55% of blood is
plasma
Hematocrit measures ____________ in a given volume of whole blood .
Red Blood Cells (RBC's)
BCX or C&S are drawn in what tube?
red
Which tube are lead levels drawn in?
royal blue or tan
Negligence
Duty: of care, Derelict: breach of duty of care, Direct cause: Legally recognizable injury that occurs as a result of the breach of duty of care. Damage: Wrongful activity must have caused injury because of another failure to live up to a required duty of
Nosocomial
Healthcare setting aquired infections
Thixotropic gel forms a
Barrier between the Serum and the Cells
What is the function of a Leukocyte
provide the body protection against infection
Allergic reaction is a
physical reaction
Universal precautions
Name used to describe a prevention strategy in which all blood and potential infectious materials are treated as if they are, in fact, infectious, regardless of the perceived status of the source individual
Graft is?
artificial permanent surgical connection between veins
What is the proper way to identify a patient?
patient id number name and birthday
You are asked to draw the following test
Rotavirus
T4 Thyroxine
Magnesium
Lithium
Red, Tiger Top or marble red Gold
What vein is commonly used to draw blood from for an obese patient?
cephalic vein
Do veins have valves
yes
What is a Capillary defined as?
microscopic blood vessel
Sodium Floride keeps
Glucose molecule intact for 3 days
Common infectious entry sites are what?
broken skin, mucous membrane and body systems exposed to the external environment such as the respiratory, gastrointestinal and reproductive
Hyperglycemia
high glucose in blood
Butterfly
a small needle with two plastic wings and tubing,
What are the two tiers or levels of precautions?
standard precautions and transmission-based precautions
Tortuos veins are
impaired blood flow, susceptible for infection
Vacutainer System
The vacuum collection consists of a doubled-pointed needle, plastic holder/adapter, and series of vacuum tubes with rubber stoppers of various colors.
Sodium Citrate is in what tube color?
light blue
The great toe is?
the big toe
Pink tube is used for
blood banking
A "Lytes" panel consists of what electrolytes?
Sodium, Potassium, Chloride, Calcium & Phosphate
What tube does an ESR (erythrocyte Sedimentation Rate) go into?
lavender
Pathogen
any microorganism that produces disease
What is medical asepsis?
destruction of pathogenic microorganisms after they leave the body
What tube contains an antiglycolytic agent?
gray
What do Basophils PRODUCE?
histamine to help control allergies, and increase in inflammation,Basophils produce histamine and heparin
Antigents are ?
A. infectious microorganisms that can be classified into four groups:
Viruses
Bacteria
Fungi
Parasite (Your Answer)
B. infectious microorganisms that can be classified into four groups:
Viruses
Bracial
Fungi
Parachute
C. infectious microorganisms that can
Capillary samples are collected normally from which part of the body?
middle or ring finger
Whole blood
Blood from which none of the elements have been removed,red blood cells,White blood cells , and platelets,45% FORMED ELEMENT AND 55%LIQUID ELEMENT
what is another name for winged infusion set?
butterfly
FUO means
Fever Of Unknown Origin
Indirect Transmission
An infection transmitted through body fluids to blood
BCX blood culture or C&S culture and sensitivity
What items do you need for the draw?
2 bottles Aerobic & Anaerobic , gloves ,Iodine wipes , cotton ball , gauze ,alcohol wipes .
If a patient is on an aspirin regimen; what would be most affected?
clotting time, coagulation test
when removing PPE what order do you use?
gloves, gown and then the mask
Fomite is?
inanimate object that spreads germs
All Healthcare workers are required to vaccinate for which virus?
HBV, hepatitis B according with OSHA regulation
Blood cultures are drawn to identify what in the blood stream?
microorganisms
Fibrinogen
The protein from which fibrin is formed/generated in normal blood clotting
Thrombophlebitis
inflammation of a vein with formation of a clot
Tourniquet
Constrictive band used for venipuncture, blood aspiration and intravenous injections
PT & PTT tests are drawn from what tube?
light blue
If a person is having a vasovagal episode, what is the most important thing the phlebotomist needs to do?
get the needle out of the arm, lay patient on their back with feet raised Trendelenburg position
Glucose
measure in blood and urine specimens to determine the presence or absence of diabetes. Glucose is the end product of carbohydrate metabolism and is the chief source of energy in all living organisms
if a person donates 500 ml of blood how many weeks does it take for your body to replenish the amount lost?
