phlebotomy
icteric
"marked by jaundice", abnormal yellow color from bilirubin levels
hematocrit
% of total blood volume that is cells
hemoglobin
(f) 12-16 ; (m) 14 - 18 A four-subunit protein found in red blood cells that binds oxygen. Each subunit contains a heme group, a large multi-ring molecule with an iron atom at its center. One hemoglobin molecule can bind four oxygen molecules in a cooperative manner.
Occupational exposure to bloodborne pathogens can occur while the healthcare worker is performing his or her duties
- A human bite breaks the skin - blood comes in contact with a cut - body fluids splash into the mouth
Veins that are antecubital
- Basilic - Cephalic - Median
The Joint Commisions Sentinel Event QI program policy is designed to do
-Identify unfavorable events for immediate investigation -improve the safety of patients in healthcare institutions -prevent unfavorable events from happening again
aseptic technique
-Includes all activities to prevent or break the chain of infection
Never leave a tourniquet on for more than
1 minute
The volume of cumulative blood to be collected during a hospital stay
1 month or less from a new join weighing 6 to I lbs is approximately 23 ml
plasma
1. Yellow liquid component of blood in which the blood cells in whole blood are normally suspended 2. It makes up about 55% of the total blood volume 3. Intravascular fluid part of extracellular fluid 4. mostly water (93% by volume) and contains dissolved proteins, glucose, clotting factors, mineral ions, hormones and carbon dioxide
order of draw
1. Yellow, 2. Light Blue, 3. Red, 4. Gold, Tiger Top, Red/Yellow/Black, 5. Green, Light Green, Green/Gray, 6. Purple/Lavender, 7. Pink, 8. Gray, 9. Royal Blue, 10. Tan
Of the 35 million patients admitted to hospitals annually in the US, about how may acquire a nosocomial infection?
1.75-3 million
what are the 3 phases of Coagulation?
1.Initiation 2.Amplification 3.Propagation
What Vein(s) are used for Venipuncture and in what order? Starting with your first choice
1.Median Cubital 2.Cephalic 3.Basilic
Venipuncture Order of Draw <Tube Colors and Additive>
1.Sterile 2.Light Blue(Citrate) 3.Red(serum) 4.Tiger(serum) 5.Gold(serum) 6.Green(Heparin) 7.Lavender(EDTA) 8.Grey(Oxalate) 9.Royal Blue(EDTA) 10.Yellow(ACD)
Capillary Order of Draw <tube color and Additive>
1.White (Blood Gas) 2.Lavender (EDTA) 3.Green(Heparin) 4.Grey (Oxalate) 5.Red (Serum) 6. Black ( NewBorn Screens)<Card>
Winged infusion set
1/2 - 3/4 inch stainless steel needle connected to 5-12 inch tube w multisample luer adapter for evacuated tubes (Butterfly Needle) 23 gauge common
What does a Lipid panel require?
12 hour Fasting
Proper handwashing prior to and after blood collection requires rubbing wet, soapy hands together vigorously for at least:
15 seconds
platelets
150,000-400,000 Blood clotting
baby boomers are individuals who were born during which time period
1940s - 1964
What is the "rule" for tourniquet use before and during blood draw?
1min. before and 2min while obtaining blood sample
Median cubical vein
1st choice Middle location of antecubital fossa
According to CLSI, depth of heel puncture should not exceed:
2.0 mm
CLSI recommended maximum depth of heel puncture
2.0 mm
What is the number and size of a platelet?
250,000-500,000 1-4 hm (not an actual h)
Cephalic vein
2nd choice, located lateral of antecubital fossa
How many Microcollection containers (Max) can you draw on an Infant?(Microtubes/Microcontainer)
3 Microtubes
Which numbered arrows on the diagram of an infant's foot in Fig. 10-2 point toward the safest areas for capillary puncture?
3 and 4
How full does a Sharps container need to be before sealing/disposal?
3/4 full
When drawing an Allen test the needle should be
30 Degrees or higher
How long does it take a Blood Sample to Clot?
30 Min.
When making a blood smear by hand using two glass slides, the typical angle required of the spreader slide is:
30 degrees
How long does it take for a PKU to dry?
4 Hours
What is the number and size of a white blood cell?
4,000-11,000 9-16 hm (not an actual h)
What is the number and size of a red blood cell?
4-6 Million 6-7 hm (not an actual h)
The temperature of heel warming devices should never exceed:
42 degrees C
Formed Elements (Cells) make up what percentage of the blood?
45%
The recommended antiseptic for cleaning capillary puncture sites is:
70% isopropanol
glucose
70-110
What levels are tested for Electrolyte Testing?
< Sodium(Na+), Potassium(K+) > Bicarbonate(HO3-),and Ionized Calcium(iCa2+)
Six Sigma
A QI measure that focuses on DMAIC (define, measure, analyze, improve and control) to improve process performance.
The best angle for spreading
A blood smear using two glass slides is approximately 30 degress
What is insulin?
A chemical that is released into the bloodstream by the pancreas when glucose levels in the blood increase after meals.
What is diabetes mellitus?
A chronic disease in which the pancreas cannot produce enough insulin or cannot use the insulin that it does produce.
Hematocrit
A commonly ordered laboratory test to asses the circulatory system; it describes the concentration of the RBCs and therefore provides an indirect measure of the oxygen-carrying capacity of the blood.
Integrity
A concept that has to do with a personal feeling of "wholeness".
Hypoxia
A condition in which body tissues are not receiving enough oxygen.
anemia
A condition in which the blood is deficient in red blood cells, in hemoglobin, or in total volume.
centrifuge
A device that spins test tubes of blood
tourniquet
A device used for bleeding control that constricts all blood flow to and from an extremity.
polycythemia
A disorder characterized by an abnormal increase in the number of red blood cells in the blood
The Health Insurance Portability and Accountability Act (HIPPA) of 1996.
A federal law was passed requiring all healthcare providers to obtain as patients consent in writing before disclosing medical information.
hepatitis B
A form of hepatitis that is transmitted through contact with infected blood, body fluids (sexually transmitted), contaminated needles
lactate
A form of lactic acid that is used as a marker for severity of metabolic acidosis and stress response
To maintain electrolyte balance
A function of the Urinary System
vaccine
A harmless variant or derivative of a pathogen that stimulates a host's immune system to mount defenses against the pathogen
Integrated healthcare delivery systems (IDSs)
A healthcare provider made up of a number of associated medical facilities that furnish coordinated healthcare services from prebirth to death.
insulin
A hormone produced by the pancreas or taken as a medication by many diabetics
Heart
A key organ of the cardiovascular system, it is the pump that forces blood throughout the body.
Differential
A laboratory test that enumerates and categorizes white blood cells and any abnormalities present.
hematoma
A localized swelling filled with blood
ABO Blood Group System
A method by which red blood cell antigens are classified. (Type A & Type B)
Which of the following statements most accurately describes capillary puncture blood?
A mix of venous, arterial, and capillary blood
Vascular
A network of vessels that include veins, arteries, and capillaries.
Coagulation
A phase in the blood-clotting sequence in which many factors are released and interact to form a fibrin meshwork, or blood clot.
What does a routine UA include?
A physical, chemical, and sometimes microscopic analysis
disinfection
A process that eliminates many or all microorganisms, with the exception of bacteria spores, from inanimate objects
What is Tropnin T?
A protein released and deteced after a myocardial infarction (MI); It is elevated only when heart damage has occured; thus, it is valuable in the early diagnosis of MI and in monitoring the effectiveness of therapy after an MI.
antigen
A protein that, when introduced in the blood, triggers the production of an antibody
What is the most convenietn specimen to obtain
A random UA
phenylketonuria
A rare inborn error of phenylalanine metabolism. Inherited as an autosomal recessive trait. Accumulation of phenylalanine in untreated cases causes CNS toxicity, most notably mental deficiency; organ damage; unusual posture; and can, in cases of maternal, severely compromise pregnancy PKU
Active Listening
A set of skills that enables one to become a more effective listener.
Medicaid
A shared federal and state funded program designed to provide health insurance for individuals with low income
microorganism
A small living plant or animal seen only with a microscope; a microbe
A Chain Of Custody is
A special protocol used when collecting forensic specimens
standard precautions
A strict form of infection control that is based on the assumption that all blood and other body fluids are infectious.
Anticoagulant
A substance introduced to the blood to keep it from clotting.
Culture
A system of values, beliefs and practices that stem from one's concept of reality
capillary
A tiny blood vessel where substances are exchanged between the blood and the body cells.
cholesterol
A type of fat made by the body from saturated fat; a minor part of fat in foods. <200 mg/d
Basophils
A type of granulocyte (WBC). Basophilic granules stain dark purple or black with basic dyes, and their nuclei are often S-shaped.
Eosinophils
A type of granulocyte. Eosinophilic granules stain orange-red with acidic dyes. Their nuclei normally have two lobes.
Butterfly needle
A type of needle used to collect blood from small or difficult veins
HIV
A virus that attacks and destroys the human immune system.
Certification
A voluntary process by which an agency grants recognition to an individual who has met certain prerequisites in a particular technical area.
a national organisation that develops guidelines and safety measures and sets national standards that affect lab professionals is the
AHA
which of the following is the best example of setting the standard of care for blood collection
AHA
Hepatic function panel A
AST, ALT, alkaline phosphatase, total protein, albumin, total bilirubin, direct bilirubin
ETOH
Abbreviation for ethanol or blood alcohol
Cerebrospinal and other body fluids
Abbreviation: CSF Tube: Lavender Presence or absence, number and type of cells. Hematocrit on fluid indirectly measures fluid volume.
Erythrocyte sedimentation rate
Abbreviation: ESR Tube: Lavender Increased rate at which red blood cells settle out is indicative of inflammatory conditions or necrosis of tissue.
Hematocrit
Abbreviation: Hct Tube: Lavender Values correspond to the red cell count and hemaglobin level; when decreased indicates anemic conditions.
Hemoglobin
Abbreviation: Hgb Tube: Lavender Decreased values indicate anemic conditions; values normally differ with age, sex, altitude, and hydration.
Lupus erythematosus
Abbreviation: LE cells Tube: Lavender presence of typical LE cells is diagnostic of systemic LE.
Mean corpuscular hemoglobin
Abbreviation: MCH Tube: Lavender Reveals the weight of the hemoglobin in the cell, regardless of size.
Mean corpuscular hemoglobin concentration
Abbreviation: MCHC Tube: Lavender Reveals the hemoglobin concentration per unit volume of RBCs.
mean corpuscular volume
Abbreviation: MCV Tube: Lavender Reveals the size of the cell, Decreased MCV is associated with thalassemia and iron-deficiency anemia.
Platelet Count
Abbreviation: Plt Ct. Tube: Lavender Decreased numbers are indicative of hemorrhagic diseases; values may be used to monitor chemotherapy or radiation treatments.
Red blood cell count
Abbreviation: RBC count Tube: Lavender Measure of erythropoietic activity; decreases in numbers are related to anemic conditions.
Red blood cell distribution width
Abbreviation: RDW Tube: Lavender Reveals the size differences of the RBCs.
White blood cell count
Abbreviation: WBC count Tube: Lavender Abnormal leukocyte response indicative of various conditions, such as infections and malignancies; When accompanied by low WBCs, differential test becomes more specific.
Reticulocyte (retic) count
Abbreviation: retic count Tube: Lavender Increased number of retics in circulating blood attest to bone marrow hyperactivity.
Differential white count
Abbreviations: Diff Tube: Lavender Changes in the appearance or number of specific cell types signify specific disease conditions; values are also used to monitor chemotherapy or radiation treatments.
Neutropenic
Abnormal small number of neutrophils in the blood
A tourniquet should be applied
About 3 inches above the venipuncture site. It should be tight but not painful and should be partially looped to allow for easy release with one hand
Asepsis
Absence of bacteria, viruses, and other microorganisms, typically during surgery.
ACO
Accountable Care Organization
Yellow
Acid citrate dextrose (ACD) Blood Bank/Immunohematology
ACD
Acid citrate dextrose (anticoagulant)
Assault
Act or threat causing another to be in fear of immediate battery
ACT
Activated clotting time
Parenteral
Administration by any route other than digestive tract. Example: intravenous or intramuscular injection
Blood culture bottles (& order of draw)
Aerobic Anaerobic
ACA
Affordable Care Act
Abreviation PP means
After a meal
Hemostasis
After injury coagulation process
Eosinophils
Aids the body in fighting parasites which occurs in increased number in patients with allergies
Alcohol should be allowed to
Air dry for 30 to 60 seconds, this prevents re contamination, prevents stinging and prevents the chances of contaminating the specimen with the alcohol
Which of the following are required characteristics of capillary puncture lancets?
All of the above: A controlled depth of puncture, Blades or points that are sterile, Permanently retractable blades
Capillary specimens contain:
All of the above: Arterial blood, tissue fluids, venous blood
It is inappropriate to apply a bandage to a capillary puncture site on an infant or child younger than 2 years of age because it can:
All of the above: Irritate the infant's tender skin, pull off & be a chocking hazard, tear delicate skin when removed
Test affected by povidone-iodine contamination of a capillary specimen include:
All of the above; Phosphorus, Potassium, Uric Acid
metabolism
All of the chemical reactions that occur within an organism.
A capillary puncture that parallels the whorls of the fingerprint will:
Allow blood to run down the finger
AFP
Alpha-fetoprotein
AABB
American Association of Blood Bank
ASCP
American Society for Clinical Pathology offers many levels of certification for Lab personnel with avenues of continuing ed.
Nosocomial infection
An infection acquired in a healthcare facility
What "tubes" are used for Blood Culture?
Anaerobic and Aerobic Sample Bottles
What is a creatinine clearance test?
Analytic procedure to determine wether or not the kidneys are able to remove creatinine from the blood
What is Blood Urea Nitrogen (BUN)
Analytic testing procedure to determine the amount of urea in the blood.
