What mask needs to be worn in a room with airborne isolation precautions
N-95 Mask (plus gloves & a gown)
What does PPE stand for
Personal Protective Equipment
What PPE needs to be worn in a room with droplet isolation precautions
Gloves, mask, eye protection & gown
What PPE needs to be worn in a room with contact precautions
Gloves & gown
What gauge needle will cause hemolysis
25 gauge (and above) (to small & it breaks the blood up; to large and it slams into the back of the tube)
What is the range of needle gauges for blood donation
16-18 gauge
Needles for phlebotomy should be pitched how many degrees
15o-30 degree angle
Needles should be inserted how far
�"- �" or until you reach a change of resistance
What are the three vessels of the anti cubital fossa
Median Cubital Vein, Cephalic Vein, Brachial/basilic Vein
Which vessel is the first choice for a blood draw
Median Cubital Vein
Which vessel is the second choice for a blood draw
Cephalic Vein
Which vessel is the third choice for a blood draw
Brachial/basilic Vein
Which vessel is lateral to the patient's body
Cephalic Vein
What are the names of the three main vessels of the body
Veins, arteries, capillaries
What are the microscopic blood vessels responsible for O2 exchange
Capillaries
How much blood is needed for each blood culture bottle
Adults: 8-10ml (3-4ml in each bottle, aerobic & anaerobic)
How many liters of blood does the average adult have
5 (4-6 liters)
What is the name of the part of the blood which suspends all of its whole material
Plasma
What is serum
Plasma without the clotting factor
What type of anemia can occur in infants because of frequent excessive blood drawing
Iatrogenic anemia
What is the lifespan of an RBC
90-120 days
What does CBC stand for
Complete blood count
What is a CBC with differential
measures the levels of red blood cells, white blood cells, platelet levels, hemoglobin and hematocrit
What are responsible for forming clots
Platelets (Thrombocytes)
What element of the blood is responsible for achieving hemostasis
Platelets
What is the term for an increase in the number of formed elements of blood due to a decrease in plasma
Hemoconcentration
If an emergency arises during a blood draw, what is the first action of the phlebotomist
Stop
What is the maximum time length a tourniquet can be left on
60 seconds
What is the term for when bleeding has stopped
Hemostasis
Hemostasis does what to the vessels
Stops bleeding
What is the medical term for a fainting episode
Syncope
What are some examples of emergencies during a blood draw
Stroke, syncope, heart attack, choking, shock, seizure
If a patient is having a seizure, what should you do for them
Protect patient, inform nurse/EMS
What are three signs and symptoms of a stroke
Weakness to one side of body, slurred speech, impaired gait, headache, drooling, confusion, trouble speaking or swallowing
What are the three steps to stop bleeding
Pressure to site, elevation of extremity, pressure to main artery (pressure point)
What are the three signs and symptoms of shock
Diaphoresis, clammy skin, fainting, blank stare
What position should a person be placed in if they have a history of fainting
Supine
If a patient just had surgery to the right side of their body, which arm should you draw from
Left
If you during a blood draw you notice petechiae or a hematoma forming what should you do
Petechiae = remove tourniquet; hematoma = stop
If a patient has an IV running in their arm, where should you perform the blood draw on the same arm
Below IV
Name two tests that patients have to fast for before getting their blood drawn
Fasting glucose & lipid panel
What is the medical term for touching
Palpating
What is the term for inflammation of a blood vessel
Phlebitis
What is the name of the small purple-dots in the upper layer of the skin, illustrating damaged capillaries and/or collateral vessels
Petechiae
What are three things that every patient must be asked prior to drawing their blood
Name, DOB, Latex allergy, on blood thinners, which arm, blood ever drawn with a negative reaction
What is the name of a substance that discourages the growth or action of microorganisms
Antiseptic
What type of alcohol do we use to cleanse the puncture site
70% Isopropyl alcohol
What are 2 alternatives that can be used to cleanse a puncture site besides alcohol
Povidone Iodine or Chlorhexadine Prep
What cleansing agent should be used when drawing a blood culture
Iodine (Betadine)
What cleaning agent should be used when drawing a BAL
Chlorhexadine Prep
What does BAL stand for
Blood alcohol level
What will occur if a blood tube is shaken vigorously, dropped, or drawn through a 25 gauge (or smaller) needle
Hemolysis
We clean a puncture site outside to in. True or False
False
Which vial gets filled first when doing a blood culture?
