Phlebotomy Essentials 6th edition. ALL quizzes, ALL ch. tests, GRADED work, NOT guesses. PLUS, the FULL NAHP study guide

NAHP CERT CPT STUDY GUIDE: CH 2 ABBREVIATIONS

NAHP CERT CPT STUDY GUIDE: CH 2 ABBREVIATIONS red blood cell: RBC centimeter: cm milligram: mg hematocrit: Hct hemoglobin: Hb sodium chloride (saline): NaCI complete blood count: CBC intravenous: IV deoxyribonucleic acid: DNA urinalysis: UA CSF: Cerebrospinal fluid follicle-stimulating hormone: FSH milliliter: mL Optical Density: OD Carbon Dioxide: CO2 specific gravity: SpGr Fahrenheit: F common lab test: magnesium intramuscular: IM outpatient: OPT liter: L hydrochloric acid; HCl millimeter: mm kilogram: Kg white blood cell/ white blood count: WBC Differential count of White Blood Cells: diff blood type: ABO exc: none of choices blood pressure: B/P nanometer: nm fasting blood sugar: FBS blood urea nitrogen: BUN ESR: erythrocyte sedimentation rate test associated w/ reproductive sys: HCG TQM: Total Quality Management OSHA: Occupational Safety Health Administration QA: Quality Assurance The Joint Commision: TJC MSDS: Material Safety Data Sheets ICD- 10-CM: diagnosis coding system POCT: Point-of-care testing PPM: Provider-performed microscopy Clinical Laboratory Improvement Amendments of 1988: CLIA, CLIA '88 (both) TQM sys, QC: Quality Control FDA: Food and Drug Administration EPA: Environmental Protection Agency PPE: Personal Protective Equipment HDL: High-Density Lipoprotein LDL: Low-Density Lipoprotein ABGs: arterial blood gases a.c.: before meals ADH: antidiuretic hormone b.i.d.: twice a day bili: bilirubin Ca: calcium CNS: central nervous system CPR: cardio pulmonary respiration DOB: date of birth ER: emergency room Fe: iron GTT: glucose tolerance test: MCH: mean corpuscular hemoglobin MRI: magnetic resonance imaging oz: ounce PT: prothrombin time pt: patient Rx: prescription STAT, stat: immediately T: temperature TB: tuberculosis TPR: temperature, pulse, respiration URI: upper respiratory infection UTI: urinary tract infection UV: ultraviolet WT, wt: weight

CH 1 TEST---GRADE: 100%

CH 1 TEST---GRADE: 100% 1) blood bank: Immunology 2) other hospital dept lab's coordinate w/ for therapeutic drug monitoring: Pharmacy 3) lyte testing includes: sodium, potassium 4) Promoting good pr part of phleb's role: All options correct 5) Outpt phleb, (dr's office, pt care service center), assigned codes for reimbursement using national coding sys: CPT 6) oxygen therapy: Respiratory Therapy 7) highly complex care: Tertiary 8) phlebotomy, Greek words: vein incision 9) NOT phleb's duty: Starting IV line 10) creds for ASCP-certified phleb: PBT 11) Proof of participation in workshops to renew cert: CEU'S 12) med lab scientist, AKA: Med lab technician 13) barrier to effective communication: All correct 14) confirming response: I understand how you must be feeling. 15) negative kinesics: Frowning 16) communicates unprofessionalism: Intense odor of cologne 17) improper phone protocol: hang up on angry caller 18) NOT performed by public health agencies: Licensure of HC personnel 19) acknowledge pt's beliefs, customs, knowledge, attitudes exemplify: Diversity Awareness 20) phleb taking shortcuts: unprofessionalism 21) lab dept infectious disease/antibodies: immunology 22) blood withdrawn to dangerous/deadly limit: Exsanguination 23) federal law that defines responsibilities of med lab: CLIA '88 24) study of person's concept/use of space: Proxemics 25) Pt's who go to lab/dr's office on own: Ambulatory 26) IDN: Integrated delivery network 27) PM: Personalized medicine 28) MCO: Managed Care Org 29) Quality indicators, QI: Guides used as monitors of all areas of pt care

CH 10 TEST---GRADE: 100%

CH 10 TEST---GRADE: 100% 1) Blood smears made using EDTA spec should be prepared within: 1 hr 2) why are cap blood gases less desirable than arterial blood gases: ALL: punture contains tissue fluid, only partly arterial, exposed to air during collection 3) According to CLSI, heel puncture lancet should puncture no deeper than 2.0 mm 4) why EDTA spec obtained before other spec w/ collected by skin puncture: minimize effects of platelet clumping 5) why should lab report indicate fact spec collected by cap puncture: Because test results can vary depending on method of collection 6) safest area of infant's foot for cap puncture: Lateral plantar surface 7) cap puncture should be done rather than venipuncture except when: L. blue top is needed. 8) purpose of wiping away first drop of blood during cap: eliminate tissue fluid contamination 9) Cap blood composition more closely resembles: arterial blood 11) concentration of this analyte is normally higher in cap spec: GLUCOSE 12) which microtube used to collect spec for CBC: Purple (hematology tests) 13) what is PKU: a heridetary inability to metabolize phenylalanine 14) necessary to control depth of lancet during heel puncture to avoid: injuring the heel bone 15) primary purpose of warming cap puncture site increase blood flow 16) preferred cap puncture site: middle finger 17) if the alcohol is still wet w/ cap puncture made: ALL: cause hemolysis of spec, lead to errors in test process, prevent round drops from forming 18) Capillary action: how blood fills microhematocrit tube. 19) Skin pain fibers increase in abundance: below 2.4 mm in depth 20) correct cap puncture: Puncture perpendicular to whorls 21) Cap collection preferred method of blood collection in infants: Removing larger quantities can lead to anemia, vein puncture may damage veins/surrounding tissue, cap blood preferred for some tests 22) lab report form should indicate w/ spec collected by cap puncture: some tests results vary with spec source 23) to make thick blood smear, take large drop of blood and spread to size of dime 24) fluid in tissue spaces between cells interstitial fluid 25) cap puncture site should not appear CYANOTIC, which is described as being bluish from lack of OXYGEN 26) a good blood smear covers 1/2 to 3/4 of slide, exhibits FEATHER edge 27) cap puntcure infant bili spec drawn amber microtubule to protect from light 28) a finger puncture thats parallel to whorls is not correct, it allows blood to run down finger 29) a metal BAR and a MAGNENT are used to mix a CBG spec 30) OSTEOMYELITIS can result from heel punctures that are too deep

CH 11 TEST---GRADE: 100%

CH 11 TEST---GRADE: 100% 1) Of the following tests, which is most likely to result in fatal consequences if the patient is misidentified: Type and crossmatch 2) Which test requires strict skin antisepsis procedures before specimen collection: Blood culture 3) Included in DOT'S 10 steps for collection site security/integrity, EXCEPT: ensure video monitoring equipment working during spec collection 4) What type of additive is recommended for collecting an ethanol specimen? Sodium fluoride 5) When performing a GTT, the timing should begin As soon as the patient finishes the drink 6) Which test is used to monitor heparin therapy? ACT 7) CLSI recommends blood culture site disinfectant for infants 2 months and older: Chlorhexidine gluconate 8) to prevent introducing a contaminating substance in trace element tube, suggested phleb: draw it by itself w/ syringe/ETS 9) all POC gluc analyzers approved for hospital use have in common: ALL: can use cap, venous, arterial blood, data can be downloaded to data management program, require authorized operator ID # 10) w/ collectiing blood culture spec directly from butterfly into culture bottles, which one filled first: aerobic 11) chain of custody: special protocol w/ collecting forensic spec 12) unit of blood drawn for treatment: hemochromatosis 13) tube used for type and crossmatch: Pink 14) autologous blood transfusion is transfusion of blood: donated by/for PT 15) most critical aspect of blood culture: skin antisepsis 16) requires spec w/ 9:1 ratio blood-to-anticoagulant: Prothrombin time 17) hormone detected in positve pregnancy test: HCG 18) ARD or FAN blood culture bottles: remove any antibiotics from blood cells 19) TDM used by dr's to: determine benificial drug dosage for pt 20) 2-hr pp drawn: 2 hrs after pt eats a meal 21) preferred sample for parentage: buccal swab 22) can be collected in tube other than trace element free tube: sodium 23) CAP requires QC for many waived tests be performed: w/ test manufacturers specifies 24) noninvasive transcutaneous method available to measure: neonatal bili 25) accumilation in blood can cause metabolic acidosis: lactate 26) recommended disenfectant for blood culture site in infants 2 months and older: chlorhexidine gluconate 27) unused autologous units cannot be used by other pt's 28) Everyone who performs POCT in clinical setting must meet requirements of CLSI for testing and guidelines of OSHA for spec handling. 29) pt has high glucose level: Hyperglycemic 30) tan tubes w/ K2EDTA: lead analysis

CH 12 TEST---GRADE: 100%

CH 12 TEST---GRADE: 100% 1) spec arrives w/ less volume than needed, noted w/ abbreviation: QNS 2) series of bars/spaces represent numbers/letters: barcode 3) spec likely accepted for testing despite: No phleb initials 4) preanalytical error during specimen processing: inadequate centrifugation 5) best way to prepare routine blood spec tubes for transport to offsite lab: Seal tubes in plastic bags 6) spec can be centrifuged immediately upon arrival in specimen processing? Calcium, green top 7) develops standards for spec handling/processing: CLSI 8) Lab inspection for compliance w/ shipping regs, imposing severe penalties for noncompliance done by US: DOT 9) middleware: accepts data downloaded from POC instruments 10) RFID emerging in HC: method of spec id 11) enter password, gain access to computer: logging on 12) spec processed before routine: STAT, ASAP, Timed 13) Critical values: panic values 14) preanalytical error before spec collection: Dehydrated pt 15) handling of spec before tested: preanalytical phase 16) pneumatic tube: pressurized air transport sys 17) used by lab to id spec throughout testing processL Accession number 18) activity is least likely takes place in central processing/triage: analysis/reporting 19) CLSI, max time separating serum/plasma from cells: 2 hrs 20) CLSI/OSHA dont require spec transport bags to have: shock-resistance features 21) not recommended sent pneumatic: serum potassium 22) not preanalytical error: Misreporting pt results 23) least likely to result in delayed clotting of serum sample: Collection difficult, hemolyzing red cells 24) proper centrifuge operation: place equal size/vol opposite for balance 25) CLSI: tubes placed upright as soon as mixed: gel barrier 26) Transporting blood spec w/ stopper up, nothing to do w/: maintaining sterility of sample 27) improper aliquot prep: Carefully pouring contents in aliquot tube

CH 13 TEST---GRADE: 100%

CH 13 TEST---GRADE: 100% 1) spec that can detect chronic alcohol/drug use: hair 2) fluid around fetus: amniotic fluid 3) needle between 2nd/3rd lumbar: lumbar puncture 4) 24 hr urine sample steps: void 1st morning sample, continue collection all day/night, include next morning sample 5) test for cystic fibrosis: sweat chloride 6) pregnancy detected 8-10 after conception from hormone: Human chorionic gonadotropin 7) protect from light: amniotic fluid 8) test involves IV administered histamin or pentogastrin: gastric analysis 9) requires a 24 hr urine spec: creatinine clearance 10) drugs of abuse detected: hair, saliva, urine 11) catheterized urine collected from sterile cath inserted through: urethra 12) throat cultures determine microorganism: streptococcus 13) post prandial: after a meal 14) procedure to remove synovial fluid: athrocentesis 15) refrigerated stool sample unsuitable for: ova/parasites 16) required for urine c&s: midstream clean catch 17) fluid from lumbar puncture: cerobrospinal 18) sputum typically for: tuberculosis 19) fluid from peritoneal cavity: ascitic 20) fecal test w/ 72 hr collection: urobilingen 21) fluid in sac surrounding heart: pericardial 22) first morning urine for HCG: typically more concentrated 23) NP culture detects organisms that cause: whooping cough 24) urine C&S typically ordered to detect: UTI 25) breath samples detect: lactose intolerance, recent Marajuana use, H-pylori (all) 26) aspiration of urine through wall of bladder w/ sterile syringe/needle: subrapubic 27) fecal immunochemical (FIT) detects: globin, hemoglobin 28) DNA analysis can be done w/: bucal swabs 29) mucus/phlegm ejected from deep coughs from trachea, bronchi, lungs: sputum 30) additional info typically required w/ labeling non blood spec: spec type/ source

