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55 Cards in this Set
- Front
- Back
Venipuncture is the term used to describe?
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the process of collecting or drawing blood from a vein
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blood collection procedures legally begin with
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the test request
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test requisition
definition? why specific info required? |
form on which orders are entered(part of PTs medical record)
-ensure: -right PT is tested -physician's orders are met -correct tests are performed at proper time under the required conditions - Pt is billed properly |
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manual requisitions
what are 3 parts used for? |
diff styles and types
3 parts are used for request, report, and billing |
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Computer requisitions
what prints with? what special info on it? |
normally contain the actual labels that are placed on the specimen tubes
in addition to patient ID and test status info many indicate the type of tube needed special instructions (ie.. potential bleeder) |
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when a computer generated label is used the phlebotomist is generally required to
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write the time of collection and initials on the lable after collecting the specimen
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bar code requisition
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manual requisition may contain a bar code that can be peeled off and placed on the specimens
computer requisitions typically have the bar code printed on each label can be scanned into a computer allow fast, accurate processing and have been shown to decrease laboratory errors associated with clerical mistakes |
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who is it up to to make certain the required info is on the requisition
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personnel of the blood collection site
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review the requisition
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-check to see that all required info is present and complete
-verify the tests to be collected and time and date of collection -identify diet restrictions or other special circumstances that must be met prior to collection - determine test status or collection priority |
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definition of accesssion
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is to record in the order received
to accession a specimen means to take steps to unmistakably connect the specimen and the accompanying paper work to a specific individual |
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where do you find signs containing info concerning PT
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wall beside or behind PT's head
on door |
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DNR and DNAR and AND
what do they mean |
do not resuscitate
do not attempt resusciatation Allow natural death |
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if a physician or member of clergy is in the room?
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do not interrupt
if STAT or timed excuse yourself, explain why there and ask permission to proceed |
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if a visitor or family is in room?
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Ask them to step out
some will insist, okay to let stay |
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Unavailable patien
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unable to obtain specimen..fill out form..one to nursing station other to lab
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Identify yourself?
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state your nam, title, why there
tell pt your a student PT has the right to refuse to have blood draw by student or anyone else |
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bedside manner?
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behavior of healthcare worker toward, or as perceived by, a PT
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most important step in specimen collection?
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verify PT's identity
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How to verify identity?
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ask pt to state full name and date of birth
check PT Id band or bracelet verify to orders ck against labels |
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ID band has what info
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name
hosp Number (medical record number(MR number) DOB room number bed designation Physicians name |
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what info on ID is allowed to differ
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room#, bed # phys
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What must you do before leaving room
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label tubes
raise bed rails wash hands |
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what is 3-Way ID
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PTs verbal statement
check ID band visual comparison of labeled speciman with PTs ID band |
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sleeping PT, what to do?
Not to do? |
wake gently
don't startle (bright lights) speak softly -never attempt to collect from sleeping PT |
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Unconscious PT
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speak as if alert
identify yourself inform of intent |
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emergency room PT, no ID
what to do? |
special 3 part ID
all 3 contain same number 1. attach to PT 2. attach to specimen 3. attach to blood unit (if needed for transfusion) |
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handling PT inquiries
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direct to Phys
NEVE attempt to expalin purpose of test best to allow DR or Nurse explain |
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PT objections?
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does have the right to refuse..let Nurse/dr know
fill out form stating why unable to collect |
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addressing needle phobia
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intense fear of needles
Pt can experience "shock" type symptoms(pallor, profuse sweating, lightheadedness, nausa,fainting....severe..arrhythmia/cardiac arrest) Never allow a PT to be standing apply ice pack 10 to 15 min to numb before venipuncture only most experienced should do it |
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objects in PTs mouth
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do not allow anything in PTs mouth
(eat, drink, chew, thermometer, toothpick, other foreign objects) |
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Diet restrictions
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verify that fasting instructions have been followed
if not PHYS or Nurse notified if decision made to go ahead..must mark "nonfasting" on specimen label |
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tourniquet application
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3-4 inches above site(too close may collapse vein)
restrict venous flow(allow arterial flow) makes veins more prominent walls thinner |
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what levels do fist pumping affect?
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potassium & ionized calcium
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most prominent veins in H pattern?
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median cubital, cephalic, basilic
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most prominent veins in M pattern?
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median, median cephalic, median basilic
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palpate
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examine by touch or feel
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patency
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state of being freely open
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do not select veins that feel?
why? |
hard or cordlike
roll easily hard to penetrate no adequate blood flow |
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concentric circles
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circles with a common center
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how to prevent contamination of site
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DO NOT:
dry alcohol with gauze fan or blow to dry touch site(if you must repalpate site sterilize finger) |
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needle sheath
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cap or cover
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anchor the vein
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secure firmly (helps prevent rolling)
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degree angle needed to insert needle in cubital area?
in hand? how to choose angle? |
15-30
10-15 shallow vein closer to 15 and deeper vein closer to 30 |
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what samples require cooling before transport(crushed ice)
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ammonia
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what samples require transport at body temp?
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cold agglutinin
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what samples require protection from light
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bilirubin
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how many tries before get someone else?
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2X only
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eutectic
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easily melted
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EMLA
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eutectic mixture of local anesthetic
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baby method of restraint?
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get a nurse to hold a baby
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capillary tubes..blood assumed in them?
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lab will assume capillary ..mark venous because reference ranges are different
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diseases that effect the elderly
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arthritis-osteoarthritis and rheumatoid
coagualtion problems-blood thinners diabetes-circulation and healing parkinsons-affect speach pulmonary-colds and influenxa, more severe , wear a mask |
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blood collection procedures
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know them
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hospice?
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type of care for PTs who are terminally ill
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NPO means
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nothing by mouth
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