- Shuffle
Toggle OnToggle Off
- Alphabetize
Toggle OnToggle Off
- Front First
Toggle OnToggle Off
- Both Sides
Toggle OnToggle Off
Front
How to study your flashcards.
Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key
Up/Down arrow keys: Flip the card between the front and back.down keyup key
H key: Show hint (3rd side).h key
PLAY BUTTON
PLAY BUTTON
178 Cards in this Set
- Front
- Back
|
Branches of support personnel in the hospital organizational system
|
1. Fiscal
2. Support 3. Nursing 4. Professional services |
|
2 areas of laboratory:
Identify which area the phlebotomist works in |
1. Anatomic
2. Clinical *Works in the clinical area |
|
The specialty of the physician who oversees the lab
|
Pathologist
|
|
2 common lab tests performed in the coagulation department and which therapy does each test monitor
|
1. PT- Coumadin therapy
2. INR- Coumadin therapy 3. APTT - Heparin therapy |
|
The test that the immunology department forms
|
tests to monitor the immune response through the direction of antibodies
|
|
Characterized by genetic and biochemical techniques used to diagnose genetic disorders, analyze forensic evidence, and track disease
|
Molecular Diagnostics
|
|
5 liver function tests:
|
1. ALT
2. AST 3. GGT 4. ALP 5. Enzymes 6. Bilirubin |
|
What is the importance of CLIA '88
|
Mandates that facilities that perform pt testing meet performance standards to ensure the quality of procedures
|
|
What is CLIA '88?
|
Clinical Laboratory Improvement Act of 1988
|
|
2 organizations that accredit clinical labs?
|
1. Joint Commission (TJC)
2. College of American Pathologists |
|
Joint Commission Fun Facts!
|
-every 2 yrs
-pt safety goals -Medicare/ Medicaid reimbursement |
|
Organizations that set lab standards or guidelines
|
Clinical Laboratory Standards Institute (*old name: NCCLS)
|
|
4 healthcare settings other than the hospital in which a phlebotomist may be employed
|
1. HMOs
2. PPOs 3. POLs 4. Nursing Homes 5. Urgent Care 6. References Labs |
|
Name the lab that has a special specimen or pt identification system. What might be the outcome of mislabeling and mishandling specimens w/in this lab?
|
The blood bank or immunohematology.
*May result in pt's death. |
|
Define professional services and provide 2 examples of them:
|
Services that are provided at the request of the physician to aid in the diagnosis and treatment of the pt.
*ie: physical, occupational, or respiratory therapy |
|
Fiscal services is responsible for:
|
Admitting medical records and billing
|
|
In addition to the laboratory the following department may draw arterial blood gases:
|
Respiratory Therapy
|
|
The following department use radioisotopes:
|
Nuclear Medicine
|
|
The clinical lab is under the direction of a:
|
Pathologist
|
|
A sample of blood from a pt with HIV is likely to be analyzed using:
|
A flow cytometer
|
|
A CBC is performed in the __________ department:
|
Hematology department
|
|
APPTT testing monitors ________:
|
Heperin therapy
|
|
The type of chemistry test associated with drug analysis is known as:
|
toxicology
|
|
A C&S test is analyzed in the _____ department.
|
Microbiology
|
|
Occult blood testing is performed on:
|
feces
|
|
When pts donate their blood for use during their own surgery:
|
autologous donation
|
|
Independent labs that analyze samples from other healthcare facilities are known as:
|
reference labs
|
|
Ch.3:
Name 6 types of safety hazards in the workplace with an example |
1.Biological- bacteria viruses
2. Sharps- needles, lancets, broken glass 3. Electrical- high voltage equipment 4. Chemical- lab reagents and preservatives 5. Latex Sensitivity- gloves 6. Physical- wet floors, lifting heavy objects 7. Fire & Explosives- O2 & chemicals 8. Radioactive, X-Ray- equipment & reagents |
|
List 5 safety precautions that can reduce the risk of injury in the workplace:
|
1. Wearing PPEs
2. Never storing food w/ biohazard substances 3. Protecting feet from spills, slips, and falling 4. Avoiding putting things in ur mouth in the work area 5. Avoid eye to hand contact in the work area 6. Not wearing loose clothing, hair, jewelry that can be contaminated or caught in equipment |
|
What should you never do after performing a venipuncture bcuz needlesticks are a major risk:
|
Never recap the needle after collection
|
|
List the 4 identifying features that all hazardous material labels must display:
|
1. Warning to alert the hazard
2. Explanation of the hazard 3. List of precautions to reduce risk 4. First Aid measures to take incase of exposure |
|
A hazardous material has an _______ to provide personnel with information on the chemical, its hazards, the procedure for its clean up, and first aid incase of exposure
|
MSDS
|
|
What does MSDS stand for?