An individual's blood type is determined by the presence or absence of a certain type of
Antigen present on the red blood cells
ARD
Antimicrobial removal device
Boihazard
Anything potentially harmful to health.
Which of the following steps should be omitted from infant heel puncture?
Apply bandage
Granulocytes
Are composed of basophils, eosinophils, and neutrophils
Agranulocytes
Are composed of monocytes and lymphocytes
The fingers of newborns
Are not recommended for skin punctures sites
Pt and ptt tests
Are performed on blood collected with the anticoagulant sodium citrates. If the require blood level is not collected in the sodium citrate tube, then the ration of sodium citrate to blood is increase causing erroneous prolonged coagulation results
Laser devices
Are skin puncture alternatives
BD bactec culture vials
Are used for microbiology collections
Microscopy specimens
Are usually urine collections and therefore do not require a blood collection system
anatomic pathology
Area of laboratory where autopsies are preformed, cytology procedures and surgical biopsy tissues are analyzed
Zone of Comfort
Area of space surrounding a person/patient that is considered "private or personal"
AHCCCS
Arizona Health Care Cost Containment System
What is Not a Duty of a Phlebotomist?
Arterial Collection
Capillary puncture blood most closely resembles
Arterial blood
The composition of blood obtained by capillary puncture more closely resembles:
Arterial blood
What provides useful information about respiratory status and the acid-base balance of patients with pulmonary disorders?
Arterial blood gases (ABGs)
Why is arterial blood instead of venous blood used?
Arterial blood has the same composition throughout the body tissues, whereas venous blood has various compositions relative to metabolic activates in body tissues.
"Arterialized" means
Arterial content has been increased
brachial artery
Artery located in the medial anterior aspect of the antecubital fossa near insertion of the bicep muscle; 2nd choice for arterial puncture
Blood Pressure
Assessment of the cardiovascular system using an instrument called the sphygmomanometer or blood pressure cuff. It is measured as a systolic pressure (when the heart receives blood) and the diastolic pressure (when the hearts ventricles relax.)
The major blood vessels of the skin are located:
At the dermal-subcutaneous junction
BNP
B-type natriuretic peptide
venous blood
BLOOD OBTAINED FROM A VEIN; OXYGEN-DEPLETED BLOOD WHICH IS DARKER THAN ARTERIAL BLOOD.
Biobank
Bank where human biological samples, blood, saliva, plasma, skin cells, organ tissues can be stored & used in research
BMP
Basic metabolic panel Glucose, blood urea nitrogen (BUN), creatinine, sodium, potassium, chloride, CO2, calcium
What are the types of a white blood cell?
Basophil Eosihophil Lympocyte Neutrophil Monocyte
A cyanotic extremity would:
Be bluish in color
A laboratory report form should state that a specimen has been collected by capillary puncture:
Because results can vary by specimen source
What does Preanalitical mean?
Before Analysis
In an infant's heel, the area of the vascular bed that is rich in capillary loops is located:
Between .35 and .82 mm deep
Communication barriers
Biases or personalized filters that are major obstructions to verbal communication
An infant may require a blood transfusion if blood levels of this substance exceed 18 mg/dL
Bilirubin
If collected by capillary puncture, which of the following specimens should be collected in an amber microtube?
Bilirubin
Jaundice in a newborn is associated with high levels of:
Bilirubin
This specimen is collected in an Amber tube
Bilirubin
Immuno-Hemotology is now know as what?
Blood Bank
A test that requires strict skin antisepsis procedure before specimen collection
Blood Culture
BAC
Blood alcohol concentration
BBP
Blood borne pathogen
Purple top tubes
Blood cell count, WBC, RBC, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, requires whole blood collected in purple tube
Platelets
Blood cells that aid in the blood clot formation.
Red Blood Cells
Blood cells that function to transport oxygen and carbon dioxide in the body.
White Blood Cells
Blood cells that provide defense against infectious agents.
What is the major function of a platelet?
Blood clotting (9-12 days).
Coagulation
Blood clotting process
Polycythemia
Blood condition of many cells
Which test must be collected by venipucture?
Blood culture
A list of capillary puncture equipment would exclude:
Blood culture bottles
The preferred order of draw would be
Blood cultures, coagukation, hematology and chemistry tubes. However, phlebotomist must follow the order of draw recommended by individual manufacturers and by their health care organizations
A blood smear is:
Blood spread out on a microscope slide
autologous
Blood that is donated for one's own use
Veins
Blood vessels that carry blood toward the heart after oxygen has been delivered to the tissues. Veins carry deoxygenated blood (except in the case of the pulmonary veins, the only veins that carry deoxygenated blood from the lungs to the heart.)
Hematopoietic
Blood-forming
Cyanotic finger is
Bluish in color due to insufficient oxygen
What creates RBC?
Bone marrow
Bilirubin
Breaks down chemically when exposed to light and thus the blood must be protected from light bili rub is to be measured
amino acid
Building blocks of protein
A microcollection container is sometimes called a:
Bullet
What is another term for a Microcontainer?
Bullet
Referring to fig. 10-1, identify the letters of the fingers that are recommended as sites for capillary puncture:
C and D *read/look at the figure.*
CRP
C-reactive protein
CPR
CARDIOPULMONARY RESUSCITATION
A ____ Test must be performed on whole blood
CBC
If the following tests are collected from a patient by capillary puncture, which test specimen is collected first?
CBC
For accurate results, the heel must be warmed before capillary specimen for this test:
CBG
This is the abbreviation for a pulmonary function test:
CBG
the federal law enacted that regulates the quality and accuracy of lab testing (including phleb procedure) by creating a uniform set of provisions governing all clinical lab is reffered to as
CLIA88
which federal agency or act states that a lab with moderately complex or highly complex testing must have written policies and procedures for specimen collection and labelling
CLIA88
which of the following agencies requires an inspection for quality lab testing
CLIA88
Patient care services will be assigned a code for reimbursement using which national coding system
CPT
A third party payer.
Can be an insurance company, the federal government, a managed care program, or a self-insured company that pays for healthcare services on behalf of its employees.
Blood for creatine kinase
Can be collected in the gold top tube since it contains no interfering additives
Blood for creatinine kinase
Can be collected in the red top tube since it contains no interfering additives
Coagulation of blood
Can be prevented of oxalates, citrates and or edta by their ability to remove calcium, forming insoluble calcium salts
Speckled top tube
Can be used for the collection of alkaline phosphatase and many other enzymes in the blood
Over filling of EDTA microcollection tube
Can cause clot formation
Using the first drop of blood
Can have an adverse on a skin puncture specimen because it may be diluted with tissue fluids thus causing erroneous results in laboratory test
Strong repetitive pressure, such as squeezing or milking a site during capillary specimen collection:
Can hemolyze and contaminate specimens
Primary care
Care by General physician who assumes on going responsibility for maintaining a patient's health
Secondary care
Care by a physician (specialist) who can perform out-of-the-ordinary procedures in outpatient facilities
What are the Functions of the Circulatory System?
Carries oxygen and food to cells and carries carbon dioxide away, aids in coagulation,Runs the heart(cardiac cycle), circulates blood through out the body, removes micro-organisms and impurities
Question 34 and 35 relate to the following case scenario: Mary was a medical assistant in a family health clinic with a small laboratory. She had responsibilities in several areas, including answering the phone in the laboratory, drawing blood specimens, clerical duties, and assisting with laboratory testing. One morning when the clinic was particularly busy, she had collected blood specimens for numerous patients and tried to process them quickly so that they could be tested in a timely manner. When the phone rang, she was reluctant to answer it because she had almost finished processing a batch of specimens. It rang several times; then she hurried to to pick it up and asked the individual to "hold please." She went back to finish processing the samples and forgot the person on hold. Later, she found out the individual on hold was a doctor who was trying to request another test on a previous drawn
Case Scenerio
CMS
Center for Medicare and Medicaid Services
CDC
Centers for Disease Control Prevention, division of the U.S. Public Health Service They investigate and control disease w epidemic potential.
What, as part of the U.S. Public Health Service, oversees the investigation of various diseases?
Centers for Disease Control and Prevention (CDC)
CMS
Centers for Medicare and Medicaid Services: Overseas financing and regulation of health care industry. Includes Medicare, Medicaid, HIPPA and CLIA
CSF
Cerebrospinal fluid
What is the process of documents that identifies of each individual who handles specimen and transferred within the chain.
Chain of custody.
Indices
Changes in RBC size, weight, and Hgb content indicate certain types of anemias.
Drawing a patient's blood without permission can result in a
Charge of assault and battery
Lipid panel
Cholesterol, lipoprotein, high-density cholesterol(HDL) Triglycerides
What is the Word Root for Cartilage?
Chondr
Blood
Circulating fluid and cells in the cardiovascular system.
The skin puncture site should be
Cleaned with 70% isopranol and thoroughly dried before being punctured because residual alcohol prevents round drops of blood from forming which is needed for blood smear preparation
Plasma
Clear fluid Contains fibrinogen
Amniotic fluid
Clear fluid fills the membrane surrounding/ cushioning fetus in uterus
Serum
Clear pale fluid Can be separated from blood specimen No fibrinogen
What does CLSI stand for?
Clinical & Laboratory Standards Institute
CLIA ''88''
Clinical Laboratory Improvement Amendments of 1988
What does CLIA '88 stand for?
Clinical Laboratory Improvement Amendments of 1988
CLIA
Clinical Laboratory Improvement Amendments of 1988: federal guidelines regulating US labs. Regulations apply to ALL sites that test human specimens.
CLSI
Clinical and Laboratory Standards Institute
What is the second tube of cerebrospinal fluid used for?
Clinical microbiology testing for cultures
What does a Red top Tube Contain/Do?
Clot Activator/ Clots Blood
Red Tiger Top
Clot activator & Gel separator Chemistry BUN/creatine/glucose
Red (plastic)
Clot activator/ gel barrier Chemistry Bilirubin(fridge,foil),Creatinine(kidney,fridge)
A tube with a Light Blue stopper belongs to what department
Coagulation
Intrinsic
Coagulation factors circulating the bloodstream
Coagulation
Coagulation is the study of the ability of blood to form and dissolve clots.
Extrinsic
Coagulation pathway starts by release of thromboplastin from injury
Delta check
Comparison of current results of a lab test w previous results for the same test and patient
A butterfly system could be used to diminish the likelihood of
Complications, in addition the phlebotomist should be careful with site selection and document the patients conditions to explain ung results
CMP
Comprehensive metabolic panel Albumin, glucose, BUN, creatinine, sodium, potassium, chloride, CO2, AST, ALT, total protein, total bilirubin, calcium
Hardware
Computer equipment used to process data
Thrombosis
Condition of clotting
Hyperglycemia
Condition of high blood glucose levels
Interface
Connect for the purpose of interaction
Confidentiality is such an important issue in testing for HIV that the patient must sign a ____
Consent form before the specimen for the test can be collected.
Green top tubes
Contain heparin that can alter the accuracy of blood counts
Red topped tubes
Contain no additive but sodium heparin is required for chromosomes analysis
Gray topped tubes
Contain potassium oxalate and sodium flouride or lithium iodoacetate and heparin which will interfere in chromosome analysis
Light blue topped tubes
Contain sodium citrate which will interfere in chromosome analysis
Gray top tubes
Contain sodium flouride and pottasium oxalate or lithium iodoacetate and heparin. These additives can falsely alter the blood cell count levels.
Gray top tube
Contains a glycolytic inhibitor used in glucose testing
BD Vacutainer serum separator tube
Contains a separator barrier to separate the blood cells from the serum
Purple top tube
Contains anticoagulant edta and is generally used for hematology testing
Green top tube
Contains heparin which is not a glycolytic inhibitor
Laboratory requisition for clinical testing
Contains patients full name, identification number and date of virth, the dates and types of tests to be performed, the physicians name, the location of the patient and timing instructions
Gray top tube
Contains sodium flouride that destroys alkaline phosphatase and many other enzymes in the blood.
CE
Continuing Education: ongoing education required to maintain certifications and keep healthcare workers updated in their field
CQI
Continuous Quality Improvement
CQI
Continuous Quality Improvement: concept of meeting and exceeding customer expectations by monitoring, resolving and seeking to improve areas of poor performance.
Fomites
Countertops and computer keyboards that can harbor infectious agents.
What is the Word Root for Cold?
Cryo
CPT
Current Procedural Terminology
Cytology
Cytology tests are concerned with the structure of cells.
Fraud
Deceitful practice or false portrayal of facts by either words or conduct
Povidone iodine preparation are used primarily for
Decontaminating the skin before venipuncture for blood gas analysis and blood cultures. Excess iodine should be removed from the skin with sterile gauze before the puncture
If the phlebotomist makes a blood smear that is too short, he or she should try again and:
Decrease the angle of the spreader slide
What is the major function of a white blood cell?
Defense against pathogens, and immunity protection (1 Day- 1 Year).
Histology
Defined as the study of the microscopic structure of tissues.
Capillary puncture is a poor choice for specimen collection if the patient is:
Dehydrated
What causes Hemoconcentration?
Dehydration (decrease in fluid content of the blood, with an increase in non-filterable large molecule,or protein-based blood components such as RBC)
DOT
Department of transportation
The royal blue top tube has been
Designed to collect sterile blood specimens for trace elements, toxicology and or nutritional studies
Continuing Education
Designed to update the knowledge or skills of participants and is generally geared to a learning activity or course of study for a specific group of health professionals, such as phlebotomists.
hemolysis
Destruction of blood (breakdown of red blood cells with release of hemoglobin).
Potassium value is
Determined from the blood collected in the green top tube.
Patient's Bill of Rights
Developed in 1973 by the AHA to affirm the rights of patients
Engineering controls
Devices that isolate or remove a blood borne pathogen hazard from the workplace.
