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Personal Protective equipment-gown, mask, and gloves.
What is PPE?
What is the best way to let a clean site dry?
Blood borne pathogens and needle safety
OSHA requires all phlebotomist to be trained regarding what?
Universal and /or standard precautions.
All specimens are considered hazardous and infectious so we must use what?
OSHA-occupational safety and health administration.
What organization should be contacted regarding employee safety and unsafe working conditions?
Material Safety Data Sheet, (the right to know law).
What does MSDS mean and what is it part of?
What color tube, and additive is used for CBC, Hct,Hgb, Sed rate?
Which tube has no additives?
Lt. Blue, sodium citrate
What color tube and which additive is used for protime and APTT?
Lt. Blue, sodium citrat
9 to 1
What is the ratio of blood to additive in a light blue tube?
Which additive is the best choice for an ethanol specimen?
What color tube is an ethanol specimen drawn in?
*Cleanse the site,
*get patient information if able, and
*notify your supervisor
In case of a needle stick accident you should...
It reduces the chance of aerosol and microbial contamination
Why is it necessary to keep the centrifuge lid closed until it comes to a complete stop?
To find a vein
What is the purpose of the tourniquet?
How long can the tourniquet be in place?
Wipe away the first drop
What is the first thing you must do after every finger stick?
What angle should your slider be when making blood smears?
20. What should y
Use a pediatric tube.
What should you do if a standard size tube collapses the vein?
povidone iodine and chlorhexidrine.
Which cleansers are most common for blood culture site preparations?
*and puncture resistant
What characteristics do sharps disposal containers have?
10% bleach, 90% water.
When used for decontamination, the dilution for bleach in water should be what?
Bleeding time (also known as platelet function assay
Which point of care test is done to determine a platelet plug formation?
Outer aspect of the wrist and from the radial artery.
Where in the wrist area is ABG's done and which artery?
Which are the smallest vessels in the body?
Which are the smallest veins in the body?
The respiratory system is responsible for?
70% isopropyl alcohol
Common site cleaner for a venipuncture is?
buffy coat=WBCs & platelets (middle),
Red blood cells (bottom
When anticoagulated blood is spun down in the centrifuge, how does it separate?
Right to know law.
MSDS is part of the ?
Everything is returned to where you found it including bed rails. (up if up, down if down).
When you leave a patients room, make sure that...
Serum=the fluid portion of clotted blood,
Plasma= fluid portion of unclotted blood
which contains all of its clotting factors. (fibrinogen)
What is the difference between serum and plasma?
the validation of a persons feelings.
QA indicators are what?
System that filters, eliminates wastes, regulates water balance is the
Over the clothing or a piece of coflex/ coband.
If a patient has fragile skin or excessive hair, where should the tourniquet be places?
look for a site that is the least damaged or scarred for the draw
When drawing on a burn victim...
Before and after specimen collection, toilet use, every time they could become soiled
Even if you wear gloves, your hands should be washed when?
Errors in the results by diluting with tissue fluid
What happens if you squeeze too much during a finger stick/ capillary puncture?
Below the I.V.
If an I.V. is present you must draw blood where?
What vein is the most likely to be used for an obeased patient?
Remove the tourniquet and needle and apply pressure.
If swelling occurs or a hematoma begins to form at the venipuncter site you must...
The most prevalent work related acquired infection in the laboratory is?
it was centrifuged before it fully clotted
Fibrin strands may be present in serum because?
Do not draw the blood until the patient is properly identified/ banded.
What should you do if the information is not correct on the patients ID bands/ requisitions?
DO NOT DRAW
If a patient who is legally responsible for himself says NO to a blood draw, what should you do?
Spelling of name and birth date
Two forms of patient I.D. are?
Bursting capillaries cause small red pin-point clusters are known as?
Imuno- compromised patients.
Reverse or protective isolation is for the protection of
Special 3 part I.D. systems
What is the name of the system used for unidentified patients?
What is the most common complication of phlebotomy?
What happens when the tourniquet is on too long?
By protecting it from the light.
How do you transfer Bilirubin?
Arterial Blood Gases (ABCs)
What test is ordered to determine PH and blood gas?
What test would be ordered to detect hematuria?
What test would be ordered if the patient is suffering from FUO? (fever of unknown region)
Green top and Heparin is the additive.
What tube is used for STAT electrolytes and what is the additive?
*send to CDC in case of breakage,
*name and address of sender and receive
Sample mailers have a few distinctive warnings on their label. They are...
The tracking of legal samples.
What is the chain of custody?
Doctors order glucose monitoring for patients with which disorder?
How long do Red blood cells live for?
A immature red cell and lives for about one day
What is a reticulocyte and how long does it live for?
What does a glucose test monitor?
A.I.V supplies must be handles with care and kept...
