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CPT final

Terms in this set (163)

What does the term phlebotomy actually mean?
incision of a vein
Define certification.
evidence that an individual has demonstrated proficiency in a particular area of practice
A duty associated with routine blood collection includes:
a.) transporting sample to laboratory.
b.) performing complex point-of-care testing.
c.) ordering tests for patients.
d.) setting HIPAA regulations for phlebotomy.
a.) transporting sample to laboratory.
Define informed consent.
a patient must be informed of all intended treatments and risks before the treatment is performed.
Define implied consent.
apparent through a patient's action of seeking the treatment/services of the physician
The Health Insurance Portability and Accountability Act of 1996 regulates which areas?
HIPPA of 1996 is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient's consent or knowledge. There are four areas of HIPAA that are directly the concern of patients. These are privacy of medical/health data, security of health data, notification of health data breaches and the right to get copies of healthcare data.
You have entered a patient's room and explained that you need to draw blood, and the patient repeatedly refuses. What should you do?
Notify the patient's physician according to the institution's written policies.
Define Protected Health Information (PHI).
any information about the patient's health status, treatment, or payment for health care
Define SST.
serum separator tube
Which department of the laboratory processes Pap smears?
cytology
Which anticoagulant is used most often in collection tubes for hematology studies?
EDTA
Which hematology test measures the blood's capacity. to carry oxygen?
hemoglobin
What color tube may be used to obtain serum for a laboratory test?
gold or tiger top
What term is used to describe serum that is darker yellow than normal?
icteric
What term is used to describe serum that is cloudy or milky?
lipemic
What term is used to describe serum that is pink-tinged?
hemolyzed
Sodium, potassium, and chloride are all part of which panel of tests?
electrolytes
Culture and sensitivity tests are performed by which of the laboratory departments?
microbiology
Which department within the laboratory performs complete blood counts (CBCs)?
hematology
Which government agency is responsible for laboratory workplace safety?
OSHA (Occupational Safety and Health Administration)
What should you do if you get stuck with a needle?
First aid of the injury is always the initial step in dealing with minor injuries. Washing the wound may also prevent infectious agents from entering it. Afterward, report the injury and fill out an incident report according to your institution's policy.
Written information about a chemical, its hazards, and procedures for cleanup and first aid are available in what kind of documents?
chemical label
Define anaphylaxis.
rapid, severe, life-threatening immune reaction, that can result in death as airway may swell shut, blood pressure drop
A wet floor is which type of safety hazard?
physical
What is the most common allergy in the healthcare field?
latex
What is the term for infections contracted by patients during hospitalization?
healthcare-associated or nosocomial infections
Proper hand-washing technique includes scrubbing hands together vigorously for at least _____.
15 seconds
When donning a gown, mask, respirator, face shield, and gloves, which item should be put on last?
gloves
What is the term for infection control measures that use barrier protection and work practice controls that prevent contact with infections body fluids from all patients?
standard precautions
When removing PPE, what is the last thing one should do?
a.) Remove gown.
b.) Remove mask.
c.) Wash hands.
d.) Remove gloves.
c.) Wash hands.
The Bloodborne Pathogens Standards require an employer to provide which of the following immunizations?
hepatitis B
According to the Bloodborne Pathogens Standards, who is responsible for providing PPE to an employee?
The employer must provide and pay for PPE.
According to the Bloodborne Pathogen Standard rules, which specimens are considered to be potentially infectious?
all blood and bodily fluids
A diluted solution of _____ can be used as a disinfectant against bloodborne pathogens on countertops and work spaces.
10% bleach
In addition to standard precautions, what type of precautions should also be used for patients with such diseases as tuberculosis and measles?
airborne
In addition to standard precautions, what type of precautions should be used for patients with such diseases as HIV or hepatitis B?
bloodborne
For a phlebotomist, what is the principal occupational risk for infection?
infection from an accidental needle stick
A small blood spill from a specimen you are handling occurs on a laboratory countertop. What is the usual procedure you should use to handle the spill?
