Phlebotomy and Blood Collection: Techniques, Safety, and Laboratory Procedures, Exams of Medicine

Download Phlebotomy and Blood Collection: Techniques, Safety, and Laboratory Procedures and more Exams Medicine in PDF only on Docsity! NHA CPT Exam Questions with Answers 2024. What are phlebotomist job tasks? \ n ✔equipment assembly keep track of supplies follow safety rules verify & record patient information assist patients before, during, and after procedures cleansing & disinfecting area before puncture collect blood & other specimens label & store blood collection devices report potential hazards What is the hub/tube holder part of the needle? \ n ✔plastic sleeve that the needle hilt screws into, also holds the tube What are the four major work duties of a Phlebotomy Technician? \ n ✔equipment procedure patient care records & patient information What is the safety device of the needle? \ n ✔to prevent accidental needle sticks and possible exposure to bloodborne pathogens What is the primary duty for the phlebotomist? \ n ✔collection of blood samples via venipuncture or micro techniques When do you use the non-evacuated collection system? \ n ✔when the veins are prone to collapse or if the phlebotomist needs more control over the blood collection flow rate List examples of bodily fluids besides blood. \ n ✔urine feces sputum cerebrospinal fluid (CSF) synovial fluid from joints pleural fluid from lungs pericardial fluid from around the heart When should a phlebotomist use a syringe? \ n ✔non-evacuated collection system; when the veins are prone to collapse or if the phlebotomist needs more control over the blood collection flow rate What are the three phases of the testing process in a laboratory? \ n ✔pre-analytical phase analytical phase post-analytical phase When should a phlebotomist use the lancet system? \ n ✔when smaller amounts of blood needed Define quality improvement. \ n ✔the analysis of performance and the systematic efforts to make it better ...in other words, to systematically improve the ways care is delivered to patients What is the criteria to consider when choosing a vein? \ n ✔location, size, depth, direction, condition, and turgor List two methods of quality improvement \ n ✔flow chart pareto chart What is the most common location for a venipuncture? \ n ✔the antecubital fossa What is a pareto chart? \ n ✔bar charts made to show the frequency of problems What are the three main veins in the antecubital fossa? \ n ✔median cubital vein, cephalic vein, and basilic vein Define quality control. \ n ✔a system of maintaining standards in manufactured products ...in other words, a procedure or set of procedures intended to ensure that a manufactured product adheres to a defined set of quality criteria Which vein in the antecubital fossa is the most preferred? \ n ✔medial cubital fossa; cephalic is the second choice Quality control records should include ... \ n ✔expiration dates proper use stability information storage information precision and accuracy of testing supplies/reagent Why is the median cubital vein the most preferred vein in the antecubital fossa? \ n ✔it has structural support, large, and less likely to develop a hematoma the cephalic vein is the second best because it lies on the outside of the antecubital fossa so it makes positioning the patient and needle slightly more difficult What is the CDC? \ n ✔Centers for Disease Control and Prevention What is a centrifuge? \ n ✔Machine used to separate fluids to different densities by spinning at radial force What is the normal anatomical position? \ n ✔standard position patient standing erect, facing forward, arms at the side with the palms facing forward What is the lateral recumbent position? \ n ✔safety position patient is lying on the side What is the supine position? \ n ✔patient is lying down, face up, palms up What is the prone position? \ n ✔patient is lying face down, palms down What are examples of position specific tests when it comes to drawing blood? \ n ✔aldosterone, renin, and cortisol testing What are fasting tests? \ n ✔tests that require the patient abstain from all food or liquids for 8 to 12 hours prior to the procedure What are examples of fasting test? \ n ✔glucose and cholesterol testing What does NPO mean? \ n ✔nothing per oral What are timed specimen draws? \ n ✔specimens that are collected at specific intervals What are examples of timed specimen tests? \ n ✔glucose tolerance tests, cardiac enzymes, and therapeutic drug monitoring What is the most commonly requested timed specimen? \ n ✔glucose level What is a trough level? \ n ✔absolute lowest blood level of a drug must draw specimen 30 minutes prior to the next scheduled dose What is a peak level? \ n ✔absolute highest blood level of a drug must draw specimen 1 to 1.5 hours after medication is infused by IV or 4 hours after medication is orally taken What are the methods of collecting blood? \ n ✔venipuncture, capillary puncture, arterial puncture What is venipuncture? \ n ✔collection of blood from a vein using a multi-sample needle or syringe when large amounts of blood is required What is the most common blood