Presence of glucose in urine (glycosuria)
Diabetes mellitus
Presence of ketones bodies in urine
Dibetes melitus, starvation, vomiting
Polycythemia
Disorder of overproduction of RBC's
Which of the following is normally a proper site for finger puncture on an adult?
Distal segment of the middle finger
DNR / DNAR
Do Not Resuscitate / Do Not Attempt Resuscitate
Clinical immunology specimens
Do not require culture media vials
Clinical chemistry specimens
Do not require culture vials
The safety T fill capillary blood collection device
Does not have solutions for dilution of the blood
An autologous blood transfusion is a transfusion of blood
Donated by patient for the patient
peak level
Drug level collected when the highest serum concentration of the drug is anticipated
Additive present in a Lavendar stopper
EDTA
Pink Top Additive(s) and Department? Yield?
EDTA Blood Bank Plasma
Pink
EDTA Blood Bank/Immunohemotology
Royal Blue Top Additive(s) and Department? Yield?
EDTA Chemistry Plasma
Tan
EDTA Chemistry leads
Lavender Top Additive(s) and Department? Yield?
EDTA Hematology Plasma
Lavender
EDTA Hematology WBC,RBC,Hgb,Hct, Platelet,diff ct., Eryth. sed.rate,MCV, MCH, MCHC globin, RDW-red dist. Width Ammonia(Ice,chemistry)
What Additives Yield Plasma?
EDTA Lithium/Sodium Haparin Potassium Oxalate Sodium Citrate
Erythrocyte Sedimentation Rate
ESR; TEST THAT MEASURES THE SPEED AT WHICH RBC'S SETTLE OUT IN ANTICOAGULATED BLOOD
Alcohol based hand rubs are
Effective for hand decontamination purposes if the hands are not visibly soiled
During multisample capillary specimen collection, blood smears and EDTA specimens are obtained before other specimens to minimize:
Effects of platelet aggregation
The purpose of wiping away the first drop of blood during skin puncture is to
Eliminate tissue fluid contamination
Input
Enter data into computer
venipuncture
Entering the skin with a needle, generally to draw a blood sample.
EPA
Environmental Protection Agency federal that regulates the disposal of hazardous waste.
what is the thin outer layer of the heart?
Epicardium
What are the 3 layers of the heart?
Epicardium myocardium endocardium
Personal Protective Equipment
Equipment designed to protect the health care worker from hazards in the work place
Abbreviation "ESR" means
Erythrocyte Sedimentation Rate
What are the 3 cell types?
Erythrocytes, Leukocytes, and Platelets.
A commonly identified causative agent of health-care-acquired infections in the nursery unit is:
Escherichia coli
Blood gases are usually
Evaluated using arterial samples
Certification
Evidence an individual has Mastered fundamental competencies in a particular technical area
PPD Testing
Example of Employee screening for infection control
If you get Serum in your eye what procedures do you take?
Eye wash for 15min, Fill out an Incident report and go to Employee Health
Falsely decreased bilirubin results can be caused by:
Failing to protect the specimen from light
Negligents
Failing to put the needle and holder in the sharps container
Negligence
Failure to exercise due care
Breach
Failure to keep medical information private
Breach of confidentiality
Failure to keep privileged medical information private
Distal
Farthest from the point of attachment
FAN
Fastidious antimicrobial neutralization
glucose tolerance test
Fasting = 60-110 mm/dL, 1 hour = 190 mm/dL, 2 hours = 140 mm/dL, 3 hours = 125 mm/dL
What is the proper chain of events for a GTT?
Fasting Blood Sugar<Within Range> Glucola drink Finish within 5mins then test every 1/2,1,2,3 hours from time of finished drink
FIT
Fecal immunochemical test/ fecal occult blood test
Medicaid
Federal and State program that provides medical assistance for low-income Americans
Medicare
Federal program designed to provide health insurance for the elderly and members of special groups
Medicare
Federally funded program that provides healthcare to people over age 65 and disabled
FUO
Fever of unknown origin
Which of the following equipment should be deleted from a list of capillary blood gas equipment?
Filter paper for blotting
postanalytical/examination phase
Final phase of lab where the final test results are relayed to appropriate Drs. Clinical data reviewed and error correction occurs.
Aerosol
Fine mist of specimen
_____ were used for general phlebotomy to open an artery or, more commonly, a vein to remove large amounts of blood.
Fleams
Pericardial fluid
Fluid around the heart
Synovial fluid
Fluid around the joint cavity
Synovial fluid is
Fluid found in between joints.
FDA
Food and Drug Administration: federal agency responsible for safety and efficacy of USA food and drug supply. Includes equipment and supplies used in blood collection and analysis.
Warming a site skin
For skin puncture increases blood flow to the site
Discovery
Formal process in litigation that involves taking depositions and interrogating the parties involved
Ketosis
Found in diabetes
Proper direction of blood flow
From arterioles to capillaries to venules
Example of negative kinesics
Frowning
department of health and human services
Funds medical research
Which of the following is a newborn screening test?
GALT
What does the color coding of needles stand for?
Gauge
What equipment is used to obtain blood in Capillary puncture?
Gauze Alcohol Swab Microtainer Lancet Band-aid Gloves
What are Types of Communication Barriers?
Gender, Age, Language, Emotions, Culture, and Physical Issues
Royal blue top tubes
Generally contain sodium heparin, edta or no anticoagulant
Medical Technologist/Medical Laboratory Scientist
Generally has a bachelor's (BS) degree plus additional studies and experience in clinical laboratory testing.
Phenylketonuria (PKU) is a:
Genetic disorder involving phenylalanine metabolism
Reference values for this test are higher for capillary specimens:
Glucose
GTT
Glucose tolerance test
Renal function panel
Glucose, BUN, creatinine, sodium, potassium, chloride, CO2, calcium, albumin, phosphorus
GLP
Good Laboratory Practices
Proper order for putting on PPE
Gown first,mask,goggles,gloves last
Lactate Test (tube,additive,Lab, Special handling)
Gray, Potassium Oxalate Chemistry, NO Tourniquet
You need to collect blood cultures, and green, light blue, and purple top tubes on an adult with difficult veins. Which of these can be collected by skin puncture?
Green top and purple top
Amonia Test (tube,additive,Lab, Special handling)
Green,Lithium Heparin , Chemistry, Ice Slurry
Quality indicators
Guides used as monitors of all areas of patient care
The hormone detected in a positive urine pregnancy test is
HCG
mrs bacon s phle who collects blood in valley view hosp from 6.00 am to 12pm during the week must annually review and sign a confidentiality and nondisclosure agreement that describes the sensitivity of patient information due to which of the following acts
HIPAA
the term PHI was actually created by which of the following
HIPAA
Example of a work practice control that reduces the risk of exposure to bloodborne pathogens
Hand decontamination
Arteriosclerosis
Hardening of the artery
An acceptable routine blood smear:
Has a feathered edge
Heparinized whole blood
Has become the specimen of choice for the clinical chemistry instruments used in STAT situations
Tan top tube
Has been designed for the collection of lead determination s
Heparinized microcollection tubes
Have an anticoagulant but are not prefilled with a dilution of the blood.
HCS
Hazard Communication Standard
HIPAA
Health Insurance Portability and Accountability Act
HMO
Health Maintenance Organization
Acute Care
Health care delivered in a hospital setting that is associated with a hospital stay usually less than 30 days
Ambulatory Care
Health care services that are delivered in an out-patient, or non hospital setting. It implies that the patients are able to ambulate to the clinic to receive their services
Long Term Care
Health care services that are provided for more than 30 days
long term care
Health care that is provided for more than 30 days. Usually related to chronic conditions. i.e.: rehab or nursing homes
HAI
Healthcare Associated Infection
HICPAC
Healthcare Infection Control Practices Advisory Committee
An enzyme and CK test can diagnose what?
Heart Attack
What are the Main components of the Circulatory System?
Heart, Vascular System, Blood, Hemostasis &Coagulation, Lymphatic systems
The calcaneus is a bone located in the:
Heel
H. pylori
Helicobacter pylori, Bacterial secreting substances that damage lining of stomach & cause chronic gastritis which can lead to peptic ulcer disease
Iron fillings used in capillary blood gas collection:
Help mix anticoagulant
Which of the following collection devices fill by capillary action?
Hematocrit tubes
Where is the first tube of cerebrospinal fluid usually sent?
Hematology for cell counts and different stains
What is the main Component of RBC?
Hemoglobin
Mixing a specimen too vigorously can result in
Hemolysis
A tube with a Green stopper normally contains
Heparin
Microhematocrit tubes with a red band on one end contain:
Heparin
HBV
Hepatitis B Virus
HCV
Hepatitis C Virus
occult blood
Hidden blood in feces
Good Cholesterol
High Density Lipoprotein
CLIA high complexity
High complexity-complex to preform with a much greater risk to patient if results are inaccurate. i.e.: molecular analysis, bone marrow evils, immunoassays
Arteries
Highly oxygenated blood vessels that carry blood away from the heart.
An early medical theory developed by ___ stated that disease was the result of excess substance...
Hippocrates
The finger stick procedure involves
Holding a patient's finger firmly with the phlebotomist thumb away from the puncture site. The puncture should be done on one sharp, continuous movement and gentle pressure can be applied to the finger the preferred site for skin puncture are the third and fourth fingerm
Erythropoietin
Hormone produced in the kidney that initiates the production of red blood cells.
Inpatients
Hospitalized patients
HIV
Human Immunodeficiency Virus
hCG
Human chorionic gonadotropin
for a phleb to collect blood for a research study in a health care institution he or she must obtain consent from the research participant due to
IRB requirements
Which of the following patient conditions would make capillary puncture a good choice for specimen collection?
Iatrogenic anemia
ID Band / bracelet
Identification
Zinc levels maybe erroneous
If collected with lithium heparin since the green top tubes are not manufactured for trace element collection
Icon
Images used to request appropriate programs or functions on computer
Blood Bank
Immunohematology
Informed consent
Implies voluntary and competent permission for a medical procedure, test or meds
Malpractice is a claim of
Improper treatment
Defendant
In a lawsuit, a person against whom a complaint is filed
Residual alcohol may
In fact provide an extra measure of sterility, it does not provide an extra measure of test reliability
Blood for creatine kinase can be collected
In the speckled top tube since it separates serum from the blood cells and has no effect on the creatine kinase level
Cygogenetics
In this section, samples are examined for chromosomal deficiences that relate to genetic disease.
Phlebotomy
Incision into the vein for the purpose of drawing blood or Venesection
phlebotomy
Incision of a vein
What is the purpose of warming the site before capillary puncture?
Increase the flow of blood
Which of the following sites would normally be eliminated as a capillary puncture site?
Index finger of a woman
Susceptible host
Individual who has little resistance to an infectious agent.
Phlebotomist
Individual who practices phlebotomy
IQCP
Individualized Quality Control Plan
Nosocomial Infection
Infection acquired in a hospital setting
Presence of leukocytes in urine (white blood cells)
Infections of the kidney, infection of the urinary bladder, infection of the urethra
Osteochondritis is:
Inflammation of the bone and cartilage
Data
Information collected for analysis
Many laboratory tests can be affected by the
Ingestion of food and drink. It is important to note whether or not the patient has been fasting
What phase is Factor V(5)?
Initiation & Amplification
Plaintiff
Injured party in the litigation process
It is necessary to control the depth of lancet insertion during heel puncture to avoid:
Injuring the calcaneus
Two general categories of facilities.
Inpatient (Nonambulatory) and Outpatient (Ambulatory)
Acute care
Inpatient hospitals for non-ambulatory more critical patient care
The needle should be
Inserted in the same direction as the veins at a 15 to 30 degree angle to the skin
IDN
Integrated delivery networks
Battery
Intentional harmful or offensive touching or use of force on a person without consent or legal justification
IATA
International Air Transport Association
ICD-10-PCS
International Classification of Diseases, Revision Procedural Coding System
IOS
International Organization for Standardization; a non-govt network of standards institutes from 155 countries that develops standards for manufacturing and service industries.
INR
International normalized ratio
Fluid in the spaces between the cells is called:
Interstitial fluid
Discussing a patients condition with another person or employee is an example of
Invasion of privacy
The best way to mix blood in an additive microtube is to:
Invert it gently
iCa2+
Ionized calcium
Arrhythmia
Irregular heart rhythm
BD unopette
Is a blood collection and dilution device used in the measurement of the RBC count, WBC count, platelet count and other procedures but not bleeding time
BD unopette
Is a blood collection device that is prefilled with specific amounts of diluent or reagents
Vacuette tube
Is a blood collection tube that does not have a diluent for dilution of the blood
Creatine kinase testing
Is a chemistry test and should be occur in the red and black speckled top tube that yields blood cells and serun
BD vacutainer systems
Is a collection and dilution unit used for various procedures WBC, RBC, platelet, hemoglobin, RBC fragility and sodium, potassium and lead determination
The Clinical Laboratory Improvement Amendments of 1988 (CLIA '88)
Is a federal law that allows the Centers for Medicare and Medicaid services to regulate all sites performing laboratory testing in the United States.
Cortisol
Is a hormone and to measure it, blood needs to be collected in a green top tube
The BD unopette
Is a microcollection and dilution device that is used to measure various analytes
Hepanized microcollection tube
Is a microcollection capillary tube that contains heparin to mix with the blood to avoid blood coagulation
The microhematocrit tube
Is a microcollection capillary tube that contains heparin to mix with the blood to avoid blood coagulation
Tenderletts
Is a safety microcollection device
Surgicutt
Is a sterile standarized, disposable instrument that is used for bleeding time assay
The RPR tests
Is a syphilis test requiring serum collected I'm red or speckled top tubes
Interstitial fluid
Is a tissue fluid
Selenium
Is a trace element and must be tested on blood collected in a trace element tube, royal blue with heparin or in edta purple tube
Coughing or sneezing
Is a type of "droplet" contact infection transmission that involves infective microbe to the mucous membranes
Sodium flouride
Is an additive to inhibit glycolytic action/ glucose breakdown.
