Phlebotomy NHA exam with complete solutions

two most common methods for collecting specimens are: - ANSWER-venipuncture- withdrawing from a vein skin puncture- puncturing of the finger Phlebotomy in greek words - ANSWER-Phlebo- veins tomy- cutting Three major reason blood specimens are tested - ANSWER-diagnostic screening test therapeutic monitoring impatient - ANSWER-patient that is placed in the hospital outpatient - ANSWER-patient that is less critical and can be treated with out hospitalization. every team member should... - ANSWER-know basic skills for group process show reliability communicate ones own ideas and feelings participate in decision making manage conflict contribute to problem solving support and encourage other team members Clinical pathology or clinical laboratory - ANSWER-blood and other body fluids tissues are analyzed anatomic pathology - ANSWER-autopsies histologic and cytologic procedures are preformed for tissue and fluid specimens as well as surgical biopsy are analyzed. hematology - ANSWER-studies the formed elements of blood chemistry - ANSWER-testing is done primarily on serum tubes. blood bank - ANSWER-responsible for collections and storing as well as preparing blood for transfusion. blood typing and compatibility is also done here. immunology - ANSWER-these test for the presence of antibodies toxicology - ANSWER-detect drug and alcohol abuse microbiology - ANSWER-identifies pathogenic microorganisms found in blood, urine, sputum, and feces. Verbal communication - ANSWER-show empathy, respect, build trust, show rapport, listen actively, provide feedback. hearing sensory impairment - ANSWER-speak louder without shouting if the patient did not hear. have writing tools available, or sign language. seeing impairment - ANSWER-speak directly to the patient. communicate who you are and what you are doing. non-verbal communication - ANSWER-consists of 80%-90% of communication smiling, eye contact, and face to face. verbal communication - ANSWER-consists of 10%-20% of communication zone of comfort - ANSWER-space in which a person is comfortable intimate, personal, social, public intimate zone of comfort - ANSWER-direct up to 18 inches person zone of comfort - ANSWER-18 inches to 4 feet social zone of comfort - ANSWER-4 feet to 12 feet public zone of comfort - ANSWER-more than 12 feet cultural sensativity - ANSWER-values: accepted prinicples of a group belifs, faith, family bonds, and spirtual orientation. traditions and practices: customs and behaviors. negative body language - ANSWER-wandering eyes nervous behavior breathing pattern crossed arms glancing at the clock chewing gum yawning active listening - ANSWER-get ready pause occasionally verify that you are listening avoid judgment provide feed back notice body launguage maintain eye contact encouragement confiring patient identification - ANSWER-priority in order to reduce and prevent meical errors. patient ID should never be done by room number compare arm band to requisition forms get a verbal conformation patient must have an arm band. Requisition forms - ANSWER-patient ID Gender DOB Name of physician test requested time and date collected source of specimen Barcodes reduce the risk - ANSWER-of transcription error speeds up processing proper labeling - ANSWER-specimens must begin as soon as the specimen is collected. Specimen labels must contain - ANSWER-Patient ID, test requested, type of specimen, smaller transfer labels, blood draw list by floor Medical records contain - ANSWER-personal information person and family medical history ordering documentation consent and release form patient plan of care diagnostic test results medicatioin administration progress notes consultation healthcare team notes discharge plan Laws - ANSWER-societal rules or regulations that are advisable or obligatory to observe ethics - ANSWER-refers to the moral standards of behavior or conduct that govern an individuals actions bioethics - ANSWER-refers to the moral issues or problems that have resulted because of modern medicine, clinical research, and/or technique number one way to prevent infection - ANSWER-hand washing neglligence - ANSWER-a violation of a duty to exersise reasonable skill anad care in preforming a