NCCT Phlebotomy Test Review

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NCCT Phlebotomy Test Review

The forearm vein most commonly used for venipuncture

Median cubital

The smallest veins in the human body are known as

Venules

The aorta branches into smaller divisions called arteries, which in turn branch into even smaller divisions called

Arterioles

Characteristics of capillaries include

(1) Having thin walls
(2) Forming microscopic pathways
(3) Connecting arterioles with venules

Within the capillaries, blood cell functions include

(1) Releasing oxygen
(2) Binding carbon dioxide
(3) Eliminating waste

The heart, lymphatic organs, & blood vessels are in which system

Cardiovascular system

Suffix -URIA at the end of a medical term refers what body location

Urine

Study of blood

Hematology

The liver, stomach, mouth, & pancreas are in which system

Digestive system

The most important step to ensure accuracy in sample collection is

Identifying the pt properly

The bladder, urethra, kidneys, & ureters are in which system

Urinary system

The trachea, nose, lungs, & pharynx are in which system

Respiratory system

The sebaceous glands, skin hair & nails are in which system

Integumentary system

The body system that is a primary regulator hormones is which system

Endocrine system

Neutrophils, eosinophils, basophils, lymphocytes & monocytes are type of

White blood cells (WBC)

Common name for the thrombocyte is the

Platelet

Liquid portion of an anticoagulated blood sample is known as

Plasma

Instrument that measures blood pressure

Sphygmomanometer

Artery can be distinguished from a vein because an artery will be

Pulsating

Lancets are used to collect blood samples by

Capillary or skin puncture

VAD is commonly used in hospitals to refer to

Venous Access Devices

To determine the size of the needle, remember that the higher the gauge, the

Smaller the needle bore

Adult capillary punctures most often involve use of which finger(s)

3rd & 4th (middle & ring) fingers

Centrifuge is used in a clinical laboratory setting to

Separate liquid from cells in blood

Oral gulcose tolerance test is used for detection of

Diabetes

Evacuated tube top for collection of CBC test is which color

Lavender

Evacuated tube top for collection of blood for electrolyte test is which color

Red

Evacuated tube top for collection of blood for cholesterol test is which color

Red

Sodium citrate is an anticoagulant of choice for coagulation studies because it protects

Clotting factors. Calcium

When preparing a blood smear directly from a skin puncture it is best to

Wipe away the first drop of blood

The Order of Draw

(1) Blood culture tube (YELLOW)
(2) Coagulation tube (BLUE)
(3) Serum tubes (RED) w/ or w/o clot activator or gel
(4) Heparin tube w/ or w/o gel plasma separator (GREEN)
(5) EDTA (LAVENDER)
(6) Glycolytic inhibitor (GRAY)

10 phlebotomy steps in order

(1) Greet & identify the pt
(2) Explain the procedure to the pt
(3) Assemble the equipment
(4) Cleanse the venipuncture site
(5) Anchor the vein
(6) Insert the needle
(7) Collect blood in vacuum tube
(8) Remove tourniquet
(9) Dispose of needle
(10) Label tubes

Purpose of doing blood cultures is to detect

Septicemia

Anticoagulants are used to

Prevent the blood from clotting

WBC help the body by

Defending against foreign invaders

Platelets help the circulation by

Participating in hemostasis

When the blood seeps into the surronding tissue during a venipuncture a _____ may form

Hematoma

In a pt with a clotting disorder, pressure should be applied to the puncture site for at least ____ after venipuncture to insure blood stoppage

5 minutes

Skin puncture may be indicated for use when

(1) pt is an infant, toddler, or preschooler
(2) Only a small amount of blood is needed
(3) pt veins need to be preserved for IV therapy

All specimens should be labeled with

(1) pt name (& numeric ID)
(2) Date & time the specimen was drawn
(3) Collector's initials

When performing a skin puncture, squeezing the finger too tightly may dilute the blood with ___ & ruin the test

Tissue fluid

1 test often used to assess hemostasis before surgery is

Bleeding time

1 possible cause of unexpected clotting in an anticoagulated blood tube might be

Insufficient mixing

When performing a venipuncture, position the bevel of the needle

Facing up

If blood does not appear in an evacuated tube upon venipuncture, a phlebotomist's 1st course of action should be to

Slightly reposition the needle

Redirecting a needle during venipuncture is sometimes necessary when

(1) Vein was not properly anchored
(2) pt moves unexpectedly
(3) Blood flow starts, & then stops

Vein might be prone to collapse if the

(1) Vacuum tube is too large for vein
(2) Syringe plunger was pulled back too quickly

Hemolysis would cause rejection of a sample collected for ____ testing

Potassium

If a pt is prone to syncope during venipuncture, the phlebotomist should

Watch in case of fainting

Tube of blood that arrives in the lab without a label must be

Rejected automatically

If a blood sample should be collected 2 hrs post-prandial, the phlebotomist should collect the sample

2 hours after a meal. Means after mealtime. Prandial: Of or relating to a meal.

