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73 Cards in this Set
- Front
- Back
Why do evacuated tubes fill with blood automatically?
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because there is a vacuum (negative pressure)
the amount of vacuum is measured precisely by the manufacturer so that the tube will draw the exact volume of blood indicated on the label. |
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What is Thixotropic Gel and what does it do?
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is an inert (nonreacting) synthetic substance initially contained in or near the bottom of certain blood collection tubes. When a specimen in a gel tube is centrifuged, the gel undergoes a change in thickness and moves to position between the cells and the serum or plasma, forming a physical barrier between them. This physical separation prevents the cells from continuing to metabolize substances such as glucose in the serum or plasma
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What is the primary duty of the phlebotomist?
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is to collect blood specimens for laboratory testing.
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What are the most common volumes of syringes used in phlebotomy?
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2, 5, and 10mL.
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What procedure can and must be done to reduce tourniquet contamination on the part of the phlebotomist?
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Good Hand Hygiene (wash hands before handling the tourniquet)
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How does Heparin prevent clotting? What color is the tube top? How many inversions are needed to mix the specimen after collection?
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By inhibiting thrombin formation. (Thrombin is an enzyme needed to convert fibrinogen into the fibrin necessary for clot formation).
Green tube top 5 to 10 inversions |
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List the needle gauges from the smallest to the largest.
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23 Butterfly
22 Multisample Hypodermic 21 Multisample Hypodermic 20 Multisample Hypodermic 18 Hypodermic 15-17 Special needle attached to collection bag |
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During a Blood Specimen collection when might a bed or padded table be needed
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if the patient has a history of fainting during blood collection or has a fear of needles
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Which additive in tubes has been the source to more carryover problems than any other additive?
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EDTA
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What gauge of butterfly needle is used most commonly for phlebotomy?
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21 guage
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What is a clot activator and what do they do?
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Is a Substance that enhances coagulation in tubes used to collect serum specimens.
they make the blood clot within 15 to 30 mins red plastic tube tops 5 gentle inversions |
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When is phlebotomy carts commonly used?
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Early morning hospital phlebotomy rounds
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What gauge of needle would be used on an elderly patient with thin bad veins?
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23 gauge
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Give 3 examples of a vein-locating device.
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1. Venoscope II
2. Neonatal Transilluminator 3. Accu Vein AV300 |
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What does the CLSI recommend for the proper order of draw?
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1. Sterile tube (blood culture)
2. Blue-top coagulation tube 3. Serum tube with or without clot activator, with or without gel 4. heparin tube with or without gel plasma separator 5. EDTA tube 6 Glycolytic inhibitor tube |
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Sodium fluoride are used to collect __________ Specimens and why is this used to collect this certain kind of specimen?
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blood sugar
it preserves glucose for up to 3 days and also inhibits the growth of bacteria. |
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What does the OSHA acronym SESIP stand for?
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Sharps with Engineered Sharps Injury Protection
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A syringe transfer device allows what?
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allows the safe transfer of blood into the tubes without using the syringe needle or removing the tube stopper.
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How do Oxalates prevent coagulation? Which one is the most widely used? How many inversions are required for proper mixing after specimen collection?
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By precipitating calcium. Potassium oxalate is the most widely used It is commonly added to tubes containing glucose preservatives to provide plasma for glucose testing.
8 to 10 inversions gray plastic stopper |
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What color of tube contains EDTA in a multi specimen draw? What order is it drawn in? How many inversions are normally required for proper mixing after specimen collection?
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Lavender
it is drawn last unless you need to draw a gray tube 8 to 10 inversions |
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What are the clot activators in Serum-Separator tubes (SSTs)? What color are the tube tops? How many inversions are required for complete and rapid clotting to occur?
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Silica particles are the clot activators
Red Plastic tube tops 5 gentle inversions |
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What is a resheating device?
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Shields that cover needle after use; blunting devices; and equipment with devices that retract the needle after use.
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What must be done if the first butterfly tube contains an additive on a draw? What is this referred to as?
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collect a few mL in a nonadditive tube or another additive tube of the same type and discard it prior to collecting the first tube. to clear the air out of the line.
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State the memory jogger for the order of draw.
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Stop, light, Red, Stay, Put, Green, Light, Go
(sterile) (Lt. blue) (red) (SST) (PST) (Green) (Lavender) Gray) |
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Name the slanted tip of the needle that pierces the vein easily?
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Bevel
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What is used? Then folded in what to hold pressure over a site following blood collection procedures?
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clean 2x2 gauze pads folded in fourths
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By what 2 methods is clotting prevented?
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by chelating (binding) or precipitating calcium so it is unavailable to the coagulation process
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What factors determine the needle gauge to be used for venipunctures?
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the size and condition of the patients vein
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Define an antiglycolytic. What is the most common antiglycolytic agent? What color is the tube top? How many inversions is needed for proper mixing after a specimen is collected?
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: A substance that prevents glycolysis, the breakdown or metabolism of glucose (blood sugar) by blood cells—e.g., sodium fluoride.
gray stopper between 5 and 10 inversions |
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When using the antiseptic povidone iodine for blood culture collection what information about the patient and patient's history should be obtained from the patient before cleansing the site?
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Make sure they are not allergic to it
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What length of needle is most commonly used for venipuncture?
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1 to 1.5
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Who regulates glove quality? what are their initials?