|
Material Safety Data Sheet
|
|
What is the purpose of a chemical hygiene plan?
|
It describes all safety procedures, special precautions, and emergency procedures when working with chemicals
|
|
In the event on chemical spills on your arm, what steps should be taken?
|
Proceed to the safety shower, flush the area for 15 minutes, and go to the emergency room for treatment
|
|
Describe the steps to the emergency response to electric shock:
|
1. Turn off the equipment/ break contact btwn the equipment & victim using a nonconductive material
2. Do not touch victim until risk of shock is further removed 3. Call 911 4. Start CPR if indicated, and keep the victim warm |
|
Name the organization that regulates workplace safety and define its purpose:
|
OSHA regulates all work environments to prevent accidents. It provides guidelines for accident prevention
|
|
What does OSHA stand for?
|
Occupational Safety & Health Administration
|
|
Explain the process that should be followed in controlling a bleeding emergency:
|
To control a bleeding emergency you must apply pressure to the area or wound, elevate limb (unless fractured) and maintain pressure until medical help arrives.
|
|
List the signs of shock and the steps to take to prevent further complications:
|
Early signs of shock include: pale, cold, clammy skin, tachycardia (rapid pulse), shallow breathing, weakness, and nausea or vomiting or both. Incase of shock: keep the victim warm, and laying down, with the airway open, and call for professional assistance
|
|
When mixing acids and water, you should:
|
Add acid to water.
*Reversing this order an be dangerous |
|
NFPA label does not include which:
|
Protective Equipment
|
|
First thing you do when giving breathing aid to a victim is:
|
determine whether the victim is conscious
|
|
Safety equipment in the lab may include:
|
PPEs, Emergency Shower, Eyewash Station
|
|
The yellow diamond in the NFPA label indicates:
*Blue: *Red: *White: Text book page 26 - look over pictures/ symbols |
Reactivity Warning
*Health Hazards *Flamability *Other |
|
Ch.4:
Define INFECTION |
The invasion and growth of disease-causing microorganisms in the human body
|
|
Name 4 classes of pathogens:
|
1. Viruses
2. Bacteria 3. Fungi 4. Protists |
|
What are the healthcare associated infections and how are they typically caused:
|
Contracted by a pt during a hospital stay due to direct contact with other pt's, or by failure of personnel to follow infection control protocols.
|
|
What 5 main elements make up the chain of infection:
|
Reservoir Host, Portal of Exit, Method of Transmission, Portal of Entry, Susceptible Host
|
|
List 3 ways in which u can break the chain of infection:
|
Preventing transmission by:
hand-washing, using PPEs, isolating pt's at risk of spreading or contracting infections, & using standard precautions |
|
Difference btwn. direct and indirect contact:
|
Direct: transfer of microorganisms from an infected person to susceptible host by body contact
Indirect: contact btwn. a susceptible host & a contaminated object |
|
Most important & effective way of preventing the spread of infection:
|
handwashing
|
|
Some examples of PPE items:
|
Fluid-resistant gowns, masks, respirators, face shields, gloves, shoe covers
|
|
Explain what standard precautions are and why are they used:
|
An infection-controlled method that uses barrier protection and work control practices to prevent direct skin contact w/ biohazardous materials
|
|
Name 3 BBPs:
|
1. HIV
2. Hep A-E 3. Syphilis 4. Malaria 5. |
|
What does BBP stand for:
|
Bloodborne pathogens
|
|
Hep B may be stable in dry blood for at least ____ days.
|
7
|
|
Bleach should be in contact with contaminated area for _________ minutes for complete disinfection.
|
20
|
|
Which of the following would not be considered a pathogen?