Lead
Is an analyte that must be collected in a brown top vacuum tube, but it does not have to be protected from light
Acid citrate dextrose/ACD
Is an anticoagulant and preservative that is frequently used in the collection of blood for blood donations
Citrate phosphate dextrose/CPD
Is an anticoagulant and preservative that is frequently used in the collection of blood for blood donations
Potassium oxalate
Is an anticoagulant that is used in the gray too vacuum tubes for blood glucose testing
Osteomyelitis
Is defined an inflammation and infection of the bone
Professionalism
Is defined as the conduct and qualities that characterize a professional person.
Royal blue top tube
Is designed for collection of trace such as copper
Lithium heparin
Is found in green top tubes and is very suitable for blood glucose measurements
The BD microtainer tube
Is frequently used in the microllection of electrolytes and general chemistry blood specimens
Sodium citrate
Is generally used in light blue top tubes
Fasting status
Is important for collecting many types of blood specimens
Technical Supervisor
Is responsible for the administration of the area and who reports to the laboratory administrator.
Capillary blood acquired by skin puncture
Is significantly different than that of venous blood acquired by venipuncture. It is composed of blood from arteries, venules, capillaries and intracellular and interstitial fluids
Glycolysis
Is the break down of glucos, which can lead to erroneous low blood glucose results if the RBC are not separated from the serum
Hemolysis
Is the breakdown of RBC which is not the most critical reason for separating blood cells from the serum
ESR
Is the same laboratory assay as a sedimentation rate, erythrocyte sedimentation rate or red rate
If a light blue top tube
Is underfilled coagulation results will be erroneous prolonged
Sodium polynethole sulfonate/ sps
Is used in the collection of blood culture specimens
Microvette capillary blood collection system
Is used to collect and store capillary blood specimens
Ethylene diamine tetra acetic acid/ Edta
Is used to collect blood for blood smears since it creates minimal distortion of WBC
The VDRL test
Is used to detect syphilis in blood and requires a red or speckled top tube for collection
Errors in capillary glucose results have been attributed to:
Isopropanol contamination of the specimen
What is cysticfibrosis
It is a genetic disorder of the endocrine glans it is the most common fatal autosomal recessive disease among the Caucasian population.
What is Arterial Blood Gasses (ABGs)
It is analytical test that measures oxygen and carbon dioxide in the blood.
Blood collected by puncturing the skin is called capillary blood because:
It is from the dermal capillary bed
Blood Vessels
Key component of the circulatory system, these vessels transport blood throughout the body.
Presence of protein in the urine?
Kidney disease, inflammatory disease or disorder, prolonged exercise, chemical poisoning.
Presence of hemoglobin in the urine
Kidney disease, inflammatory disease, Malaria, Server burns, chemical poisoning.
If venous blood is placed in a microtube, it is important to:
Label it as a venous specimen
Cross-match Testing
Laboratory analysis that involves exposure of a donor's blood to a patients blood to a patient's blood to see if they are compatible or incompatible.
LIS
Laboratory information system
Who is able to do laboratory drug monitoring of therapeutic agents?
Laboratory, nursing, and pharmacy personnel
This is a sharp-pointed device used to make capillary punctures:
Lancet
Megakaryocytes
Large cells located in the bone from which platelets are formed.
Reference Laboratories
Large independent laboratories that receive and test specimens from many different facilities
Reference Laboratories
Large independent laboratories that receive specimens from many different facilities located in the same city, other cities in the same state, or even cities that are out of state.
Monocytes
Large leukocyte formed in bone marrow that ingests: bacteria, old red blood cells, and debris in tissues
Aorta
Largest artery in the body.
Venae Cavae
Largest veins of the body.
Which of the following equipment is reusable?
Laser Lancet
Basilic vein
Last choice, large vein on inner side of antecubital area
Respondent Superior
Latin ,``let the master respond``. Employers must answer for damages their employees cause
Which color-coded microtube would be used to collect a CBC?
Lavendar
CBC is drawn in a
Lavendar stopper
What color tube does Lead for the Department of Health go in?
Lavender
What Color tube and Lab for Leukocytosis?
Lavender and Hemotology
Statue of Limitations
Law setting the length of time an alleged injury which the injured person is permitted to file a lawsuit
Basophils
Least numerous type of leukocyte that releases histamine and helarin to damaged tissues
For localized bloodletting, ___ were used.
Leeches
Civil actions
Legal actions in which the alleged injured party sues for monetary damages
After making a blood smear:
Let it dry naturally
A blood cell that has the ability to pass through the blood vessel walla
Leukocyte
Lymphocytes
Leukocyte that multiplies in the lymphoid tissue and has a role in the body's immune system.
Threshold Values
Level of acceptable practice beyond which quality patient care cannot be assured
Vicarious liability
Liability imposed by law on one person for acts committed by another
Prothrombin Time is drawn into a
Light Blue stopper
plasma separating tube
Light Green Tube Top (PST) additive
Situations that require a venipuncture instead of capillary puncture include when a:
Light blue top tube has been ordered
The coagulation tube
Light blue top tubes should be collected before the hematology tube or purple top tubes
Platelet function screening
Light-blue topped tube.
Plasma
Liquid portion of the blood in which cells are suspended. Plasma
Green Top Additive(s) and Department? Yield?
Lithium Heparin (Chemistry) Sodium Heparin (Send Out Lab) Plasma
Green
Lithium heparin Sodium heparin Chemistry STAT Plasma separator
Green/gray Light green
Lithium heparin & Gel separator Chemistry
A Jaundiced appearance of a patient means?
Liver Inflammation with High levels of Bilirubin
Presence of bilirubin in urine
Liver disease, obstructive jaundice
Bad Cholesterol
Low Density Lipoprotein
It is unlikely that hold in a blood smear would be caused by:
Low hemoglobin
What does cysticfibrosis affect?
Lungs, upper respiratory tract, liver, and pancreas
Centrifuge
Machine that spins blood tubes at a high number of revolutions per minute
Hemostasis
Maintenance of circulating blood in the liquid state and retention of blood I the vascular system by prevention of blood loss.
Clinical Pathology
Major area of laboratory services where blood and other types of body fluids and tissues are analyzed
Antecubital veins
Major superficial veins in antecubital fossa
Collection of a thick blood smear may be requested to detect:
Malaria
MCO
Managed Care Organization
A blood smear is required for this test:
Manual differential
An acceptable way to confirm the patients identity
Match the ID band and requisition with his verbal statement of ID
Granulocytes
Mature white blood cells in the circulating blood; when strained and viewed by a microscope, granules are present.
Cell morphology
May change because of inadequate filling, thereby altering the blood to additive ration
Blood pressure
Measure of force exerted by the blood on walls of blood vessels
Thrombocyte
Med term for platelets, help coagulate, smallest of formed elements
What is the most desirable site for skin puncture on an infant, or neonate?
Medial or lateral aspect
Which of the following is the safest area of an infant's foot for capillary puncture?
Medial plantar heel
MLS
Medical Lab Scientist
MR number
Medical record number for patient
The Patient Bill of Rights in Medicare and Medicaid.
Medicare now requires that patients be informed of their rights, including the right to know what treatment, and the right to confidentiality.
MRSA signifies
Methicillin resistant staphylococcus aureus
Pathogens/Pathogenic
Microbes capable of causing disease
What is culture and sensitivity (C&S)
Microbiologic test to determine the growth of infectious microoganisms in bodily specimens (urine) and to determine which antibiotics are most effective on the microorganism.
Which of the following equipment is used to collect a manual packed cell volume test?
Microhematocrit tube
septicemia
Microorganisms/toxins in the blood
Capillaries
Microscopic blood vessels that carry blood and link arterioles to ventricles.
Venules
Minute veins that flow into larger veins.
What is the most critical error a phlebotomist can make
Misidentifying a patient specimen
CLIA moderate complexity
Moderate complexity-simple to preform with more risk to patient if errors are made i.e.: white or red blood counts, hemoglobin, urine cultures
Why is venous blood brighter then arterial blood?
More Oxygen in the blood
Neutrophils
Most numerous type of leukocyte which surrounds and digests pathogens found in tissue
What infectious agent affecting a patient requires the use of a personal respirator by the phlebotomist?
Mycobacterium tuberculosis
Which of the following would require droplet precautions?
Mycoplasma pneumonia
Which capillary specimen should be collected separately?
NBS
CBG specimens are collected in:
Narrow-bore capillary tubes
NP
Nasopharyngeal
NHSN
National Healthcare Safety Network
NIOSH
National Institute for Occupational Safety and Health
NIDA
National Institute on Drug Abuse
NPSG
National Patient Safety Goals
NPA
National Phlebotomy Association; established in 1978 to recognize Phlebotomists as a definable part of the healthcare team.
The enzyme, lactate dehydrogenase
Needs to be detected in a blood sample collected with speckled top tube
When is it acceptable to put a Hole in the glove?
Never
Neonatal screening is the testing of:
Newborns for certain disorders
Red (glass)
No additive Chemistry, Blood Bank Serology/Immunology
fasting
No food / drink for 12 hrs
Blood smears
No rideges, lines, or holes should be present on a blood smear
Physician's Office Laboratories (POL)
Non hospital laboratories usually based in a physician's office/clinic at the private practice
American Hospital Association (AHA)
Non profit group or alliance of member hospitals and health care organizations that promote the interests of hospitals. It is an advocacy group for health care organizations, particularly hospitals
Red Top,Tiger(SST),Gold Additive(s) and Department? Yield?
None Clot Activator and gel separator Chemistry Serum
Royal blue
None EDTA Sodium heparin Chemistry
Standard of Care
Normal level of skill and care a healthcare practitioner would provide for their patients
Tripod I'm citrate is
Normally used in light blue top tubes
What is considered the most dangerous to a patient?
Not properly Labeling the tubes
NPO
Nothing by mouth
fasting
Nothing to eat or drink for at least 12 hours.
What point of care instrument can measure electrolytes?
Nova Stat Profile pHOx plus
Accession number
Number generated by laboratory information system (LIS) when specimen request is entered into the computer
Chain of infection
Number of events in a series, lead to an infection.
The warning label in Figure 4.2 was originally established as a requirement by:
OSHA
What does OSHA stand for?
Occupational Safety & Health Administration
OSHA
Occupational Safety and Health Administration U.S. gov't agency that mandates and enforces safe working conditions for employees.
Peak and trough levels
Of certain drugs are useful to monitor the therapeutic levels.
The external tube diameter and light plus the maximum amount
Of specimen to be collected into the vacuum tube are the criteria that are used to describe vacuum collection tube size
The gauge size
Of the needle is identified by the color code on the sealed shiekd
The patients who have mastectomies
Often have lymph nodes removed from the same surgical area. Swelling often occurs on the affected side of the body. Blood should not be withdrawn from the mastectomy side unless approved by a physician. The other arm should be considered first as an alternate site
Cardiac cycle
One complete contraction & relaxation of the heart
Inferior Vena Cava
One of the two large veins that bring oxygen-poor blood to the heart from the lower trunk of the body.
Superior Vena Cava
One of the two large veins that brings oxygen-poor blood to the heart from the head, neck, arms, and chest region.
Most veins have
One way valves
In which of the following areas does capillary specimen collection differ from routine venipuncture for tests that can be collected either way?
Order of draw
Lt blue Gold Red Green Lavendar Pink Gray Navy blue
Order of draw
Class A Class B Class C Class D Class K
Ordinary Flammable Electrical Combustible metals Kitchen, oils
Which of the following can be a complication of a heel puncture that is too deep?
Osteomyelitis
What ID is required for Outpatient Testing? Inpatient?
Outpatient: Name & DOB Inpatient: ID band matches Requistion
ambulatory care
Outpatients are more mobile and tend to be less critical
O&P
Ova & parasites test to detect intestinal parasites & eggs in feces
Which of the following can result in microclot formation in a specimen collected in an anticoagulant microtube?
Overfilling the tube
The function of the left ventricle is to deliver
Oxygenated blood to the aorta
Neonatal screening for this disorder is required by law in the United States:
PKU
This test is typically performed on capillary blood:
PKU
To prevent skin and mucous membrane exposure when contact with a patient's blood is anticipated, which of the following should be worn?
PPE
A differential test is unable to determine:
Packed cell volume
A recommended capillary puncture site on children 2 years of age or older is on the:
Pad of a middle finger
preanalytical/examination phase
Part of process from time lab tests are ordered through the time specimens are delivered to lab. i.e.: pt identification, drawing, labeling and transporting
Systemic Circuit
Part of the cardiovascular system that carries blood to the tissues of the body.
Intrinsic System
Part of the coagulation process that involves the clotting factors contained in the blood.
Systemic circulation
Pathway carries oxygenated blood from heart Returns blood to heart carrying CO2
Pulmonary circulation
Pathway that carries CO2 blood from heart to lungs Where CO2 is removed, returns oxygenated blood to the heart
PSC
Patient Service Centers
All specimens labels should include the
Patients name and identification number, the date and time of collection and the phlebotomist initials. The patients room number, bed assignment, or out patient status is optional but useful information
Wing infusion sets are used for difficult venipuncture
Patients with small hand and wrist veins, patients who are young children, severely burned, geriatric, patients who have numerous needlestick/ oncology patients, restrictive position/ arthritis and fragile skin. Young and adult males
What do blood gasses analyze and measures?
Pco2,pO2, and PH
Competency Statement
Performance expectations that include entry-level skills, tasks, and roles performed by the designated health care worker
PPE
Personal Protection Equipment
PPE
Personal Protective Equipment
PM
Personalized medicine
What is the Singular for for Phalanges?
Phalanx
Which of the following is the medical term for a finger bone?