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Food and Drug Administration (FDA)
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A _________ is a device that is applied or tied around a patients arm prior to venipuncture to restrict blood flow.
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Tourniquet
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List the 4 most common types of anticoagulants.
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Oxalates
Acid Citrate Dextrose Citrate Phosphate Dextrose Sodium Polyanethol Sulfonate |
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It is always important to fill tubes until what happens?
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the amount of vacuum is used up for evacuated tubes
or if not evacuated tube make sure you draw exactly the right amount of blood to compensate for additive or for the test being done |
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What are the reasons nonaddictive tubes are used?
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for clearing and discarding purposes only
nonadditive tubes yield serum samples |
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List 4 parts of a needle.
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bevel, shaft, hub, lumen
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What EPA registered disinfectant is preferred?
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sodium hypochlorite (house hold bleach)
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List the 3 things that a typical blood drawing station includes.
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a table for supplies, a special chair where the patient sits during the blood collection procedure, and a bed or reclining chair for patients with a history of fainting.
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When using the syringe method for collecting a specimen what must be done immediately after blood is collected?
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resheath it and dispose of it in a sharps container
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What antiseptic is most commonly used for routine blood collection?
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alcohol
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What type of container should needles, lancets and other sharp objects be disposed in?
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Sharps container
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What do royal-blue stoppers on specimen tubes indicate?
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indicates a tube that is as free of trace element contamination as possible
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List the 2 parts of a syringe.
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barrel and plunger
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What type of tourniquet can be used more than once, but must be discarded if dropped or contaminated with blood or other visible contaminants.
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Strap touniquet
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An under filled tube is called a __________ __________.
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Short Draw
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List 3 forms that additives are available in.
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Liquid, powder, or spray-dried coating
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How does Citrates prevent coagulation? What color are the tube tops? What test are they used for? How many inversions are required for adequate mixing after collecting a specimen?
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it prevents coagulation by binding or chelating calcium.
sodium citrate, which is used for coagulation tests (PT and aPTT) because it does the best job of preserving the coagulation factors light blue stoppers 3 to 4 gentle inversions |
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When must lithium heparin not be used, and when should sodium heparin not be used?
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lithium heparin must not be used to collect lithium levels. Sodium heparin must not be used to collect sodium specimens or electrolyte panels because sodium is part of the panel.
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What gauges and lengths of syringe needles is appropriate for phlebotomy procedures?
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20 to 23 gauge 21 is the most common
1 to 1.5 lengths |
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What substances are used to prevent sepsis and inhibits growth and development of microorganisms, but does necessarily kill them?
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Antiseptics
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The gauge of a needle is related to the ___________ of the lumen.
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diameter
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What type of bandage should not be used on babies younger than 2 years of age because of the danger of aspiration and suffocation.
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No bandage should be used!
hold pressure on wound until it stops bleeding |
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What chemical substances or solutions regulated by the EPA that are used to remove or kill microorganisms on surfaces and instruments.
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sodium hypochlorite (bleach) products are preferred
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What factors are considered when using syringes to obtain a blood specimen.
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if the patient has small or difficult veins
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What elements are in EDTA which prevents coagulation by binding or chelating to what other element?
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Calcium
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The Most common and efficient system for collecting blood that the CLSI prefers is? list name and initials.
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evacuated tube system (ETS)
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Define hemolysis.
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The destruction of red blood cells which leads to the release of hemoglobin from within the red blood cells into the blood plasma
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Define anticoagulants.
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A substance that prevents blood from clotting.
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List the types of phlebotomy needles.
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Multisample needles
hypodermic needle butterfly needle |
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Where are phlebotomy carts parked at on morning draw?
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Outside in the Hallway.
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List 2 things that need to be inspected before using a needle for venipuncture.
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defects such as blocked , blunt or bent tips
rough bevels or shafts |
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Define carryover or cross-contamination and how does it occur?
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transfer of additive from one tube to the next.
Blood remaining on or within the needle can be transferred to the next tube drawn or filled Contaminating that tube with additive from the previous tube and possible affecting test results on the specimen |
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what gauge of needle is considered the standard for most routine antecubital venipunctures?
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21 gauge
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Whole blood or plasma must be collected in a tube that contains a/an _____________
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Anticoagulant
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List the three heparin formulations.
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ammonium, lithium, and sodium heparin.
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What type of gloves are acceptable for most phlebotomy procedures?
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Nonsterile, disposable latex, nitrile, neoprene, polyethylene, and vinyl
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List the basic components of and ETS.
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Multisample needle, Tube holder, Evacuated tube
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Blood is collected by several methods list 3.
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arterial puncture, capillary puncture, and venipuncture
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What is the most common reason for using an additive?
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preventing clotting or preserving certain blood components. Blood in additive tubes may or may not clot depending on the additive type
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why are ETS tubes called multisample needles?
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because they allow multiple tubes of blood to be collected during a single venipuncture
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Define a winged infusion blood collection set or butterfly.
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an indispensable tool for collecting blood from small or difficult veins such as hand veins and veins of elderly and pediatric patients as it allows much more flexibility and precision than a needle and syringe
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Define additive and list 2 functions of an additive.
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: A substance (other than the tube stopper or coating) such as an anticoagulant, antiglycolytic agent, separator gel, preservative, or clot activator placed within a tube or collection container. An additive can be a liquid, powder, or spray-dried coating.
it can prevent clotting or help with clotting |