PHLEBOTOMY NATIONAL EXAM (NHA)/Answered/A+ Rated/2023, Exams of Nursing

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PHLEBOTOMY NATIONAL EXAM (NHA)/Answered/A+ Rated/2023 Characteristics imperative to a phlebotomist Dependability, honesty, integrity, empathy and compassion, professional appearance, interpersonal skills Circulatory system function deliver oxygen, nutrients, hormones, & enzymes to cells and transport cellular waste (CO2) to organs where they can be expelled The two circulations Pulmonary & Systemic Pulmonary circulation carries deoxygenated blood from the right ventricle to the lungs and returns oxygenated blood from lungs to left atrium Where does oxygenation take place in the lungs? alveoli Systemic circulation carries oxygenated blood from left ventricle throughout the body Upper chambers of the heart right and left atria lower chambers of the heart right and left ventricle tricuspid valve atrioventricular valve, situated between right atrium and right ventricle **to remember this valve is on the right side of the heart-- people TRY to be RIGHT pulmonic valve semi-lunar valve situated between the right ventricle and the pulmonary artery Mitral valve (or bicuspid) atrioventricular valve located between the left atrium and left ventricle aortic valve semi lunar valve situated between the left ventricle and aorta Flow of blood through the heart Superior and Inferior Vena Cavae< Right atrium< tricuspid valve< right ventricle< pulmonic valve< pulmonary artery< lungs< pulmonary vein< left atrium< mitral (bicuspid) valve< left ventricle< aorta< rest of body Three layers of the heart Endocardium, myocardium, epicardium Blood vessels arteries, arterioles, capillaries, venules, veins, superior & inferior vena cavae aorta, arteries, and arterioles carry_____ blood _______ the heart oxygenated & away from venules, veins, and superior and inferior vena cave carry _____ blood ________ the heart deoxygenated & back to The average adult has ______ liters of blood 5-6 Plasma comprises how much of circulating blood? 55% Plasma contains.... proteins, amino acids, gases, electrolytes, sugars, hormones, minerals, vitamins, and water What percent of plasma is water? 92% Three major veins located in antecubital fossa Median cubital vein, cephalic vein, basilic vein The vein of choice because it is large and doesn't tend to move Median cubital vein What vein would you use in an obese patient when the median cubital vein cannot be found? cephalic vein What side of the arm is the cephalic vein located? thumb side What side of the arm is the basilic vein located? inner side unsuitable veins for venipuncture... sclerosed, thrombotic, and tortuous veins sclerosed veins hard and cordlike tortuous veins winding/crooked. susceptible to infection Do you draw above or below an IV? below How long should the IV be shut off before you can perform a venipuncture? 2 minutes Is a phlebotomist allowed to shut off/turn on and IV? NOOOO Complications associated with phlebotomy Hematoma, hemoconcentration, phlebitis, petechiae, thrombus, thrombophlebitis, septicemia, trauma Most common complication of phlebotomy procedure hematoma What is a hematoma? blood accumulated in the tissue surrounding a vein two most common causes of a hematoma... 1. needle going through the vein 2. failure to apply enough pressure on site after need removal What is hemoconcentration? INCREASE in proportion of formed elements to plasma What is the cause of hemoconcentration? tourniquet being left on too long What is petechiae? tine NON-RAISED red spots that appear on skin due to ruptured capillaries What is the cause of petechiae? prolonged use of tourniquet What is a thrombus? blood clot What is thrombophlebitis? inflammation of a vein with formation of a clot septicemia is... systemic infection associated with the presence of pathogenic organisms Trauma in reference to venipuncture is... an injury to an underlying tissue cause by probing of the needle Factors to consider prior to performing venipuncture fasting, edema, and a fistula Quality assurance is... a program that guarantees quality patient care by tracking the outcomes through scheduled audits in which areas of the hospital look at the appropriateness, applicability, and timeliness of patient care Where should the tourniquet be applied? 