Knowing when to collect peak & trough levels is important when drawing

Therapeutic drugs

Pre-warming technique may be used to

Increase pt tendency to bleed

Role of all anticoagulants is ultimately to prevent formation of

Fibrin (Protein formed during normal blood clotting that is the essence of the clot.)

Anticoagulant EDTA works by

Binding calcium

If the tourniquet is not released before the needle is withdrawn from the arm during venipuncture, this will most likely result in

Bleeding from the site

Test sample that is light sensitive

Bilirubin

The ____must be followed exactly whenever drawing pt test samples that may be used in a legal proceeding

Chain of custody

Anticoagulant SPS (Sodium Polyanetholesulfonate) is recommended for use in blood cultures because it

Does not inhibit bacterial growth

Before entering an inpatient room if the door is closed, the phlebotomist should always

(1) Knock
(2) Ask permission to enter
(3) Check for isolation signage

Before entering designated isolation rooms, phlebotomists should always

Check for requirements on signs

Single most important means of preventing the spread of infection in a hospital is by

Hand washing

Most prevalent type of nosocomial infections(An infection acquired in a hospital.) are those of the

Urinary tract

Phlebotomists have a statistically greater chance of contracting _____in a work-related incident than they do of contracting AIDS

Hepatitis

AIDS is caused by

HIV virus

When performing heelsticks on infants in a hospital nursery, it is important never to

Share supplies from one infant to another

When delivering blood samples to a lab, they should always be transported

Inside sealed plastic bags

If a biohazard spills in the lab, a phlebotomist should first try to

Contain the spill safely

According to OSHA, a contaminate needle may be safely discarded into a

Sharps container

In most hospitals, a phlebotomist with a cough may draw blood from a pt provided the

(1) pt is not in reverse isolation
(2) Phlebotomist wears a mask
(3) Phlebotomist does not have a fever

When drawing blood from pediatric inpatients, a phlebotomist can increase safety for the pt by

(1) Getting help to hold the pt securely during the draw
(2) Using a smaller bore needle & smaller collection tubes
(3) Making sure the bedrails are left raised if found that way

To eliminate bacteria from the skin of a bacterial culture venipuncture site,____ is sometimes used in addition to alcohol in the skin cleansing process

Iodine

Term that refers to right & wrong conduct is

Ethics

Unlawful threat or attempt to do bodily injury to another

Assult

Law protects the health worker if it can be determined that he or she acted reasonably as compared with fellow workers; this is called

Reasonable care

Negligence by a professional person is called

Malpractice

Ability to see things from another person's point of view is

Empathy

Violation of a person's right not to have his or her name, photograph, or private affairs made public without giving consent is

Invasion of privacy

Info given by a pt to medical personnel that cannot be disclosed without consent constitutes

Privileged communication

Failure to do something a reasonable person would do under ordinary circumstances, or doing something a reasonable person would not do under ordinary circumstances thereby causing harm to another person is called

Negligence

Permission granted by a person voluntarily (and in his right mind) is

Consent

Phlebotomist who attempts to draw blood without sufficient training could be accused of ____if the procedure is performed incorrectly, causing harm to the pt

Incompetence

Forcing venipuncture on a pt who has refused it would be considered

Battery

Branch of study of moral issues, questions, & problems arising in the practice of medicine & biomedical research is called

Bioethics

Conduct, courtesy, & manners, customary in the medical profession, is called

Medical etiquette

Each & every pt is entitled to____as part of his/her pt rights

Respect & complete care

Some suggested methods for controlling on the job stress during phlebotomy might include

Taking deep breaths

Means of communicating with a pt who is hearing impaired

Using written communication

Performing phlebotomy on children, it is best to

(1) Talk softly & gently
(2) Enlist the help of parents
(3) Tell the truth if asked

Elderly pt it's appropriate to call the pt by name using

Miss, Mrs., or Mr.