CH 14 TEST---GRADE: 100%

CH 14 TEST---GRADE: 100% 1) what phleb should do if pt has no pulse/faints following ABG: notify pt's dr/nurse 2) most common local anesthetic for ABG: lidocaine 3) after ABG, check pulse: DISTAL to puncture 4) arm out to side, away from body: abducted 5) site for ABG located: about 1 inch above crease, thumb side of arm, underside of arm (all) 6) if ABG spec left @ room T prolonged period of time: (all) levels of carbon dioxide increase, continued metabolism produces acid, blood cells continue to consume oxygen 7) when performing Allen test, 1st artery to release: ulnar 8) proper needle angle for ABG puncture: 45 9) composition of venous blood varies relative to what needs based on area of body served: meatbolic 10) area supplied w/ blood from more than artery, site has: collateral circulation 11) chance of hematoma formation as a result of ABG greater if: (all) inadequate pressure applied after draw, large gauge needle used, pt recieving anticoag therapy 12) ABG spec can clot if inadequate/delayed: mixing 13) typically part of ABG evaluationL PA02 14) 1st choice artery for ABG: radial 15) thumb shouldn't be used to palpate artery: has pulse 16) 2nd artery of choice for ABG: brachial 17) maintain integrity of ABG collected w/ plastic syringe: analyzed within 30 min. 18) proper cleaning solution for ABG: isopropyl alcohol 19) : pt at rest, no changes in respiratory therapy: steady state 20) ABG spec rejectioncriteria: (all) air bubbles in spec, incomplete/ missing label, insufficient volume of blood 21) ABG syringe pre-treated to prevent clotting w/: heparin 22) best way to tell spec arterial: pulses into syringe 23) most important factor w/ selecting arterial puncture site: existence of collateral circulation 24) disadvantage of collecting ABG from radial: can be hard to locate on pt w/ decreased blood volume 25) heparin used in ABG spec collection: prevents clotting 26) acidity or alkalinity of pt blood: Ph 27) w/ blood leaks into surrounding tissue after ABG: hematoma 28) steady state fo rABG: pt asleep for 30 min, breathing normal air 29) most common AP complication: arteriospasm 30) common needle size for ABG: 22 gauge

CH 2 TEST---GRADE: 100%

CH 2 TEST---GRADE: 100% 1) Drawing w/o permission: assault/battery 2) Two phleb's discuss pt's condition, overheard by pt's daughter: invasion of privacy 3) would NOT violate pt's right to confidentiality: Sharing collection site info on difficult pt 4) Malpractice, claim of: improper treatment 5) phleb negligent if: fails to put needle/holder in sharps container 6) national org that sets standards for phleb procedures: CLSI 7) action will compromise quality: Partially filling EDTA tube (l. blue) 8) TJC's Sentinel Event QI program policy NOT designed to: demonstrate flexibility setting QC measures. 9) unrelated to quality control: Employees filling out timesheets daily 10) analyte test results adversely affected by chilling: Pottasium 11) W/ threshold value of clinical indicator of QA exceeded, problem identified: corrective action plan implemented. 12) Significant gaps in quality of testing practices in dr's offices resulted in developing: good lab practices 13) standard of care in phleb influenced by: TJC 14) LEAST likely reason spec rejection: A clotted spec for CBC 15) spec mislabeled on floor, phleb required to fill out incident report form. NOT part of report: Suggestion for new guidelines 16) QA indicator: blood culture contamination rate will not exceed national rate 17) phleb in outpt draw center not familiar w/ test order: Refer to collection manual. 18) NPSG's specified 2014 goals for lab: improve communication. 19) Some test spec require immediate cooling in slurry to: slow down metabolic processes. 20) NOT included in various phases of malpractice litigation: HC institution informed injury to pt. 21) found in procedure manual: all revision dates for procedure 22) QC protocols prohibit use of outdated evacuated tubes: tubes may not fill completely, changing additive-to-sample ratio 23) Unauthorized release of confidential pt info: failure to use due care 24) definition of minor: anyone not age of majority. 25) screening criteria used by TJC to determine accreditation of clinical lab is category Immediate Threat to Health/Safety. not meeting this criterion: recurrent problems w/ pt id. 26) preanalytical factor that can affect validity of results, not always under phleb's control: Pt prep (in final, this is changed to PT ID!!!!) 27) key player in bringing quality assessment review techniques to HC: TJC 28) Good Lab Practices: emphasize quality assurance in collecting/performing blood work using waived testing kits 29) global, nonprofit, standards-developing org w/ reps from profession, industry, gov that use consensus process to develop voluntary guidelines/standards for all areas of lab: CLSI

CH 3 TEST---GRADE: 100%

CH 3 TEST---GRADE: 100% 1) standard first aid severe external bleeding best control: apply direct pressure. 2) Class C fires: electrical equipment 3) Vaccine HBV: 1 dose, second dose 1 month later, 3rd and last dose 6 months later 4) employee screening infection control: PPD test 5) NOT code word in NFPA order of action in event of fire: Smother 6) protective isolation: protect OTHERS from pt's w/ transmissible diseases. 7) OSHA HazCom Standard AKA: Right-to-Know Law. 8) proper order putting on PPE: Gown, gloves, goggles, mask 9) Federal law requires hepB vac made available to employees assigned to duties w/ occupational exposure risk: 10 working days of initial assignment 10) FIRST thing phleb should do, needlestick: Wash w/ soap/water 30 secs. 11) radiation exposure: exposure time, distance, shielding 12) nosocomial infections: catheter site of pt in ICU becomes infected 13) potential permucosal exposure to bio hazardous microorganisms: Rubbing eye w/ contaminated hand 14) pt in protective isolation: pt w/ TB. 15) work practice control reduces BBP risk: HBV vac 16) contact infection transmission involves transfer of infective microbe to mucous membranes of susceptible individual by means of cough/sneeze: Droplet 17) needlestick Safety/Prevention Act directed OSHA to revise BBP standard in all areas EXCEPT: availability of vac against HBV for all employees. 18) Occupational exposure to BBP can occur as HCW performs duties: (All correct) Blood comes in contact w/ cut, human bite breaks skin, body fluids splash in mouth 19) PPE that is removed only AFTER leaving pt's room, door COMPLETLY closed: Respirator 20) To comply with latest HazCom revision, label of hazardous chemicals must: (All correct) GHS hazard statement, hazard class pictogram, severity signal word. 21) CLSI guideline, scrubs/slacks off floor: 1 to 1 1/2 inches 22) sign on door in contact isolation, all enter must use soap/water to wash hands before leaving room. pt may be infected w/ spore-forming microbe: (All correct) Neisseria meningitides, Clostridium difficile, Bordetella pertussus 23) body fluid splash eyes, immediately flush w/ water/sterile saline for: 15 min 24) N-95 respirator must be worn w/ precaution: Airborne 25) pictogram signifies hazard: respiratory health (Might be different each test. THIS test was starburst pattern inside human silhouette) 26) HAI: HEALTHCARE ASSOCIATED INFECTIONS, AKA nosocomial, term applied to any infection acquired in HEALTHCARE setting or HOME CARE 27) HAI most common HAI pathogen: Clostridium difficile 28) PPE: personal protective equipment 29) most important means of breaking chain of infections: hand hygiene/hand washing 30) Eating fresh VEGETABLES/whole grains can help person stay HEALTHY

CH 4 TEST---GRADE: 100%

CH 4 TEST---GRADE: 100% 1) kidney inflammation: Nephritis 2) word roots "nephr" and "ren": kidneys 3) "g" like "j": gestation 4) Do Not Use, EXCEPT: electronic lab reports 5) suffix of "arteriospasm": constriction/movement of muscles 6) condition of clotting: Thrombosis 7) UTI: urinary tract infection 8) med term WBC: leukocyte 9) plural form ovum: ova 10) If suffix added to word root that ends in "x", "x" changes to: g or c. 11) WR in electrocardiogram: cardi 12) Do Not Use EXCEPT: Kg 13) "c" sounds like "s": Cellular 14) symbol µ: micro 15) singular form phalanges: phalanx 16) singular form alveoli: alveolus 17) "osteochondritis" suffix: itis 18) o, between path, logist: connecting vowel 19) muscle pain: Myalgia 20) suffix of "glycolysis": Breakdown 21) hardening of artery: Arteriosclerosis 22) PP: post prandial after meal 23) prefix: adds info about term, modifies term's meaning, precedes word root 24) cyan: blue 25) "HYPER"natremia word element: too much, prefix 26) word elements of "polycythemia": blood condition of many cells 27) Which part that's prefix: hypo is correct my, lysis, hypo, aer 28) suffix in "lipase": ase 29) ESR: erythrocyte sedimentation rate 30) "e" pronounced separately: syncope

CH 5 TEST---GRADE: 100%

CH 5 TEST---GRADE: 100% 1) finger bones: phalanx 2) command center of cell, contains chromosomes/genetic material: nucleus 3) major cause of respiratory distress in infants/young children: respiratory syncytial virus 4) ability of body to repair/maintain itself to achieve steady state: Homeostasis 5) avascular layer of skin:epidermis 6) nervous system disorder: Multiple sclerosis 7) When facing someone in normal anatomic position: Frontal body plane 8) type of metabolism that breaks complex substances: catobolism 9) study of function of body/organs: physiology 10) layers of skin containing blood vessels: dermis, subcutaneous 11) dangerous condition w/ pt's pH decreases: acidosis 12) test of respiratory system: Sputum culture 13) test of respiratory system: ABG 14) distal: farthest from point of attachment 15) lumbar puncture, performed by dr, withdraw: Cerebrospinal (CSF) 16) considered accessory organ of digestive sys, associated w/ endocrine sys: Pancreas 17) Glomeruli, tufts of capillaries, located: nephrons of kidneys 18) Synovial fluid analysis performed on fluid aspirated from: joints, test of: skeletal system 19) test of urinary system: Creatinine clearance 20) heart ventricles secreted hormone, response to volume expansion/pressure overload: B-type Natriuretic Peptide (BNP) 21) brain encased in cranial cavity, located in body cavity: dorsal 22) body plane that divides body into equal portions: Midsagittal 23) spinal cavity enclosed/protected by 3 layers connective tissue: meninges 24) function of urinary sys: maintain electrolyte balance 25) peripheral nervous sys composed: brain/spinal cord 26) muscle under voluntary control: Skeletal 27) master gland of endocrine system: Pituitary 28) basic tissue types covers/lines organs, vessels, and cavities: Epithelial 29) exchange of gases in lungs takes place in: alveoli 30) Hormones produced in reproductive sys: estrogen, progesterone

CH 6 TEST---GRADE: 100%

CH 6 TEST---GRADE: 100% 1) Lymphatic fluid originates from: excess tissue fluid 2) blood cell w/ ability to pass through blood vessel walls: Leukocyte (WBC) 3) spec collected in anticoagulant tube separates into 3 layers: bottom layer: RBC middle layer: BUFFY COAT, composed: WBC, PLATELETS, top layer: PLASMA 4) major difference between arteries and veins, most veins: have one-way valves 5) fluid portion of blood is approximately 55% of blood specimen 6) primary function of RBCs, platelets, and WBCs: oxygen transport, blood clotting, pathogen destruction 7) proper direction of blood flow: From arterioles, capillaries, venules 8) pulmonary veins: provide oxygen-rich blood to heart 9) receiving chambers of heart: atria 10) relaxing phase of cardiac cycle: diastole 11) test must be performed on anticoagulated whole blood: CBC 12) pt has antecubital veins listed below. All veins large, easily palpated, but basilic vein is most visible. Which one should be chosen for venipuncture: Median 13) Hemostasis refers to: the stoppage of bleeding 14) Hemoglobin is an: IRON -containing molecule that enables: RBC'S to transport oxygen and carbon dioxide 15) L. ventricle delivers: oxygenated blood to aorta 16) main difference between serum and plasma is: SERUM depleted of fibrinogen because it was used in CLOTTING/COAGULATION process. 17) greatest chance of nerve injury associated with venipuncture, most MEDIAL or LATERAL portions of AC fossa. 18) first response in hemostatic process in vivo is: vasoconstriction 19) How can you visually tell serum from plasma? You cannot visually tell them apart. 20) vascular sys disease involving hardening of the arteries: arteriosclerosis 21) vascular system disease involving hardening of arteries: arteriosclerosis (YEP, QUESTION WAS IN TEST TWO TIMES) 22) blood type determined by presence/absence of: antigen present on RBC's 23) specimen clotted, been spun down yields: serum 24) graphic record of heart's electrical activity during cardiac cycle: ECG 25) The R. ATRIUM of heart receives oxygen-poor VENOUS blood that is flowing back to the heart from the SYSTEMATIC circulation 26) NOT antecubital vein: Femoral 27) med term for RBC's, WBC'S, platelets, in order: erythocytes, leukocytes, thrombocytes 28) IF pt receives transfusion of wrong type: all options correct: adverse reaction could result in pt's death, donor's RBCs could clump together (agglutinate), pt antibodies could react w/ donor's RBCs. 29) blood clot circulating in bloodstream: embolus 30) Capillaries are: (all correct): tiny, one-cell thick blood vessels, what link arterioles/venules, where gas exchange takes place

CH 7 TEST---GRADE: 100%

CH 7 TEST---GRADE: 100% 1) rapid serum tube contains: thrombin. 2) what does BD tan contain, and used for test: EDTA, lead 3) You must collect routine hematology, a coagulation, and stat chem test. tubes you use, list OOD: L. blue, green, purple 4) substance used to kill bacteria on surfaces/instruments: disinfectant 5) substances known as biocides: Isopropyl alcohol, Hydrogen peroxide, Povidone iodine 6) inert synthetic substance that forms physical barrier between tcells and serum or plasma of spec: thixotropic gel 7) Substances that provide increased surface for platelet activation: clot activators 8) solution normally used to clean site before routine venipuncture: 70% isopropanol. 9)type of needle used to collect blood from small/difficult veins: winged infusion set butterfly 10) Heparin prevents blood from clotting by: binding calcium 11) phleb collects a L. blue, lav, and gray tubes from inpt. Respectively, additives tubes contain: Citrate, EDTA, sodium fluoride 12) proper blood-to-additive ratio for a L. tube collected for coag test: 9:1 13) CLSI standards, tubes filled last w/ using syringe: EDTA 14) When nitrile/vinyl strap tourniquets become soiled w/ blood: throw them away 15) Evacuated tubes fill w/ blood automatically w/: vacuum 16) needle gauge w/ largest lumen: 18 17) safest way to transfer blood from syringe: syringe transfer device 18) additive usually present in lav: EDTA 19) Glass particles present in SST: enhance clotting 20) multisample needle considered standard for routine draws: 21 21) tests performed in what dept typically collected in L. blue: Coagulation 22) slanted tip of needle: bevel 23) needles without safety feature must be used with: HOLDER w/ SAFETY FEATURE 24) W/ using winged infusion, if first tube is additive tube, important to collect few milliliters of blood in nonadditive tube first to: maintain proper blood-to-additive ratio 25) classified as disinfectant: Sodium hypochlorite 26) most important factor in choosing gauge needle to use for venipuncture: Size/condition of vein 27) green tube normally contains: heparin 28) additive responsible for most carryover problems: ethylenediaminetetraacetic acid (EDTA) 29) Citrate prevents clotting by: binding calcium 30) purpose of antiglycolytic agent: preserve glucose