3-4 inches above site What motion do you use when cleansing the site? circular Which way does the bevel face? UPWARD What angle should the needle be inserted at? 15-30 degrees How long are you allowed to leave the tourniquet on? one minute What might happen if you leave the tourniquet on for more than one minute? hemoconcentration, petechiae, and a thrombus What should be written on the collected specimen labels? patients name and ID number, the time and date, and YOUR initials Should you label the tubes before or after you dismiss the patient? BEFORE! Basal state fasted and refrained from strenuous exercise for 12 hours prior to draw Two-Hour Postprandial Test used to evaluate diabetes mellitus. Fasting glucose level is compared with the levels 2 hours after eating a full meal Oral Glucose Tolerance Test (OGTT) used to diagnose diabetes mellitus and evaluate patients with frequent low blood sugar How does heparin work? inhibiting thrombin in the coagulation cascade How many times do you invert a green top tube? 8 Common tests for a green top tube are? Chemistry tests, STAT electrolytes, carboxyhemoglobin Gray top tube additive sodium fluoride/potassium oxalate How long does sodium fluoride preserve glucose? 3 days How long does lithium iodoacetate preserve glucose? 24 hours How many times should you invert a gray top tube? 8 Common tests for a gray top tube are? Fasting blood sugar (FBS), glucose tolerance test (GTT), Blood alcohol levels, and lactic acid measurement FBS fasting blood sugar GTT glucose tolerance test PT Prothrombin time APTT activated partial thromboplastin time PTT partial thromboplastin time FDP fibrinogen degradation products BT bleeding time ESR erythrocyte sedimentation rate tiger top tube (SST) additive serum separator SST serum separator tubes How many times should you invert a tiger top tube? five times Common tests for a tiger top tube are? most chemistry tests Red top tube additive no additive or anticoagulant How many times do you invert a red top tube? 0 Common tests for a red top tube consist of what? SERUM chemistry tests, serology tests, and blood bank Yellow top tube additive SPS- sodium polyanetholesulfonate how many times should you invert a yellow top tube? 8 What are yellow top tubes used for? to be cultured for the presence of microorganisms Hematology section tests CBC, ESR, lupus erythematous (LE), sometimes coagulation Tests performed in coagulation area of lab are? APTT, PT, BT electrophoresis analyzes chemical components of blood such as hemoglobin and serum, urine and cerebrospinal fluid toxicology analyzes plasma levels of drugs and poisons immunochemistry detect and measure substances such as hormones, enzymes, and drugs Serology (immunology) Section performs tests to evaluate the patients immune response through the production of antibodies Microbiology section detection of pathogenic microorganisms in patient samples C&S culture and sensitivity urinalysis section performs tests on urine to detect disorders and infection of the kidney and urinary tract OSHA Occupational Safety and Health administration Types of Hazards Biologic, sharps, chemical, electrical, fire/explosive, physical, and allergic reaction Biologic hazard is defined as what? infectious agents that can cause bacterial, viral, fungal, or parasitic infections Sharps hazards is defined as what? Health insurance portability and accountability act negligence failure to exercise the standard of care that a reasonable person would give under similar circumstances Four elements of negligence Duty, derelict, direct cause, and damage tort a wrongful act that results in injury to one person by another hemoglobin iron containing pigment of red blood cells Phlebotomists are primarily responsible for what phase of laboratory testing? pre-analytical centrifuge instrument used to speed the removal of serum by spinning the blood What is an RFID? identification tag using silicon chips and a wireless receiver what is the blood pH range of a normal body? 7.35-7.45 blood for lead levels needs to be collected in a..... tan top tube Serum should be transported to the lab for testing and seperated from blood cells within what time period? 2 hours A primary consultant on the timing for collecting blood for DRUG levels is found in which of the following departments? pharmacy Anemic A person who has too little hemoglobin or a decreased number of red blood cells Type and Cross-match The process of determining if a person will react after a transfusion fibrinogen is found in plasma or serum? plasma When performing bleeding time the blood pressure cuff should be inflated to what? 40mm hG