task malpractice - ANSWER-improper or unskillful care of a patient by a member of the health care team or proffessional misconduct or unreasonable lack of skill. Health Insurance Portability and Accountability Act (HIPAA) - ANSWER-law created legal requirements for the protection, security, and appropiate sharing of patients personal health information. informed consent - ANSWER-verbal agreement to habe whatever presedure done to the patient. implied consent - ANSWER-a nonverbal agreement to have what ever procedure done tot the patient. statute of limitation - ANSWER-a law that defines how soon after an injury a plaintiff must file lawsuit or be forever barred from doing so. (2 years) infection - ANSWER-when the body is invaded with pathogens communicable disease - ANSWER-infectious microorganism that is present in the blood or other bodily fluids. Noncicomial infection - ANSWER-infection acquired by a patient after admission into a health care setting. Aseptic techniques for health care workers include - ANSWER-frequent hand washing, PPE, waste management of contaminated materials, prper cleaning solutions, standard precautions, and use of sterile procedures when necessary. Universal precautions - ANSWER-needle stick protection devices, and placing warning lebels on containers that contain blood or infectious material. Chain of infection - ANSWER-Pathogen, Reservoir, Portal of Exit, Mode of transmission, Portal of entry, Suseptible host. Standard precautions - ANSWER-Designed by the CDC to decrease transmission of microorganisms. hand hygiene, gloves, mask, eye proptection, gown. diffent types of precautions - ANSWER-airborne, droplet, contact. disinfectant - ANSWER-a chemical compound ueed to remove or kill pathogenic microorganisms. antiseptic - ANSWER-chemcals used to inhibit growth and development of microorganisms signs of shock - ANSWER-pale, clammy, weakness, rapid pulse, increased shallow breathing. nausea and vommiting. Reasons for clinical lab testing - ANSWER-screening diagnosis treatment monitoring Integumentary - ANSWER-largest organ of the human body -skin -hair -nails -teeth -sweat glands Skeletal system - ANSWER-bone, cartilage, joints, ligaments, tendons muscles are classified as - ANSWER-skeletal- attached to thte bones visceral or smooth- linning of innteral structures such as veins and arteries cardiac-make up the heart wall. Nervous system - ANSWER-neurons, brain, spinal cord, brain and spinal cord covering, and cerebralspinal fluid. respritory system consists of - ANSWER-nose, pharynx, larynx, trachea, bronch, lungs. urinary system consists of - ANSWER-2 kidneys, 2 ureters, urinary bladder, urethra endocrine system consits of - ANSWER-exocrine glands, endocrine glands, exocrine glands - ANSWER-secrete sweat saliva, mucous and digestive juices. endocrine glands - ANSWER-Ductless glands that empty their hormonal products directly into the blood male reproductive system consists of - ANSWER-scrotum, testes, seminal vesicles, prostate gland, urethral glands, urethera and the penis female reproductive system consists of - ANSWER-ovaries, uterine tubes, uterus, vagina, labia, breasts and mammary glands Digestive system consits of - ANSWER-mouth and teeth, pharynx, esophagus, stomach, intestines, and vital accessory organs. the cario vasuclar system - ANSWER-affects every part of the body mainstains homeostasis contributes tot he defence and coagulation process and maintatining body temp. covers the heart, circulation blood, and blood vessels. size of the heart - ANSWER-same size as a mans closed fist the heart consists of how many chambers - ANSWER-4 2 atrias 2 ventricles heart valves are positioned - ANSWER-between each ventricle and atria so blood flows in one direction right atrium of the heart - ANSWER-receives oxygen-poor blood from systemic circuit: superior vena cava, inferior vena cava once the blood reaches the lungs - ANSWER-it branches off into smaller arterioles and capillaries for gass exchange. systemic circuit - ANSWER-carries blood throughout the body blood pressure increases - ANSWER-during ventricular systole (contraction) blood pressure decreases - ANSWER-during ventricular diastole (relaxed) arteries - ANSWER-have a pulse carry oxygenated