CH 8 TEST---GRADE: 100%

CH 8 TEST---GRADE: 100% 1) process of id pt: 3-way id: written req, armband, verbal 2) spec needed immediately: STAT 3) sys of choice to ID lab spec from unconscious ER pt: use 3 part id band and labels. written, req, armband, verbal 4) MOST critical error phleb can make: mis-ID pt spec 5) if door closed: knock softly, open door slowly, ask permission to enter 6) if after 5 min still bleeding, alert: nurse, other HCW 7) pt eating for fasting: ask nurse if should still collect 8) never tourniquet more than: 1 min 9) allowing pt to pump fist during vein selection bad for spec 10) pt ask about test, say: best to discuss w/ your dr 11) hospice: terminally ill 12) hemolysis: if mixed too vigorously 13) apologize, replace needle, clean site, warn pt, finish draw 14) no id band, only draw: AFTER ID APPLIED 15) angle of needle: 30* arm, 10* hand 16) priority designations for tests based on: diet restrictions/condition, timed collection. (NOT age/gender) 17) folding arm can disrupt: platelet plug formation 18) 2 attempts, get: another phleb 19) 1st step in testing process starts W/ test: ordered 20) draw spec from inpt John Doe. confirm pt's id: Match ID band/ requisition w/ pt's verbal ID 21) in vein w/: blood appears in: hub of needle 22) test ordered at same time, one phleb, draw: stat lytes, then asap cbc, then timed bc, last is routine 23) tourniquet: 3-4 inches above site, tight to slow venous blood, w/o affecting arterial flow, snug/slightly tight but not uncomfortable 24) new phleb shouldn't handle pt w/ beloniphobia: experienced phleb should do draw 25) belonephobia: fear of pins/needles 26) additive tubes must be: mixed as removed 27) if pt sleep: gently wake to avoid startle reaction 28) hard of hearing, speak: distinctly. normal tone of voice 29) let pt know: you're a student 30) telling child won't hurt: poor communication technique

CH 9 TEST---GRADE: 100%

CH 9 TEST---GRADE: 100% 1) hemolysis can elevate- magnesium, ammonia, potassium 2) punctured artery vs. vein: blood pulses in tube 3) peak level of cortisol normally occurs: morning 4) pt feels pain radiating from site: immediately terminate draw 5) pt wakes up at 6, fasting all night closest to basal state 6) creatine clearance rate decreases in eldery, due to normal decline of: kidney function 7) w/ test requires fasting, but serum: lipemic, clue pt not fasting 8) blood very slow, hematoma forms: remove needle 9) w/ blood componets cant easily leave bloodstream, become concentrated in smaller plasma vol: hemoconcentration 10) test influenced by diurnal variation often ordered as: timed tests, important to collect as close as possible to time ordered 11) removing blood regular basis/lg amounts can lead to: latrigenic anemia 12) not good idea to draw CBC from screaming infant, WBC falsy elevated 13) drawn too quickly from small vein, has tendency: collapse 14) drug interfere w/ urine, discontinue: 48-72 hrs 15) w/ blood from EST backwashes into pt: reflux 16) fill EST: from bottom up, best way to avoid reflux 17) pregnant pt lower ref rates RBC count, increased fluids dilute RBC 18) med term for fainting: synocope, fainting due to action of vagus nerve on blood vessels: vasovagal syncope 19) tube fails to fill w/ blood, what might lead you to think vein collapsed: vein disappears w/ you engage tube 20) tattoo should be avoided as site: more prone to infection, mask adverse reaction, undetected infection 21) prolonged tourniquet may cause change in blood composition because of: hemoconcentration 22) cortisol: can differ by 50% between am, late pm 23) have no choice but draw from site w/ hematoma, where obtain: distal to hematoma 24) paralyzed arm has lost: muscle function 25) pt in Pikes Peak, likey has higher RBC than pt in Florida 26) drugs known to interfere w/ blood test discontinue: 4-24 hrs 27) fistula: perm fusion of artery/vein 28) must draw protime spec from pt w/ IV both arms. Best action: draw below an IV 29) phleb attempted twice to draw PTT spec from pt w/ difficult veins. Both times phleb able to draw only partial tube. What to do: Have another phleb attempt draw the spec 30) heparin lock: device in peripheral vein for purpose of blood collection, medication 31) obstruction or complete stoppage of lymph flow: lymphostasis

DA #1 QUIZ---GRADE: 100%

DA #1 QUIZ---GRADE: 100% 1. hiring phleb, what credentials, professional qualities, & work ethics would person have? ANSWER: certification, professional demeanor, attitude, & dress/groom. Outstanding work/personal set, always interested in training opportunities. 2. on rounds, phleb sees order to collect from Pt who lives in neighborhood. Calls neighbor to let them know friend in hospital so neighbor can send card/flower. proper? ANSWER: No. HIPPA violation. Even if best friends, a violation of pt's rights to disclose to anyone info about pt. 3. well-known person admitted, phleb collects blood from pt. upon return to lab, checks computer for results. phleb knows info not to be shared, plans to keep confidential. Explain consequences of such actions. ANSWER: violation of HIPPA, job of phleb is to collect blood, never to get info on pt. Unless more blood needs to be drawn, need to be connected to pt is ZERO. 4. phleb must collect blood from elderly woman who's hard of hearing, broken English, looks angry w/ attempt made to communicate. communication barriers involved? best approach? How to tell she understands? ANSWER: Language is barrier, best option is find an interpreter, family member or wait to do draw until communication is established. Unless test is explained in picture form, and can be understood to gain consent, no work should be performed unless a life/death situation or emergency. 5. requisition received in lab for STAT spec from INPT whos been in hospital a few days. After carefully checking pt's ID, phleb tells pt order for blood to be drawn immediately. pt says all phlebs are vampires, doesn't want to see another one ever again. complains everyone poking somewhere w/ something, hes tired of it. How to handle situation? ANSWER: would smile, and ask to sit in chair beside bed, make a little small talk, and tell him I totally understand, inform him that yes, we are paid vampires, make other types of jokes and get him comfortable. would let him know test ordered by his dr that day requires a little blood, and ask if I may do tests. I would try to get him to smile and continue making jokes with him and ask if he would like or needs anything as I leave, to show him that I really care he is comfortable/happy. I would try my best to put him at ease without being insincere 6. phone rings in phleb station. new, inexperienced phleb says hello hesitant manner. person on line is angry for being charged twice for same test. call on another line, phleb says, "Just a minute," to 1st caller, picks up other line and says, "Can you hold?" puts on hold before person says anything. 1st caller hung up angry/frustrated, phleb goes back to 2nd caller, find its phleb supervisor, needs info about schedules. What phone etiquette broken? How to handle calls better? ANSWER: Should say hello in confident, upbeat tone. person whos angry being charged twice for same test should be told yes, you will look into double charges and you are sorry for issue, ask politely if you can place them on brief hold while you look into charges. Then answer call on other line, say whatever lab requires them to say, then politely ask if you may place them on hold, wait for reply. Discovering its supervisor, politely let them know client on other line, ask if you may call them with schedule info w/ done w/ caller 7. busy multi-specialty clinic often short-staffed, so clinic administrator decides all employees should be cross-trained. phlebs are asked to learn how to load samples on chemistry/hematology analyzers, and give lab reports over phone. Should phlebs agree to new responsibilities? Why/why not? ANSWER: If I personally am asked to learn the new procedures, I would ask how to go about receiving training. Until I am proficient and certified, I would not do the extra job functions to ensure my pt's safety. If I am allowed to go to training and get certification, then yes. Until that time, I would not agree as it could put someone's life at risk, would politely ask admin if training provided at no cost to me since they are requesting me to be trained for more job functions. 8. dr collects CSF specimen on pt in ICU, hands 3 tubes to phleb to take to lab STAT. There's no central processing/receiving area in lab. Where should specimens be taken, transported? ANSWER: Specimens should be carefully packaged in special containers meeting federal safety regs, sent to ref lab hospital uses

DA #10 Quiz---GRADE: 100%

DA #10 Quiz---GRADE: 100% 1. test requires arterialized spec: Blood gases 2. Capillary puncture supplies include EXCEPT: povidone-iodine pad 3. Read Case Study , answer questions: CASE STUDY 10-1: Capillary Puncture Procedure: A phleb sent to collect CBC spec on 5-yr-old ped pt. w/ IV in l. forearm, R. arm has no palpable veins, phleb decides to perform cap on middle finger R. hand. phleb's 1st job and, although quite good at routine venipuncture, has not performed many cap's. child uncooperative, mother tries to help steady child's hand during procedure. phleb able to puncture site, but child pulls hand away. Blood runs down finger. phleb grabs child's finger, tries to fill collection device w/ blood as runs down finger. child continues trying to wiggle finger free. phleb finally fills container to min level. W/ spec tested, platelet count abnormally low. slide made, platelet count is abnormally low. new spec requested. Hemolysis later observed in spec. How might circumstances of collection contributed to platelet clumping in spec? ANSWER: catching blood as it ran down finger, fighting child to get rest of spec, it took so much time that specimen was not mixed together in time, blood-to-additive ration was off What most likely caused hemolysis? ANSWER: Didn't wipe away first drop of blood off, possibly fighting w/ child caused blood to be handled in such a way that RBC's broke down What factors may have contributed to collection difficulties? ANSWER: phleb didnt take time to get to know child in a way child trusted him, did not speak to mother and have her understand way she needed to hold child's fingers to make sure spec usable, and did not do puncture against grooves/whirls to get drops of blood.

DA #12 Quiz---GRADE: 100%

DA #12 Quiz---GRADE: 100% 1) A pt scheduled for operation suspects shes pregnant. If PG, operation has to be postponed. DR sends her to outpt lab for PG test. When Dr calls lab for results, lab asst says info will be sent immediately through lab's puter network. Before info sent, lab asst called away, leaves pt's PG test results on screen. Is this a problem? Explain answer. What law addresses this situation? ANSWER: Yes, hippa violation. She should have logged out before leaving her desk 2) A nurse calls from cardiac intensive care unit (CICU) to complain pt has huge hematoma that wasnt there before last venipuncture. data clerk goes to sys to see who performed draw, ID code belongs to phleb clerk knows wasnt assigned to CICU this morning. What could have happened? ANSWER: assigned phleb may have done 2 draws, was unsuccessful, may have needed another phleb for help so thats why theres a discrepancy. 3) glucose spec was forgotten in phleb's collection tray, discovered 3 hours later. Should spec be submitted for testing, or recollected? Explain. ANSWER: Good for testing IF drawn in sodium fluoride tube, good for 24 hrs at room temp, and 48 hrs at 2C 4) phleb needs to collect ammonia and potassium spec from same pt. both require collection in lithium heparin. Can one tube be collected for both specs? ANSWER: Yes, both contain same anitcoagulate. A separate Aliquot will be used, but all blood will be from one tube 5) During spec processing, a phleb loads centrifuge w/ specs, closes lid, starts centrifuge. centrifuge makes strange noise, vibrates more than usual, followed by sound of glass breaking. Whats wrong? What should phleb do? ANSWER: centrifuge needs to be balanced, and once centrifuge cleaned/disinfected, balance and remake another sample to centrifuge 6) A young couple arrives at outpt facility to have blood test drawn. requisition indicates paternity test ordered. woman cooperates, blood drawn. man refuses to state name/DOB. sits in drawing chair, extends arm so phleb assumes he has consented to draw and hes same person as listed on requisition. blood drawn and chain of custody paperwork completed. What possible legal consequences might occur because of phleb's actions? ANSWER: pt did not state name/DOB, so draw should not be done on male. should be documented in file he refused draw, alert nurse, supervisor, or manager. Had draw been done, male can claim that he was not the person drawn and deny paternity to the child. 7) TDM level ordered to be drawn at 0400 hrs. Only one phleb on duty, has to draw several STAT lytes in ER and ICU. By time she gets STATS and delivers spec to lab, its 0500 hrs. She hurries to pt's room for TDM level, only to find pt is having CT scan at 0500, not in room. By time shes able to draw pt its 0600. Not wanting to get reprimanded, she records time of draw as 0400. What are implications of her actions? How could supervisor detect pre-analytical error? ANSWER: By not recording correct time of draw, pt's results will reflect different level of medication in system. If doctor adjust patient's dose, could have drastic effect on pt, possibly a life/death situation. A supervisor could look at all tubes drawn by phleb, at what time they were all drawn to determine if TDM was drawn at correct time. 8) courier picks up specs from lab once a day at 1500 hrs for delivery to ref lab. To get hospital patient results out faster, spec processor places all ETS tubes and specs that are to go to ref lab in refrigerator until early afternoon, then centrifuges and processes all ref tests just prior to arrival of courier. She believes this is most efficient way to handle workload, get results out faster. Are there possible errors in testing that might result from her actions? How would this be discovered by lab personnel conducting testing? ANSWER: Some specs may not be able to be in refrigerator, some may need to be separated as soon as clotted, and if test results are erroneous, lab conducting test will know by test results. 9) A busy hospital lab has two spec processors on duty. One's worked for 30 yrs, knows routine well. She's wearing lab coat, gloves, personal eyeglasses. Are PPEs adequate? Why is that important? ANSWER: She is in lab and needs goggles or a face shield to protect her eyes from splashes and droplets of not only body fluids but from chemicals as well.