Phalanx
Which other hospital department would the labratory coordinate therapeutic drug monitor
Pharmacy
In the United Sates, newborns are routinely screened for a variety of metabolic and genetic defects by analysis of blood collected on a special filter paper called what?
Phenylketonuria PKU, and Congenital Hypothyrodism
PKU
Phenylketonuria defect in metabolism of phenylalanine
Self confidence
Phlebotomists who exhibit self confidence has the ability to trust his or her own personal judgement.
POL
Physician Office Laboratories: labs that are located in private physicians offices subject to same laws and regulations.
Cross match and blood banks are collected in a
Pink stopper tube
This is a term for the bottom surface of the heel:
Plantar
What is needed to determine circulating levels of the drug?
Plasma, serum, or whole blood.
Whats the component of blood for clotting?
Platelets
POCT
Point of Care Testing
POC
Point of Care: tests that are performed at the patients bedside, at ancillary or mobile sites or in patient home.
PCR
Polymerase chain reaction
A tourniquet causes
Pooling or filling of blood in veijs. Such pooling makes blood collection easier during a venipuncture procedure, regardless of the method used to withdraw blood from the vein
Aliquot
Portion of specimen used for testing
PP
Postprandial
Hemolysis of a capillary specimen can erroneously elevate results for this test:
Potassium
K+
Potassium
Work practice controls
Practices used to reduce the likelihood of bloodborne pathogen exposure
What does the chemical analysis UA include?
Presence of glucose, protein, blood (red blood cells and hemoglobin), white blood cells, ketones, bacteria, bilirubin, and other constituents. The test is done by using plastic reagent strips.
The purpose of an antiglycolytic agent is to
Preserve glucose
Which of the following capillary puncture techniques is incorrect?
Press the lancet down into the skin so it does not slip
Heparin
Prevents coagulation by in activating blood clotting thrombin and thromboplastin
Antiglycolytic agent
Prevents glycolysis (glucose breakdown)
PCP
Primary Care Physician
Three levels of healthcare
Primary, Secondary, and Tertiary
Isolation procedures
Procedures to separate patients with transmissible infections from contact with others.
Deposition
Process in which one party questions another under oath while a court reporter records every word
Erythropoiesis
Production of red blood cells.
American Society for Clinical Laboratory Services (ASCLS)
Professional organization for laboratory personnel that provides continuing education, conference activities, and certification examinations for specified groups
American Nurses Association (ANA)
Professional organization for nurses
National Phlebotomy Association (NPA)
Professional organization for phlebotomists that offers continuing educational activities and a certification examination for phlebotomists
lookback
Program that requires all components of a unit of blood to be traceable back to the donor and requires notification to blood recipients who received, turned positive, for a transmissible disease
PHI
Protected health information
Immune
Protected or resistant to a particular disease/infection because of development of antibody's through vaccination or recovery from the disease.
Reverse isolation
Protective isolation for patients with compromised health conditions. Example: Burn victims, HIV, etc.
Purpose of "protective" isolation is
Protects patients who are highly susceptible to infection
Dinning/ putting on a clean pair of gloves in the presence of the patient
Provides a reassuring and safety conscious gesture for the patient and the health care worker
The Pulmonary Vein
Provides oxygen-rich blood to the heart
Home Health Services
Provision of health care services in a patient's home under the direction of a physician
What Tests Can Not be collected by Capillary draw?
Pt, PTT, Blood Cultures
PHS
Public Health Service
Proper finger puncture technique would exclude:
Puncturing parallel to the fingerprint
quality control
QC measures help insure that all test results reflect what they are supposed to measure and that results can be accurately reproduced time after time
quality improvement
QI; Concept of meeting and exceeding customer expectations by recognizing, resolving and improving on areas of dissatisfaction.
QA
Quality assurance Processes used to create standard quality service/prevention of problems.
QC
Quality control Specific activities/techniques to fulfill requirements for a quality service/product.
QNS
Quality not sufficient
Erythrocyte
RBC Carry oxygen from lungs to cells Transport CO2 away from cell to lungs
What is a cardiac point care test that qualitatively measure troponin T to detect heart damage?
ROCHE TROPT
Vasoconstriction
Rapid construction of the blood vessels to decrease blood flow to the area.
Phlebotomist should follow the manufacturer
Recommended amouny of hand rub to decontaminate hands. Usually it is a small s mount that should be applied on one palm, then while rubbing hands together.. All surfaces of hands and fingers should be covered and rubbed until hands are dry
If Collecting a T3,T4 and TSH what size and color Tube would you use?
Red Top 10mL
What does Hemolysis Mean?
Red blood cells are destroyed
A BMP is drawn into a
Red stopper
What Tubes produce Serum?
Red, Gold, Tiger Top/ SST
What Tubes contain Clot Activators?
Red,Gold,(SST)Tiger
What Color tube and Lab for Liver enzymes?
Red,Green,Gold,Tiger(SST) Chemistry
One purpose of wiping away the first drop of blood (fig. 10-4) during capillary specimen collection is to:
Reduce tissue fluid contamination
Unsure of a specimen test ordered from a physician, take what action
Refer to the collection manual for instructions
Point-of Care
Refers to tests and procedures that are actually performed at the patients bedside or "point of care".
Hand lotions are used to
Relieve dryness caused by excessive hand washing or excessive used of hand rubs. They minimize the occurrence of dermatitis associated with hand decontamination
Therapeutic Reasons
Removal of blood Polycythemia, Hemochromatosis
What is therapeutic phlebotomy?
Removal of blood for therapeutic reasons.
ARD or FAN blood culture bottles
Remove any antibiotics that are in the blood
Lead levels in blood are very minute and
Require a blood collection tube without any detectable lead such as the brown top tube
Erythrocytes sedimentation rate
Requires a black topped tube with sodium citrate or purple top tube with edta
CBC levels
Requires blood collected in edta/ purple top tube
The APTT/ activated partial thromboplastin
Requires blood collection in the light blue top tubes containing citrate
The evacuated tube system
Requires three components, the evacuated sample tube, the double pointed needle and a special plastic adapter
Cytogenetic analysis
Requires whole blood collected in a green topped / Na heparin blood collection tube
R A C E
Rescue Alarm Confine Extinguish
Which statement concerning capillary blood gases is untrue?
Results are much more accurate than ABGs
Which of the following would be excluded form a list of reasons why capillary puncture is the preferred method to obtain blood from infants and children?
Results on capillary specimens are more accurate
A Rh-negative patient should receive a
RhoGam shot
Heavy Metal Testing (tube,additive,Lab)
Royal Blue, EDTA Send Out Lab
lancet
SMALL, SHARP INSTRUMENT USED TO PERFORM CAPILLARY PUNCTURES
serum separating tube
SST Tube
SDS
Safety Data Sheets
The value of leach therapy lies in the components of the worm's_____.
Saliva; which contains a local vasodilator, a local anethetic, and hirudin (an anticoagulant)
Which of the following actions taken while filling microcollection tubes would be considered incorrect technique?
Scooping up blood as it runs down the finger
Central processing
Screening & prioritizing area where specimens are received & prepared for testing
analytical/examination phase
Second phase of the lab process where the appropriate methods, equipment and quality control measures are applied to provide accurate test results.
Bar code
Series of black stripes & white spaces of varying widths that correspond to letters and numbers
Lancets with permanently retractable blades are disposed of in the:
Sharps container
The distance between the skin surface and the bone in the end segment of a finger is:
Shortest at the side and the tip
The average depth of a skin puncture
Should be 2 to 3 mm for an adult to avoid hitting the bone
Contaminated gloves
Should be disposed of in a biohazardous container adjacent to the procedure area
The red and black speckled top blood a collection tube
Should be gently inverted five times so that the blood clotting occurs in 30 minutes
Good blood smears
Should cover about one half of the slide, have feathered edge
Tenderletts breakdown safe
Single use, atomically retracting, disposable devices used for microcollection by skin puncture
To increase the likelihood of a successful puncture
Slight rotation of the patients arm to a different position, palpation the entire antecubital area to trace vein path, warming the site, gentle massaging, lowering the arm over the bed side, asking the patient for a preferred site, or using the other arm. But ask the doctor for a preferred site.
Arterioles
Smaller branches of arteries.
What else can the Nova Stat Profile pHOx plus measure?
Sodium (Na*) Potassium (K*), Chloride (Cl-) or Calcium (Ca++) plus glucose, calculate bierbonate (HCO3-) and total carbon dioxide (TCO2) Levels.
Light Blue Top Additive(s) and Department? Yield?
Sodium Citrate Coagulation Plasma
What type of additive is recommended for collecting an ethanol test specimen
Sodium Fluoride
Grey Top Additive(s) and Department? Yield?
Sodium Fluoride Potassium Oxalate Chemistry Plasma
Light blue
Sodium citrate Coagulation Dept PT, aPTT, bleeding time, dDimer(frozen), Fibrinogen(frozen) INR- international normalized ratio (TT)-thrombin time (FSP)Fibrin split products
Gray
Sodium fluoride & potassium oxalate Sodium fluoride & EDTA Sodium fluoride Chemistry Glucose
Yellow
Sodium polyanethol sulfonate (SPS) Microbiology
Tertiary Care
Specialized health care for inpatients
The antiseptic must be completely dried before performing capillary puncture to avoid:
Specimen hemolysis
Whorls as related to capillary puncture are:
Spiral patterns of fingerprints
Vasoconstriction
Stage 1 of hemostasis, damaged vessel narrows to decrease flow of blood to injury
Fibrinolysis
Stage 4 homeostasis Removal of blood clot once healing starts
What is NOT a phlebotomist's duty
Starting intravenous lines (IV)
a phlebotomist had to avoid contact with patients for 24 hours after being started on an appropriate antibiotic and appearing symptom-free. What type of infection could he or she have acquired for such work limitations to apply?
Strep throat (group A)
Proxemics
Study of an individual's concept and use of space
Kinesics
Study of nonverbal communication
Fibrin
Substance that forms a blood clot.
Anticoagulant
Substance that prevents blood from clotting
Additive
Substance within a tube
Extrinsic Factors
Substances involved in the clotting process that are stimulated when tissue damage occurs.
Edema
Swelling
What is a type of Air born precaution?
TB
The label shown in Figure 41 will most likely be posted in the entrance to the:
TB culture
Cross match
Test to determine compatibility of donor & recipient blood or tissue
CLIA waived test
Tests that provide simple, unvarying results and require minimal amount of judgment and interpretation
Tenderly to automated skin incision device
That is used for make a skin puncture in the finger or heel for the collection of capillary blood used for microhematocrit measurement test per formed on capillary bloodm
"Standard of care" comes from what organization
The Joint Commission
Which of the following organizations requires the development and implementation of an infection control program in a health care facility?
The Joint Commission
TJC
The Joint Commission Organization, establishing standards for hospitals/health related facilities.
The safest area for infant heel puncture
The Lateral Plantar Surface
Antisepsis is a technique used on what?
The Skin
Buffy Coat
The WBCs and platelets that form a thin white layer above the RBCs in blood specimens that contain anticoagulants.
Sodium citrate
The anticoagulant in light blue top blood collection tubes is frequently used in coagulation blood studies
Epidermis
The avascular layer of the skin
Blood Bank (Immunohematology)
The blood bank or immunohematology department of the laboratory prepares blood products to be used for patient transfusions.
Lymphatic System
The body system that is responsible for balancing fluids, provide defense against disease, and absorption of fats and other substances from the blood stream.
Cardiovascular System
The body system that provides for rapid transport of water, nutrients, electrolytes, hormones, enzymes, antibodies, cells, and gases to all ells of the body.
Chemistry
The chemistry department performs most laboratory tests.
During the skin puncture procedure
The cut should be oriented across the fingerprint lines
Fibrinolysis
The final phase of the hemostatic process whereby repair and regeneration of the injured blood vessel occurs and the clot slowly begins to dissolve or break up.
The preferred site is
The fleshy, central surface of the fingertip, not the extreme tip on. On the third finger
Hematology
The hematology department performs laboratory tests that identify diseases associated with blood and blood-forming tissues.
phlebotomy (phlebo/tomy)
The incision of a vein for blood letting. aka: venesection/venisection
phlebotomist
The individual that performs the phlebotomy. Primary function is in the accurate, safe, and reliable collection of specimens.
Laboratory Administrator/Laboratory Manager
The lab administrator is usually the technologist with an advanced degree and several years of experience.
The smaller the gauge number
The larger the diameter of the needle
Dermis and Subcutaneous
The layers of the skin containing blood vessels
Due care
The level of care a person w intelligence and good sense would exercise under the circumstances
Communications defined
The means by which information is exchanged or transmitted.
Rh Factor
The method to categorize blood according to the presence or absence of the Rh antigen.
Microbiology
The microbiology department analyzes body fluids and tissues for the presence of microorganisms, primarily by means of culture and sensitivity (C&S) testing.
In a venipuncture procedure
The needle should always be inserted with the bevel side upward and directly above a prominent vein or slightly below the palpable vein.
complete blood count
The number of RBC's (red blood cells), WBC's (white blood cells) and platelets (per cubic millimeter) that are present in the patient's sample of blood is determined.
Laboratory Director/Pathologist
The pathologist is a physician who specializes in diagnosing disease, through the use of laboratory tests results, in tissues removed at operations from postmortem examinations.
What is a clean catch?
The patient is instructed to void approximately one third of the urine into the toilet, collect approximately one fourth in ready available sterile container, and allow the rest to pass into the toilet.
By recognizing diversity
The phlebotomist promotes goodwill and harmonious relationships that directly improve health outcomes, the quality of services, and public relations.
For hand vein punctures
The posterior , dorsal surface of the wrist is preferred because the veins are larger.
