?

A

Pinkish

92
Q

Moderate hemolysis is indicated by what hue of red?

A

Dark Pink to Light Red

93
Q

Gross hemolysis is indicated by what hue of red?

A

Dark Red

94
Q

T or F: Short-draw serum tubes are generally unacceptable

A

False (acceptable)

95
Q

T or F: Never pour two partially filled additive tubes together to fill one tube (affects the blood-to-additive ratio)

A

True

96
Q

What forms in wrong/expired collection tubes?

A

Microclots

97
Q

T or F: Tube vacuum can be lost if the bevel backs out the skin slightly

A

True

98
Q

T or F: When probing, move the needle horizontally

A

False (retract a bit first before probing)

99
Q

T or F: If vein disappears as the tube is engaged or when tourniquet is removed, that is an indicator of a collapsed vein

A

True

100
Q

T or F: You can palpate the site of entry near the needle

A

False (this is painful for the patient)