Light yellow
What does ESR stand for
Light yellow
What dies ESR measure
measures the rate at which red blood cells (RBCs) in a test tube separate from blood serum over time
What does A1C stand for
Long term glucose control
What color tube is used for a CBC
Lavender
What color tube is used for an A1C
Lavender
What color tube(s) contain EDTA
Pink, purple, lavender, pearl
What is a pink (red) tube commonly used for
Blood typing
What color tube is commonly used for blood typing
Red
What do you do with the first drop of capillary blood
Wipe it away
What is the anatomical site for a heel puncture
Heel sides
What will cause impaired test results and trauma during a capillary stick
Over milking
Which finger is used for a capillary stick for a child older than 12 months
Ring or middle finger on non-dominant hand
What is the maximum depth for a heel-stick on an infant
2mm
If the patient did not have arms, where could you obtain a capillary sample
Ear
What are the three patient identifiers
First name, last name, last 4 number of SS, DOB
What belongs on a properly labeled specimen
Patient info, date, time of draw, initials
What is the name for a civil wrong, such as bad behavior
Tort
What is the act of intentionally, physically touching someone without permission
Battery
What is HIPAA
Health Insurance Portability and Accountability Act of 1996
What is PHI
Protected health information
What is an assault
Using threating words
What is the term for failing to execute a duty responsibly or safely
Negligence
Who does OSHA protect
Employees
What is an example of invasion of privacy
Looking at medical records without permission, talking about a patient
What are three examples when chain-of-custody is paramount
Blood alcohol level/drug tests, rape tests/sexual assault, paternity
What is the term for the standards that would best be described as quality control, instrument maintenance, and procedure manuals
Quality Assurance (QA)
A phlebotomist's job includes greeting and instructing patients. True or False
True
A phlebotomist's job includes performing QA on laboratory equipment. True or False
True
It is sufficient to explain a procedure to a minor, and not their parent. True or False
False
What cleanser must a phlebotomist use for a BAL test, in order for the test's results to be used as evidence in court
Chlorhexadine Prep
The first urine is used for what two urinalysis tests
Pregnancy, suspected UTI
When taking a urine sample out of the refrigerator, how long does it need to sit at room temperature before you can test it
1 hour
If looking for either fat or urobilinogen in a stool sample, it needs to be refrigerated for how many hours
72 hours
It is important to correctly perform the order of the draw correctly because an incorrect order of draw can affect the accuracy of the tests. True or False
True
What test needs to be protected from daylight
Bilirubin & folic acid
What is a GTT
Glucose tolerance test (3 hr test in 4 tubes)
How many minutes after the last glucose drink is ingested should a GTT be drawn
30 min
An expired blood tube loses what
Vacuum
Blood smears need what kind of edge
Feathered
How much blood is needed for an infant's blood culture
1 ml
What is the word for a spinning centrifuge
Centripetal
Why must microbiological test be rushed to the lab
Make sure the organisms are alive
What is an ABG
Arterial blood gas
How must an ABG be transported
On ice
What is an example of a special sample test
CSF (Cerebral Spinal Fluid)
What does sodium citrate help to do
Prevent clotting
What is the purpose of serum separator tubes
Separates platelets from the packed red blood cells
What does SST stand for
Serum separator tube
What color tubes contain SST
Red/Tiger Top
What is sodium heparin used for
Ammonium levels
EDTA is a coagulant. True or False
False
What color tube is used for an A1C test
Lavender
Sodium fluoride is found in which tube
Gray
What is sodium fluoride used for
Glucose
What does a PKU test for
Infant test testing for phenylalanine (down's)
What will happen if a patient sample is missing label information or is labeled incorrectly
Rejected