When arm veins cannot be used for venipuncture
The preferred site is that back of the hand or wrist that is the dorsal surface not the palm side of the hand
What is the chain of custody
The process for maintaining control of and accountability for each specimen from the time it is collected to the time of disposal.
professionalism
The skill, competence, or character expected of an individual in a trained profession. Respect, Service, Support, Growth
Bevel
The slanted tip of a needle that enters the vein
Hemostasis refers to
The stoppage of bleeding
Proxemics
The study of an individual's concept and use of space.
Kinesics
The study of nonverbal communication. It includes characteristics of body motion and language such as facial expression, gestures, and eye contact.
Serology or Immunology
The term serology means the study of serum. Serology tests deal with the body's response to the presence of bacterial, viral, fungal, or parasitic diseases stimulating antigen-antibody reactions that can easily be demonstrated in the laboratory.
"Feather" is a term used to describe the appearance of:
The thinnest area of a blood film
After a needle is inserted and the blood begins to flow
The tourniquet should be released and the patient may open his or her fist
TDM
Therapeutic drug monitoring
Which statement concerning microhematocrit tubes is incorrect?
They are coated with lithium heparin
arterial blood
They take blood from an artery. Done by respiratory. It is an arterial blood specimen done at the hand or forearm. Looks at - Oxygen carried in the blood, Carbon dioxide carried in the blood, pH level. Following an ABG make sure that there is no bleeding in the site afterwards.
blood culture tube
This test is collected in a tube with a light-blue top the first order of draw recommended by the NCCLS (2004)
Permucosal
Through mucous membranes
Percutaneous
Through the skin
TGC
Tight glycemic index
Skin puncture blood is composed of
Tissue fluids, blood from arterioles, and venules and blood from capillaries. The content of arterial blood is actually grater in skin puncture blood than venous blood because the arterial pressure in the capital is stronger than the venous pressure
Specimens used for chromosomal studies include:
Tissue, blood, and amniotic fluid.
contaminate
To harm by contact with something undesirable
What is Therapeutic drug monitoring (TDM) used for?
To monitor the serum concentration of certain drug.
Hemochromatosis
To much iron
Public Health Service (PHS)
To promote the protection and advancement of the nation's physical and mental health.
Exsanguinate
To remove all blood
Why do you wipe away the first drop of blood in capillary testing?
To remove tissue "juices" and possible alcohol residue
Hyper
Too much (prefix)
What item can be used more then once for blood collection?
Tourniquet
What equipment is used to obtain blood in Venipuncture?
Tourniquet Gauze Alcohol Swab Collection Device ( Multi draw needle, ETS holder, Butterfly,Ect..) Evacuated Tube Co-ban Gloves
What is the major function of a red blood cell?
Transports oxygen and carbon dioxide (Every 120 Days).
What is the best room to use for a child during a painful procedure?
Treatment room. Away from where the child sleeps, and way from play room.
Fire Tetrahedron
Triangle of fire components Heat, Fuel, Oxygen, Chemical
Tnl
Troponin I, protein specific to heart muscle used in diagnosing an acute myocardial infarction/heart attack
TnT
Troponin T, protein specific to heart muscle, heart attack and to monitor effectiveness of thrombolytic therapy
Bone marrow
Tube: Lavender Detects abnormal blood cells and evaluates blood cell formation and function.
Eosinophil count
Tube: Lavender Increased numbers in direct count indicate parasitic infections and allergies.
Osmotic fragility
Tube: Lavender Increased red cell fragility is indicative of hemolytic and autoimmune anemias.
Sick cell screen
Tube: Lavender Sickling of red cells indicates presence of Hgb S, and abnormal hemoglobin variant.
Atria
Two of the four chambers of the heart.
Ventricles
Two of the four chambers of the heart.
arm / wrist band
Two other names for ID band / bracelet
Most likely to result in fatal consequences if the patient is misidentified
Type and crossmatch
Monocytes
Type of WBC that is non-granular and also plays a role in defense.
Lymphocytes
Type of WBC that is non-granular in appearance; plays role in immunity and the production of antibodies. ,
Neutrophils
Type of granulocyte. Neutrophilic granules stain bluish with natural dyes, and their nuclei generally have two or more lobes.
Malpractice
Type of negligence committed by a professional
ID code
Unique identification for users
Pictogram
Universally accepted symbols representing a word or idea by illustration.
Atria
Upper receiving chambers on each side of heart
UA
Urinalysis
UTI
Urinary tract infection
Ammonium heparin is not
Used in blood collection tubes
separator gel
Used to create a physical barrier between the serum and the cells; after collection, tube is inverted 5 times, blood allowed to clot for 30 minutes, then centrifuged; during centrifugation, the gel positions between the serum and cell layers. The gel also contains a clot activator
Which of the following is least likely to contaminate a PKU test?
Using isopropyl alcohol to clean the site
Correct newborn screening test collection of handling includeds:
Using one large drop to entirely fill a collection circle
Drug levels
Usually requires urine or larger amounts of blood than are possible from a skin puncture
Evacuated tubes fill with blood automatically because _______ exists in the tube
Vacuum suction
Hemostatic Process
Vasoconstriction Primary platelet plug formation Secondary hemostatic plug formation Fibrinolysis
Median Cubital Vein
Vein in the antecubital area that is most commonly used for venipuncture.
Cephalic Vein
Vein of the forearm that is acceptable for venipuncture.
Basilic Vein
Vessel in the forearm that is acceptable for venipuncture.
Which of the following is a commonly occurring pathogenic agent that causes health-care-acquired (nosocomial) infections of the gastrointestinal tract?
Vibrio cholerae
Invasion of Privacy
Violation of one's right to be left alone
Leukocyte
WBC nucleus cell function to fight infection
When you have to draw two different two sets of blood cultural what should you do?
Wait 60 minutes if you have to use the same arm, or use both arms. 2.5 inches.
CLIA catogories
Waived, Moderate complexity, High complexity
CLIA Waived Category
Waived-easy to preform with little risk of error or harm to patient i.e.: urinalysis, blood glucose screening, mono
Which of the following action words associated with capillary puncture procedures steps are in the correct order?
Warm, clean, puncture, wipe, collect
What is Ok for the patient to have while testing GTT?
Water
How do you determine the Daily Blood Limitation?
Weight and Total Volume
Serum
When blood is allowed to clot, sera separates from the blood cells, which are meshed in a fibrin clot. Serum contains the same constituents as plasma except that the clotting factors are contained within the clot.
Pulmonary Circuit
When blood leaves the heart and enters the right and left pulmonary arteries, the carry deoxygenated blood.
Kinetic slip
When verbal and nonverbal do not match
Kinesic slip
When verbal and nonverbal messages do not match.
A capillary tube fills with blood during a puncture procedure using capillary action
Whereby blood flows freely into the tube on contact without suction
Skin puncture samples are often used for
White blood cell differentials.they are also used for a variety of screening tests. E.g glucise, cholesterol. And other point of care procedures
Leukocyte
White blood cells
The blood lithium level
Wi be falsely increased if collected with lithium heparin anticoagulant
Partially filling a liquid EDTA tube
Will compromise the quality of a specimen
Which of the following would be least likely to introduce excess tissue fluid into a capillary puncture specimen?
Wiping the alcohol dry
The order of draw for filling microcollection tubes
With capillary blood is noy the same as for venipuncture
A blood smear prepared from an EDTA specimen should be made:
Within 1 hour of specimen collection
At what point does Bilirubin start to deteriorate after UV/Light exposure?
Within 2 Hours
Tort
Wrongful act committed against one's person, property, reputation, or legally protected right
Paternity Test (Color Tube, Additive,and Department)
Yellow ACD Blood Bank
Blood culture tubes
Yellow top tubes are always collected first to reduce the chances of contamination
specimen
a bit of tissue or blood or urine that is taken for diagnostic purposes
an IRB requires
a blood collector in research project to attend a course on the protection of research participants
Susceptible host
a component in the "chain of infection"; the degree to which an individual is at risk for acquiring an infection. Factors affecting susceptibility are age, drug use, degree and nature of the patient's illness, and status of the patient's immune system
what type laboratory test result should be reported to a patient's physician as soon as possible?
a critical value
Asepsis
a degree of cleanliness that prevents infection and the growth of microorganisms
Aseptic techniques
a degree of cleanliness that prevents infection and the growth of microorganisms. The technique to achieve this condition includes frequent handwashing, use of barrier garments and personal protective equipment (PPE), waste management of contaminated materials, use of cleaning solutions, following standard precautions, and using sterile procedures when necessary
Polycythemia
a disorder involving the overproduction of red blood cells.
anticoagulant
a drug that prevents clotting of the blood
the term critical value refers to which of the following
a life threatening test results
aliquot
a portion of a blood sample that has been removed/separated from the primary specimen tube
Standard precautions
a set of safeguards designed to reduce the risk of transmission of microorganisms; guidelines apply to all patients and all body fluids, nonintact, skin, and mucous membranes, and include the use of barrier protection (protective equipment such as gloves, gowns, etc.), hand hygiene, and proper use and disposal of needles and other sharps. Standard Precautions are more comprehensive than "Universal Precautions," which apply only to transmission of blood-borne pathogens. Policies must comply with OSHA Standards. Standard Precautions and Universal Precautions are available from the U.S. Centers for Disease Control and Prevention
Leukocyte
a white blood cell. There are several types, all amoeboid cells with a nucleus, including lymphocytes, granulocytes, monocytes, and macrophages.
Compatibility
ability to be mixed together; blood transfusions
AFB
acid fast bacilli
AIDS
acquired immune deficiency syndrome
APTT (PTT)
activated partial thromboplastin time
The following are key elements in effective communication
active listening nonverbal cues verbal skills
iatrogenic
adjective used to describe condition by effects of treatment
Postcentrifugation
after centrifuge
Pathogenic
agents include disease-causing bacteria, fungi, viruses, or parasites that are transmitted by direct contact, air, medical instruments, other objects, or vectors
Which of the following requires respiratory protective equipment for the plebotomist?
airborne precautions
Under the CDC isolation guidelines, three sets of precautions include:
airborne, droplet, and contact
Alb
albumin
a phlebotomist noticed that new printed labels for lab specimens came with a smaller transfer label,what could this smaller label be used for
aliquot tubes,cuvettes and microscope slides
jaundice
also called icterus; increased bilirubin, breakdown RBC's.
The following are common categorizations for health care organizations
ambulatory care inpatient care
an agency that has recognized patients rights through the patient care partnership is
american hospitality association AHA
Occupational Health and Safety Administration (OSHA)
an agency of the U.S. Department of Labor requiring employers to provide a safe work environment, including measures to protect workers exposed to biological and occupational hazards. OSHA is also responsible for responding to complaints, monitoring employer practices, and imposing sanctions (fines or closure) on employers who are noncompliant
Universal precautions
an infection control concept of blood-borne disease control, requiring that all human blood and other potentially infectious materials be treated as if known to be infectious for HIV, HBV, HCV, or other blood-borne pathogens, regardless of the perceived risk. Other concepts in infection control are referred to as Body Substance Isolation (BSI), meaning that all body fluids and substances are potentially infectious. Also called Standard Precautions and Standard Universal Precautions
Licensure
an official document or permit granted by a state agency that gives legal permission for a person to work in a particular health profession.
Heparin
anitcoagulant prevents clotting, inhibits thrombin formation
AC
antecubital
AB
antibody
Potassium oxalate
anticoagulant commonly used w antiglycolytic agent sodium fluoride
Sodium citrate
anticoagulant, prevents clotting by binding calcium, preserves coagulation factors
Ag
antigen
What feelings does one experience when a stranger gets too close for comfort
anxiety fear
clinical pathology
area of laboratory where blood and other types of body fluids and tissues are analyzed
collateral circulation
area supplied with blood from more than one artery so circulation can be maintained if one vessel is obstructed
Intensive care unit (ICU)
area where patients are more critically ill, require additional monitoring, and are more susceptible to infections
ABG
arterial blood gas
ABG
arterial blood gases
ASAP
as soon as possible
if a phleb walks into a patient room that has tv on very loud,what should be the first course of action prior to beginning the procedure
ask the patient if it is ok to reduce the volume or turn the television off
a child who refused to have his blood collected was locked in a room by a health care worker and was forced to have his blood collected .this is an example of
assault and battery
Stat
at once
abducted
away from the body; position of arm for arterial blood gas collection
posterior curvature
back of heel
reflux
backflow, blood into vein from collection tube during venipuncture
bacteremia
bacteria in the blood
C. difficile
bacterium that causes symptoms from diarrhea to life-threatening inflammation of the colon
BMP
basic metabolic profile
Baso
basophil
Hospitals differ according to
bed size length of stay mission ownership
Precentrifugation
before centrifuge
preop/postop
before surgery / after surgery
bedside manner
behavior of healthcare provider toward patient
when a phle builds a good rapport with a patient,what is he or she doing
being courteous and showing interest to improve patient satisfaction
Culture is composed of
beliefs spirituality traditions values
Billi
billirubin
moral issues or problems that have occured because of the latest medical research and technology are described as
bioethics
circadian
biologic rhythms, having 24hr cycle
BT
bleeding time
BC
blood culture
blood film/smear
blood drop spread thinly on slide
exsanguination
blood loss, life cannot be sustained
ABO
blood type
BUN
blood urea nitrogen
In spanish, peligro biologico refers to the English term:
bloodborne pathogens
One important surgical technique was venesection (cutting vein), used in the process of _____
bloodletting.
cyanotic
blue color from lack of oxygen
planter surface
bottom of foot
in alleged negligence cases when the plaintiff must be able ti show what actually happened and that the defendant acted unreasonably what factor does this indicate
breach of duty
bilirubin
breakdown of RBC's
Glycolysis
breakdown of glucose by blood cells
Ca
calcium
if the phleb unintentionally hit the patient median nerve in the venipuncture procedure he or she
can be accused of professional negligence
violation of patients confidiantially
can be considered professional negligence
chemical additive
can prevent growth of microbes, but may be toxic
Which of the following is a commonly identified pathogenic microorganism that causes health-care-acquired skin infections
candida albicans
CBG's
capillary blood gases
arterialized
capillary blood increased by warming site
hospice
care of terminally ill
Transmission-based precautions
categories of precautionary measures based on the route of transmission of disease. Three types of transmission-based precautions are airborne, droplet, and contact precautions
Communicable disease
category of diseases resulting from the transmission of infectious microorganisms to individuals by direct or indirect contact or as an airborne infection
saline lock
catheter in vein( access to meds, drawing blood for 48 hrs)
A-line
catheter placed in artery for(blood pressure, collect gas, blood specimens, administer drugs)
CVAD
central vascular access device
CVC
central venous catheter
CSF
cerebrospinal fluid
Health-care-acquired infections occur when what is complete?
chain of infection
implanted port
chamber, permanent, indwelling line under skin, upper chest or arm
Disinfectants
chemical compounds used to remove or kill pathogenic microorganisms; typically used on medical instruments or countertops
Antiseptics
chemicals (e.g., 70 percent isopropyl alcohol, chlorhexidine, iodine, hexachlorophene, chlorooxylenol, quaternary ammonium compounds, and triclosan) used to clean human skin by inhibiting the growth of microorganisms
Disinfectants are:
chemicals that are used to remove or kill pathogenic microorganisms
Examples of nonverbal, distracting behaviors include
chewing gum gazing out the window glancing at the clock
The work status of a health care provider should be "off from work" if he or she has:
chicken pox
Chol
cholesterol
COPD
chronic obstructive pulmonary disease
If an accident occurs, such as a needlestick, the injured health care provider should immediately:
cleanse the area with isopropyl alcohol and apply and adhesive bandage
ID card
clinic issued ID document
CLS
clinical laboratory specialist
CLT
clinical laboratory technician
hematoma
clotted blood following venipuncture
Password
code that identifies a person and allows them to be a user
What does the physical properties include of an UA?
color, transparency versus cloudiness, odor, and concentration as detected through a specific gravity measurement.