Pt who is making a fist & frowning is exhibiting

Uncooperative body language

Rubber or plastic tube used to drain or inject fluid through a body opening is called

Catheter

24-hr. Urine specimen must be kept

Refrigerated

Chronic disease in which the pancreas fails to secrete enough insulin

Diabetes mellitus

Purpose of the bleeding time test is to assess

Platelet plug formation in the capillaries

Diurnal rhythms refer to variations in the body's functions or fluids that occur during

Every 24 hours

EMLA is an emulsion of Lidocaine & Prilocaine that can be used to

Topically anesthetize a draw site

Another name for red blood cells (RBC)

Erythrocytes

Artery located in the groin, lateral to the femur bone, which is used as an alternative site for arterial blood gas collections

Femoral artery

Federal law that was expanded in 2000 to protect the confidentiality of electronically stored health info

HIPAA

Study of all aspects of disease in the body

Pathology

Phase of laboratory testing that refers to test orders, test collection & test sample preparation are all part of this phase

Pre-analytical phase

Pt in reverse isolation has been so placed because he/she

Needs protection from others carrying infection

EDTA

Anticoagulant in Lavender top tubes

NaCitrate

Anticoagulant in Blue top tubes

ABG

Arterial Blood Gases

FUO

Fever of unknown origin

STD

Sexually transmitted disease

H&H

Hemoglobin & Hematocrit

CBC

Complete blood count

Electrolytes

Red Top or Speckled Tube

QC

Quality Control

CDC

Center for Disease Control

Contaminated objects that can penetrate the skin including, but not limited to needles, scalpels, broken glass, broken capillary tubes, & exposed ends of dental wires

Contaminated sharps

Reasonable possibility of skin, eye, mucous membrane, or parenteral contact with blood or other potentially infectious materials that may result from the performance of an employee's regular duties

Occupational exposure

Personal Protective Equipment (PPE)

(1) Gloves
(2) Masks
(3) Aprons
Not considered this is a uniform.

Physical-chemical procedure to destroy all microbial life including highly resistant bacterial endospores is

Sterilize

Single most important source of HIV & HBV in the workplace

Blood

OSHA requires that training & educational info on bloodborne pathogens be provided to hospital or clinical employees

At no cost to them

All workers whose jobs involve participation in tasks or activities with exposure to blood or other body fluids, to which universal precautions apply, should be vaccinated with a

Hepatitis B

After they used, disposable syringes & needles, scalpel blades & other sharp items, should be placed in

Puncture-resistant containers for disposal

Broken glassware that may be contaminated should be picked up by

Mechanical means (broom/dustpan)

Contaminated laundry should be

Bagged or containerized at the location where is was soiled

Specific eye, mouth, other mucous membrane, non-intact skin, or parenteral contact with blood or other potentially infectious materials that results from the performance of an employees duties is

Exposure incident

Health care field when all evaluated services & the results compare with accepted standards, principles of

Quality assurance have been used

Federal gov. requires that specimens are transported or shipped in

Watertight containers

Classification the physician's office lab (POL) falls into will be determined by

Complexity of laboratory tests performed

Tests that basically pose insignificant risks to pt if errors occur in the test performance

Waived tests

When you send blood tubes by mail for analysis in a watertight container, they should be enclosed in

2nd durable watertight container

When you send specimens in the mail, the label should state

(1) Biohazardous materials
(2) In case of breakage, send to CDC
(3) Address of lab

Supplies for venipuncture

(1) Evacuated collection tubes
(2) Needles
(3) Holder/Adapter
(4) Tourniquet
(5) Alcohol Wipes- 70% Isopropyl Alcohol
(6) Povidone-iodine wipes/swabs- Used if blood culture is to be drawn
(7) Gauze sponges- for application on the site from which the needle is withdrawn
(8) Adhesive bandages/tape
(9) Sharps container
(10) Gloves
(11) Syringes- for special circumstances

Infant heel sticks lancet size

Smaller than 2.5mm

Common heatology tests

CBC hgb, hct, Differential, sickle screen, Sed rate, platelet counts

Light blue top chemical & tests

Sodium Citrate
Coagulation studies, PT, PTT

Allergy to Iodine (shellfish) what antiseptic is used?

Chlorahexadine

Allergy to alcohol what antiseptic is used?

Betadine

Person has a IV on arm what arm do u draw on?

Below the IV or other arm.

Smallest blood vessels

Capillaries

Heparin blocks what during a clot formation

Thrombin

Bleach solutions dilution ratio

1:10

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