DA #13 QUIZ---GRADE: 100%

DA #13 QUIZ---GRADE: 100% 1) on rounds collecting blood spec, phleb asked by nurse to take nonblood spec to lab. spec Labeled w/ proper pt id info, name of test requested. Should phleb accept spec? Why or why not? ANSWER: If specimen is properly identified with all required patient information, and accompanying requisiton, then yes, accept it, take to lab. 2) urine spec for urinalysis and C&S was not collected in sterile container. Should specimen be accepted for testing? Why/why not? ANSWER: No, the urine C&S has to be collected in a sterile container, but it is acceptable for the urinalysis testing. Need to recollect another specimen for the C&S in a gray-topped container. Gray top C&S urine containers are only for culture and not acceptable for urinalysis/urine chemistries because preservative interferes with testing 3) pt delivers 24-hr urine spec to lab. and spec processor notices theres a lot less urine in container than most spec, asks if last spec was included. pt says yes, but mentions he got up during night to urinate, forgot to collect. Should spec be accepted for testing? Explain. ANSWER: Specimen proccesor should ask pt what time approximately he voided but did not collect, and then reach out to dr who ordered the test if he wants pt to recollect another 24 hrs or accept specimen and do the test 4) phleb working in lab spec processing dept. sees a nonblood spec left on counter, labeled w/ proper pt id info but doesn't have info about type/source of spec. Its clear pale yellow fluid that looks similar to amniotic fluid. How should phleb proceed? ANSWER: should follow info on bottle and look for who collected it. If it is amniotic fluid, time is of the essence and a very painful, dangerous procedure, so all efforts should be made to immediately get the information to determine if specimen is viable for testing and all paperwork associated, then an incident report should be filled out 5) pt arrives at 0630 to have blood drawn for 2-hr. PP test. pt says has not had anything to eat/drink since 2200 hrs last night. phleb collects fasting blood spec and gives urine cup to pt to collect a fasting urine. pt is instructed to eat a normal breakfast and return to drawing station in exactly two hours. pt goes home to get her husband and they go to local restaurant to eat breakfast. Service is slow, so meal finished at 0730. pt returns to the lab exactly on time and phleb collects another urine and draws pt's blood at 0830. What additional info should be written on spec labels? Were the instructions given to pt for 2 hr spec correct? How might results adversely affect pt's diagnosis/treatment? ANSWER: yes, a meal should be eaten two hours before tests, but test should have been drawn at 9:30. info needs to be written on label pt came in fasting, drew test an hr early, and note on urine its fasting specimen

DA #14 QUIZ---GRADE: 100%

DA #14 QUIZ---GRADE: 100% 1) When performing Allen test, phleb holds pressure over both arteries, then releases pressure over radial artery. hand flushes pink almost immediately. Is this positive reaction? Is it acceptable to collect an ABG specimen from that arm? ANSWER: Even though test is positive, it needs to be performed again, but release Ulnar artery first, not radial. Then, if hand flushes pink, yes, that arm's suitable to be used. 2) While attempting to collect ABG spec, phleb has to redirect needle several times. A flash of blood finally appears in syringe, but then blood flow stops. phleb pulls on syringe plunger and aspirates blood into syringe. Is this specimen arterial? Why/why not? ANSWER: while doing ABG, probing or needle redirecting can cause hematoma, thrombosis, or damage to the artery. And is painful. It probably needs to be redrawn, since arterial blood pulses and fills a plunger on its own power. Phlebotomist needs to seek assistance from a more experienced phlebotomist or nurse. 3) When collecting an ABG spec, blood pulses into tube, but not bright red. A hematoma forms while pt holding pressure over site after collection. Is spec arterial? Was proper procedure followed? How can phleb determine if hematoma is blocking blood flow through artery? ANSWER: Yes, bright red color and pulse indicates it was arteriel. Pt should NEVER hold pressure themselves, so no, proper procedure wasnt followed. An Allen test can be performed to determine if artery is being blocked. 4) Within 15 minutes of collection, a phleb delivers an arterial spec to lab for ABG/lyte evaluation. The spec is on ice, and there is air space in syringe. Should lab accept spec for test? Explain answer. ANSWER: specimen should have been drawn without air entering/leaving syringe. Any air bubbles introduced during sampling procedure will lead to overestimation of arterial oxygen tension (PaO2), underestimation of arterial carbon dioxide tension (PaCO2)

DA #2 QUIZ---GRADE: 100%

DA #2 QUIZ---GRADE: 100% 1) out of 17 spec's phleb collected, 10 required redraws. What QA implications? What actions might be taken to remedy situation? ANSWER: Have phleb review guidelines/techniques for blood samples 2) CBC spec rejected by hematology dept. Tube filled completely, labeled properly. What might have been reason for rejection? ANSWER: no req form, Anticoags might be expired, not transported correctly 3) glucose spec forgotten, discovered 3 hours after draw. Should spec be submitted or recollected? ANSWER: No, don't submit, it's past the 2-hour window to test 4) new phleb criticized by super for not meeting 5 min/pt limit, told to increase speed. next pt hesitant to extend arm, proceeds to force pt to cooperate, draws blood quickly w/o any explanation. What legal/ethical issues associated w/ situation? ANSWER: She should not do draw by force, she could be charged with assault/battery. Unethical to be rushed, blood draw every 5 min not taking pts/situations into consideration. 5) As phleb is redirecting /digging in pt's arm, adjacent vein spotted. Thinking pt wont notice, she quickly withdraws needle and moves it to vein centimeters away, w/o changing needles/explaining situation to pt. blood comes quickly, phleb dismisses pt, satisfied, unaware of what happened. What are safety issues, legal ramifications? ANSWER: Once needle is removed, for whatever reason, not usable again, could infect pt. Could be sued, safety of pt is most important. 6) phleb goes to ER to draw from unconscious, badly injured accident vic. An anxious RN tells phleb to draw "rainbow", and blood alcohol level, adds she'll send dr's orders to lab when she gets them. injured man doesn't have ID band, phleb there when he arrived. How should phleb id pt in order to meet NPSG's? Should phleb collect, or wait for dr's orders? ANSWER: should wait for drs orders

GRADES

GRADES WEIGHT LEGEND FOR OVERALL GRADE: QUIZ:20% HW:15% TEST:35% BR:15% OTHER:15% ----------------------------------------------------- CH--QUIZ--HW--TEST-BELLRINGER --------------------------------------------------- 01---100%---100%------100%---not entered yet 02---100%---100%------100%---not entered yet 03---100%---100%------100%---not entered yet 04---100%---100%------100%---not entered yet 05---100%---100%------100%---not entered yet 06---100%---100%------100%---not entered yet 07---100%---100%------100%---not entered yet 08---100%---100%------100%---not entered yet 09---100%---100%------100%---not entered yet 10---100%---100%------100%---not entered yet 11---100%---100%------100%---not entered yet 12---100%---100%------100%---not entered yet 13---100%---100%------100%---not entered yet 14---100%---100%------100%---not entered yet FALLS UNDER OTHER: ATTENDANCE: NOT ENTERED YET EXTRA CREDIT: NOT ENETERED YET

DA #3 QUIZ---GRADE: 100%

DA #3 QUIZ---GRADE: 100% 1) ped pt breaks out w/ measles day after being admitted to hospital w/ breathing problem. nosocomial infection? ANSWER: Not a nosocomial infection, incubation period for measles 10-12 days, pt not in hospital long enough. 2) pt w/ pulmonary tuberculosis, type of precautions entering pt's room? ANSWER: transmission-based 3) A lab worker sneezes, covers mouth w/ hand, reaches for Kimwipe knocks over sharps container, stuck by needle fell out of sharps container. What means of BBP transmission may be involved/safety rules violated, how incident handled? ANSWER: Sharps container not mounted securely, BBP exposure when needle entered skin, wash skin with soap/water for 30 secs., file incident report, follow workplace safety precautions, get tested, and any treatment needed to be released to go back to work. 4) tertiary care hospital lab chronically understaffed in Phleb Dept. Employees constantly asked to work ot, additional evening shifts, and many weekends. "Time-off" very difficult to get approved. Describe ways stress might manifest in employees, ways employees can manage. ANSWER: Could start to have a weakened immune system, hypertension, ulcers, migraines, and nervous breakdowns could eventually result. Can manage stress levels by talking about problems with friends, family, exercise, setting realistic goals, and relaxing throughout the day. 5) phleb working in spec processing area. Suddenly co-worker removing specs from centrifuge collapses. phleb notices water leaking from sink next to centrifuge. Describe steps necessary to safely provide assistance to co-worker. ANSWER: Use something non-conductive to pull plug of machine, call for help, start CPR IF NEEDED, keep warm.

DA #4 QUIZ---GRADE: 100%

DA #4 QUIZ---GRADE: 100% 1) word root "ped" has 3 different meanings. What are they, how correct meaning determined? ANSWER: Latin: foot, Greek: child, Latin: louse. Establish meaning of root in these cases to consider context in which word being used. 2) Assume you don't know meaning of word "arteriosclerosis." Describe how to figure out meaning by identifying each word element and what it means, starting with suffix. Then use term correctly in sentence ANSWER: arteriosclerosis: sclerosis abnormal hardening. arteri/o: artery. pt is suffering from arteriosclerosis. 3) HbsAg test ordered on pt w/ hepatitis. What does HbsAg stand for, what does hepatitis mean? ANSWER: HbsAg-Hepatitis B surface antigen Hepatitis, BBP that targets liver. 4) Describe guidelines for pronouncing letters "ae," "e," and "es" when at end of a term, and "i" when at end of a plural term. Give examples of terms with these endings. ANSWER: ae, pronounce second vowel only. e, may be pronounced separately when at end of term. es, may be pronounced as a separate syllable when at end of term. 5) abbreviations "U" and "IU" are on TJC Do Not Use List. Why are these abbreviations problem, whats solution to problem? ANSWER: u: unit. can be mistaken for 0, zero, number 4, or CCIU IU: international unit. can be mistaken for IV, or number 10, ten

DA #5 QUIZ---GRADE: 100%

DA #5 QUIZ---GRADE: 100% 1) pt w/ bruise, phleb collects spec distal to it. Describe where spec collected, why area chosen. ANSWER: taken BELOW bruise, least sensitive, limits pain to pt. should not draw altered/injured/infected area 2) alkaline phosphatase, bilirubin, cortisol, PSA, and urinalysis ordered. What body sys's associated w/ each test? ANSWER: ALP, bilirubin Liver or bonescortisol for adrenal gland, PSA for prostate, Urinalysis for kidneys, renal for pelvis, ureters, bladder, urethra.

DA #6 QUIZ---GRADE: 100%

DA #6 QUIZ---GRADE: 100% 1) pt has congestive heart failure caused by damage to L. chamber of heart, resulting in more blood entering chamber than heart can deliver to body. Where will blood back up initially? ANSWER: lungs 2) pt w/ blood pressure reading of 160/100 mm Hg. What does reading represent, is reading normal? ANSWER: 120/80 is normal reading, this pt's reading considered hypertension 3) phleb draws spec from median cubital vein in antecubital fossa. Describe where vein located. ANSWER: bend of elbow 4) How can you tell difference between serum and plasma after specimen is centrifuged? How can you tell pt has high platelet/white blood count by looking at centrifuged plasma specimen? ANSWER: serum on bottom, plasma on top. Buffy coat may indicate WBC count. 5) Rh-positive woman gives birth to an Rh-negative baby. Will this result in problem for mother, baby, for both, or neither? ANSWER: no problems will occur, if baby is girl, needs to be told should be treated w/ RhoGAM when she gets pregnant. 6) pt has deep vein thrombosis (DVT) for unknown reasons. What phase of coagulation process, what coagulation factors might be involved? What role does drug Arixtra play in treatment of DVT? ANSWER: Hypercoagulable state, Factor V Leiden (the most common), Prothrombin gene mutation. Deficiencies of natural proteins that prevent clotting such as antithrombin, protein C and S, Elevated levels of homocysteine. Elevated levels of fibrinogen, dysfunctional fibrinogen (dysfibrinogenemia). Atrixia was developed to inactivate thrombin inside clot, prevent clot propagation in individuals w/ clotting disorders such as DVT 7) elderly outpt on Coumadin (Warfarin) comes regularly to have blood drawn. phleb on duty notices lot of bruising on arms. What are some potential problems to expect during/after draw? What additional steps should she take to ensure quality pt care? ANSWER: longer bleed times, should make sure bleeding stops completely before leaving pt. Should get more frequent blood draws to make sure levels of drug is enough.