Wearing gloves and using 10% bleach as a disinfectant, clean-up visible blood first, then disinfect the entire area of potential contamination.
For what duration can HBV survive in dried blood?
1 week
What virus can survive in dried blood for up to 3 weeks?
hepatits C
Define homeostasis.
the body's constant maintenance of trying to keep itself at a dynamic steady state of good health
A group of organs functioning together for a common purpose:
system
What term describes the wrist in relation to the shoulder?
distal
Protein within red blood cells that binds oxygen:
hemoglobin
Wha is called the "master gland" of the endocrine system?
pituitary
Which hormone is detected by pregnancy tests?
HCG (human chorionic gonadotropin)
Instrument used to measure blood pressure:
sphygmomanometer
What is the medical term for "hear attack"?
myocardial infarction
The medical term for reduced blood supply to the heart tissue, thereby causing damage to the heart muscle?
ischemia
CK-MB, myoglobin, and troponin are all measured in tests that can be used to diagnose:
myocardial infarction (aka heart attack)
The cephalic, basilic, and median cubital veins are all located in the
the antecubital fossa of the arm
Plasma makes up approximately what percentage of whole blood in a healthy person?
55%
How much water is found in plasma?
90%
What substance is produced when blood is collected in a tube, allowed to clot, and then centrifuged?
serum
Another term for white blood cells (WBCs):
leukocytes
Another term for red blood cells (RBCs):
erythrocytes
The formed elements constitute what portion of the blood volume?
45%
Formed elements of the blood that play a role in blood coagulation:
platelets
The process by which blood vessels repair after injury:
hemostasis
The term for an increase in the total number of RBCs:
polycythemia
What cells are infected and destroyed in HIV infection?
helper T-cells
Lymph nodes, fluids, and vessels, along with associated organs, are all part of what system?
lymphatic
A blood specimen collected in a gold top tube will produce which of the following after centrifuging?
serum
What is the first stage of hemostasis?
vascular spasm
A substance used to clean surfaces other than living tissue:
disinfectant
What is the most commonly used antiseptic for routine blood draws?
isopropyl alcohol
What actions should be taken immediately after withdrawing the needle from the patient?
Apply pressure to the puncture site immediately. The tourniquet should have been removed sometime before withdrawing the needle. After the bleeding stops, an adhesive bandage can be applied if needed (except in the case of a small child, who may put a bandage in his or her mouth and choke on it). The last step before leaving the room is to wash your hands.
Which needle gauge is most commonly used for routine venipunctures?
21
The term for the hollow tube inside a needle's shaft:
lumen
The part of a needle that attaches to the collecting tube or syringe:
the hub
What does the term multisample needle mean?
The needle has a retractable rubber sleeve that covers one end of the needle when a blood collecting tube is not attached.
What is the most common gauge of butterfly needle?
23
The anticoagulant EDTA works by binding which substance needed for blood clotting?
calcium
Which anticoagulant is used for coagulation studies?
sodium citrate
What color tube should be collected for a CBC?
lavender
A tube containing thixotropic gel could be used to collect blood for which of the following tests?
chemistry screen
What color tube should be collected for coagulation studies?
light blue
For maximum effectiveness, an antiseptic should be left in contact with the skin for how long?
30-60 seconds
What is the appropriate equipment selection when performing venipuncture on fragile, easy to collapse veins?
needle and syringe set-up
What is the best placement for the phlebotomy tray in a patient's room?
Should be on a solid surface away from the patients personal effects.
The procedure for the proper disposal of used needles includes
discarding safety needles/collection device as intact unit
Selection of equipment for venipuncture depends on:
the type of collection and the condition of the patient
Before drawing blood in an inpatient setting, information found on the requisition form should be matched against what?
the patient's wristband
What is the single most important step of the blood collection procedure?
patient identification
At what angle should the venipuncture needle be inserted?
15-30 degrees
If the number on the requisition does not match the arm band, what should you do?
Contact the patient's nurse to attach a proper ID wristband to the patient.
If a blood test requires a fasting specimen, what is the best way to verify that the patient is fasting?