A. Bacteria B. Viruses C. Fungi D. Vectors |
D. Vectors
|
|
Varicella-zoster is the cause of _________.
|
Chicken-pox
|
|
HIV is the causative agent of _______.
|
AIDS
|
|
Vectors include:
|
Insects
|
|
Some types of E.Coli are normal flora of the _________.
|
colon
|
|
In putting on PPEs the first article that is put on is the:
|
Pair of gloves
|
|
Which of the following is not an OSHA standard:
A. All biohazard material must be labeled B. Employees must practice standard precautions C. Employers must have written airborne pathogen exposure control plans in the workplace D. Employers must provide immunization of Hep B Virus free of charge |
C. Employers must have a written airborne pathogen exposure control plan in the workplace.
|
|
10% bleach used as a cleaning agent should be made fresh how often?
|
Every day.
|
|
The purpose of a PE (protective environment) for highly immunosuppressed pt's is to _________.
|
Prevent transmission of infection to the patient.
|
|
Ch. 8:
A _________ prevents venous flow out of the arm. |
tourniquet
|
|
What does the gauge of the needle indicate?
|
Indicates the diameter or the needle's lumen.
|
|
Describe the consequences of using a needle with a large gauge number:
|
Collection is slower and blood cells may be hemolyzed (destroyed) as they past thru the narrow opening.
|
|
What is the purpose of the rubber sleeve on the multi-sample needle?
|
Keeps the needle from becoming contaminated or injuring you or the patient and keeps blood from leaking onto or into the adapter or tube holder, especially when changing tubes.
|
|
Advantages and disadvantages of syringe-method of drawing blood vs. the evacuated tube system (ETS- what we used) :
|
Advantage: blood appears in the hub when the vein has been entered.
Disadvantage: potential for needle stick when depositing blood into the collection tube |
|
What does it mean when blood tubes are evacuated?
|
A vacuum is created w/in the tube so that a measured amount of blood will flow in easily.
|
|
Why must unused blood tubes be discarded when expired?
|
Out-of-date tubes may have decreased vacuum preventing a proper fill, or additives have degraded overtime.
|
|
What is a SPS?
|
Anticoagulant additive
|
|
What must be done immediately after collecting a specimen in a tube w/ an anticoagulant?
|
Must be mixed thoroughly after collection by gently, repeatedly inverting tube (4-8)
|
|
Cellular reaction used to harvest energy from glucose
|
Glycolysis
|
|
3 types of blood specimens used for analysis:
|
1. Whole blood
2. Serum 3. Plasma |
|
Red:
|
Blood bank
*(only tube with NO additives) |
|
Light blue:
|
coagulation
|
|
Lavender:
(EDTA) |
CBC
|
|
Gray:
|
glucose tolerance test
|
|
Gold, Marble, Tiger:
|
Chemistry and serum separators
|
|
Green:
|
ABGs, Heperin
|
|
Yellow:
|
Sterile
|
|
List the Order of color top tube draws (using ETS):
|
1. Yellow
2. Lt. Blue 3. Red 4. Gold 5. Green 6. Lavender 7. Gray |
|
Which of the following is not an anticoagulant:
A. polymer gel B. sodium heparin C. sodium citrate D. EDTA |
A. polymer gel
|
|
Most common antiseptic used in routine venipuncture:
|
Isopropyl alcohol
|
|
How many times may a needle be used before discarding it:
|
ONE!!!
|
|
The ________ the gauge number, the smaller the lumen.
|
larger
|
|
Complete clotting of a blood sample in a SST (gold or red/gray) tube takes _________ minutes at room temperature.
|
30
|
|
What is a SST?
|
Serum separator tube
|
|
EDTA prevents coagulation by:
|
binding calcium.
|
|
Green tube tops may contain:
|
sodium heparin
|
|
Why is the syringe method of draw useful?
|
Allows for control of blood flow and shoes appearance of blood at the hub.
*better for small, fragile veins |
|
The additive sodium citrate is used in blood collections for what test:
|
Prothrombin Time (Pro Time)
|
|
Why is the syringe method of draw useful?
|
Allows for control of blood flow and shoes appearance of blood at the hub.