DA #7 QUIZ---GRADE: 100%

DA #7 QUIZ---GRADE: 100% 1) phleb must collect spec from isolation pt w/ contact transmission precautions. best type of tourniquet ANSWER: disposable tourniquet 2) phleb must collect red, l blue, green, and lav tubes from pt. Whats OOD? What additives in each tube, which are anticoagulants? Name lab depts/areas where each tube would most likely be sent for testing. ANSWER: order of draw: 1, l blue, sodium citrate, coag, 2, red no additive or red clot activator, sst's, serum separator tube, chem dept, 3, green, heparin, chem dept, 4, lav edta, hematology dept. 3) phleb goes to collect blood culture, draw ETS tube for trace elements. disinfects pt's arm w/ povidone-iodine scrub, draws culture using winged-infusion set w/ adapter attached for culture bottle. She fills anaerobic bottle first, then aerobic bottle, removes adaptor and attaches ETS tube holder to line. The royal-blue top tube fills, phleb happy she got all spec's w/ one stick. What errors made? What substances might interfere w/ results? Will lab be able to tell if spec were collected properly? How should samples have been collected? ANSWER: First, she should have used friction scrub, then iodine removed from skin w/ alcohol, to make sure test results are correct. Then she filled bottles in wrong order. Then she attached ETS holder to line, could possibly have residue from culture bottles or sodium citrate interfere w/ trace elements test results. 4) ECHO-most common anticoagulants. Id anticoagulant associated w/ acronym, stopper color/colors associated them. Explain how each prevents blood from clotting. ANSWER: E=EDTA, lav, purple, tall pink tube-removes calcium from blood by binding calcium to form an insoluble salt C=Citrate, L Blue, binds calcium H=Heparin, d green, inhibits thrombin formation O=Oxalate, grey, removes calcium, prevent clotting by binding calcium in form of insoluble salt

DA #8 QUIZ---GRADE: 100%

DA #8 QUIZ---GRADE: 100% 1) phleb receives orders to collect STAT hemoglobin and hematocrit in ER, STAT blood cultures on another ER pt, and STAT glucose in ICU. Which STAT spec collected first? Explain. ANSWER: Stat glucose, because high/low blood sugar can cause death, Stat H&H, Stat blood cultures. order performed in order of emergency. 2) phleb arrives to collect spec from inpt. not wearing ID band, but an ID band on night stand next to bed that matches requisition. name/dob stated by patient also match requisition. What should phleb do? ANSWER: Ask nurse to place ID on pt's wrist, dont draw until pt wearing ID 3) phleb has order to collect spec from an inpt. name of dr on requisition doesnt match dr's name on pt's ID band. What should phleb do? ANSWER: Consult with nurse to confirm pt has more than one dr before proceeding, as well as confirm patient id, name, DOB to make sure working with right pt. 4) phleb about to collect a fasting glucose spec from outpt, chewing gum but assures phleb its sugarless. W/ phleb asks if pt fasting, pt admits to cup of black coffee. How should phleb proceed? ANSWER: call dr, inform pt has had coffee, chewing gum, if should proceed or not, if yes, then document nonfasting on spec, but better to reschedule test since gum chewing stimulates digestive response, can throw off test results. 5) After 2 unsuccessfully to collect spec, phleb sees excellent wrist vein not noticed before. What should phleb do? ANSWER: Get another phleb to perform draw 6) phleb has order to collect BC from 7 yo. child crying/squirming in chair, child's mother getting frustrated and upset. How should situation be handled? What method of restraint should be used, what equipment be used to collect spec? ANSWER: Calmly ask mom for permission to draw child's while she waits outside. Get another phleb, approach child w/ smiles, possibly sticker, compliment, or other distraction, explain procedure, make sure they understand, allow them to ask questions. Let them know another phleb there to help them hold their arm very still. if child lying down, other phleb leans over child from opposite side. 23 gauge butterfly needle 7) phleb assigned to answer phone in lab. A dr calls to "add-on" a test to previous order already collected. phleb does not know if there is enough specimen remaining to run additional test, so tells dr he needs to write new orders and pt's spec need to be redrawn. How should phleb handled situation? ANSWER: should inform dr that draw already done, may not be enough spec to do add-on test, request dr to have another test ordered to draw another spec. 8) request for BW received in lab. A new phleb goes to pt's room to collect. notices large vein on L arm, applies tourniquet. When she palpates vein, feels vibration/"buzzing". Should she draw from vein? Whats she palpating? What should she have done differently? Why does pt require dialysis? ANSWER: no, not in L. arm, should try right arm. feeling a shunt, should NEVER put tourniquet on this arm, should ask for assistance so she can be taught what to do. She should have palpated first before ever putting on tourniquet. Possible kidney failure pt. 9) phleb has orders to collect from outPT. She notices pt elderly, waiting room she yells loudly Mrs. Smith. gives a urine collection cup, directs her to collect spec, then come to draw room. W/ pt sits in draw chair, phleb notices well beyond 5 min limit per pt her super requires. So, ties tourniquet tightly, palpates a vein, cleans arm, assembles equipment, and inserts needle before alcohol is dry. vein rolls so redirects needle. Finally blood slowly enters ETS tube, but she manages to fill all tubes. W/ releasing tourniquet, notices petechiae on pt's arm, places cotton ball and holds in place w/ tape. She directs pt to exit. What errors were made, complications might be expected in pt? ANSWER: First, she shouted for pt, doesn't give directions on how to do urine collection, ties tourniquet too tightly, doesn't adjust it, doesn't wait for alcohol to dry, has to redirect needle due to poor technique and patient has to feel pain, doesn't address petechia on pt's arm, no bandage, or check elderly pt still bleeding or not, since petechiae may indicate she will have excessive bleeding. Poor behavior, could make pt upset w/ all phleb's for poor treatment shown to her, phleb was extremely unkind to her. even if there is a five minute between pt limit, I wont rush and do my job properly, ensure pt safety first.

DA #9 QUIZ---GRADE: 100%

DA #9 QUIZ---GRADE: 100% 1) Which pt is closest to basal state: pt who worked all night but was fasting, bedridden pt who has not eaten for 6 hrs, or pt who just awakened after sleeping for 8 hrs? Explain answer. ANSWER: Basil state is defined as resting and NPO for 12 hrs, person who slept for 8 hrs 2) phleb has orders to collect CBC and a protime spec from pt who has IVs in both forearms, major bruising on L. hand. Should spec be collected above or below IV on either arm or hand, from an ankle or foot vein, or by fingerstick? Explain choice. ANSWER: Collect below IV, make sure nurse turns off IV for at least 5 min, Draw 5ml discard tube, draw blood in R. hand, which isn't bruised. Prothrombin cant be done with capillary puncture, and foot/ankle requires Dr's. permission 3) W/ drawing spec from pt, huge hematoma starts to form, and blood spurts into collection tube. pt starts to faint. How should situation be handled? What was likely cause of hematoma? ANSWER: WITHDRAW needle immediately, activate safety feature, and if possible, discard it immediately. apply pressure to site. hematoma was caused by needle going through/not in far enough into vein. Use call button to call nurse. 4) phleb collected serum potassium spec by syringe, forced blood in collection tube pushing syringe plunger until tube was full. Spec processing rejected spec after centrifuged. reason rejected? ANSWER: spec rejected because hemolyzed, blood forced in tube, not allowed to fill by vacuum. pressure of pushing plunger destroyed RBC's releasing hemoglobin, causing hemolysis 5) phleb about to collect spec from prominent antecubital vein. When needle enters vein, drop of blood appears on surface of skin. When tube engaged, small amount of blood enters tube then stops. What happened, how should situation be handled? ANSWER: Vein collapsed, entry too slow, no vacuum in tube, change tube. no blood still, start over 6) phleb w/ 30 yrs experience has to draw pt she's drawn before. She knows difficult to find vein, so asks pt to make tight fist, pump hand several times. After several minutes with tourniquet, vein palpable. inserts needle, successfully draws several ETS tubes in following order: lavender, green, gold. What errors made? What test results likely to be affected? ANSWER: Incorrect order of draw, as well as pumping fist may cause hemolyzed samples. Incorrect additives may have been mixed into other tubes and cause tests to be incorrect readings. Lavender has EDTA and should have been drawn last.

DA #11 Quiz---GRADE: 100%

Da #11 Quiz---GRADE: 100% phleb receives STAT order to collect spec for type/crossmatch from ER pt. Several spec on same pt collected hr earlier. Enough blood left from collection for new tests. Can any of spec collected earlier be used? Explain what should be done? ANSWER: should check and see if any of tubes have been drawn for blood bank, but to be on safe side, should re-draw pt to ensure 100% beyond a doubt that crossmatch test accurate since pts life at risk. 2) phleb prepared site for blood culture collection. Just before needle inserted, pt complains of intense burning sensation at site. What should be done? ANSWER: needle sheathed/discarded. Reaction to site cleaner may be occurring, should reclean site with water/sterile solution, once or if reaction under control, note in pt chart may be allergic to what was inititally used to clean site, then proceed w/ another site w/ different site cleaner. 3) phleb performing glucose tolerance test (GTT). fasting blood spec collected 0600 hrs. pt given drink 0610, finishes 0615. what times are rest spec collected? What's done if pt vomits soon after consuming drink? ANSWER: second test performed at 8:15. If vomits within 30 minutes of drink, need to reschedule, if vomits within 45 minutes of drink, needs to contact dr, get further instructions. 4) phleb attempted to collect prothrombin time (PT) spec from pt. tube filled partway, stopped, withdrew tube, restuck pt, finished filling l. blue tube. Sometime later phleb asked to recollect spec. Why? What should phleb tried before withdrawing needle? ANSWER: Tried new tube, vacuum may be defective. multiple tests from diff sites in 1 tube will affect results. 5) peak TDM level ordered for 0900 hrs. phleb draws spec 20 min late, unavoidable circumstances. What additional action? ANSWER: Record actual time of collection 6) New POC instruments recently purchased, enhanced w/ electronic QC, has internal checks to determine if functioning properly, able to detect clotting, short samples, air bubbles. nurses see process foolproof, lab still having probs w/ POC results not matching well enough w/ results when drawn/processed by lab. What could be cause? ANSWER: improper operation of machines. 7) Blue Alert received on trauma pager in lab. pt involved in auto accident, several people sustained serious injuries. unconscious patient has so much damage to body, impossible to place armband. phleb asks trauma surgeon if pt will require blood transfusions, if should set up immediately. surgeon responds yes, procedure is draw rainbow, get out of way ASAP. How should phleb id pt? How should skin be disinfected? What paperwork needed, how should spec be transported to lab? ANSWER: tie paperwork/label w/ written requistion from dr, and assigned records number to the spec. Should cleanse skin with 70% alcohol, requistion from dr required, and should be transported STAT to lab.

FINAL---GRADE: 100%---WEIGHT: 3.50

FINAL---GRADE: 100%---WEIGHT: 3.50 1) "distal": Farthest from point of attachment 2) basic tissue types covers/lines organs, cavities, and vessels: Epithelial 3) Glomeruli, tufts of capillaries located: Nephrons of kidneys 4) lumbar puncture, performed by dr to withdraw: Cerebrospinal 5) nephr/ren refer to: Kidneys 6) TJC "Do Not Use" list applies to all EXCEPT: Electronic laboratory reports, kg 7) ESR: Erythrocyte sedimentation rate 8) kidney inflammation: Nephritis 9) major difference between arteries/veins, most veins: have one-way valves 10) relaxing phase of cardiac cycle: Diastole 11) Capillaries: Where gas exchange takes place, Tiny, one-cell thick blood vessels, links arterioles and venules (All) 12) first response in hemostatic process in vivo: Vasocontriction 13) work practice control that reduces risk of exposure to BBP: exposure control plan 14) An N-95 respirator must be worn w/ entering room of pt w/ precaution sign: Airborne 15) Example of nosocomial infection: catheter site of pt in ICU becomes infected 16) To comply w/ latest HazCom revision, label of hazardous chemical must include: GHS hazard statement, Hazard class pictogram, Severity signal word (All) 17) According to standard first aid procedures, severe external bleeding best controlled by: Applying direct pressure 18) When threshold value of clinical indicator of QA is exceeded, and a problem identified: a corrective action plan is implemented 19) Some test require immediate cooling in slurry to: Slow down metabolic processes 20) national org that sets standards for phleb procedures: CLSI 21) LEAST likely to be reason for spec rejection? clotted spec for CBC 22) preanalytical factor, affects validity of test result, not always under phleb's control: Pt prep 23) area of lab where testing performed to detect infectious disease/antibodies: Immunology 24) NOT phleb's duty: Starting IV lines 25) Outpt phleb, such as dr's office/pt care service, assigned code for reimbursement using national coding system: CPT

