PHLEBOTOMY NATIONAL EXAM (NHA) Questions and Answers

PHLEBOTOMY NATIONAL EXAM (NHA) Questions and Answers Characteristics imperative to a phlebotomist Dependability, honesty, integrity, empathy and compassion, professional appearance, interpersonal skills Circulatory system function deliver oxygen, nutrients, hormones, & enzymes to cells and transport cellular waste (CO2) to organs where they can be expelled The two circulations Pulmonary & Systemic Pulmonary circulation carries deoxygenated blood from the right ventricle to the lungs and returns oxygenated blood from lungs to left atrium Where does oxygenation take place in the lungs? alveoli Systemic circulation carries oxygenated blood from left ventricle throughout the body Upper chambers of the heart right and left atria lower chambers of the heart right and left ventricle tricuspid valve atrioventricular valve, situated between right atrium and right ventricle **to remember this valve is on the right side of the heart-- people TRY to be RIGHT pulmonic valve semi-lunar valve situated between the right ventricle and the pulmonary artery Mitral valve (or bicuspid) atrioventricular valve located between the left atrium and left ventricle aortic valve semi lunar valve situated between the left ventricle and aorta Flow of blood through the heart Superior and Inferior Vena Cavae Right atrium tricuspid valve right ventricle pulmonic valve pulmonary artery lungs pulmonary vein left atrium mitral (bicuspid) valve left ventricle aorta rest of body Three layers of the heart Endocardium, myocardium, epicardium Blood vessels arteries, arterioles, capillaries, venules, veins, superior & inferior vena cavae aorta, arteries, and arterioles carry_____ blood _______ the heart oxygenated & away from venules, veins, and superior and inferior vena cave carry _____ blood ________ the heart deoxygenated & back to The average adult has ______ liters of blood 5-6 Plasma comprises how much of circulating blood? 55% Plasma contains.... proteins, amino acids, gases, electrolytes, sugars, hormones, minerals, vitamins, and water What percent of plasma is water? 92% Formed elements comprise what percent of circulating blood? 45% another name for red blood cells... Erythrocytes What makes up the formed elements? Red blood cells, White blood cells, and platelets Another name for white blood cells... leukocytes another name for platelets... thrombocytes What comprises 99% of the formed elements? red blood cells (erythrocytes) Where do blood cells originate? stem cells in bone marrow How many RBCs are in a microliter of blood? 4.2 to 6.2 million Normal life span of an RBS is... 120 days Function of a leukocyte provide the body protection against infection Amount of WBCs per microliter of blood 5,000-10,000 leukocytosis increase in WBCs leukocytosis is seen when? cases of infection and leukemia leukopenia decrease in WBCs leukopenia is seen when? viral infections or chemotherapy Five types of WBCs neutrophils, lymphocytes, monocytes, eosinophils, basophils Average number of platelets per microliter of blood 140,000-440,000 Hemostasis process by which blood vessels are repaired after injury Stage 1 of Hemostasis Vascular phase Vascular phase blood vessel constricts slowing blood flow Stage 2 of Hemostasis platelet phase Platelet phase platelets adhere to inner lining of vessel to form a platelet plug Stage 3 of Hemostasis Coagulation phase Coagulation phase converts platelet plug to a stable fibrin clot Stage 4 of Hemostasis Fibrinolysis Fibrinolysis breakdown and removal of the clot Preferred site for venipuncture antecubital fossa Three major veins located in antecubital fossa Median cubital vein, cephalic vein, basilic vein The vein of choice because it is large and doesn't tend to move Median cubital vein What vein would you use in an obese patient when the median cubital vein cannot be found? cephalic vein What side of the arm is the cephalic vein located? thumb side What side of the arm is the basilic vein located? inner side unsuitable veins for venipuncture... sclerosed, thrombotic, and tortuous veins sclerosed veins hard and cordlike tortuous veins winding/crooked. susceptible to infection Do you draw above or below an IV? below How long should the IV be shut off before you can perform a venipuncture? 2 minutes Is a phlebotomist allowed to shut off/turn on and IV? NOOOO Complications associated with phlebotomy Hematoma, hemoconcentration, phlebitis, petechiae, thrombus, thrombophlebitis, septicemia, trauma Most common complication of phlebotomy procedure hematoma What is a hematoma? blood accumulated in the tissue surrounding a vein two most common causes of a hematoma... 1. needle going through the vein 2. failure to apply enough pressure on site after need removal What is hemoconcentration? INCREASE in proportion of formed elements to plasma What is the cause of hemoconcentration? tourniquet being left on too long What is petechiae? tine NON-RAISED red spots that appear on skin due to ruptured capillaries What is the cause of petechiae? prolonged use of tourniquet What is a thrombus? blood clot What is thrombophlebitis? inflammation of a vein with formation of a clot septicemia is... systemic infection associated with the presence of pathogenic organisms Trauma in reference to venipuncture is... an injury to an underlying tissue cause by probing of the needle Factors to consider prior to performing venipuncture fasting, edema, and a fistula Quality assurance is... a program that guarantees quality patient care by tracking the outcomes through scheduled audits in which areas of the hospital look at the appropriateness, applicability, and timeliness of patient care Where should the tourniquet be applied? 3-4 inches above site What motion do you use when cleansing the site? circular Which way does the bevel face? UPWARD What angle should the needle be inserted at? 15-30 degrees How long are you allowed to leave the tourniquet on? one minute What might happen if you leave the tourniquet on for more than one minute? hemoconcentration, petechiae, and a thrombus What should be written on the collected specimen labels? patients name and ID number, the time and date, and YOUR initials Should you label the tubes before or after you dismiss the patient? BEFORE! Basal state fasted and refrained from strenuous exercise for 12 hours prior to draw Two-Hour Postprandial Test used to evaluate diabetes mellitus. Fasting glucose level is compared with the levels 2 hours after eating a full meal Oral Glucose Tolerance Test (OGTT) used to diagnose diabetes mellitus and evaluate patients with frequent low blood sugar hyperglycemia is... abnormally high blood sugar level hypoglycemia is... abnormally low blood sugar level Therapeutic Drug Monitoring used to monitor blood levels of certain medication to ensure patient safety & maintain a plasma level Blood Cultures (BC) ordered to detect presence of microorganisms in blood FUO means... fever of unknown origin PKU ordered for infants to detect phenylketonuria Cold Agglutinins are... antibodies produced in response to infection Cold Agglutinins should be kept warm or cold? warm What color tube is blood for cold agglutinins collected in? red-topped Tests that require chilled specimens... arterial blood gases, ammonia, lactic acid, pyruvate, ACTH, gastrin, and parathyroid hormone