Along with all the patient identifiers, you also need what from the doctor
Resuscitation form
What is the first thing you do with a patient
Introduce yourself
If a STAT call comes over the audio-system for the phlebotomist to do a draw, it should include what information
Location, resuscitation form, patient ID
A red tube is used for STAT electrolytes. True or False
False
How must an ammonia sample be transported
On ice or ice slurry
What chemical additive is in a red tube
Silicone
What chemical additive is in a light blue tube
Sodium citrate (light blue used for PT/PTT and INR)(clot time)
What chemical additive is in a lavender tube
EDTA (ethylenediaminetetraacetic acid) (used for HA1C, ESR, CBC, CBC w/ Diff, Smears)
What chemical additive is in a green tube
Sodium Heparin (can also have Lithium Heparin) (Used for Cardiac tests - CK and Tropnin; found in light green tubes)
What fluid is extracted during a lumbar puncture
CSF (Cerebral Spinal Fluid)
You put a tourniquet on and notice a red mark, what most likely is it
Hematoma
What can cause petachiae
tourniquet on to long
After anchoring the vein what should you do
Do the procedure
What can happen if you do a blood draw on interrupted (damaged) skin
Increase the risk of infection
If a patient needs a sterile urine, what is important for the patient to know?
Have a sterile genital area
Who tells us how to dispose of needles
NIOSH
If patient has a shunt in one arm and an IV in the other hand, where do you draw
Do a capillary stick
If a name is not located on a requisition from an inpatient patient, what is the next best identifier
MRN (Medical record number)
What is the most important thing to identify prior to obtaining a specimen
Patient ID
What is a critical value after a 2hr post prandial
Greater than 105
If the needle is too small, what is possible complication
Hemolysis
After performing a capillary puncture what should you do next
Dispose of lancet if no wipe blood away
What is ESR testing for
Inflammation
If you have a lt. blue tube and there is liquid inside, what is it
Anticoagulant (if not lt. blue tube then condensation)
Why do we warm a blood draw site
To increase blood flow
Why do we perform quality controls
Promote accurate results
You need to collect a serum tube, what color tube is it
Tiger top or SST tube
What is the order of capillary stick
Lavender, gray, red
If someone is allergic to alcohol wipes what should you use
chlorhexidine
For the YELLOW tube what is the test typically run, anticoagulant & lab section it is sent to
Test: blood cultures (aerobic & anaerobic)
Anticoagulant: SPS
Lab Section: Microbiology
For the LIGHT BLUE tube what is the test typically run, anticoagulant & lab section it is sent to
Test: coagulation studies (PK, PKK, INR)
Anticoagulant: Sodium citrate
Lab Section: serology
For the RED tube what is the test typically run, anticoagulant & lab section it is sent to
Test: blood typing/tissue
Anticoagulant: none
Lab Section: blood bank
For the TIGER TOP/GOLD tube what is the test typically run, anticoagulant & lab section it is sent to
Test: routine chemistry/electrolytes
Anticoagulant: SST
Lab Section: chemistry
For the DARK GREEN tube what is the test typically run, anticoagulant & lab section it is sent to
Test: stat chemistry
chemistry/electrolytes
Anticoagulant: sodium heparin
Lab Section: chemistry
For the LIGHT GREEN tube what is the test typically run, anticoagulant & lab section it is sent to
Test: cardiac (CK, troponin)
Anticoagulant: lithium heparin
Lab Section: chemistry
For the LAVENDAR/PINK/PEARL/PURPLE tube what is the test typically run, anticoagulant & lab section it is sent to
Test: CBC, ESR, HA1C
Anticoagulant: EDTA
Lab Section: hematology
For the GREY tube what is the test typically run, anticoagulant & lab section it is sent to
Test: Glucose GTT or BAL
Anticoagulant: Sodium fluoride (GTT) or Potassium Oxalate (BAL)
Lab Section: chemistry
For the ROYAL BLUE tube what is the test typically run, anticoagulant & lab section it is sent to
Test: Toxicology levels or nutritional studies
Anticoagulant: K2ETALab Section: Toxicology