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Module 8 Flashcards

(68 cards)

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1
Q

Phlebotomy

A

Process of withdrawing blood from a vein for laboratory testing

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2
Q

Fasting

A

The absence of eating or drinking

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3
Q

Laboratory Directory

A

A catalog of information regarding laboratory tests with up to date test menus; testing information; specimen collection requirements; and storage; preservation; and transportation guidelines

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4
Q

If a phlebotomy chair doesn’t have a extended arm rest available

A

Have the patient make a fist with the opposite hand and place it behind the elbow of the arm being used for the procedure

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5
Q

For pediatric patients

A

A support person could assist in holding the patient’s arm still to avoid injury

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6
Q

If the patient is in obvious distress during the procedure

A

It may be stopped

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7
Q

First step to beginning any phlebotomy procedure

A

Obtain the provider’s order for lab testing

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8
Q

The lab requisition form includes

A
  • Ordering provider’s name and contact information
  • Test and test code (unique to each lab, usually on the requisition or in the laboratory reference manual)
  • Diagnosis code that correlates with tests being ordered (ICD-10
  • special specimen requirements (like fasting)
  • Patient Demographics
  • Insurance or billing information
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9
Q

Where should the MA look if they don’t recognize one of the tests being performed?

A

Check in the laboratory directory manual: it contains information on specimen requirements, patient preparation requirements needed, container type needed, transport or processing requirements

A hard copy or digital copy are available in most labs

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10
Q

General supplies needed for venipunctures

A
  • Alcohol wipes
  • Gauze
  • Adhesive bandages
  • Biohazard sharps container
  • PPE, including disposable gloves
  • Tourniquet
  • Collection Tubes
  • Needle System
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11
Q

Evacuated System

A
  • Consists of double pointed needle, a plastic needle holder/adapter, and collection tubes
  • Collection tube system creates a slight vacuum that helps transport the blood into the collection tube when penetrated
  • It’s the most commonly used system
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12
Q

Vacutainer needles

A
  • typically 20-22 gauge
  • needle length of about 3/4 inch and 1 1/2 inches

Both will depend on the perceived depth of the vein and the size of the patient.

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13
Q

Winged Infusion Set (Butterfly System)

A
  • About 21-23 gauge
  • Needle length of about 1/2 to 3/4 inch
  • Length of the needle depends on the size of the patient
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14
Q

Butterfly Needles

A
  • About 21-23 gauge
  • Needle length of about 1/2 to 3/4 inch
  • Length of the needle depends on the size of the patient
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15
Q
A
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16
Q

Needle Syringe System

A
  • Can be used to draw blood from a vein
  • Not ideal because only a small amount of blood can be obtained with this method
  • One advantage is the amount of suction can be controlled by the plunger of the syringe instead of the vacuum method
  • Genreally a 16 gauge needle and syringe is used for this method
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17
Q

Parts of the needle

A

Lumen: Hollow space inside the needle (aka gauge) Larger the number smaller the diameter

Bevel: Shaft at the end of the needle that creates a point

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18
Q

4 main components of blood

A

Plasma, white blood cells, red blood cells, platelets

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19
Q

Plasma contains

A

Water, waste products, gases, proteins, nutrients

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20
Q

Serum

A

Liquid portion of the blood obtained after a serum sample tube has clotted and centrifuged

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21
Q

Plasma

A
  • Liquid portion of blood obtained after centrifuging
  • Blood specimen must be collected in a tube containing anticoagulant
  • 3 layers after its centrifuged: plasma (top layer) Buffy coat (middle) and RBC (bottom)
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22
Q

Whole blood

A

Obtained when drawn in a tube that contains an anticoagulant

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23
Q

Order of color top tubes

A

1.) Yellow
2.) Light Blue
3.) Red
4.) Red/Gray Marbled
5.) Green
6.) Green/Gray Marbled
7.) Lavender
8.) Gray

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24
Q

Yellow

A

Additive: Sodium polyanethol sulfonate; prevents blood from clotting and stabilizes bacterial growth