blood located deep withing the muscle have thicker more elastic walls than veins veins - ANSWER-carry deoxygenated blood back to the heart. have thinger walls than arteries. are located both deep and superficial. have valves phlebotomist choice of veins - ANSWER-medical cubital, basilic and cehpalic. capillaries - ANSWER-connect arterioles and venules exchange point in tissue for carbon dioxide blood carries - ANSWER-nutrients, oxygen. any regions deprived of blood and oxygen - ANSWER-will begin to die from hypoxia how much blood does the body contain on average - ANSWER-5 quarts of whole blood whole blood consists of... - ANSWER-3 quarter of plasma and 2 quarts of cells plama contains - ANSWER-92% water, 8% solutes such as albumin, fibrinogen, lipids, glucose, and many more when does blood begin to clot - ANSWER-immediately after the blood leaves the body unless mixed with an anticoagulant circulating blood is composed of - ANSWER-erythrocytes (red blood cells) leukocytes (white blood cells) thrombocytes (platelets) red blood cells make up what percentage of blood - ANSWER-99% neutrophils - ANSWER-A type of white blood cell that engulfs invading microbes and contributes to the nonspecific defenses of the body against disease. Eosinophils - ANSWER-white blood cell that are responsible for combating infection by parasites in vertebrates basophils - ANSWER-A circulating leukocyte that produces histamine to cause inflammation monocytes - ANSWER-white blood cells responsible for immune defense Lymphocytes - ANSWER-A type of white blood cell that make antibodies to fight off infections blood cells begin as - ANSWER-stem cells life span of a red blood cell - ANSWER-120 days after red blood cells are defragmented where are they destroyed - ANSWER-liver, spleen, and bone marrow what hormone triggers the production of red blood cells - ANSWER-erythropioetin produced by the kidney four types of blood - ANSWER-A, AB, B, O Type A blood type - ANSWER-A antigen on their RBC, and anti-B antibodies their plasma. type B blood - ANSWER-B antigens on RBC and anti-A antibodies in their plasma. AB type blood - ANSWER-Both the A and B antigens on their RBC and no antibodies in the plasma type O blood - ANSWER-neither antigen on RBC, and both anti-A and anti-B antibodies in their plasma WBC are formed - ANSWER-in the bone marrow and lymphatic tissue WBC have a life span of - ANSWER-a few days to a few years. thrombocytes or platelets size - ANSWER-Smaller than blood cells thrombocytes are - ANSWER-fragments of large megakaryocytes platelets aid in - ANSWER-the clotting process thrombocytes life span - ANSWER-9-12 days plasma is what portion of the blood - ANSWER-liquid portion containing blood cells, dissolved gasses, proteins and much more proteins in the plasma - ANSWER-stay in the vascular space because they are too large to pass through capillary pores. They exhibit osmosis pressure to keep blood volume in balance serum - ANSWER-contain the same chemicals as plasma without the clotting factor. hemostasis - ANSWER-stoppage of bleeding steps of hemostasis - ANSWER-vascular spasm, platelet plug formation, coagulation, clot retraction, fibrinolysis. vascular phase of hemostasis - ANSWER-A phase involving vasoconstriction and adhesion of platelets to damaged endothelium. platelet phase of hemostasis - ANSWER-platelets degranulate, clump together and adhere to the injured vessel to form a plug. Coagulation phase of hemostasis - ANSWER-clotting cascade - platelets contract - torn area pulled together Fibrinolysis Phase of Hemostasis - ANSWER-the clot begins to break up and dissolve lymphatic system contains - ANSWER-lymph, lymphatic, lymph nodes, tonsils, spleen, bone marrow, and thymus gland. three types of lymph cells - ANSWER-T-cells, B-cells, and the natural killer T-cells - ANSWER-provide cellular immunity again bacteria, virus, and fungi. thymus dependent B- cells - ANSWER-provide humoral immunity and antibody production in body fluids bone marrow derived The natural killer - ANSWER-attack cells that are foreign or normal cells infected with virus or cancer. anticoagulants - ANSWER-prevent blood clot formation Light Blue Tube - ANSWER-sodium citrate for coagulation determination invert 3- 4 times