6 to 8 weeks
Oncology
study and treatment of cancer
Fistula is
artificial permanent surgical connection between an artery and a vein
person may donate how much blood in one sitting
500ml
What is the most important thing to remember when creating a blood slide/smear?
thin, feathered edge
Which tube(s) contain anticoagulants?
Lavender, Green, Blue, Lt. Blue Grey
The order of Draw
1.blood culture
citrate (blue top)
.serum (red top)or marble red , or gold
.heparin (green top)
E DTA (purple top)
.k-oxalate (gray top)
What is the main difference between arterial and venous blood?
arterial blood is oxygenated venous blood is deoxygenated
Hemoglobin
Oxygen carrying, pigment of the red blood cells, main red blood cells component
What is the most common cause for blood culture contamination?
improper skin preparation
The Sharps container is overflowing; what is the appropriate response?
wear appropriate PPE, close the lid, hand-carry to the nearest medical waste accumulated pickup container, be sure the container is lined with a RED biohazzard bag. Fill out the Medical Waste Accumulated log. Remove your gloves and WASH YOUR HANDS!
If someone is admitted to the emergency department unconscious how do we identify them, until they can be property identified?
chart that provide a hospital ,ID number, medical record number and identification band and labels.
What types of antigens are there?
A and B
What is the correct order of draw for a BCX, APTT, CBC, ESR, LYTES and CMP?
BCX - Red with iodine, aerobic & anerobic bottles
APTT - Lt. Blue
CMP - Tiger Top
LYTES - Dark Green
CBC - Lavender
ESR - Lavender
Needles should never be
recapped
Hemolisis
The breaking of the RBC's (red blood cells) membrane releasing free hemoglobin into the circulating blood. In phlebotomy, this is usually a result of mechanical damage due to poor technique
Portal of Exit
the method in which an infectious agent leaves it's reservoir
Patient is being treated for cancer; what section of the hospital would they be in?
oncology
Which way should the bevel be facing when entering in the arm?
upwards, facing up
NPO means
nothing by mouth
What sample needs to be run within 15 minutes of collection?
ABG arterial blood gasses
Many types of WBC's are in human blood?
5; Granulocytes:Neutrophils, Eosinophils and Basophils. Agranulocytes: Lymphocytes and
What is quality assurance?
Quality Assurance is defined as a program that guarantees quality patient care, by tracking the outcomes through scheduled audits. QA included appropriateness, applicability and timeliness of patient care
What tube(s) contain an anticoagulant?
Lavender, Green, Blue, Light Blue, Grey
You are asked to draw for the following tests:
Complete Blood Count with Diff
Estrogen - total
Glucose
Uric Acid
First Red or marble red and Lavander for CBC and white blood cell
White Cell Count
The number of WBC's (leukocytes) found in the peripheral blood and measured per cubic millimeter
Droplet precautions are designed to do what?
reduce the risk of droplet transmission of infectious agents
CDC
Centers for Disease Control and Prevention
You are asked to draw for Cortisol AM, General Health Panel and Partial Thromboplastine Time (PTT) what is the order of draw
Light Blue for PTT, Cortisol red or marble red or Gold
Sodium Citrate
sodium citrate is effective as an anticoagulant due to binding calcium in the specimen, is the additive in the Light Blue for PT and PTT
What is the difference between Plasma and Serum?
Plasma fluid portion of blood in which cellular components are suspended. Serum is the clear liquid portion of blood that separates out after clotting has taken place after centrifuge , serum do not contain Fibrinogen
Light-sensitive specimens are?
bilirubin, beta-carotene, vitamins A & B6 ,porfirins
You are asked to draw for reticulocyte Count, what tube do you use?