NAHP CERT CPT STUDY GUIDE CH 7 SAFETY PROCEDURES

NAHP CERT CPT STUDY GUIDE CH 7 SAFETY PROCEDURES NEEDS EDIT 1) chain of infection: source, means of transmission, susceptible host 2) majority of microbes are non pathogenic. 3) Infection can be local/systemic. 4) susceptible host, someone w/ decreased ability to resist infection. 5) Hand washing necessary before/after contact w/ each pt 6) necessary to remove rings/watch for effective hand wash 7) never recap needles/manipulate by hand before disposal 8) Standard precautions intended #1 strategy for successful nonsocomial infection control 9) Airborne Droplet, Contact precautions NOT parts of Standard precautions 10) Never touch electrical equip w/ drawing blood, current can pass through phleb/needle, shock pt 11) biohazard, material/substance harmful to health 12) Bloodbourne pathogen, term applied to any infectious microorganism present in blood/other body fluids/tissues 13) 2001, OSHA updated Occupational Exposure to BBP Standard to conform to Needlestick Safety/Prevention Act 14) If electric shock occurs, shut off electricity, call for med assistance, start CPR (if necessary), keep victim warm 15) NFPA code word for order of action in event of fire: RACE. Rescue-Alarm-Confine-Extinguish 16) HazCom standard AKA Right to Know Law 17) American Heart Association Chain of Survival. EARLY: access to care, CPR, defibrillation, advanced care 18) estimated back injuries account for approximately 20% all workplace injuries/illness. 19) Persistent/excessive stress can be harmful to personal wellness 20) Proper nutrition is NOT overrated 21) 1st line of defense during phleb procedure: gloves 22) All procedures/manipulations of potentially infectious material should be performed carefully to minimize creating: droplets/aerosols 23) Safe working conditions ensured by employer, mandated by law: OSHA 24) Needles shouldn't be bent, but promptly placed in puncture resistant container, dont re-sheath before discarding: this is common cause of needle injury 25) If fire starts in your area of facility, your 1st action: pull nearest alarm box 26) Fluorescent activated cell sorters generate droplets that could potentially result in: infectious aerosols 27) disease usually leads to complete isolation: rabies 28) If phleb required to obtain blood spec from pt in nuclear med dept, risk: radiation hazard 29) most frequent lab-acquired infection: HBV 30) vaccine OSHA requires all HC personnel: HepB 31) set of rules established by CDC, adopted by OSHA, to control infection from body fluids in HC setting: UNIVERSAL PRECAUTIONS 32) Due to poorly run labs, misdiagnosing/mishandling lab tests, Congress Oct 88 passed public law 100-578: CLIA '88 33) not considered link in chain of infection: poor isolation technique 34) workers w/ highest rate of needle stick injury: medical students (dont think this is correct, research needed) I think one fo these: surgeons, ER workers, lab room professionals, nurses 35) during phleb procedure, greatest real/potential hazard caused by failure to properly id pt. following are ways to control stress: A. id prob, discuss w/ close friend, partner or person at source B. learn to relax throughout day - close eyes, relax body, clear mind C. exercise regularly (D.) all choices 36) Which of following help prevent lower back pain? a. exercise b. lumbar support c. proper lifting techniques (d.) all of the choices 37) Safe working conditions for employees are mandated by: OSHA 38) Which of following situations involves nosocomial infection? pt in ICU whose surgical wound becomes infected 39) Which following items PPE? non-latex gloves 40) In event of chem splash in eyes, first thing victim should do: immediately flush eyes w/ water for 15 min. To destroy transient microorganisms when washing hands, use antiseptic soap Reverse isolation may be used for patients with severe burns Electrical safety involves knowing the breaker box locations The newest American Heart Association CPR recommendation is compressions to breaths 30:2 What is the significance of a rash appearing on the hands after wearing gloves? latex allergy The proper order for putting on PPE is gown-mask-gloves The proper order for taking off PPE is gloves-mask-gown Which of the following is an example of conditions associated with airborne transmission? Tuberculosis Which of the following is an example of conditions associated with droplet transmission? Diphtheria Which of the following is an example of conditions associated with contact transmission? Scabies Which of the following is a Class A fire? wood, paper, or clothing Which type of fire extinguisher is used to extinguish a Class A fire? Class A or Class ABC Which of the following is a Class B fire? flammable organic chemicals Which type of fire extinguisher is used to extinguish a Class B fire? Class B or Class ABC Which of the following is a Class C fire? electrical Which type of fire extinguisher is used to extinguish a Class C fire? Class C or Class ABC Which of the following is a Class D fire? combustible materials Which type of fire extinguisher is used to extinguish a Class D fire? none use sand or dry powder Which of the following are standard physical hazards in any setting? a. running in rooms or hall waysb. wet floorsc. open-toed shoes, or high heels(d.) all of the choices Which of the following PPE is necessary for Strict Isolation? gown, mask, & gloves Which of the following PPE is necessary for Respiratory Isolation? mask & gloves Which of the following PPE is necessary for Enteric Isolation? gown & gloves Which of the following PPE is necessary for Protective Isolation? sterile gown, mask, & gloves Which route of transmission is the most important and the most frequent? contact What are fomites? objects or surfaces that harbor bacteria Which of the following are protective apparel? a. gownsb. apronsc. laboratory coats(d.) all of the choices To maintain medical asepsis, hands and wrists are washed for a minimum of 1-2 minutes Which of the following would not be considered a sterile pack a phlebotomist would be required to open? sterile surgical equipment Which of the following hazards requires wearing a lead apron and gloves? radioactive hazard Disposal of chem regulated by: EPA OSHA requires chem manufacturers make info available to consumers: material safety data sheets condition free of germs, infection, any form of life: asepsis/sterile phleb comes in contact w/ when adding preservatives to 24-hour urine sample: chem hazard not considered biohazardous waste? used gloves, wet paper towels, used 2x2 gauze squares, none of the choices

NAHP CERT CPT STUDY GUIDE CH 8 LAW, ETHICS & QUALITY

NAHP CERT CPT STUDY GUIDE CH 8 LAW, ETHICS & QUALITY NEEDS EDIT civil law is law of private rights between persons/parties: TRUE tort, wrongful act committed upon one person by another: TRUE HIPAA, health insurance portability and accountability act: TRUE negligence, failure to responsibly act on behalf of pt, resulting in injury: TRUE ASSALUT is act threatening to inflict injury on another person: TRUE In april 2003, pt care partnership was adopted as replacement for pts bill of rights: TRUE pts bill of rights/pt care partnership are NOT legally binding documents criminal law is divided into felonies and misdemeanors: TRUE ethics is the study of a society values actions and determination of right and wrong: TRUE acquiring informed consent prior to specimen collection is a form of preventive law: TRUE there are 3 types of torts intentional, unintentional, AND NEGLIGENCE. slander is a LIABLE statement of false facts about someone that affects that persons reputation SLANDER is lies about someone that is spoken that affects that person reputation respondent superior, latin phrase that indicates employer ultimately responsible for actions of employee within scope of their job: TRUE due care is responsibility of HC providers to protect others from harm: TRUE medical malpractice, misconduct/unprofessional treatment by professional/official representative of office/hospital: TRUE fraud is an intentional misrepresentation: TRUE quality assurance, program designed to guarantee highest level of quality pt care: TRUE total quality management, a team concept to achieve customer satisfaction: TRUE continuous quality improvement involves a circular chart in which each action is evaluated in a plan-do-check-act format to improve quality: TRUE goals for HIPAA: PROTECT WORKERS W/ PRE-EXISTING CONDITIONS FROM LOSING HEALTH INSURANCE W/ CHANGING JOBS, PROVIDE EASIER DETECTION OF ABUSE/FRAUD, REDUCE PAPAERWORK BY REQUIRING ELECTRONIC DATA TRANSACTIONS, GUARANTEE PRIVACY OF INDIVIDUAL HEALTH INFO ANSWER: ALL CHOICES for negligence to occur there must be: LEGAL OBLIGATION OWED BY ONE PERSON TO ANOTHER, BREACH OF DUTY, HARM DONE AS A DIRECT RESULT OF THE ACTION. ALL CHOICES invasion of privacy is: DISCLOSURE OF PRIVATE FACTS, MISREPRESENTATION OF FACTS, ILLEGALLY GAINING A PERSON'S NAME ALL CHOICES legal nature of dr/pt relationship: CONTRACT in certain cases pt may not legally be able to act on his/her own to establish contract with dr, in these cases, pt would need: AGENT could not legally act on behalf of pt: MINOR SIBLING FOR YOUNGER CHILD violation of federal/state narcotics law constitutes: A CRIMINAL ACT PHI in HIPPA: PROTECTED HEALTH INFO w/ physician treats another physician/health professional at no charge: PROFESSIONAL COURTESY HIPPA "privacy" covers PHI in ANY medium, Hippa "SECURITY" specifically covers: ELECTRONIC incorrect info given verbally, may injure reputation of other: SLANDER rule of conduct established/enforced by an authority/governing body such as federal government: LAW process which opposing sides choose to discuss/ decide a dispute w/ mediator: arbitration an employee considered acting on office/hospital behalf while performing job: RESPONDENT SUPERIOR Dr reports AIDS case to CDC: PUBlIC DUTY Dr reports AIDS case, w/ pts name to CDC: INVASION OF PRIVACY situation w/ pt automatically gives up right to confidentiality: SUES A PHYSICIAN unauthorized disclosure of client info: INVASION OF PRIVACY age of majority in most jurisdictions: 18 YEARS agency responsible for enforcing HIPPA privacy, security and confidentiality provisions of pt safety rule: OFFICE OF CIVIL RIGHTS employee agrees to give blood sample after being exposed to HIV but refuses to allow sample to be tested. blood sample must be kept, in case employee later develops symptoms/decides to have it tested, for: THREE MONTHS physician's required to report: BIRTHS, ABUSE, HIV CASE. ALL CHOICES OSHA created federal laws to protect HCW from health hazards on job study of values/principles governing personal relationships including ideals of autonomy justice and conduct: ETHICS not usually considered part of vital statistics reported to med examiner: NARCOTIC INVENTORY government agency having legal responsibility for enforcing proper drug manufacture/clinical use: FDA res ipsa loquitur: PHYSICIAN MISTAKE IS OBVIOUS a minor's med record can be released: PARENT SIGNED RELEASE FORMS statue of limitations for bringing malpractice suits varies from state to state but most states: 1 YEAR could constitute law suit being filed by pt: FAILURE TO TAKE X-RAY IN CASE OF POSSIBLE FRACTURE, TRYING NEW/EXPERIMENTAL TREATMENT W/O CONSENT, PHOTO OF PT W/O RELEASE FOR SCIENTIFIC REASONS. ALL CHOICES exception to doctrine of informed consent: UNCONCIOUS/ EMERGENCY PT malpractice law suits are part of: CIVIL LAW legal doc addressed to pts family/dr's stating treatment wishes/doesn't wish w/ terminally ill: LIVING WILL OSHA form 300, a log of occupation injuries/ illness kept: 5 YEARS w/ med worker starts new job, employer required to offer HBV vac: WITHIN 10 DAYS general work area laws restrict in work area: EATING/DRINKING services it's ethical for dr to bill for: OFFICE VISIT OSHA req employee med/exposure records to be kept: DURING EMPLOYMENT + 30 YEARS failure to perform act that's ones required duty or required by law: NONFEASANCE quality assurance program must include: QUALITY CONTROL PROGRAM QC program monitors: PROCEDURES QA programs necessary: FOR CAREFUL MONITORING OF PT CARE book describes in detail steps to follow for spec collection: PROCEDURE MANUAL necessary elements of risk management include: EDUCATION, EVALUATION, IDENTIFICATION. national org that develops guidelines, sets standards for lab procedures: NCCLS physician, employer of phleb, who injuries pt during draw sued for negligence, example of: RESPONDENT SUPERIOR purpose of JCAHO, now TJC: ENSURE PT CARE QUALITY young adult comes to outpt lab for draw. before draw, phleb should know: AGE OF MAJORITY IN THE STATE, DOB OF PT, NAME OF PT, ALL CHOICES OSHA mandates: PROPER DISPOSAL OF HAZARDOUS WASTE, PPE, AVAILABILITY OF HEPB VAC. ALL CHOICES procedure manuals: MUST BE MADE AVAILABLE TO EVERY HCW THAT COLLECTS BLOOD SPEC'S, NECESSARY PART OF A GOOD TOTAL QUALITY MANAGEMENT SYS, OUTLINE CORRECT STEPS TAKEN FOR EVERY PROCEDURE PERFORMED IN FACILITY. ALL CHOICES TQM is combination of concepts based on: CUSTOMER SATISFACTION 3 level of tests defined by CLIA: WAIVED, HIGH COMPLEXITY, MODERATE COMPLEXITY. DOES NOT BELONG: LOW COMPLEXITY TJC 10-STEP PROCESS TO IMPLEMENT CONTINUOUS QUALITY IMPROVEMENT: APPOINT RESPONSIBILITY OUTLINE SCOPE OF CARE ID KEY ASPECTS OF CARE DEVISE INDICATORS DEFINE THRESHOLDS OF EVALUATION COLLECT/ORGINIZE DATA EVALUATE DATA DEVELOP A CORRECTIVE ACTION PLAN ASSESS ACTIONS/DOCUMENT IMPROVEMENT COMMUNICATE RELEVANT INFO initiate department heads- NO assign new duties- NO evaluate employees- NO

