NHA Phlebotomy Exam – Flashcards

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What is the most preferred site for venipuncture?
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Median Cubital
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Prior to preforming the capillary (dermal) puncture the PT should select the
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Lancet size
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When collecting blood cultures from an adult patient it is recommended to collect
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8-10 mL per bottle
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Feather edge reflects the correct results for a
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Peripheral Blood Smear
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What tests require fasting
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Glucose, triglycerides, cholesterol, vitamin & mineral problems and pregnancy
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When entering a patients room you should
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introduce yourself and explain procedure
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What two factors that determine weather a child should have capillary collection by heel or stick?
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Age & developmental factors
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What is used to collect cerebrospinal fluid, which is a non blood specimen?
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Lumbar tap
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What type of alcohol compound is appropriate for a routine skin puncture?
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70% isopropyl alcohol
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When running an IV what is the preferred site for drawing blood specimen?
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Going Distal
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If during a venipunture the patient moves needle and needle comes out PT should
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Release tourniquet
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If patient notifies PT of fainting during blood collection you should
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Position in supine
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OSHA guidelines are standards for
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Reduction of risks and injuries to employee
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The lavender evacuated tube contains
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EDTA
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Stool specimen should be refrigerated for 24 hours when conducting what test
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Ova and parasite test
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If a PT needs to collect a prothrombin time from a patient with difficult veins
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A light blue tube is best
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According to CISI order of draw guidelines, the following samples should be collected first
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Cultures
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What is the most important info included on MSDS (material safety data sheet)
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The composition of compounds
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In order for blood alcohol level to be admitted by evidence in court of law what must be done
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PT must document the process of cleansing the site with chlohexadine prep
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What is needed for proper out patient ID
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Name and DOB
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If a patient is a contact isolation
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Precaution gown and gloves must be worn
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If a female refuses to get blood drawn from a male for religious purposes
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A female PT should collect the specimen
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A PT should explain the procedure prior to the venipuncture in order to
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Obtain patient consent
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According to CISI the standard depth of dermal puncture for infants is
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2mm
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What are one of the complications associated with dermal puncture?
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Osteomyelitis
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What is the most common reason for glucose monitoring through point of care testing
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To monitor glucose levels
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If a patient had a mastectomy when preforming a venipuncture you should
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Draw from opposite arm
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When is it appropriate to place specimen in ice when transporting
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For ABG analysis
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The timing for a GTT begins when
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Patient finishes drinking glucose solution
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The proper order of draw of capillary specimen is
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Lavender, green, gray, SST
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An alcohol level test is ordered
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The sodium fluoride tube should be used
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After collecting a billirubin test the specimen should
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Be kept away from direct light to ensure accurate results
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Using antimicrobial sanitizers is a way of preventing
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Nosocomial infections
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The proper way a Pt should instruct their patient to collect a C&S stool specimen is to tell them to
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Chill stool specimen in a container
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Which veins should be avoided by PT unless otherwise instructed by Physician
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Dorsalis Pedis
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When receiving a specimen collected by a patient PT shoudl
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Compare the lab requisition form to patient photo ID
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After cleansing a site PT should
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Always let the spot dry
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What is the most important to verify prior to obtaining specimen
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Patient identity
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When performing a capillary collection serum tubes sample should be drawn when?
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Last
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What is a complication that could happen is the needle is too small?
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Hemolysis
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Which veins should be used by a PT at first choice by a venipuncture on a 3 yr old?
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Dorsal veins of the hand
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What does warming the site do?
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Increases blood flow
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When collecting a bilirubin specimen from a newborn it must?
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Be protected from the light
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If PT is inserting needle and patient complains of sharp radiating pain down his arm you should?
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Release tourniquet, remove needle and apply pressure and cover
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What is needed for homeostasis to take place?
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Thrombocytes
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When collecting a capillary specimen after the site is punctured you should?
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Wipe the first draw
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When is the winged infusion needle used?
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With patients who have fragile veins
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If the PT observes a hematoma forming at the site of draw the PT should?
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Release tourniquet and stop draw
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When a PT enters room without introducing or asking permission to enter its considered
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Invasion of privacy
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The duties of a PT are to
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Instruct and greet patients
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When drawing blood on a small child the PT should explain procedure to
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Parents and child
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When performing a dermal puncture on patients 1 year or older they should perform it on which finger?
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Middle finger
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A PT has orders to draw blood cultures, CBC, PTT, and iron panels but forgets to draw PTT what should you do?
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Draw a discard tube and redraw blood cultures
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Quality control testing of glucometer is important to
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Promote accurate test results
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What are additives sodium citrate and EDTA used to prevent?
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Hemostais
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While on flood a PT is paged for a STAT which is the most useful to PT?