*better for small, fragile veins |
|
The additive sodium citrate is used in blood collections for what test:
|
Prothrombin Time (Pro Time)
|
|
List the Order of color top tube draws (using ETS):
|
1. Yellow
2. Lt. Blue 3. Red 4. Gold 5. Green 6. Lavender 7. Gray |
|
Which of the following is not an anticoagulant:
A. polymer gel B. sodium heparin C. sodium citrate D. EDTA |
A. polymer gel
|
|
Most common antiseptic used in routine venipuncture:
|
Isopropyl alcohol
|
|
How many times may a needle be used before discarding it:
|
ONE!!!
|
|
The ________ the gauge number, the smaller the lumen.
|
larger
|
|
Complete clotting of a blood sample in a SST (gold or red/gray) tube takes _________ minutes at room temperature.
|
30
|
|
What is a SST?
|
Serum separator tube
|
|
EDTA prevents coagulation by:
|
binding calcium.
|
|
Green tube tops may contain:
|
sodium heparin
|
|
Most common gauge used for routine venipuncture is:
|
21 gauge
|
|
Blood banks use a ______ gauge needle to collect blood from donors for transfusion.
|
16-18 gauge
|
|
Blood collection tubes containing an anticoagulant should be :
|
inverted gently repeatedly after blood collection
|
|
Tubes containing the SPS anticoagulant are used for:
|
Blood culture analysis
|
|
FBS (fasting blood sugar) is collected in a _________ top tube.
|
gray
|
|
CH. 9:
Most important aspect of any phlebotomy procedure? |
Correctly and positively identify the pt
|
|
Describe how to properly identify a pt:
|
Inpatients: compare info on requisition against pt's identification band
Outpatients: Information provided by pt (1st, Last name, spelling, DOB) |
|
List the steps you should perform when requisitions are received:
|
Examine them for necessary information, check for duplicates or errors, group together for same pt, prioritize them, & gather all necessary equipment for collections
|
|
What is the name for the increase in the ratio of formed elements to plasma caused by leaving the tourniquet on too long.
|
Hemoconcentration
|
|
3 veins in the antecubital area suitable for venipuncture:
|
1. Median
2. Cephalic 3. Basilic |
|
Why is the median cubital vein the first choice for draw?
|
Large and well-anchored and does not move when needle's inserted
|
|
How do veins, arteries, and tendons feel when palpating them:
|
Veins- spongey, bouncey, firm
Arteries- pulsate Tendons- rugged |
|
Techniques for locating the vein:
|
Tap the arm, have pt make fist, warm site w/ warm towel or hot pack
|
|
Reddened, swollen area in which blood collects under skin
*(can form when extra pressure from tourniquet forces blood out thru puncture) |
Hematoma
|
|
Correct position of pt's arm after w/drawing the venipuncture needle:
|
straight, or slightly bent.... but not bent back over the puncture site
|
|
Correct procedure for labeling blood tubes:
|
At bedside w/ pen or perm. marker:
-pts name -id number -date & time -collector's initials/ id number -Dr's name |
|
Phlebotomist must look for what info on the requisition slip?
|
Patient's ID or chart #, last and first names, DOB, physicians name, and tests ordered
|
|
Which vein is often the only vein that can be palpated in obese pts?
|
Cephalic
|
|
Upon entering a pt's room you should first:
|
Identify yourself
|
|
Which veins lies closest to the brachial artery:
|
Basilic
|
|
What angle should venipuncture needle puncture the skin :
|
15-30 degrees
|
|
Tourniquet should be placed _________ inches above the venipuncture site:
|
3-4
|
|
What can occur if the tourniquet is left in too long:
|
Hemoconcentration
|
|
Removing the tourniquet AFTER removing the needle can cause:
|
Hematoma
|
|
Increase in ratio of formed elements to plasma is called:
|
Hemoconcentration
|
|
Small red spots on the skin are referred to as:
|
Petechaie
|
|
List as many blood thinners as possible:
|
*aspirin
*advil *ibuprofen *tylenol *NSAIDS *heparin |
|
Whats the longest amount of time a tourniquet can be kept on during a venipuncture procedure?
|
No longer than 1 minute
|
|
CH.7
Veins carry blood _________. Arteries carry blood ________. |
*toward the heart
*away from the heart |
|
contraction of heart is:
relaxation of heart is: |
systole
diastole |
|
List systemic circulation order beginning with blood flow away from the heart:
|
Arteries
Arterioles Capillaries Venules Veins |
|
Yellow liquid portion of whole blood, contains fibrinogen:
|
plasma
|
|
Formed elements constitute _____% of blood volume
|
45%
|
|
What is serum?
|
Plasma without clotting factors
|
|
RBC's make up ___% of the formed elements in the blood
|
99%?