NAHP CERT CPT STUDY GUIDE: CH 1 MEDICAL TERMINOLOGY

NAHP CERT CPT STUDY GUIDE: CH 1 MEDICAL TERMINOLOGY hyperkalemia: excess of potassium in blood immunity: resistance to disease/infection palpitate: rapid intense beating of heart thrombophlebitis: inflammation of wall of vein w/ accompanying clot at sight pt w/ rapid pulse: tachicardia med terms based on understanding few basic elements greek/latin words abbreviation is way of shortening words/phrases hypertension: high blood pressure leukopenia: abnormally low level of WBC's gestation: from conception to birth, 280 days plural form vena cava: vena cavae plural form nucleus: nuclei coagulation: blood-clotting process epicardium: thin outer layer of heart, continuous w/ lining of pericardium extravascular: outside bloodstream anterior: front area of the body example of anisocytosis: microcyte combing form: root word + combing vowel if two combining forms present, least important comes first hepat root word: liver most common combining vowel: o prefix: beginning of word suffix: end of word combining form is root of word hemoglobin: protein that contains iron, main component of RBC's formed elements: RBC's, WBC's, platelets plasma: liquid/fluid portion of blood test that measures creatine kinase (CK) can identify: heart disease fibrinogen: protein involved in clotting hematology: study of blood oncology: branch deals w/ tumors phlebotomy: insertion of needle/cannula in vein for purpose of withdrawing blood serum: clear yellow liquid that remains after blood clot forms megalocardia: enlarged heart orthopedic: branch that deals w/ skeleton joints, muscles. other supporting structures hemophilia: disorder w/ blood doesnt coagulate at wound or puncture site lymphocytes: non-granular WBC's that produce antibodies to combat specific pathogens hemolysis: rupturing of red blood cells, which release hemoglobin, can cause kidney failure/death after incompatible blood transfusion morphology: study of shape/form of objects eosinophils: granular WBC that produce chemical histamine, aid body in controlling allergic reactions/exaggerated immunologuic aneurysm: bulge in an artery caused by weakening wall anastomosis- common communication between two vessels, either end to end or by means of a connecting channel during hemostasis, hair-like molecules of protein form protein: fibrin crenate: notched red blood cells antibiotic: substance used in treatment of infection/disease caused by bacteria anemia: deficiency of red blood cells, hemoglobin, or both band cell: immature neutrophil w/ non-segmented nucleus neurocyte is NOT a blood cell nucleus/nuclei: central structure of cell, contains DNA, controls cell growth/function dysentery: diarrhea, blood,mucus, or both may be present heme: portion of hemoglobin molecule containing iron bradycardia: slow heart beat thrombocytopenia: decrease below normal number of platelets in blood immunohematology: study of blood group antigens/antibodies reticulopenia: decrease below normal number of reticulocytes exudate: fluid created by tissue, which may occur normally but usually in response to inflammation damage, irritation agglutination: clumping together of cells as of blood cells/bacteria (Why matching test crucial) hemoglobin: gives blood red color leukocyte, AKA WBC: protects from disease hematoma: swelling of tissue around vessels due to leakage of blood in tissue erythrocytosis: increase above normal of RBC's in circulation microcyte: abnormally small RBC found in cases of iron-deficient anemia & thalassemia leukocytosis: increase in number of WBC'S heme: portion of hemoglobin molecule containing iron pericarditis: pericardium becomes inflammed gram stain: stain that differentiates bacteria according to chemical composition of cell walls nephr-: combining form for kidney basal state: early morning, after 12 hour fasting hemolytic disease of the newborn: disease in which antibody from mother destroys RBC's of fetus, HDN phagocytosis: process where bacteria/antigens surrounded/engulfed by WBC's petechiae: small red spots on skin, indicates low platelet count septicema: infection of blood w/ presence of pathogenic organism megakaryocyte: large bone marrow cell which releases platelets into bloodstream erythropoietin: secreted by kidneys, stimulates RBC production fibrillation: quivering of heart muscle vs. normal contraction fomites: substances that adhere to/transmit infectious material encephalitis: inflammation of brain suffix of word modifies word or the syllable at end low blood sugar: hypoglycemia osteitis: inflammation of bone, especially bone marrow, caused by bacteria pain: suffix-algia embolus: part of blood clot circulating in bloodstream, blocks blood flow erythrocyte: RBC sclerosed veins: hard/cord-like w/ palpated hemoglobin: substance in RBC's that carries oxygen aneurysm: localized dilation/bulging in blood vessel wall, usually artery prefix inter- : Between suffix - cyte : cell suffix - stasis: stopping, controlling prefix intra-: within suffix -itis: inflammation inflammation of vein: phlebitis hemostasis: body stops leakage of blood from vascular system cannula: temp surgical connection of artery/vein for dialysis/blood drawing hemolysis: destruction of RBC's hematopoiesis: primarily occurs in bone marrow aer- air angi, vas- vessel arteri- artery arthr- joint bili- bile bronch- bronchus cardi- heart cephal- head chondr- cartilage cry- cold cyst- bladder cyt,cyte- cell derm- skin encephal- brain fibrin- fiber gastr- stomach glyc- glucose, sugar hem,hemat- blood hepat- liver lip- fat my- muscle nephr, ren- kidney onc- tumor oste- bone path- disease phleb,ven- vein pulmon- lung sclera- hard thromb- clot thorac- chest tox- poison a-, an-, ar- w/o aniso- unequal anti- against bi- two brady- slow cyan- blue dys- difficult endo, intra-, in, within epi- on, over, above erythr- red extra- outside hetero- different homo-,homeo- same hyper- too much, high hypo- low, under inter- between iso- equal same macro- large, long mal- poor micro- small mono- one neo- new poly- many, much post- after pre- before per- through semi- half tachy- rapid tri- three -ac, -al, -ar, -ary, -ic- pertaining to -algia- pain -centesis- surgical puncture to remove fluid -emia- blood condition recording, writing- gram -ism,-osis- conditiion -itis- inflammation -rhage- bursting forth -logist- specialist in study of -lysis- breakdown, separation -megaly- enlargement meter- instrument, measures/counts -oma- tumor -oxia- oxygen level -pathy- disease -penia- deficiency -pnea- breathing -spasm- twitch, involuntary muscle movement -stasis- stopping, controlling, standing -tomy- cutting, incision

LABS: GRADE ONLY GIVEN AS HANDS-ON

LABS: GRADE ONLY GIVEN AS HANDS-ON PROCEDURE: GRADE: WEIGHT: VENIPUNCTURE---------100%----7.50 BLOOD COLLECT--------100%-----7.50 BUTTERFLY---------------100%-----7.50 CAPILLARY---------------100%----7.50 CBG-----------------------100%-----7.50 SYRINGE------------------100%-----7.50 TB TEST--------------------100%-----7.50 TRANSFER-----------------100%-----7.50 SKILL DRILL WB----------100%------8.33 SD PREG WB-------------100%------8.33 SD NEEDLE/syringe-----100%-------8.33 NOT DONE YET: GLUCOSE TOLERANCE---INCOMPLETE---7.50 HCG PG---INCOMPLETE---7.50

NAHP CERT CPT STUDY GUIDE CH 5 CELL & BODY ANATOMY

NAHP CERT CPT STUDY GUIDE CH 5 CELL & BODY ANATOMY Superior: higher, above, or toward head Proximal: closest to center of body, origin, or point of attachment. foot not proximal to hip. integumentary sys prevents excessive water loss. urinary sys removes waste products from blood. lymphatic sys destroys pathogens that enter body. digestive system changes food to simple chemicals absorbed/used in body. nervous sys interprets sensory info. endocrine sys regulates body functions through hormones. muscular sys produces heat, moves skeleton. respiratory sys exchanges oxygen/carbon dioxide between air/blood. circulatory sys transports oxygen/nutrients to tissues. small intestine longest part of digestive tract. Bones/ligaments: skeletal sys stomach, colon, liver: digestive sys spleen/lymph nodes: lymphatic sys ovaries, uterus, testes, prostate gland, reproductive sys Kidneys, bladder, urethra: urinary sys dorsal cavity located back of body. outermost layer of skin, epidermis. smallest living unit of structure: cell Epithelial cells: form continuous layer, produce secretions, cover/line tissue (all) great toe side of foot: medial protective membranous covering, protects both brain/spinal cord: meninges Bones made of hard, dense tissue, covered by membrane: periosteum sys that supports body, protects internal organs, stores minerals: skeletal system living substance only found within a cell: protpplasm compromises over half body's weight: muscles sys works w/ circulatory sys by mediating blood supply in capillaries/tissues of body: lymphatic organ that secretes bile: gallbladder Meninges: protective membrane coverings complex compound able to initiate chemical changes in body: enzyme nonspecific name for group of bacteria that generally have shape of slender, straight bar: rod bacterium spherical in form: coccus bones in the feet: metacarsal sebaceous glands associated with: integumentary sys plasma protein manufactured by liver that functions to regulate osmotic pressure of blood: albumin condition: impaired carbohydrate, fat, protein metabolism due to deficiency of insulin: diabetes mellitus essential to fluid balance, muscle contraction, nerve impulse conduction: electrolytes overall chem functioning of body: metabolism 'brain' of a cell: nucleus provides hereditary info that directs all cell activities, allows cell to reproduce: DNA, deoxyribonucleic acid Smooth muscle found: stomach, intestines framework of body: bones 1st line of defense against infection: skin ball-and-socket joint: hip Bending elbow: example of flexion controls/coordinates all body activities: nervous sys produced by pancreas, lowers blood sugar: insulin adrenal glands: above kidneys part of brain assists in controlling body t, water balance, sleep, appetite, emotions: hypothalamus cranial nerves: 12 pairs responsible for male deep voice, body hair, muscle: testosterone helps buffer body fluids, maintain fluid volume, levels of potassium, sodium, chloride: kidneys main functional organs of urinary sys: kidneys Bile aids body in digestion/absorption: fats digestive sys organ produces bile: liver semi-liquid undigested food leaves stomach: chyme propels food through digestive tract by rhythmic contractions: peristalsis Mech/chem digestion begins in: mouth both superior to intestines, inferior to neck: lungs Another name for anterior w/ locating anatomical positions: ventral indicates a position in relation to midline: medial causes lining of uterus to prep for pregnancy: estrogen near the surface: superficial nearest the point of origin: proximal Caudal: toward the feet example of sub-cellular microorganism: virus prokaryotic cells: simple structure w/ single chromosome, no organelles ceukaryotic cells: complex cell structure, have specialized organelles in cytoplasm closes over larynx during swallowing, keeps food out of lungs: epiglottis malignant abnormal growth of skin: melanoma long bones of body located: arms/legs thoracic cavity: lungs, heart, major blood vessels, esophahus tissue provides movement, maintains posture, produces heat: muscle tissue

NAHP CERT CPT STUDY GUIDE CH 6 CARDIVACULAR SYSTEM

NAHP CERT CPT STUDY GUIDE CH 6 CARDIOVASCULAR SYSTEM NEEDS EDIT Which of the following elements does not belong in the cardiovascular system: stomach The upper chambers of the heart are called atria The lower chambers of the heart are called ventricles A decrease in the oxygen-carrying ability of the blood is called, in any form, anemia The function of the leukocytes is to: protect the body against infection Whole blood is the: total volume of plasma formed elements Cardiac muscle is striated and involuntary Plasma is ____% water. 90 Which of the following is the clear, yellow liquid in which the formed elements of the blood are suspended? plasma Which of the following play a viral role in the exchange of gasses between blood and body cells. erythrocytes The process of clotting is called coagulation Which blood type carried both the A and B antigens, but neither the anti-A or anti-B antibodies? Type AB Which blood type carries neither the A or B antigens, but contains both anti-A and anti-B antibodies? Type O Which blood type if considered the universal donor, because it lacks the A, B, and Rh antigens? Type O negative Which blood type carries the A antigen and contains anti-B antigens? Type A Which blood type carries the B antigen and contains only anti-A antibodies? Type B Which blood type is considered the universal recipient, because it will not react with donated blood from any blood group? Type AB positive The four valves located in the heart control the direction and flow of blood, which of the following is not one of those valves? left valve Of the following proteins, which is found in plasma, but not in serum? fibrinogen Death of a segment of tissue, resulting from lack of blood supply to that area is infarct A substance that can cause the narrowing of a blood vessel is vasoconstrictor The smallest arteries are called arterioles Which of the following statements are true about the human heart? it has four chambers Another name for platelet count is: Thrombocyte count Negative Rh blood is found in ____% of the population. 15 Which of the following is not true about capillaries? they have sensitive nerve endings The normal leukocyte cell goes to the infection site to engulf and destroy microorganisms Erythrocytes contain all but one of the following elements: leukocytes Leukocytes function primarily as defense mechanisms Red blood cells have which of the following features? carry Oxygen and Carbon Dioxide What is the name of the fibrous sack that surrounds the heart, helps hold the heart in position, and isolates it from the other contents of the chest? pericardium Erythrocytes function primarily as Oxygen transport mechanisms 2 proteins contained in blood small blood vessel connecting the small arteries to the small veins: capillary heart: double pump At end of ventricular contraction, AORTIC valve closes so blood just expelled wont flow back into ventricles. longest vein in body: great saphenous Plasma: liquid portion of blood, contains 90% water AND anticoagulants (all choices) veins located in hands: metacarpal lifespan of normal RBC: 120 days When right ventricle is full, it's stimulated by electrical impulse to being contraction. As pressure within ventricle increases, it causes PULMONARY valve to close. Ventricular pressure forces blood through aortic valve into aorta to circulate through body. At end of contraction, AORTIC valve closes to prevent the backflow of blood. blood flows from L. atrium through MITRIAL (BICUSPID) valve, filling L. ventricle brachial artery located: bend/crook of elbow dorsal pedis artery located: anterior surface of foot principal vein draining upper body: superior vena cava temporal artery located: slightly above outer edge of eye principal vein draining lower body: inferior vena cava kinds of leukocytes: 5 types of WBC's: 5 3 major classes of plasma proteins: albumins, globulins, fibrinogens internal space of blood vessel: lumen relaxation phase of heart: diastole chamber of heart receiving blood from lungs: L. atrium thick muscle layer of heart: myocardium immature RBC's w/nuclear remnants in bloodstream: reticulocytes abnormal reduced number of RBC's in circulating blood: anemia Antibodies released in blood stream, circulate, attack foreign cells: immunoglobulins approximate life span of RBC: 120 days RBC's contain: hemoglobin Normally, serum is: clear, light yellow, straw-colored Approximately 55% of blood: plasma Unlike RBC's, WBC's have a: nucleus largest WBC's: monocyte megakaryocytes rupture in pieces, responsible for clotting: platelets right atrium of heart receives: DEOXYGENATED blood Formed elements in blood: erythrocytes, leukocytes, thrombocytes. (RBC'S, WBC'S, platelets) Blood does NOT increase fluid loss RBC's live about 120 days Thick-walled vessels carry blood away from heart: arteries