What is a sphygmomanometer used for?
moral and immoral
Medical ethics conduct can be both
Malpractice is negligence by a professional; Negligence is failure to exercise due care
Define negligence vs. malpractice
Sedrate or ESR is drawn on what color tube?
Which PPE will keep you the safest when body substance or wounds are present?
MSDS (material safety Data Sheet)
What has to be supplied by chemical manufacture according to the Right to Know Law?
the digestion tract.
Parental transmission means infection can enter through everything except?
no, it's the phlebotomist call.
Does the tourniquet need to be on the entire time?
Center to periphery
In what direction is a concentric circle?
What test is ordered to confirm hyper or hypoglycemia?
If something is easily combustible what color and number would you see on the diamond?
If a moderate health hazard would exist, what color and number would you expect to see?
Contaminated specimen. Skin #1 contamination of a blood culture.
If you do not let the cleansers dry before performing a blood culture you get what?
2000ml or 2L
How many ml would be in a typical 24 hr. urine container?
How do you transport cold agglutinin after collection?
heart and vessels
Cardio vascular system includes...
Make your patient as comfortable and at ease as possible.
It is your job as a part of being a health professional to...
Could cause an aerosol (like popping the champagne bottle)
What could happen if you carelessly remove a stopper from an evacuated tube of blood?
Fungus, bacterium, virus
What is included in the microorganism category that can exist in body fluids?
GTT, Medication monitoring
what are examples of timed test?
Insurance PPO/HMO. Not a patient right.
Selection of a preferred care giver has to do with what?
It is not clean anymore.
What does contamination mean?
Time of last dose
TDM means therapeutic drug monitoring. It is important to know the...
Protime, Prothrombin time, PT
Extrinsic coagulation function is evaluated by what test?
NCCLS (National Committee for Clinical Laboratory Standards)
CLSI (Clinical Laboratory Standards Institute) is formerly known as?
Every year laboratory employees must take a test to demonstrate what?
What should you do if you get blood on a requisition or on the side of a tube?
Being sure of yourself, being confident. It is not being irate or cowering.
Positive body language is...
Third and fourth digits.
Which fingers are used for skin puncture, more often?
With a doctors order
Leg and foot draws can only be done...
Skin puncture; "fingerstick"; capillary draw
If you are drawing for CBC, and having difficulty because of vein damage or bruising, it is acceptable to get blood by which method?
Missing the vein altogether, not going deep enough, or going through the vein.
What could cause "failure to obtain blood"?
Urinary tract infection is the most common...
What is the most common size needle used for venipuncture?
Which is larger 18 or 24?
When using additive tubes, when should you start the mixing process?
Na Fluoride and K oxalate
What is the additive in a gray top tub?
What is the additive in a green top tube?
The feathered edge of a smear is how many layers thick?
Introduction and explanation
What is the first step in phlebotomy?
Inpatient stays overnight and the ambulatory is outpatient.
What is the difference between "impatient" and "ambulatory patient"?
Vascular Access Device
What is a VAD?
Look for a vein in the left arm
What would you do if a patient has an I.V. in the right arm?
You would not put a tourniquet or BP cuff on that arm. No blood samples from that arm.
A patient states she/ he has had a mastectomy on the left breast. What would you NOT DO?
An alternative to adhesive/coflex is gauze all around and the taped.
If a patient has fragile skin, what would you use for a bandage?
Median antecubital, cephalic, and basilic
What are the three common veins for venipunture?
Container must be water-tight
What is the requirement by the government when shipping specimens?
Services and results that meet accepted standards are?
Extracting too much blood especially from infants could put the in danger of becoming what?
Make sure they are not duplicates.
What would you do if you found two or three requisitions from different doctors for the same order?
Nothing until you get the correct
The nurse asks you to go to room 312 and draw Robert Jones. When you get to 312 the patient's arm band says Roger Jones. What would you do?
The ability to stop bleeding.
What is Hemostasis?
All vessels, coagulation factors, and platelets.
In order to ensure Hemostasis all of these must be in good working order/ have the proper amount...
Q.N.S. stands for?
Which part of the analytical process are phlebotomist involved in?
Doing the right thing when nobody is is looking is...
Acquired Immune Deficiency Syndrome
AIDS stands for what?
You must redraw
What happens if a specimen is misplaced for several days at room temp?
One thing the healthcare industry did to lessen the spread of infection
Erythrocytes, leukocytes, thrombocyte
Parents sometimes get a prescription for a topical anesthetic for their child, which is called?
RBC transports oxygen and nutrient
Which cell is the transport cell?
you must have a translator
If there is a language barrier between you and the patient, what should you do?
Do not walk by spills without reporting them
Do not rush around corners in the halls.
Get out of patients way.
As health care workers, it is very important to be aware of the surroundings.
Which is the most prevalent blood borne pathogen among laboratory health care workers?