|
|
WBCs and platelets make up __% of the formed elements of blood
|
1%
|
|
A mature red blood cell:
|
erythrocyte
|
|
Another name for WBC's
|
Leukocytes
*fight off infection |
|
Platelets are also known as:
(side note- platelets are not an actual "cell") |
thrombocytes (critical for coagulation)
|
|
Phagoctye's role?
|
attack and digest bacteria
|
|
In the circulatory system, gas exchange occurs in the ________.
|
capillaries
|
|
Circulatory system: circulation occurs in two large loops: _______ & _________
|
Pulmonary circulation
Systemic circulation |
|
Which blood vessels are a single cell in thickness?
|
capillaries
|
|
An average adult has ____L of blood.
|
5-6L
|
|
Plasma constitutes ___% of total blood volume:
|
55%
|
|
Plasma samples are collected in tubes containing _______, and then centrifuged.... the tube is called a _______---.
|
anticoagulant; plasma separator tube
|
|
Plasma samples are used for ____________ tests:
|
STAT chemistry
|
|
True of False?
Serum separator tubes have no additives? |
True.
|
|
Group of inherited disorders marked by increased bleeding times is known as:
|
hemophilias
|
|
Helper T cells are needed to make _______.
|
antibodies
|
|
Tubes with anticoagulant should be inverted ___to___ times immediately after sample draw.
|
5-10 times
|
|
How soon after collection should cells be separated from plasma or serum?
|
No more than 2 hrs should pass btwn collection and separation of cells
|
|
True or False?
It is not necessary that a centrifuge carry a balanced load? |
False. It IS necessary that it be balanced.
|
|
True or False?
Immediate separation of cells from plasma or serum can minimize hemolysis. |
True
|
|
Once a cap is removed from a tube, the pH may _______.
|
increase
|
|
Complete blood clotting may take _____ minutes at room temperature.
|
30-45
|
|
(PAGES 43-45 - small part of ch.4 REQUIRED TO REVIEW)
What is the separation of an infection source from susceptible hosts that breaks the chain of infections? |
Isolation
|
|
An immunocompromised patient may have their own isolation unit, known as a ___________.
|
Protective environment (PE)
(HEPA-filtered air) Side notes: *(Positive air pressure: air flows out, not in) *(Negative air pressure: air flows in, not out. Ie: TB) |
|
Isolation precautions are based on a 2-Tiered system:
Tier 1 involves: Tier 2 involves: |
1: precautions used for ALL pts in hospital, regardless of dx. STANDARD PRECAUTIONS; to prevent transmission of pathogens regardless of a pts dx or infection status
2: EXPANDED PRECAUTIONS: targeted at pts known to be or suspected of being infected with a highly transmissible pathogen. (is:MRSA, or VRE) |
|
Infectious agents carried in the blood, certain body fluids, and unfixed (unpreserved) tissues.
|
BBPs (Bloodborne Pathogens)
|
|
US law mandates neonatal screening for which 2 disease:
|
1. hypothyroidism
2. PKU (phenylketonuria) |
|
PKU samples are done via _______ on _______________________.
|
*capillary stick
*special filter paper (supplied in a kit [provided by the state agency responsible for PKU tests) |
|
Physical changes of the elderly:
|
Less elastic and thinner skin; easier bruising; longer healing times; more fragile, less elastic, & narrower blood vessels; "loose skin"; loss of muscle tissue, allowing veins to move from their usual locations; arteries closer to the surface.
|
|
True or False?
For an elderly patient the tourniquet should be applied at its usual tightness. |
False. It should be applied a little looser.
|
|
What is a VAD?
|
Vascular Access Device. ie: AV shunt
(administer fluids/ meds; monitor BP; draw blood) |
|
What is the name of the substance produced by normal breakdown of RBCs?
|
Bilirubin.
*build up of bilirubin causes jaundice; & can lead to brain damage |
|
True of False?
Newborns have a higher proportion of plasma compared with adults. |
False. Newborns have a higher proportion RBCs than adult, and less plasma/ serum.
|
|
What gauge needle should be used on a child younger than 2 yrs?
|
23 gauge
|
|
Assay (verb)
|
determine the amount or quality of...
|
|
_________ during blood draws are more likely to occur as we grow older.
|
Hematomas
|
|
What is the definition of PHLEBOTOMY?
|
The practice of drawing blood samples for analysis.
|