collection system? \ n ✔evacuated blood collection system What are the parts of the needle? \ n ✔bevel, lumen, shaft/cannula, hilt, sheath/sleeve, hub/tube holder, and safety device What is the bevel part of the needle? \ n ✔slanted tip of needle What is the lumen part of the needle? \ n ✔hollow opening inside of the needle, that allows blood to flow through (expressed in gauges) What is the shaft/cannula part of the needle? \ n ✔the length on the needle (expressed in inches) What is the hilt part of the needle? \ n ✔the threaded part at the base of the needle that is used to connect to the tube holder What is the sheath/sleeve part of the needle? \ n ✔the rubber piece covering the second needle What is the safety device of the needle? \ n ✔to prevent accidential needlesticks and possible exposure to bloodborne pathogens What is the purpose of performing a venipuncture using the non-evacuated collection method? \ n ✔if the veins are prone to collapse or if the phlebotomist needs more control over the blood collection flow rate what is the purpose of using a lancet system for specimen collection? \ n ✔when smaller amounts of blood is needed to be collected from adults or when collecting from an infant? What is the criteria to consider when choosing a vein? \ n ✔location size depth direction condition turgor What are the three main veins that run through the antecubital fossa? \ n ✔median cubital vein cephalic vein basilic vein which one of the antecubital fossa veins is most preferred and why? \ n ✔the median cubital vein is first choice because is has structural support, large size, and less likely to develop a hemotoma Define turgor \ n ✔the bounce or resilience of a vein What are the areas to avoid for specimen collection? \ n ✔hematomas scar tissue sides of paralysis sides of mastectomy arteriovenous fistula IV sites If a patient has an IV in both arms, where can you draw blood? \ n ✔always draw below the site of the IV, and use a discard tube prior to drawing the tubes to be tested What is the correct angle for needle insertion when performing a venipuncture? \ n ✔15° - 30° What are the elements of a requisition form? \ n ✔Patient's first and last name DOB and gender of patient Name of physician requesting procedure Date and time of collection Indication of tests requested Source of specimen What are the main elements of specimen label? \ n ✔Patient's name Patient's DOB Date of collection Time of collection Phlebotomist's initials What is the significance of using the winged collection method when performing a venipuncture? \ n ✔For more difficult draws, it offers the phlebotomist a greater precision in placement and more flexibility during tube changes. What are the reasons for using the winged collection method? \ n ✔Small veins Fragile veins Superficial veins Many tubes Allow to let go of needle to have both hands free What is a capillary puncture? \ n ✔Aka dermal puncture, used to collect when small amounts of blood are needed. Ex: infant or anemic patient What is capillary blood composed of? \ n ✔venous, arterial, capillary, interstitial fluid and intracellular fluid Which test can be performed for the lavender tube? \ n ✔CBC, HgA1c, ESR, and platelet counts What is the function of silica coating? \ n ✔to start the clotting process Define systole \ n ✔ventricular contraction Which lab department(s) are the light green tubes sent to? \ n ✔STAT chemistry What is a CBC? \ n ✔complete blood count Define hemolysis \ n ✔the rupture or destruction of red blood cells. Define diastolic pressure \ n ✔the minimum arterial pressure during the relaxation of the heart What is the function of arteries? \ n ✔carry oxygenated blood away from the heart What is HgA1c ? \ n ✔Hemoglobin A1c levels measure average blood glucose over the past three months. What additive(s) are in the dark green tube? \ n ✔sodium heparin or ammonium heparin Define diastole \ n ✔Relaxation of the heart Function of monocytes \ n ✔become macrophages What is ESR? \ n ✔erythrocyte sedimentation rate Define centrifuge \ n ✔separates mixtures by the densities of the components Define pulse or heart rate \ n ✔the rhythmical expansion of arteries due to contractions of the heart Which lab department(s) are the yellow test tubes sent to? \ n ✔histocompatibility What is the gray test tube used for? \ n ✔contains potassium oxalate to remove calcium and sodium fluoride to preserve glucose. send to hematology to test for glucose and lactic acid Which lab department(s) are the gold/tiger tubes sent to? \ n ✔serology, chemistry, and immunology labs What is the unit of measurement of a pulse? \ n ✔BPM, beats per minute which lab department(s) are the dark green tubes sent to? \ n ✔STAT chemistry and cytogenetics What additive(s) are in the gray tubes? \ n ✔potassium oxalate and sodium fluoride What is hemoglobin? \ n ✔An iron-containing protein on the erythrocyte that carries oxygen and carbon dioxide How can a pulse be measured? \ n ✔placing the index finger and middle finger on a pulse point What is the function of sodium citrate? \ n ✔anticoagulant that binds with calcium what is the function of potassium