Ask the patient when the last time was that he had anything to eat or drink.
When you tell a patient that you need to draw blood, he says that he does not want to have his blood drawn. What is the appropriate action?
Explain the procedure and ask the patient if he will consent.
How far from the puncture site should the tourniquet be placed?
3-4 inches above the puncture site
What is the term for an increase in the ratio of formed elements to plasma?
hemoconcentration
What is the term for the small red spots on the skin that are caused by a tightly tied tourniquet?
petechiae
What is the term for destruction of red blood cells due to a tightly tied tourniquet?
hemolysis
While having a blood sample collected, the patient complains of pain and tingling in the fingers. What is the likely cause?
The tourniquet is too tight or has been on too long.
____ veins is the most common second choice when the median cubital vein is not appropriate for withdrawing a blood sample.
cephalic
Which vein lies on top of the brachial artery?
basilic
How should a needle be inserted for venipuncture?
bevel up, in a smooth quick motion
If the needle is withdrawn before the tourniquet is removed, what is likely to occur?
hematoma formation
When should the tourniquet be removed?
while the first tube is filling
What is the term for a collection of blood under the skin at the site of a venipuncture?
hematoma
How should bleeding be stopped at a venipuncture site?
Remove the needle and apply pressure to gauze over the site.
When should blood collection tubes be labeled?
at the patient's bedside, immediately after taking the blood
When using a syringe, how do you tell when you have entered a vein?
a flash of blood will appear in the syringe hub
How should blood be transferred from a syringe to a vacuum tube?
Activate the safety device on the needle, remove, and attach a needless transfer device to the syringe.
CLSI approved sites for venipuncture include all of the following except
a.) median cubital.
b.) cephalic.
c.) palmer side of wrist or forearm.
d.) dorsal hand veins.
c.) palmer side of wrist or forearm.
_____ is the preferred collection site for laboratory testing of a patient at high risk for venous thrombosis?
dermal puncture
What is the preferred method of blood collection in newborns and infants?
dermal puncture
How long should a heel warmer be applied to an infant's heel?
3-5 minutes
Puncture of a bone during dermal puncture can result in what potentially serious and sometimes fatal bone infection?
osteomyelitis
What is the maximum acceptable depth for a heel puncture?
2 mm
What is the maximum acceptable depth for a dermal puncture on an adult?
3 mm
What is the recommended depth for a heel puncture on a premature infant?
0.65-0.85 mm
Which of the following bones is close to the surface and at risk of being damaged during a heel puncture?
calcaneus
What is the maximum acceptable width for a dermal puncture?
2.4 mm
Where is the appropriate site for dermal puncture on an infant's foot?
medial and lateral borders of plantar surface
____ is an appropriate dermal puncture site for adults.
ring finger, perpendicular to the ridges
Which antiseptic may affect the results of tests for bilirubin, uric acid, potassium, and phosphorus from a dermal puncture and therefore should not be used on a dermal puncture?
povidone-iodine
Betadine may elevate results of which tests if used to clean the skin for a dermal puncture?
bilirubin, uric acid, phosphorus, potassium
What is an acceptable step during collection of blood by dermal puncture?
Wipe away the first drop of blood with a dry, clean gauze pad.
What is another name for a dermal puncture?
skin puncture
Drawing excessive amounts of blood from a patient puts them at risk for what type of anemia?
iatrogenic
When would a capillary puncture be contradicted?
in severely dehydrated patients
When could a capillary puncture be preferred?
a patient requiring frequent blood tests
The emergency department has requested that blood alcohol levels be drawn on a patient. What is the proper way to obtain the specimen?
clean the site chlorhexidine and perform a routine venipuncture
When you are unable to locate a vein after thoroughly examining a patient's arm, what step should be taken next?
examine the other arm for a vein
What is the medical term for fainting?
syncope
A patient has a seizure while you are performing a venipuncture. What should you do?
Remove the tourniquet and needle immediately, apply pressure, and call the nurse for help.