CBC
complete blood count (includes RBC & WBC)
CMP
comprehensive metabolic panel
Terminal
computer screen/keyboard combination
hypoglycemia
condition where the level of glucose sugar in the blood is low
a moderate pace and volume in ones voice can communicate a sense of
confidence and calm
CHF
congestive heart failure
Which type of isolation precaution is frequently required for patients with infections that are transmitted through direct hand contact with colonized microorganisms?
contact precautions
Systole
contracting phase of cardiac cycle
a phleb has entered a hospital room and the patient is eliza smith ,after the phle introduces himself or herself what is the next question he or she should ask to confirm the name or identify of the patient
could u please state ur name and spell it for me
CPK
creative phosphokinase
Cc
cubic centimeters
C&S
culture & sensitivity
C&S
culture and sensitivity
What is the third tube of cerebrospinal fluid used for?
cytological, chemistry and serology testing
hemolysis
damage of RBC's, (pink color, slight hemolysis, red, gross hemolysis)
use of american sign language is important for which type of patients
deaf
clinical decisions
decisions by MDs based on medical standards of practice, diagnostic tests, pt hx, and observation of signs and symptoms
The clinical laboratory contributes to all of the following except:
decontaminating the surgery rooms with disinfectants to kill amebic organisms
hemoconcentration
decrease of fluid content in blood(red blood cells)
if a phleb has a lawsuit filed against him or her he or she is the
defendant
DMAIC
define, measure, analyze, improve, control; 5 step process for improvement used in the Six Sigma method
which of the following refers to the testimony of a witness that has been recorded in a written legal format
deposition
competency statement
describe the entry level skills and tasks to be performed prior to certification/licensure of specific healthcare workers. i.e.: phlebotomists
blood type test
determine blood type and compatibility
glycohemoglobin test
determine the control of pt blood sugar in the last 2-3 months
DM
diabetes mellitus
Gauge
diameter of lumen
Which of the following illnesses is usually transmitted from one person to another by coughing or sneezing?
diphtheria
a phlebotomist performing which of the following procedures is considered a CLIA 88 waived procedure
dipstick urinalysis
examination of witnesses before and or during a trial is reffered to as
discovery
congenital disease
disease that exists at birth.
galactosemia
disorder caused by lack of enzyme needed to convert milk sugar galactose into glucose
hypothyroidism
disorder, having insufficient thyroid hormones
microhematocrit tubes
disposable, narrow, capillary tubes that fill by capillary action
Examples of process components of quality that should be checked
documentation procedures hematomas multiple sticks use of incorrect anticoagulants
In the process of preparing to enter a patient's room in isolation, which of the following wold occur first?
donning a mask
What are some reasons you might have Hemolysis?
drawing blood through a Hematoma Slow Blood Flow Rough handling of specimen failure to wipe away first drop of blood(capillary) which could contain alcohol residue Page 284 Box 9-3 for a complete list
Transmission-based precautions to reduce the spread of meningitis are referred to as:
droplet precautions
Which of the following isolation techniques requires that any blood collection equipment taken into the patient's room must be taken out after the blood is collected?
droplet precautions contact precautions
trough level
drug level collected when the lowest serum concentration of the drug is expected, usually prior to the next scheduled dose.
A factor that increases a host's susceptibility in the chain of infection is:
drug use
EMLA
easily melted mix of local anesthetics
iontophoresis
electrical stimulation from electrodes placed on skin for production of sweat in the sweat chloride test
EMR
electronic medical records
EQC
electronic quality control
QC records do not include information about
employee health
in HIV related issues for phlebotomist the
employer is legally responsible for monitoring HIV post exposure follow up
clot activator
enhances coagulation
the CLIA88 was passed to
ensure that quality and accuracy of lab testing
Thrombin
enzyme that converts fibrinogen into fibrin necessary for clot formation
EBV
epstein-barr virus
when documenting errors in a paper based medical record which of the following statement is most appropriate
errors should not be erased ,but noted and corrected
ESR(SR)
erythrocyte sedimentation rate (sed rate)
the judicial brach of the govt
establishes case law
EDTA
ethylenediaminetetraaacetic acid, anticoagulant, hematology, preserves cells & platelet clumping
EDTA
ethylenediaminetetraaceitic acid
ETS
evacuated tube system, blood flows directly from vein to tube
palpate
examine by feel or touch
Examples of unfavorable patient outcomes includes
excessive probing for a vein multiple sticks on the same patient nosocomial infections hematomas
urinate
excrete or expel urine
considering nonverbal communications ,which of the following features is the most expressive part of the human face
eyes
which of the following is the most effective form of communication
face to face conversation
FBS
fasting blood sugar
FOBT
fecal occult blood test
Centers for Disease Control and Prevention (CDC)
federal agency responsible for monitoring morbidity (disease) and mortality (death) throughout the country
Environmental Protection Agency (EPA)
federal agency that, among the other responsibilities, regulates the disposal of hazardous substances and monitors and regulates disinfectant products
Cursor
flashing indicator
peritoneal fluid
fluid aspirated from the abdominal cavity
pericardial fluid
fluid aspirated from the pericardial cavity that surrounds the heart
pleural fluid
fluid aspirated from the pleural cavity surrounding the lungs
interstitial fluid
fluid in tissue spaces between cells
intracellular fluid
fluid within the cells
a phleb was asked by a patient to fax test result to her home so she would not have to go back to the doc,what is the most appropriate course of action for the phleb
follow the employers policies regarding the use or transmission of lan results
EDTA tube
for hemoglobin A1c test
Requisition
form test orders are entered & sent to lab
FiO2
fraction of inspired oxygen, as in oxygen therapy
patency
freely open, normal condition of a vein
GGT
gamma glutamyl transepeptidase
Babies whose mothers have which of the following problems must be isolated from other infants?
genital herpes
what should a phle do if a patient cannot speak english and the patients cannot 11year old child offers to translate for his parent during the initial patient encounters
get a translator or written instruction in the patient native language
Silica
glass particles used to enhance coagulation
GTT
glucose tolerance test
Which of the following interrupts the link between the susceptible host and the source in the chain of infection?
good nutrition
Network
group of computers linked for sharing resources
a legally blind patient is entitled to use which of the following in any health care facility
guide dog
Infection control programs
guidelines designed to address surveillance, reporting, isolation procedures, education, and management of community-acquired and health-care-associated infections
standards of practice
guidelines that any reasonably prudent person would follow in a particular circumstance.
Which of the following is the most important procedure in the prevention of disease transmission in health care institutions?
hand hygiene
what type on information cannot be covered into bar code symbols
handwritten information
diurnal
happening daily
sclerosed
hardened
coagulation tube
has a blue stopper, and is used when drawing blood for coagulation (clotting) studies, such as prothrombin time (PT)
Today's large managed care organizations (MCOs) evolved from prepaid healthcare plans such as ______
health maintenance organizations (HMOs) and preferred provider organizations (PPOs)
calcaneus
heel bone
Hct
hematocrit
crito o Hct
hematocrit
Hgb
hemoglobin
Contact precautions may be required for patients infected with:
herpes simplex
Which of the following chemical compounds is an antiseptic for skin?
hexylresorcinol
home health care
hlth care provided in a pts home under the direction of a physician
HIS
hospital information system
HCG
human chorionic gonadotrophin
HIV
human immunodeficiency virus
what is an RFID
identification tag using silicon chips and a wireless receiver
Stat
immediately
when should incident reports involving accidential HIV exposure be reprted
immediately
Protective isolation is commonly used for patients who have:
immunodeficiency disorders
when the health care provider gives aid at an accident he or she is usually protected through
implied consent
why is it important for phle to enjoy communicating with patients
improve the likelihood of effective quality care
Fomites
inanimate objects that can harbor infectious agents and transmit infections (e.g., toilets, sinks, linens, door knobs, glasses, phlebotomy supplies, etc.
An outbreak of particular health-care-acquired infections in a health care facility is detected through:
infection control surveillance
Health care-associated (nosocomial) infections (HAIs)
infections acquired after admission into a health facility
nosocomial infections
infections acquired after admission into a healthcare facility.
Vector transmission
infectious disease spread by insect, anthropod (exoskeleton), or animal.
Vehicle transmission
infectious disease spread through contaminated food, water, drugs, or blood transfusion.
osteomyelitis
inflammation of bone marrow & adjacent bone
osteochondritis
inflammation of the bone & cartilage
what is cross examination in malpractice lawsuit
information obtained during the trial to obtain information regarding the possibilty of malpractice of a health care worker
during a patient appointment with his physician he fill out the necessary legal papers and meets with his physician ,after his physical exam the physician orders lab tests for diagnosis and the patient comes to the lab with a rolled uo sleeve ,the patient is giving
informed consent
which legal concept refers to the voluntary permission by a patient to allow touching,examination and or treatment by health care provider
informed consent
Antiseptic
inhibits growth of bacteria, cleans skin
Lumen
inner space of a blood vessel or tube
needle phobia
intense fear of needles
ICU
intesive care unit
IV
intravenous
a nurse stated to a phle that one of a patients lab test result was a mistake,the nurse asked the phleb to change the test result immediately,what should the phleb do
investigate the situation more thoroughly prior to taking action
Antiseptics for skin include:
iodine
Peritoneal fluid
is a liquid that is made in the abdominal cavity to lubricate the surface of the tissue that lines the abdominal wall and pelvic cavity and covers most of the organs in the abdomen
The following hand-hygiene antiseptic agent is most effective for Mycobcterium tuberculosis:
isopropyl alcohol
What is Sweat chloride test?
it used for diagnosis of cysticfibrosis
while setting up for a routine venipuncture the patient asked the phle will this hurt ,what is the most appropriate response
it will hurt a little but it should be over quickly
biohazardous
items contaminated with blood, body fluids, secretions, or excretions
malpractice phleb cases lead to decisions primarily made in what branch of govt
judicial branch
In health care facilities, which is a typical fomite?
laboratory coat
LDH
lactic acid dehydrogenase
femoral artery
large artery located in the groin, lateral to the pubic bone, used for arterial puncture
Slouching posture, a nonverbal behavior, conveys what message
laziness apathy
the phrase if u do not let me collect ur blood your infection will probably become severe spoken by a phle to a patient can
lead to an assault and battery charge
which of the following legal branches writes laws called statutes
legislative branch
bioethics refers to
life and death issues
bar codes can be used in health care for patient identification purposes,which of the following characterizes how bar codes are interpreted
light and dark bends of varying widths represents alphanumeric symbols
Menu
list of options
L
liter
L/M
liters per minute, in oxygen therapy
radial artery
located at the thumb side of the wrist, 1st choice, common site for arterial puncture
ulnar artery
located on medial aspect / little finger side of the wrist
Shaft
long cylinder portion of needle
hypoxemia
low level of oxygen in the blood
hypokalemia
low potassium in the blood
hyponatremia
low sodium in the blood
Ventricles
lower pumping, delivering chambers on each side of heart
Lymphs
lymphocytest
which of the following behaviours should the phleb avoid in his or her patient care and blood collection activities
making a deep sigh when collecting the blood
if a phleb makes a statement that is false regarding a patient his or her action is
malice
prpfessional negligence in blood collection is the same as
malpractice
the legal term for improper or unskillful care of a patient by a member of the health care team or any other professional misconduct unreasonable lack of skill or infidelity in professional or judiciary duties is
malpractice
Urinalysis (UA)
maybe housed in hematology or chemistry area.