Lavender
Invasion Of Privacy, HIPPA violation
Release of medical records without the patient's knowledge and permission
What is a fomite?
an inanimate object that transport microorganisms
PTT is the abbreviation for:
Partial Thromboplastine Time
you are asked to draw for Blood Urea Nitrogen (BUN), Bilirubin direct and CBC what is the proper order of draw?
tiger top ( marble red) ,red or gold and lavender
The average person weighing 155 pounds has approximately __________ liters of blood in their system.
5-6 liters
If you draw a sample culture and sensitivity, what section of the lab would receive that?
microbiology
EDTA
Calcium binding agent used as an anticoagulant,is the additive at the Lavander tube, Royal Blue(sodium EDTA)
If a patient asks you for test results; what do you do?
tell them that I will get their physician to help them
Plasma
The fluid portion of the blood in which the cellular components are suspended. Plasma is 55% OF THE BLOOD ( 90 TO 92% WATER and 8 to 10 % substance
Basilic Vein
Large vein on the inner side of the bicep
What tests are done using the Light . Blue tube:
Pt and PTT
Good Samaritan Law
Law deals with rendering 1st aid by health care professionals at the scene of an accident or sudden injury. Provide medical care within the scope of training without fear of being sued for negligence
ABG (Arterial Blood Gas)
analysis arterial blood for oxygen, carbon dioxide, bicarbonate content in addition the blood PH and acid base
How long can the tourniquets remain on the arm during the venipuncture?
1 min
Informed Consent
Giving the patient adequate information concerning the method, risk and consequences to a specific procedure. Expected outcome and alternatives
Lipemic
after blood is spin and separated in a centrifuge the serum/portion is milky in appearance, the lipemic plasma has a milky appearance
What is the most important thing to remember when doing a capillary puncture?
excessively milking the finger during a skin puncture can result in hemolysis and contamination of the specimen with tissue fluids, wipe the first drop of blood before the capillary blood test because the body fluids
Phlebitis
inflammation of a vein as a result of repeated venipuncture on that vein, PHLEB= vein and it is inflammation
under a patients bill of rights, can a patient decline medical treatment?
yes, one of the 10 patients right is refuse the treatment
Blood composes how much of a persons body weight?
7 to 9 percent
Airborne precautions are designed to do what?
reduce the risk of airborne transmission of infectious agents
What section of the lab would process a CBC?
Hematology, complete blood count = red blood cell , white blood cells and platelets
Disinfection is the _____________ procedure used in medical asepsis using various chemicals that can be used to destroy many pathogenic microorganisms
third
if a patient declines medical treatment; what is the first thing you do
advise the patient that you understand their concern, and document the declined procedure and notify the nurse, or the MD
If a patient asks you what tests their physician has ordered; do you tell them?
this information is to be given to the patient upon request
List five types of mode of transmission
contact - direct and indirect
droplet
airborne
common vehicle
vector borne
Hemoconcentration
Decrease in the fluid content of the blood (plasma), resulting in an increase in concentration. This is determined by an increase in the hematocrit. Caused by a filtration of plasma into the body tissues and often cause because of dehydration
serum
Referring to blood, the clear liquid portion of blood that separates out after clotting has taken place, do not contain fibrinogen
latic Acid sample must be
chilled
tort
Wrongful act that results in injury to one person by another
Pt is abbreviated for?
Prothrombin Time
Silica (glass particles) are in what tube color?
tiger top, marble red or Gold
Hypoglycemia
low glucose level
Septicemia
systemic infection associated with the presence of pathogenic organism introduced during a venipuncture, or contamination
Antecubital Fossa is defined as
the "ditch" or impression opposite the elbow
Which test would have the highest priority if all were received at the same time?
Stat CBC in ICU
ASAP ESR in ER
Timed cultures in the outpatient lab
STAT CBS in labor and delivery
STAT CBS in labor and delivery
if you were to pierce your index finger with a used needle; what is the correct response?
Wash exposed area thoroughly with hot water, using antibacterial soap for 15 minutes. Report incident to your manager or supervisor ASAP. Complete the exposure incident form
briefly explain the area in which to draw a PKU test on an infant
Glove hands, clean heel with alcohol. make an imaginary lines medially extended from the middle of the great toe to the heel and laterally from the 4th and 5th toe to the heel. Poke the side of the heel (NOT THE MIDDLE) with a 2ml lancet.