When collecting blood from a vein in the back of the hand, where should the tourniquet be placed?
just above the wrist
A large amount of bleeding into the tissues surrounding a puncture site (i.e., in a patient who takes anticoagulant medication) can cause what condition?
compartment syndrome
If the antecubital space is inaccessible when venipuncture is required, what is the next best site for specimen collection?
dorsal hand veins
What are preanalytic variables?
factors that occur before sample collection such as patient access, site selection site cleaning, tourniquet application, sample collection, completion of the procedure, and sample integrity
Basal state:
refers to body's state after 8 to 12 hours of fasting.
What is the effect of dehydration on a patient's test result?
hemconcentration
Which antiseptic is not recommended for children under the age of 2?
benzalkonium chloride
Removal of greater than what percentage of a child's blood volume can cause cardiac arrest?
10%
Infants should not have greater than what percentage of their blood volume removed in a 24-hour period?
5%
What is the maximum amount of a child's blood volume that may be removed over a 1-month period?
10%
What is the term for a buildup of bilirubin in the blood and skin?
jaundice
What special precaution must be taken with neonatal bilirubin samples?
The specimen should be protected from light.
U.S. law requires states to test for a minimum of two inherited conditions. What are the two conditions?
hypothyroidism and PKU
Why must neonatal PKU testing be performed by heel stick rather than venipuncture?
Phenylalanine levels are different between veins and capillaries.
How are neonatal screening samples usually collected?
By dermal puncture absorbed onto filter paper
If a venipuncture is required on a child younger than 2, what is the preferred site for a phlebotomist using a butterfly needle to collect the sample?
dorsal hand vein
How should the tourniquet be applied to a geriatric patient?
looser than usual
How long should pressure be applied to the venipuncture site of a geriatric patient?
more time than usual
What does the term "hyperglycemia" mean?
Increased blood glucose
What test is used to diagnose gestational diabetes?
1-hour oral GTT
When does the timing of an oral glucose tolerance test begin?
After the patient has finished drinking the glucose solution
During an oral GTT, what is the patient allowed to consume?
water only
Which test requires the blood sample to be chilled immediately after collection and delivered to the laboratory on ice?
ammonia
When preparing blood smears at what degree should the spreader slide be?
25-30 degrees
What type of urine collection is best for pregnancy tests?
first morning
The most common timed urine collection is done over what time period?
24-hours
Which of the following is the proper way to collect a 24-hour urine specimen, beginning at 9 AM Thursday?
a.) Collect and keep the 0900 Thursday urine and all the urine samples for 24 hours, and keep the 0900 Friday specimen.
b.) Collect and keep the 0900 Thursday urine and all the urine samples for 24 hours, and discard the 0900 Friday specimen.
c.) Collect and discard the first specimen (0900 Thursday). Collect and keep all the samples until 0900 Friday. At 0900 Friday, collect and keep the last sample.
d.) Collect and discard the Thursday 0900 urine. Collect and keep all urine samples for 24 hours, and discard the 0900 Friday specimen.
e.) The first collection has been in the bladder for an unknown period of time so is discarded. The timing then starts and everything is collected for the next 24 hours including whatever is in the bladder when the time is up.
c.) Collect and discard the first specimen (0900 Thursday). Collect and keep all the samples until 0900 Friday. At 0900 Friday, collect and keep the last sample.
What collection technique is most often used to collect a urine sample for a urine culture?
clean catch
What type of urine testing usually requires a temperature-sensitive strip on the outside of the container?
drug test
What type of fecal testing is used to screen for colorectal cancer?
occult blood
What type of specimen is needed for a rapid strep test?
throat swab
What is another name for point-of-care testing (POCT)?
alternate site testing (AST)
Which group of Streptococcus bacteria is detected by the rapid strep test?
group A
The detection of HCG in a patient sample is useful in the diagnosis of what condition?
pregnancy
Before urinalysis testing, a urine specimen needs to be
at room temperature and well-mixed.
Laboratory values that are well outside of the designated range is referred to as a ____.
panic value
C-reactive protein is a
predictor of cardiovascular risk due to inflammation.
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