oxalate and sodium fluoride? \ n ✔to remove calcium and preserve glucose Define antiseptic \ n ✔antimicrobial solution Where are the pulse sites? \ n ✔wrist (radial artery), neck (carotid artery), inside elbow (brachial), behind knee (popliteal), ankle (posterior tibial) What can cause hemolysis? \ n ✔incorrect order of draw Which lab department(s) are the gray tubes sent to? \ n ✔chemistry Define DNR \ n ✔do not resuscitate Define bradycardia \ n ✔Pulse rate less than 60 beats per minute What is the function of capillaries? \ n ✔site of exchange between blood and tissues Which tests can be performed for the gray test tube? \ n ✔glucose and lactic acid What is the function of white blood cells (leukocytes)? \ n ✔help the body defend against diseases and foreign materials Define tachycardia \ n ✔Pulse rate greater than 100 beats per minute What is the function of veins? \ n ✔carry deoxygenated blood to the heart What is the yellow test tube used for? \ n ✔contains ACD, acid-citrate dextrose, to bind to calcium and preserve tissues. sent to the histocompatibility lab to test for HLA, paternity testing, and maternal screens Which department(s) are light blue tubes sent? \ n ✔coagulation What is a normal range for pulse? \ n ✔60-100 bpm Most common needle gauge sizes for routine Phlebotomy \ n ✔21 to 23 gauges What is ACD? \ n ✔Acid Citrate Dextrose What occurs in the developmental stage of the RBC life cycle? \ n ✔erythropoiesis, and 2 million RBCs per second are continuously being produced What factors can cause abnormal or irregular heart rates? \ n ✔anxiety stress caffeine nicotine some medications overreactive thyroid exercise hyperventilation fever diet pills cocaine pain low oxygen levels heart valve disease What is the right side of the heart called? \ n ✔pulmonary circulation function of platelets (thrombocytes) \ n ✔to prevent excessive blood loss by forming blood clots Where are the sinusoid located? \ n ✔liver, spleen, and bone marrow Define PT \ n ✔prothrombin time What is the function of ACD? \ n ✔binds to calcium and preserves tissues function of eosinophils \ n ✔targets parasites What are the four chambers of the heart? \ n ✔right atrium, right ventricle, left atrium, left ventricle Which tube(s) are used to collect serum? \ n ✔red and gold/tiger tubes preferred anticoagulant in clinical chemistry \ n ✔heparin Function of basophils \ n ✔release histamine and other mediators of inflammation in response to an allergic reaction What is the dark green tubes used for? \ n ✔contain Sodium or Ammonium heparin to activate antithrombin to prevent clotting. send to STAT chemistry and cytogenetics to test for sodium, ammonia, and bone marrow studies Define eryptosis \ n ✔the removal of old and defective cells Which tests can be performed for the light green tubes? \ n ✔CMP, BMP, lipid panel, sodium, and potassium common light sensitive tests \ n ✔bilirubin beta-carotene vitamin B-12 folate What can blood cultures be tested for? \ n ✔cultures Define anticoagulant \ n ✔Substance that prevents blood from clotting What is tests can be performed for the dark (royal) blue test tubes? \ n ✔heavy metal screening and toxicology testing function of natural killer cells \ n ✔destroy target cells by cytolysis and apoptosis Which tests can be performed for the gold/tiger tubes? \ n ✔thyroid panel, CMP, BMP, and electrolyte panel Which tests can be performed with light blue tubes? \ n ✔PT, PTT, D-dimers, and fibrinogen Which tests can be performed with the yellow test tube? \ n ✔HLA, paternity testing, and maternal screens Common needle gauge size for dialysis \ n ✔17 to 20 gauges What is a hemopoietic stem cell? \ n ✔blood cell in the bone marrow What is the left side of the heart called? \ n ✔systemic circulation What additive(s) are in the gold/tiger tubes? \ n ✔silica coating and thixotropic polymer gel What are the characteristics of red blood cells (erythrocytes)? \ n ✔most numerous blood cells, no nucleus, contains hemoglobin What is the function of blood? \ n ✔carries nutrients, hormones, and oxygen to the cells and removes carbon dioxide and other wastes. What is the gold/tiger tubes used for? \ n ✔contains silica coating to start the clotting process and thixotropic polymer gel to separate blood from serum. send to serology, chemistry and immunology to test for thyroid panel, CMP, BMP, and electrolyte panel function of T lymphocytes \ n ✔targets viruses What can cause hemoconcentration? \ n ✔the tourniquet being left on too long What are two types of gloves? \ n ✔exam and surgicial What are the three layers of the heart? \ n ✔epicardium, myocardium, endocardium What additive(s) are in the red tube? \ n ✔No additive in glass, silica coating in plastic What is CMP? \ n ✔comprehensive metabolic panel What is the tan test tube specific for? \ n ✔lead determinations What are the types of WBCs? \ n ✔Granulocytes: neutrophils, eosinophils, basophils Lymphoid cells: B lymphocytes, T lymphocytes and Natural killer cells Monocytes What additive(s) are in blood culture bottle? \ n ✔SPS, sodium polyanethol sulfonate What additive(s) are in a light blue tube? \ n ✔sodium citrate