How long does it take for the blood in the system to make a complete circulation in the body?
1 minute
You are asked to draw the following test:
hematocrit
Albumin
Creatine
Tiger tube or marble red or Gold , Lavander
Standard precautions presume that all patients
to be treated a blood borne pathogen
What tube would you draw a PPT in?
light blue
What are antigens?
they are a substance that is able to produce ann immune response and will react with a specific antibody. The antibodies will either inhibit or destroy the antigens
basal means
Patient fasting and no exercise for 12 hours
Lymphocytes
numbers increase in viral infection and they play a role in immunity,lymphocyte B and T
Who draws an ABG?
Doctor, nurse, respiratory therapist
edema is?
Excessive water between tissue
Monocytes are also known as
the largest WBC's and their numbers increase in intracellular infection and tuberculosis, monocytes become Macrophages when defense tissues
scleroses veins are
hard and cord like
45 percent of blood is
Formed cellular elements red blood cells or erithrocytes , white blood cells or leukocytes and Platelets or Trombocyte
cyanotic
Bluish skin color due to lack of oxygen
heparin
An anticoagulant that acts to inhibit a number of coagulation factors, especially factor Xa. Heparin is formed in the liver.
platelets
Also known as thrombocyte, this is a particulate component of the blood, approximately 2-4 microns in diameter and known for it's involvement in blood coagulation. This structure has no nucleus or DNA, is formed by breaking off the cytoplasm of the parent
What are the arteries and veins in the arm a phlebotomist should know?
Basilic Vein, Cephalic Vein, Medial Cubital, NO arteries
Port of entry is what?
Allows the infectious agent access to the susceptible host
vacutainer system
Needle used to attach to a Vacutainer Holder. The needle has a male thread on one end which screws into the holder. The holder, tube and needle comprise the Vacutainer system, used to draw multiple tubes of blood with one venipuncture
List the anatomy of the heart in the order of blood flow
Superior & Inferior Vena Cava (V.C)
Right Atrium
Tricusped Valve
Right Ventricle
Pulmonary Artery to lungs (aveoli)
Pulmonary vein
Left Atrium
Bicuspis Valve
Left Ventricle
Arota
What section of the lab would a pink top tube go? What are the additive(s) in the pink top tube?
hematology- EDTA
What is a multidraw needle used for?
To draw multiple tubes during a venipuncture on the same patient
Petechiae
Tiny non-raised red spots that appear on the skin from rupturing of the capillaries due to the tourniquet being left on to long and or to tight
hematuria
blood in urine
What is additive(s) are in the mint green tube?
Sodium Heparin, Lithium Heparin, Ammonium ion
What do Eosinophils do?
first on the scene during an allergic reaction, and parasite infection
What is the additive in a Light . Blue top tube?
sodium citrate
The heart has three layers; what are the names in order?
endocardium, myocardium and epicardium or Pericardium
Mode of Transmission
specific ways in which microorganisms travel from the reservoir to the susceptible host
Contact precautions are designed to do what?
Professionalism
Dependability
Honest
Intergirty
Empathy and Compassion
Professional Appearance
Interpersonal Skills
hematoma
Localized collection of blood within the tissue due to leakage from the wall of a blood vessel producing a bluish discoloration
A group of test ordered as one is often described as what? (I.E. - CMP)
profile or panel
Green tubes have what additives?
Sodium Heparin, Lthium Heparin & Ammonium Ion
What is a nosocomial infection?
healthcare setting acquired infections
Before someone donates whole blood; what test is done?
hematocrit
What is the correct way to end a venipuncture procedure?
tourniquet, tube, cotton ball
HIV
Human immunodeficiency virus
Point-of-care (POCT)
Diagnostic testing at or near the site of patient care
A Hematocrit is
Always done before blood donation
A physician orders a drug screen, what bodily fluid would we collect from the patient?
urine
Multi-Sample Adapter
A device used with a butterfly and Vacutainer holder to allow for the withdrawal of multiple tubes of blood during a venipuncture.
What tube does a "electroytes" panel go in?
green