PTINR, APTT Yellow tube - ANSWER-SPS (sterile-sodium polyanethol sulfate) an anticoagulant that reduced antibodies thus enhancing the growth of bacteria for detection. red tube - ANSWER-Serum Seperation tube used for chemistry as well as therapeutic drug monitoring invert 5-8 times set fro 30 minutes before centrifuging. green or light green tube - ANSWER-for plasma determinations in chemistry heparin additive inversion 8 times lavender (purple tube) - ANSWER-used for whole blood in hematology determinations. K2EDTA- binds calcium, preventing blood from clotting inversion 8-10 times Pink tube - ANSWER-whole blood for hematology usually used for blood bank purposes but can be used just as a purple tube. Gray tube - ANSWER-for glucose determination sodium floride additive inversion 8 times Royal blood tube - ANSWER-for trace elements, toxicology and nutritional studies inversion 8 times tan tube - ANSWER-used for lead determination K2EDTA additive inversion 8 times orange tube - ANSWER-serum determinations in chemistry clotting time 5 minutes inversion 5-8 times clear or red rubber top tube - ANSWER-use for discard tube or secondary specimens tube. no additive no inversion preferred sight for capillary puncture - ANSWER-third finger in the fatty side portion of the finger ancappilary puncture in new borns, lancet length should be used to avoid puncture of the done - ANSWER-1.75 mm best angle using two glass slide to create a blood smear - ANSWER-30 degrees patients have the right to .. - ANSWER-refuse treatment what vacuum tube is used to collect a serum specimen - ANSWER-SST the larger the gauge number... - ANSWER-smaller the needle which tube do you used for hemoglobin - ANSWER-lavender (purple) if the tourniquet is applies for longer than 3 minutes, what analytic will likely be elevated - ANSWER-potassium capillary puncture is not useful in patients that have - ANSWER-swelling or edema in arms and hands which fingers are used for capillary puncture - ANSWER-third and forth finger blood samples from capillary puncture can not be used for which tube? - ANSWER-blue coagulation studies Capillary blood is more like arterial blood than venous blood for what reason? - ANSWER-arterial pressure is stronger than venous pressure in the capillaries. warming the puncture site causes - ANSWER-localized increased blood flow the area of a blood smear in which a differential is preformed - ANSWER-feathered edge hemolysis is caused by - ANSWER-not removing residual alcohol at the puncture site excessive milking excessive mixing or agitation of the specimen. capillary order of draw - ANSWER-ABG purple/EDTA green/ heparin gray/ other Latrogenic anemia - ANSWER-blood loss due to multiple venipunctures national patient safety goals were set in place by - ANSWER-Joint Commission Osteomyelitis - ANSWER-inflammation of bone and bone marrow 12 hours after last ingestion of food created the - ANSWER-basil state for most accurate result values Hemoconcentration - ANSWER-A decrease in the fluid content of the blood (plasma), resulting in an increase concentration. This is determined by an increase in the hematocrit. Caused by a filtration of plasma into the body tissue and often created by dehydration best angle for needle insertion - ANSWER-30 degrees syncope - ANSWER-transient loss of consciousness or fainting hemolysis - ANSWER-destruction of red blood cells labels must contain - ANSWER-patients name patient ID # Patients DOB date and time of collection and person that collected it specimens should be labeled when - ANSWER-immediately at the patients bedside Order of draw - ANSWER-blood cultures blue/ coagulation tube red/ yellow/ Serum tubes green/ heparin tubes purple/ EDTA other ankle and foot veins are not to be used - ANSWER-on a diabetic or without Docters order ideal time for specimens to be collected - ANSWER-10 hours after ingestion of food high doses of Tylenol will affect what analyte? - ANSWER-serum bilirubin thrombus - ANSWER-solid mass derived from blood constituents that can occlude a vein thrombocytopenia - ANSWER-low platelet count drawing blood from an IV - ANSWER-must be done by a Nurse or doctor 10 CC must be wasted before blood can be drawn for the blood tubes Chain of custody - ANSWER-