NHA Phlebotomy Study Guide - Pt 1

What are the two circulations of the Heart ?

Pulmonary and Systemic

The pulmonary circulation carries _____?

Deoxygenated blood to the lungs and oxygenated blood from the lungs.

What kind of valve is the tricuspid valve?

atrioventricle

The pulmonic valve is situated between _____________?

Right Ventricle (RV) and pulmonary artery

Endocardium is which layer of the heart?

inner

The myocardium is the layer of the heart that is made of ____________?

muscle

Which layer of the heart is the epicardium?

outer

What kind of blood do arteries and arterioles carry?

oxygenated

What percentage of the blood is made up of formed elements?

45%

What percentage of formed elements is erythrocytes?

90%

What is the oxygen carrying protein in erythrocytes?

hemoglobin

Where do blood cells originate?

bone marrow

How many liters of blood does the average adult have?

5-6

What is the normal life span of a RBC?

120 days

What is the liquid portion of blood (inside of body) called?

plasma

What is the function of a leukocyte?

protect from infection

What is a condition that could cause leukopenia (low white blood cell count)?

chemotherapy

How many types of leukocytes are in blood?

5

Which WBC comprises 40%-60% of the WBCs?

neutrophils

How much of 20%-40% comprises of WBC ?

lymphocytes

Which WBC carries histamine?

basophils

Another name for thrombocytes is _____?

Platelets

Hemostatis is defined as __________?

stoppage of blood

The first phase of hemostasis is ______?

vascular stage;
2) platelet stage; 3) coagulation; 4) fibrinolysis

The test used to evaluate intrinsic pathway is called ____________?

aPTT (heparin TDM)

The break down and removal of a clot in the hemostasis process is _________?

fibrinolysis

What is the preferred site for venipuncture?

antecubital fossa

Sclerosed (Schlerosis) veins feel ________?

cordlike

Crooked or winding veins are also called ______________?

tortuous

What is the preferred antiseptic for venipuncture?

isopropyl alcohol

What is the size (in inches) of needle routinely used for venipuncture?

1-1.5 inches in length

What is another name for winged infusion sets?

butterfly

Which is NOT a reason the tourniquet is used?

to make veins blue

A pad used to protect the patient's clothing?

Chux

The most common complication of phlebotomy ?

Hematoma (especially in older patients)

Leaving the tourniquet on too long may cause _________?

Hemoconcentration (pool of blood)

Tiny red spots on the skin cause from the rupturing of capillaires are called ?

Petechiae (p-t-k)

Accumulation of fluid in the tissues is called ?

Edema

Permanent surgical connection btwn an artery and a vein?

fistula

What are some of causes of a pre-analytical error(s) ?

1) improper time of collection; 2) wrong order of draw; 3) faulty technique; 4) exposure to light

What is the purpose of the post-analytical phase?

Access pt and provide tx (treatment) by medical staff(i.e. DR, RP, PA who ordered the test(s))

The most important step in a routine venipuncture?

Identify the patient

How many inches above the site should be the tourniquet be tied?

3-4 inches

If the patient continues to bleed after 8 minutes of pressure you should?

Call for help - Emergency

Which is not a reason for failure to collect blood ?

Patient drank too much liquid

There are several possibilities why tubes may lose their vacuum due to _____________?

1) manufacturing defects; 2) expired tube; 3) a fine crack in the tube

If the needle passes completely through the vein you must pull it out of the arm and try another vein.

False

Using a butterfly needle may be necessary if the vein collapses with the evacuated tube system.

True

A person should sustain from eating for how many hours prior to a fasting blood test?

12 (book).

To measure diurnal variation of cortisol hormone what kind of specimen would be required ?

Timed

Postprandial means________.

after eating

The OGTT (oral Glucose Tolerance test or GTT test diagnoses _____________

diabetes

In therapeutic blood monitoring, the trough levels are tested ___________

30 minutes BEFORE the scheduled dose.

Blood cultures are used to diagnose ______________?

FUO (fever of unknown origin)

What part of the infant is a PKU test performed on ?

Heel

What special handling does a cold agglutinins test require ?

pre-warmed tubes

What special handling does an ABG (Arterial Blood Gases) require ?

chilling

Which test is NOT a light sensitive test ?

porphyrins

What is the recommended depth of a heel puncture on an infant?

2.0mm

Blood Culture tests can be done with a dermal puncture when venipuncture is not possible.

False. Blood cultures required 5cc-10cc collected.

The first tube in the order of draw for capillary specimens are lavender.

True. Micro-containers has reverse order of draw.

In the order of draw for capillary specimens should you draw tubes with or without additives first?

With additives first

Which order of draw is correct?

Regular method: red, green, lavender

The order of draw for venipuncture is BC, blue, Red-serum, green, Lavender(EDTA), gray.

True

Which tube is used for PTT?

Light Blue

Which tube is used for a sickle cell (anemia) screen?

Lavender

Blood cultures are collected in a __________ tube.

Yellow

Which tube contains sodium citrate?

Light Blue

Which tube would you use to measure lactic acid ?

Gray

Microorganisms cultures are collected in ____________ tubes.

Yellow

To check for trace elements a phlebotomist would use a ________ tube.

Royal Blue. Toxicology/Microbiology (not in the order of draw) special use

What tube is used for a WBC differential?

Lavender

Ammonia chemical test would be done with a ___________ tube.

Green

Sodium Citrate is the additive in which tube?

Light Blue

What tube is used for ESR (erythrocyte sedimentation rate?

Lavender - to discover if there's an inflammation.

What organ would a doctor be interested in if he ordered an ALP, AST, ALT, GGT and bilirubin?

Liver (aka Liver Panel tests)

How many times should a red top tube be inverted?

0 according to textbook/NHA exam.
Note: Real life you do invert.

Invert a Gray Tube ___________ times.

8-10 times

Which tube is sometimes called a serum separator tube?

Red/gray (aka tiger top)

How many times to invert a red/gray tiger top ?

5

Lavender tubes must be 2/3 full.

True

Lavender, yellow, and green tubes should all be inverted 8 times each.

True

How many times should a light-blue tube be inverted?

3-4 times

Light Blue tubes must be _________ full.

Completely. no vacuum left. Blood ratio: 9:1

Sodium Fluoride preserves glucose for how many days?

3 days (72hrs)

A CBC would be sent to what lab section?

hemotology (lavender top)

Where is the blood collected, stored, and prepared for transfusions?

Blood Bank

Which lab section would analyze the C&S test?

Microbiolgy - Culture & Sensitivity

What are the 3 components of an urinalysis?

Physical, chemical, microscopic exams

What is the first link in the chain of infection?

Agent - because it's the source.

Contact, droplet and airborne are ______________.

Modes of transmission

Which is NOT a common symptom of shock ?

Blinking eyes

When someone is in shock you should keep them cool.

False

An open wound can be a portal of entry in an infection chain.

True

Medical asepsis is the destruction of pathogens outside the body.

True

What is the most important step in preventing infections?

handwashing

Which is not a PPE ?

Room dividers

All patients are presumed to be infectious for

Blood Borne pathogens

Always recap your needle before putting it into the sharps container.

False

What is a Systemic Circulation of the heart?

It is the part of the cardiovascular system which carries oxygenated blood away from the heart to the body, and returns deoxygenated blood back to the heart.