NAHP CERT CPT STUDY GUIDE: CH 3 UNITS OF MEASURE

NAHP CERT CPT STUDY GUIDE: CH 3 UNITS OF MEASURE metric fluid measure of 1000 milliliters: liter metric equivalent one fluid ounce: 29.57 metric equivalent one gallon: 3.78 metric equivalent one ounce: 28.35 basic unit of weight in metric sys , approximately equal to cubic centimeter: milliliter roman numeral IV- 4 roman numeral III- 3 roman numeral LIX- 59 roman numeral XXIV- 24 roman numeral MCMXCII- 1992 line over RN means to multiply numeral by: 1000 roman numeral D- 500 roman numeral L- 50 basic unit of volume measure in metric sys equal to 1000 mL- liter convert 100 grams to kilograms- 0.1 kg what percentage would 3/4 represent- 75% normal body temperature F- 98.6 F normal body temperature Celsius- 37 C approximate blood volume for average adult- 5.0 basic metric unit of volume: liter formula to convert from F to C: 5/9(F-32)- formula to convert C to F: 9/5 C+32 formula to convert decimal to percentage multiply decimal by 100 formula to convert fraction to percentage multiply fraction by 100/1 I,V,X,L,C,D,M small to large C,D,I,L,N,V,X military time NOON: 1200 military time: avoids confusion , eliminate AM/PM kilo- 1000 deci- 1/10 centi- 1/100 milli- 1/1000 micro- 1,000,000 yard(yd)- english, .9 m inch(in)- english, 2.54 cm pound(lb)- english, .454 kg ounce(oz)- english, 28 g quart(qt)- english, .95 L fluid ounce(fl oz)- english, 30 mL tablespoon(Tbsp)- english, 15 mL teaspoon(tsp)- english, 5 mL meter(m)- metric, 3.3 ft kilogram(kg)- metric, 2.2 lbs liter(L)- metric, 1.06 qts milliliter(mL)- metric, 1 cc 1/4- 25% .80- 80% I- 1 V- 5 X- 10 C- 100

NAHP CERT CPT STUDY GUIDE CHAPTER 4 LAB & BLOOD COLLECTION PROCEDURES

NAHP CERT CPT STUDY GUIDE: CH 4 LAB & BLOOD COLLECTION PROCEDURES hematocrit, buffy coat approx 1% of whole blood used to prep skin before draw, but can affect results of some tests: Alcohol prep for oral gluc tolerance test: high Carb drink after 1st draw skin prep for test affected by alcohol: use Sterile solution Unsuccessful attempts: 2 infant draw site: Heel draw ped: gather supplies, get sample quick, avoid alarming ped w/ tubes draw elderly, watch/recognize skin conditions that increase bruising most common sites: median, cubital, cephalic Blood tests potassium/sodium id: fluid/lyte imbalances erythrocyte count (RBC): Anemia blood urea nitrogen (BUN): Kidney disorders prep site: Clean site w/ circular motion from center, working out using ETS: insert needle 15° angle w/ bevel up Cap puncture: Lancet characteristic Cap puncture? non-dominant hand pt w/ small/fragile vein BD: needle/syringe blood sample from adults/ped, mid/ring finger: cap puncture several spec, same site: ETS characteristic of lancet: small, disposable instrument w/ sharp point to puncture skin calibrated glass tube, precise fluid volume: Micropipette normal sodium level: 136-145 mEq/L Normal prothrombin time (PT): 11-15 seconds normal range Potassium: 3.5-5.1 mEq/L normal blood glucose: 74-120 mg/dl coronary artery disease/atherosclerosis: Total cholesterol Gout: Uric acid puncture-resist, leak-proof disposal for needles, lancets, sharp objects: Sharps container failure to draw: Lose vacuum, needle through vein, sclerosed (ALL) Enzyme-linked immunosorbent assay (ELISA), western blot confirm: HIV w/ present on surface of RBC's causes formation of antibodies: Antigens hemocytometer: count blood cells examining diluted B sample Id's how much of sample is RBC's after centrifuged: Hematocrit determination evaluate endocrine sys: Analyze hormone levels changes basal state: Diet, exercise, stress, drugs % of each type of WBC's in total of 100 WBC's observed: Differential specific temp/time for growth/reaction: Incubation centrifuge (GLC) calibrated: every 6 months The Ivy/Duke method measures: bleeding time Ketones in urine, starvation, pregnancy, diabetes: Ketosis prothrombin time test: evaluates anticoag drugs Cholesterol: assess risk of coronary heart disease bleeding time: Assesses hemostasis WBC: Inflammation/infection Temp of centrifuge checked: beginning each day creatinine: Assesses glomerular filtration cap from infants, lancet w/ length to avoid penetrating bone: 1.5 mm Anticoags prevent blood from: Forming clot If pt starts to bleed severely: Apply pressure to site Surgicutt Bleeding time: BPC must be inflated, upper arm: 40mm Hg phleb plays active role in pt education: 24 hour urine sample, urine culture, glucose tolerance (all correct) hematocrit: Aids in diagnosis of anemia blood culture: diagnoses bacteremia insulin-releasing mech: Gluc tolerance Fasting blood spec (FBS): Triglyceride/cholesterol (both) requires 10mL normal saline & 2-3 20 Ml disposable syringes: blood through CVC'S prothrombin in blood clotting depends on: Vit K gluc tolerance: diabetes mellitus & hypoglycemia dye used for liver function test: Bromsulphalein Spinal Fluid cultures: Meningitis centrifuge: Hemacytology, spin tubes at high speed, separating cellular/liquid portion of blood, enables proper RBC (all choices) light-sensitive: Bilirubin serum should be separated from blood cells quick as possible avoids: Hemoconcentration results unreliable: ingest alcohol fluid from joint cavities: Synovial fluid bend of the arm: Antecubital fossa abnormal variations of size of RBC's: Anisocytosis items needed to collect culture: Alcohol preps, iodine scrub swab sticks, disposable gloves (all items) prolonged bleed time from: Mithramycin, dextran, aspirin (all things) w/ allowed to clot, remains: Serum, blood cells, fibrin clot (all choices) need to control depth of lancet: excessive bleeding affects lab test: Altitude, needle through vein, humidity (all choices) Hemoconcentration caused by: Squeezing/probing, long term IV therapy, leaving tourniquet on extended period of time (all choices) light-colored layer of WBC's/platelets on top red cell layer w/ centrifuged/allowed to stand: Buffy layer 2 primary tests for platelet activity: bleeding time, assess platelet function, platelet count, evaluates platelet production. warming site: increases localized blood flow Hematoma: needle bevel partially inserted in vein most frequently used: Median cubital vein test passing tube through nose: Hollander test sedimentation rate: time required for RBC's to settle at bottom upright tube room t tourniquets: rubber hose, BPC (both) blood allowed to stand separates into: 3 major components Serum containing antibodies: Antiserum Hemostasis: rapid sequence of vascular spasms, platelet plug formation, coagulation counting chambers used to count WBC's: 4 reason to reject spec: expired tubes, unlabeled, discrepancies on req (all reasons) not considered timed blood spec: Cortisol normal pH of blood: 7.4 Spectrophotometer: determines concentration of solution, measures light transmitted/absorbed by solution measurement of density: Specific density labeled spec must include: Name; Id number, date/time collected (all choices) microcollection tray WON'T find: pt's chart. WILL find: disposable gloves, lancets, alcohol/betadine pads t-controlled chamber, inoculated media placed, bacterial growth occurs: Incubator Complete Blood count (CBC): Hgb, RBC, Hcr or crit (all choices) best angle for needle insertion: 15° blood separates in 3 layers w/ centrifuged because of: their various densities To help minimize dizziness/fainting, donors should eat w/in 6 hrs of donation affected if not fasting: glucose/triglyceride Hemoguard: type of sheath most common antiseptic used in routine draw: 70% isopropyl alcohol needle gauge smallest diameter: 23 Needles colored-coded according to: Gauge NOT skin puncture equip: forceps. safety flow lancet, autolet, butterfly most common skin test: PPD (for TB) prolonged bleeding time indicates: low Platelet count series of tests measuring enzymes released after heart attack: Serum enzymes ref point that test results compared: NONE OF THESE: basal, thromboplastin time, differential W/ performing arterial puncture, you should: NONE OF THE CHOICES bevel of needle: upward position blood alcohol test, site CAN'T be prepped w/: Alcohol ACT: monitor heparin therapy retractable sheath part of: multiple draw needle winged needle in vein up to 48 hrs, admin med/draw blood: Heparin lock metal in tube of cap blood gas spec, mixing anticoag w/magnet: Flea Pathogenic bacteria/blood poisoning: Septicemia Allen test determines: presence of circulation hematoma during draw: Remove needle, apply pressure ADULT ABG, anticoag coating syringe barrel: Heparin ABG requires sample: 1ml complications assoc w/ collection of ABG: Infection, arteriospasm, hematoma (All) min vol cap tube for cap blood gas analysis: 25mL pusher slide correct angle: 30° no skin puncture: gluc test test of platelet integrity: bleeding time blood suitable for transfusion: Crossmatch absorb/utilize particular substance: Tolerance common bleeding time test: Surgicutt detects meningitis: Spinal Fluid culture fluid enters tube/pipet, attraction of glass/liquid: Aspiration diameter of needle: Gauge hematocrit/small blood sample: microhematocrit bedside gluc: Acu-Check II, iascan, glucocheck (all) pathogenic agent/skin HAI: Candida Albicans not in blood gas assay: H2O vacuum: B-D Vacutainer System not for cap blood gases: lateral anterior/elbow Therapeutic phleb treats: polycythemia rise/fall values w/ time of day, must collect on time: cortisol Lancets max length for older ped: 5mm value of total protein due to prolong use of tourniquet changes: hemoconcentration WON'T affect test results: near tattoo Phleb needles stored: room t 21 gauge: common for phleb DON'T use to obtain blood if problem occurs during reg draw: IV line Cholesterol can be tested same tube: TSH Serum gluc CANT be tested same tube: PT immunohematology: Direct Coombs Therapeutic drug monitoring: Clinical chemistry Ova & parasite usually performed: Clinical microbiology skin puncture, infants, 2.4mm best angle to spread blood smear w/ 2 glass slides: 30° surgicutt bleeding time test, BPC inflated upper arm: 40mm Hg Usual dose of D-xylose for D-xylose tolerance test: 25g lumbar puncture: Cerebrospinal Fluid NCCLS OOD, conventional: is yellow, red, l blue, red/grey, green/grey, green, lav, grey NCCLS OOD, Vac w/ Hemoguard closure: sterile, red, l blue, gold, l green, d green, lav, grey alt syringe OOD: sterile, l blue, lav, green, gray, red Yellow: BC Sodium heparin: anticoagulant: Green anticoagulants in pink, plastic: K2EDTA additives in royal-blue: EDTA orange plastic: thrombin blood glucose: grey additive in l. blue: Sodium citrate Blood group, match/type, AIDS antibody test: red/glass requires no additive: red usually lav: CBC, includes hematocrit W/ blood collected w/ syringe, transfer to ETS w/ vacuum avoids: hemolysis Dr may order stool sample if suspects cancer, colitis, bacterial protozoa/parisite infection bacteria reproduce fast culture medium used in lab, agar bacteria placed in culture plate grows sufficiently w/in several hrs optimal temp to promote bacterial growth in medium, 37° C gram-positive bacteria retain dye, turn purple w/preparing a wet mount, mix small amount of spec w/ drop of 0.9% sodium chloride on glass slide stool spec w/ urine not appropriate sputum sample is mucous coughed up from lungs device for obtaining cultures, sterile swab untreated strep throat serious, lead to complications smear is spec spread thin and unevenly on slide prep of spec in liquid allows organism to remain alive/mobil, id'd as wet mount throat culture, wear gloves, goggles, mask/face sheild no blood, turn needle 1/4 turn EST too large, pulling plunger too quickly can cause vein collapse often pt veins more prominent in dominant arm anticoags need to be mixed thoroughly immediately to totally prevent clotting WBC's fight infection arterial punctures have higher risk of infection phleb often assigned other responsibilities related to spec collection/non-blood specs clay sealer tray used to plug open end of microhematocrit tube 10 cc syringe most common for routine venipuncture routine venipuncture main method to get blood sample for testing remove needle, apply direct pressure w/ gauze pad 3-5 min Disposing needle immediately after withdrawl, a habit 2nd nature of phlebs after needle disposal, immediately label tubes bright red blood, artery rather than vein high-density lipoprotein cholesterol AKA good cholesterol prior to radial artery puncture, Allen test should be performed to determine if the radial artery capable of providing collateral circulation to the hand.