MCH
mean corpuscular hemoglobin
fasting blood sugar test
measures the glucose (blood sugar) levels after the patient has not eaten for 8-12 hours
MT
medical technologist
syncope
medical term for fainting
Mnemonic
memory aiding code or abbreviation
MRSA
methicilin resistant staphylococcus aureus
clean-catch
method of obtaining a urine sample that is free of contamination
Isolation procedures
methods used to protect individuals (health care workers) from patients with infectious diseases. Formally divided into two types (category-specific and disease-specific), guidelines now combine isolation practices for moist and potentially infectious body substances, to be used for all patients. The current categories of isolation are based on the mode of transmission and include airborne, droplet, and contact precautions
generations of workers are used to different forms of feedback from their supervisors and peers ,which group would most likely want instant feedback
millennials /generations y
Mg
milligrams
ML
milliliter
Vecotors in transmitting infectious diseases include:
mites
Which of the following is not a component that makes up the chain of infection?
mode of transportation
Mono(s)
monocytes
when a patient should be allowed to die is a topic closely related to
moral issues of bioethics
the best definition for ethics is
moral standards of behaviour
sputum
mucus or phlegm ejected from trachea, bronchi, lungs by deep coughing
nonadditive tube
name the tube that does not need mixing
the standard of care currently used in phleb malpractice legal cases involving health care providers is based on the conduct of the average health care provider in which area
national community
needle sheath
needle cover
Multisample needle
needle that allows multiple tubes to be collected
Hypodermic needle
needle used with syringe
failure to act or perform duties according to the standards of the profession is
negligence
if a phleb gives his or her friend the results of patients HIV test result,what can be claimed by the patient against the phleb
negligence
misidentifying the patient which can lead to confusion of patients samples and possible wrong diagnosis and death is considered
negligence
the largest area of litigation regarding health care workers (including phleb)is the
negligence
Thixotropic gel
non-reacting synthetic gel in ETS tubes, forms barrier between cells & serum or plasma when centrifuged
Allen test
noninvasive test to assess collateral circulation before collecting blood specimen from radial artery
reference ranges
normal lab values for healthy individuals
Health-care-acquired infections are also referred to as:
nosocomial infections
lymphostasis
obstruction of normal lymph flow
suprapubic
obtaining uncontaminated bladder urine directly from inserting needle directly into bladder
OSHA
occupational safety and health administration
Examples of customers for phlebotomy services
outpatients patient's family members attending physicians nursing staff
Duties of the administrator include:
overseeing all operations involving physician and patient services.
O2
oxygen
serous fluid
pale-yellow watery fluid found between double layered membranes that enclose the pleural, pericardial, peritoneal cavities
Infectious / causative agent
pathogen responsible for causing an infection. Also called causative agent
Blood-borne pathogens (BBPs)
pathogenic microorganisms, including hepatitis B virus and human immunodeficiency virus, that if present in blood, can cause disease in humans
in designing a report /results form for laboratory results which one of the listed elements is not required
patient and physician address
bar codes in phleb application are not used for which one of the following
patients arm preference
inpatients
patients that are hospitalized
if a patient is having a private conversation with his or her physician when the phle shows up to collect blood routine specimen what should the phleb do
perform the procedure at a later time
PICC
peripherally inserted central catheter
AV shunt fistula graft
permanent artery & vein fusion, access for dialysis. permanent artery & vein fusion,create access for dialysis. surgical connection of artery & vein using vein or tubing
Cloud
permanent secondary storage
Case Manager
person who coordinates medical services on behalf of a patient
ppe
personal protective equipment i.e. gowns, gloves, masks
PPE
personal protectiveq equipment
Which of the following chemicals has the fastest speed of action in hand-hygiene antiseptic cleaning?
phenol derivatives
PKU
phenylketonuria
Which of the following is considered a fomite?
phlebotomy tray
PST
plasma separator tube
Bevel
point of needle, cut on slant for skin entry
what should a phleb do if there are too many visitors in a patient room when a blood specimen is to be collected STAT
politely ask the visitors to step into the hall while the blood is being collected
24-hour urine
pooled urine collected over a 24 hr period, beginning in the morning
K
potassium
Double bagging
practice of using two trash bags for disposing of waste from patients' rooms, particularly those patients in isolation
The following is the main area of responsibility for every phlebotomist
pre-analytic processes
computers can be used in which of the phases of clinical lab workflow
preanalytic ,analytic postanalytic
Protective (reverse) isolation
precautionary measures and procedures designed to protect patients who are particularly susceptible or at increased risk of acquiring infections (e.g., patients with low white blood cell counts (neutropenic or leukopenic), patients with burns, and/or immunosuppressed patients)
Standard precautions
precautions intended to minimize risk of infection transmission when caring for all patients.
Transmission based precautions
precautions used with standard precautions for patients known or suspected to be infected with highly transmissible significant pathogens
Evacuated tube
premeasured vacuum, color coded w additive inside
Sodium fluoride
preserves glucose & inhibits growth of bacteria
Storage
preserving information
the most efficient and accurate way of making labels for specimen is by
printing from computerized system
Preanalytical
prior to analysis
preanalytical
prior to analysis
a large number of negligence health care lawsuit cases arise out of the violence of
privacy of patient confidentiality
patient ID
process verifying patient's ID
accession
process, recording in order received
Software
programming, coded instructions,designed to operate computer
PSA
prostate specific antigen
Contact precautions
protective measures that reduce the risk of transmission of serious diseases such as respiratory syncytial virus (RSV), herpes simplex, wound infections, and others through direct or indirect contact
Protime (PT)
prothrombin time
the use of electronically generated blood drawing list or log sheet in a specimen collection area serves to
provide a record of specimen collected
before a patients lab test result can legally be released the patient must
provide written consent
Why is the attention to grooming and personal hygiene important for phlebotomists
provides professional appearance cleanliness reduces the spread of infections provides a safer work environment
Measurand
quality/amount of substance measured
RFID
radio frequency identification
RAM
random access memory, main memory,temporary storage for data that will be lost when computer is shut off
ROM
read only memory,installed by manufacturer,permanent
RBC
red blood cells/erythrocytes
when communicating with a patient who has hearing impairment the first step in preparation would be which of the following
reduce external noise
arteriospasm
reflex involuntary contraction of the artery that can be caused by pain or irritation during needle penetration of artery muscle or result of anxiety during arterial puncture
Diastole
relaxing phase of cardiac cycle
all of the following are ways to avoid malpractice litigation except
reporting incidents within 48hrs
which of the following legal term refers to the concept that supervisors and directors may be help liable for the negligent actions of their employees
respondeat superior
basal state
resting metabolic state, morning after fasting, 12 hrs
Output
return of processed information or data to user or another location
RNA
ribonucleic acid, must be processed immediately or stored at 4 degrees C for only 48 hrs
When collecting blood from neonates in the nursery, what health-care-acquired infection is highly prevalent?
rotavirus
neonatal screening
routine test for newborns presence of metabolic & genetic disorder example: phenylketonuria
Lysis
rupturing/bursting of RBC's
anchor
secure firmly
bar code
series black stripes, spaces, corresponds to letters & numbers
SGOT
serum glumatic-oxzloacetic transminase
SGPT
serum glumatic-pyruvic transminase
SST
serum separator tubes
SST
serum seperator tube
lipemic
serum/plasma, milky, due to high lipid content
Microbe
short for microorganism Not visible to the naked eye.
some patients are intimidate when confronted with a health care worker they dont know.which of the following strategies would encourage a shy patient to communicate with a new phle
show empathy and use active listening skills
cultural sensitivity for phleb involve learning about all except which of the following factors
skin sensitivity to pain
microcollection containers or Microtubes
small plastic tubes to collect blood obtained from capillary puncture Bullets
Na
sodium
SPS
sodium polyanethol sulfonate, anticoagulant, reduces action of protein called complement, which destroys bacteria
Electrolyte Panel
sodium, potassium, chloride, CO2
Middleware
software "glued together" two separate, already existing
Disinfectant
solutions used to kill microorganisms
Good nutrition can break the chain of nosocomial infections between the:
source and the susceptible host
Reservoir
source of an infectious microorganism
antecubital space
space located at the bend in the elbow
Sharps container
special container to dispose sharps, needles
Order of draw
special sequence, minimize additive cross-contamination
Chain of custody
special strict protocol for forensic specimens that requires detailed documentation tracking the specimen from the time it's collected until results are reported
Personal protective equipment (PPE)
specialized clothing or equipment designed to protect the health care worker from hazards in the workplace (e.g., goggles, gloves, gowns, etc.)
if a phle wanted to look up details about specimen containers or tube requirement while on duty at his or her hospital ,what probably be the best source for the information
specimen collection manual
whorls
spiral pattern of ridges & grooves that form a fingerprint
expectorate
spit; act of ejecting saliva from mouth
steady state
stable condition required in order to obtain blood gas specimens, condition where no exercise, suctioning, respirator change for 20-30 minutes
in the legal cases what a reasonably prudent person would do under similar circumstance refers to
standard of care
Which of the following is designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources of infection in health care facilities?
standard precautions
lancet
sterile, disposable, sharp-pointed instrument that punctures skin for capillary blood specimens
vasovagal
sudden faintness from nervous system(pain, stress, trauma)
SIDS
sudden infant death syndrome
Pleural fluid
surrounds the lungs in the pleural cavity
Therapeutic measures (ie., chemotherapy, radiation therapy) in a patient create what part of the chain of infection?
susceptible host
buccal swab
swab material collected from the inside of the cheek
edema
swelling, abnormal fluid in tissues
sweat chloride
test of sweat production stimulation by electrical means then measuring chloride content to diagnose cystic fibrosis
a critical value is a
test result that may be life threatening
gastric analysis
test that examines stomach contents abnormalities & measures gastric acid concentration to evaluate stomach acid production
at the end of any specimen collection procedure what is the final statement the phle should say to the patient
thank you
which of the following is the appropriate protocol for health care worker who are involved in specimen collection
the blood collector should state that the patients physician ordered blood to be collected for testing and that it would be best to discuss the lab tests with the physician
A nosocomial infection occurs when:
the chain of infection is complete
quality
the degree to which a set of inherent characteristics fulfills requirements. Defined by its efficacy, appropriateness and caring function
a phleb inadvertently overheard a conversation between a doctor and a patient abt a medical condition that is unrelated to the specimen collection or lab test process,what is the best course of action regarding the sharing of this info with other individual in the hosp
the info is classified and should not be shared
which of the following organization is influential in setting the standard of care for phleb practice
the joint commision
Mode of transmission
the method by which pathogenic agents are transmitted (e.g., direct contact, air, medical instruments, other objects, and other vectors)
in past research studies the unethical treatment of humans led to
the national research act
Source
the origin of infection (e.g., human hands, lab coats or other clothing, contaminated medical instruments, etc.)
a busy phleb was in a hurry one morning when she quickly awakened he next patient and suddenly approached the patient for a routine veni, the patient became visibly nervous ,anxious,and refused to have her blood drawn ,which of the following factors could explain the patient reaction
the phleb intruded into the patient's zone of comfort too quickly
a patient claimed in court that the phleb did not perform proper blood collection procedure that led to an alleged injury, the patient must show that the phleb failed to meet
the prevailing standard
Chain of infection
the process by which infections are transmitted; components include the source of infection (nonsterile items, contaminated equipment or supplies, etc.), the mode of transmission (direct contact, airborne, medical instruments, etc.), and the susceptible host (patient)
clinical or meidcal records whether records whether they are electronic or paper based documents provide legal protection because
they provide proof that an action was performed and documented
feather
thinnest area of blood smear where differential is performed
The following statements are inappropriate during phlebotomy procedure
this wont hurt a bit your name is Mrs. Jones, isn't it? you are required to cooperate with this
stakeholders
those having an interest in or are influenced by the quality of healthcare services.
External Stakeholders
those outside the healthcare organization. i.e.: community, insurance companies, regulating agencies,
Internal Stakeholders
those within the healthcare organization. i.e.: patients, families, friends, staff, students and volunteers
Hub
threaded end where needle attaches
Permucosal
through mucous membranes of the mouth, eye, and nose
Percutaneous
through the skin
TSH
thyroid stimulating hormone
petechiae
tiny red spots with tourniquet, capillary wall defect or platelet abnormalities
why is a documentation of all clinical events important
to monitor quality and coordination of care
venous stasis
trapping blood by vein compression
bariatric
treatment of obesity
Which of the following diseases usually require(s) airborne precautions?
tuberculosis
T&S
type and screen
T&C/T&X
type or cross match
differential
under microscope test to determine number, type & characteristics of blood cells
USB drive
universal serial bus
when communicating with patients changing ones speech to faster pace and higher pitch can communicate a sense of
urgency and emergency
midstream
urine collection in middle of urination rather than beginning or end
catheterized
urine specimen collected from sterile catheter inserted through urethra into bladder
Airborne precautions
use of protective devices that reduce the spread of airborne droplet transmission of infectious agents such as rubella, varicella, and Mycobacterium tuberculosis
when sending receiving email communication which of the following should be avoided
use of symbols such as !!!
cross examination is
used during the trial to obtain information regarding the possibility of malpractice of a health care worker or in other type of trials as well
Droplet precautions
used to reduce the transmission of diseases such as pertussis, meningitis, pneumonia, and rubella. These diseases can be transmitted through contact of the mucous membranes of the eye, mouth, or nose with large-particle droplets that occur through sneezing, coughing, or talking
like many lab dept one hosp policies did not allow release of infor directly to patients ,however a patient made an emergency telephone call to the lab and asked a specific question about his or her own lab result ,what was the most appropriate course of action for the phle
using a professional tone of voice follow the organizations direction about referring the patient to the appropriate person
What is the smallest vein?
venules
thrombosed
vessel that is clotted
which generation of workers is used to a more hierarchical form of leadership
veterans/traditionalist
which group of workers most likely be happy with little or no feedback for example no news is good news
veterans/traditionalists
synovial fluid
viscid (sticky) colorless fluid found in joint cavities
After completion of blood collection in an isolation room, which of the following steps should occur last?
wash hands
aerobic
with air
IV
within a vein
anaerobic
without air
In addition to standard precautions, use contact precautions for patients with known:
wound infections
braille is defined as which of the following
writing system for sightless individuals