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Room location
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During venipuncture the needle in the vein and bloodflow is established when the second tube is attached blood flow stops the PT should
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Rotate the bevel of needle
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While the PT is drawing and patient reports feeling lightheaded and faints PT should
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Remove tourniquet
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All test results of hospital patients are available to physicians and nursing staff in house via
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Internet
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While preforming donor phlebotomy for blood bank PT should use what size needle?
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18-16 gauge
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Vein located laterally on arm is called
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Cephalic
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Hemoconcentration of a venous blood sample is most often caused when
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The tourniquet is in place for more than 2 mins
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When performing a draw on a diabetic patient with small fragile veins and PT misses twice the PT should
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Ask another PT to obtain
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Utilizing tubes that have expired may result in
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Loss of vacuum
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What causes hemolysis
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Vigorously inverting tubes
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Dermal puncture performed on an infant are routinely collected from
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Lateral plantar surface
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After introducing yourself you should
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Correctly identify patient
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What is negligence
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Failure to demonstrate proper care that results in an injury to another person
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Heel sticks are done for which neonatal screening
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PKU
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For patient compliance with GTT test PT should
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Confirm patient has been fasting
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Sclerosed vein
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Hardening of vein
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Hemoconcentration
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Concentration of blood
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Hematoma
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Accumulation of blood under skin
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Phlebitis
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Inflammation of the vein
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Thrombus
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Blood clot
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Petechaie
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Tiny hemorrhage
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Thrombophlebitis
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Infected clot in vein
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Spticemia
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Infection in the blood
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Trauma
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Bruses
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When is povidone iodine solution used?
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For collections that require more stringent infection control ex blood cultures and arterial punctures
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When is chlorhexidine gluconate used?
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For those allergic to iodine and tests for alcohol
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What should you do when antibodies are produced in response to an infection?
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The specimen must be kept warm until the serum is separated from the cells
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What specimens must be chilled immediately after collection?
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ABG blood gases, ammonia, latic acid, pyruvate, ACTH, gastrin and parathyroid hormone
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Which specimens must be protected from light after collection?
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Bilirubin, beta carotene, vitamin A & B6 and prophyrins
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Where should dermal puncture be preformed for adult?
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Distal segment of third or fourth finger of non dominant hand
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Where should dermal puncture be preformed for infant less than 1 year?
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The heel cant go deeper than 2 mm
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What is order of draw for capillary punctures?
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Lavender, tubes with additives, tubes with no additives
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Pre analytical errors
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Patient misidentification, inadequate fast, patient posture, poor coordination with other treatment
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Post analytical erros
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Processing delays, failure to separate serum from cells, rimming clots
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Intra/ Co analytical errors
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Under filling tubes
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After draw the patient begins to twitch and shake and her eyes roll back what should PT do
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Observe patient and help protect against injury
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If before draw pattient was very talkative and after draw becomes quiet and stares blankly you should?
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Ask if he or she is okay and feels faint
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When collecting blood in an evacuated tube hemolysis would occur with which gauge needle>
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25'
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What are signs PT should recognize on patient during venipuncture?
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Cold, calmmy, and diaphoretic skin
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If a patient turns pale and complains of nausea when PT is about to collect these are signs of what
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Syncope
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Where should a PT document test preformed with regent products as part of protocol
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On a quality control log
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To ensure safety of PT and psychiatric patients and others a PT should
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Bring all necessary equipment to patients room
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What does SST in a collection tube indicate
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To indicate if plasma is used and distinguish weather a collection tube contains serum or plasma
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Because of time between collection and plasma separation the PT should
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Centrifuge specimen
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If a PT is ordered to draw blood from a 6lb newborn from the NICU and the order states blood draw for HCT, HGB and potassium every 24 hours what is a complication for patient?
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Hemolytic anemia
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What is the percent of body weight is the volume of blood that can be drawn at one time or short period of time before patient faces the risk of latrogenic anemia?
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10-20%
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What must be followed exactly whenever a PT draws patient test samples that may be used in a legal proceeding?
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Chain of custody
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For inpatient in addition to patients complete name and DOB, medical record # what else must be included in the physicians requisition form
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Test to be preformed
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A positive HIV test results are an example of
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Point of care testing
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When labeling a non blood specimen where must the label be put
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On the container
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Quality assurance standards include
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Procedure manuals, instrument maintenance, quality control and proficiency testing
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A STAT electrolyte panels was reported to have critically high sodium levels
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Use gold tube explains pre analytic error
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What would exclude a patient from donating blood?
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Obesity
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The emergency dept sends 2 swabs from 2 year old child for influenza and strep only one swab has patients label PT should
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Run test on labeled swab
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Which is a likely result of filling a light blue tube with a ratio 1:6
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False elevation of international normalized ratio
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When drawing blood PT should instruct patient to
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Make a fist do not pump
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