Injury could occur on an infant's foot if you use a lancet that penetrated deeper than...
Quality assurance or quality control
Checking the expiration dates on collection tubes is part of...
One is aerobic (has air in it), the other is anaerobic (no air)
Blood cultures are drawn in a set of two bottles. Name the differences between the bottles
What five things must be on a speicmen?
What might cause clotting of an anticoagulated specimen?
The patient might have a latex allergy
If red blotches appear after a tourniquet is applied or skin is in contact with gloves. What would you suspect?
Stop everything and call for help
If you are collecting blood and the patient stops breathing, what would you do?
N95 respirator, gown and gloves (All Airborne Isolation require these)
Tb isolation requires what?
What would you do with an expired tubes?
To check for presence of Fibrin (serum only)
Why would you put a stick in a centrifuged specimen?
The patient must give written permission for medical personnel to release information. The confidentiality law that regulates this is HIPAA.
A family member wants family records. Who regulates this matter?
trauma, then the timed test.
You have a trauma and a timed test. Which should you do first?
Because TB is an airborne mycrobacteria
Why do you use a N95 for TB patients?
What is another name for a "winged apparatus?
Requires health care institutions to have an infection control program in place. QA, medical record protocol
JACHO is responsible for what? Joint Commission
How many hours does the patient have to fast for a GTT? (Glucose Tolerance test)
TWO, plus the number of hours for the test
How many draws are needed for a GTT?
Who is the Director of the Laboratory?
ER/STAT, Timed, ASAP, Fasting, Routine
List the priority of Draw
If a phlebotomist mis-I.D.'s a patient and this action causes harm to come to the patient, it is an act of?
Newborn, patient admitted through the ER, Patient transfusion.
Which patient is most likely to have more than (1) I.D. bracelet?
Name the gel in an SST or PST tube?
Yellow for BC (SPS);
Lt. Blue (Na Citrate);
Red and/or SST;
Grey (Na Fluoride/K oxalate)
Order of Draw for non-capillary blood samples?
Lavender/EDTA specimens;other additive specimens;
Name the Order of Draw capillary?
CLPIb (CA)Clinical Laboratory Phlebotomist
What initials are used to designate a phlebotomist certified by the National Credentialing Agency?
Certified phlebotomist Technician
What initials are used to designate a phlebotomist in CA certified by the American Certification Agency? What do the initials mean?
Evacuated tube system
What does ETS stand for?
0 means no hazard;1 means slight danger;2 means moderate danger;3 means severe danger;
4 means extreme danger
A European medicinal leechTerm
What is Hirudo medicinalis?
What type of controls do mechanical devices have?
Sharps containers;Safety needles; Hazard signs;Safety transfer devices;
Give two examples of engineering controls
Designated areas for activities like eating
Give an example of a "Work Practice Control"
Distance- how far away;Shielding- how you are protected/barrier;Time- how long expose
What 3 factors relate to radiation exposure?
What acronym is used for Fire Response?
College of American Pathologist
What does CAP stand for?
Clinical Laboratory Improvement Amendment (of 1988)
What does CLIA stand for?
the Saphenous vein
What is the longest vein in the body?
Clumping or sticking together
What does agglutinate mean?
Does Ca mean the same as CA?
The "steady state",
state of equilibrium or balance
What is Homostasis
The pituitary gland
What gland is referred to as the Master gland?
Part of the Endocrine System;
What body system is it part of?
Regulates body function via hormone production.
Where is it/ what does if regulate?
The Nervous System
What body system uses chemical substances and electrical impulses to control and coordinate body activities?
Structural=1).Central nervous system;2).Peripheral Nervous System
What are the two main structural divisions in the Nervous System?
Frontal, also know as the Coronal
What anatomical plane divides the body into front and back?
What anatomical plane divides the body into the top and bottom?
Midsagittal is equal right to left;
Sagittal can be unequal right to left
What anatomical plane divides the body into equal/unequal right to left?
Front=anterior or ventr
Back=posterior or dorsal
What anatomical terms describe the front from back of the body?
Top=superior or cranial;
Bottom=inferior or caudal
What anatomical terms describe the top and the bottom of the body?
What anatomical terms describe if something is near another structure or farther away?
What word describes the palm of the hand?
What word describes the bottom or sole of the foot?
External is superficial or near the surface of the body;
Internal is deep inside the body
What anatomical terms describe something that is either on or near the surface of the body or inside the body?
Medial is closer to the middle of the body;
Lateral is more to the side/outside of the body
What anatomical terms describe if something is near the middle of the body or more to the side of the body?
The liver and the spleen
What body organs remove erythrocytes from the circulation when they are old or damaged?
Name the four body cavities?
In the bone marrow;1/4 (25%) for RBCs;3/4 (75%) for WBCs
Where is the primary place RBCs and WBCs are made? What fraction or percent for each?
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