Laboratory Use: Blood or body fluid cultures

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25
Light Blue
Additive: Sodium citrate; removes calcium to prevent blood from clotting Laboratory Use: Coagulation testing Number of inversions: 3 to 4
26
Red
Additives: None Laboratory Use: Serum test, chemistry studies, blood bank, immunology Number of Inversions: 5
27
Red/Gray Marbled
Additives: No anticoagulant but contains silica particles to enhance clot formation; use for serum separation Laboratory Use: Serum test; chemistry studies; immunology Number of Inversions: 5
28
Green
Additives: Heparin: inhibits thrombin formation to prevent clotting Laboratory Use: Chemistry test Number of Inversions: 8
29
Green/Gray Marble
Additives: Lithium heparin and gel; for plasma separation Laboratory Use: Plasma determinations in chemistry studies Number of Inversions: 8
30
Lavender
Additives: Ethylenediaminetetraacetic acid (EDTA) removes calcium to prevent blood from clotting Laboratory Use: Hematology test Number of Inversions: 8
31
Gray
Additives: Potassium Oxalate and sodium fluoride; removes calcium to prevent blood from clotting; fluoride inhibits glycolysis Laboratory Use: Chemistry testing, especially glucose and alcohol levels Number of Inversions: 8-10
32
Phlebotomy methods are based on
The condition of the patient’s veins, age, skin conditions, and overall health (as well as professional experience and judgement of the MA)
33
Antecubital
The inner front surface of the forearm at the elbow
34
Hemoconcentration
An increase of formed elements of the blood and a decrease of fluid content
35
The median cubical vein is preferred when drawing blood because
It causes less pain to the patient and is the least likely to roll during the procedure
36
Blood draws from the foot should only be performed under the supervision of a a provider because
The risk of deep vein thrombosis
37
Veins in the hand
Are the most likely to roll
38
Drawing from the arm
15-30 degree angle
39
Drawing from the hand
10-15 degree angle
40
Capillary puncture
The method of acquiring blood from a fingertip or heel
41
Lancet
A small blade with sharp point
42
Micro collection devices
Small plastic tubes designed to collect capillary blood
43
Capillary Puncture Supplies
- Gloves - Automatic retractable lancet - Disinfectant pads, such as 70% isopropyl alcohol - Clean gauze pads - Bandage - Blood collection device appropriate for the test (micropipette, small glass (capillary tube) micro-collection devices, glucometer and testing strip, screening card or paper, plastic testing cartridge or cassette) - Capillary tube sealer (when capillary tubes are used) - Biohazard sharps container
44
NEVER perform a capillary puncture on the finger of an infant because
It can risk damage to the infant’s bone, use the infant’s heel instead of
45
For excessive blood flow from the puncture site after performing a capillary puncture
Elevate the arm over the level of the heart to aid in homeostasis
46
The Clinical and Laboratory Standards Institute recommends the following order of draw for skin puncture
1.) Blood Gases 2.) EDTA tubes 3.) Other Additive tubes 4.) Serum tubes
47
If there is a concern after drawing a patient’s blood
Bring a nurse to a provider to assess the patient before they stand up
48
Instruct the patient to leave bandaging
In place for a minimum of 15 minutes
49
What to label on blood specimen tubes
- Patient’s full name - Date of birth - Date and time of the collection - MA’s Initials
50
Clotted blood
Obtained when drawn in a tube that does not contain an anticoagulant
51
Blood processing requirements
- Serum must be allowed to stand upright at room temperature for 30 to 45 minutes before being centrifuged (allows blood to clot, producing more serum for the specimen. However, blood specimens shouldn’t be allowed to stand for longer than 1 hour. This will cause leaching of substance changes and changes to the integrity of the serum) - Clotted blood must stand upright at room temperature for 30-45 mins
52
Glucose tolerance test (GTT)
Test process that evaluates glucose levels over time to assess for diabetes by measuring the body’s response to sugar
53
Preanalytical Errors
Errors that occur prior, during, or immediately after performing venipuncture procedures
54
Examples of analytical errors
Mislabeling specimens, error in patient identification, mislabeling the specimen tubes, sample collection errors, insufficient quantity for testing, incorrect handling or transporting processes
55
Post analytical errors
Errors that can occur after the specimen has been processed
56
Examples of post analytical errors
Failure in reporting results, improper data entry, misinterpretation of results
57
Timed specimens
Are crucial to therapeutic drug level monitoring to confirm the patient’s medication dosage and adherence
58
Aliquot
A whole portion of something must be divided up into equal parts Occurs when a single specimen must be divided into multiple tubes for testing on different equipment
59
Prior to centrifution
Allow serum specimens to clot prior to centrifution
60
The weight of the centrifuged
Must ALWAYS be balanced
61
When transferring a serum from one tube to another tube
Use a single-use pippette
62
If a piece of equipment is overdue for calibration
notify the office manager or lab supervisor and place the unit out of service until it has been calibrated
63
What should be worn when transferring blood into multiple test tubes?
Face and eye protection
64
A specimen should never be moved to the cooler bag until
it is already completely frozen
65
To process specimens that need to e protected from light
Keep the lights in the lab low or off. When processed it should be wrapped in foil to block out light or move to a special amber transport tube designed for light protection.
66
How should multiple specimens be packaged for transport?
Each tube should be placed in a separate biohazard bag
67
Laboratories can send patient laboratory report results via
Email, fax, or directly into the EMR The provider MUST review and acknowledge all results prior to their inclusion in the medical record
68
Steps taken when a critical lab value is received from the clinic
Immediately notify the provider and document the notification

Ma (13 decks)

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