Chapter 53 Phlebotomy – Flashcards
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hemoconcentration
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a condition in which the concentration of blood cells is increased in proportion to the plasma
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hemolysis
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the destruction or dissolution of red blood cells, with subsequent release of hemoglobin
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plasma
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the liquid portion of whole blood that contains active clotting agents
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serum
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the liquid portion of whole blood that remains after the blood has clotted
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thixotropic gel
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a material that appears to be a solid until subjected to a disturbance, such as centrifugation, whereupon it becomes a liquid
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The largest of the vacutainer tubes typically used for phlebotomy fills to a volume of 10mL. Approximately how many tubes are needed to fill a pint (473mL)?
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47
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What is the typical site for a capillary puncture in an adult?
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ring finger
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The typical site for a capillary puncture on an infant is the medial or lateral side of what?
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the plantar surface of the heel
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What are used for small veins, such as those in the hand or in a pediatric patient?
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butterfly needles
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What is the best prevention for needle-stick injuries after venipuncture?
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the use of sharp with engineered sharps injury protection (SESIP)
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What is the term used for a special laboratory filter paper used to collect a blood sample from newborns?
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Guthrie card
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Leaving a tourniquet on longer than 1 minute greatly increases the chances of what?
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hemoconcentration
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What is applied to the skin 30-60 seconds before the blood draw to prevent infection at the puncture site?
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antiseptic
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Using a collection needle with a wider lumen reduces the chances of what to occur?
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hemolysis
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By securing a patient in a blood collection chair helps prevent injuries if the patient experience what?
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syncope
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The vacutainer tube with a marbled, red-gray top contains what particles to enhance the clotting and a thixotropic gel to assist in the separation of serum and blood cells?
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silica
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Gauge is designated by a numeric value; the higher the number, the smaller the...
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lumen
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What is the part of the venipuncture needle that fits into the syringe or vacutainer adapter?
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hub
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(True/False) Can a tourniquet be used when a venous blood samples is to be drawn for the hand.
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true
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What are small blood vessels that connect small arterioles to small venules?
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capillaries
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The...the gauge number, the larger the lumen; the larger the lumen, the less chance of hemolysis.
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smaller
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Plasma could be retrieved from what 2 types of tubes?
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SST red-gray tube and PST green-gray tube
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(True/False)Medical assistants should obtain verbal consent to perform the procedure simply by asking whether they have permission to take some blood from the arm.
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true
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When the needles is inserted into the vein during a routine venipuncture, the bevel of the needles should be facing which direction?
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upward
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The tourniquet should be left tied on the arm no longer than...
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1 minute
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Routine adult venipuncture requires a... gauge needle.
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20-21
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A tourniquet prevents...out of the site, causing the veins to bulge.
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venous flow
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The medical assistant should never attempt to do what to a contaminated needle?
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recap
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When the patient regains consciousness he or she must remain in the facility for how long? and should not operate a vehicle for how long?
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15 minutes;30 minutes
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Which vacutainer tube is routinely used for hematology testing?
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lavender topped tube
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What is used to perform a dermal puncture that delivers a quick puncture to a predetermined depth?
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lancet
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During a routine venipuncture, when should the phlebotomist request that the patient release the fist?
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after blood begins to flow into the tube
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If the patient complains of tingling, numbness, or a shooting pain what should you do?
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remove the needle immediately and choose another site to puncture
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Why should a tourniquet not be tied too tightly?
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impedes arterial blood flow, restricts venous blood return, results in poor venous distention
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Blood should be collected only by... in children younger than 2 years unless the procedure warrants venous collection (lead levels or blood culture).
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dermal puncture
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(True/False) When a medical assistant obtains a capillary blood sample, it is important that he or she squeeze and "milk" the finger to obtain an adequate amount of blood.
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true
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The needle bevel is face up, and the needle is inserted at what degree?
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15
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What is the color of the tube top for the collection of a coagulation test?
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light-blue topped tube
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When is the correct time to remove the tourniquet during a routine venipuncture?
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when blood is completely drawn and before the needle is removed
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If you are drawing blood on an older patient with a history of collapsed veins, you should try to collect the blood sample with a...
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syringe
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The most common causes of hematoma formation during blood draws are excessive probing with the needle to locate a vein, failure to... into the vein, and penetration of the needle... the vein.
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insert the needle; through
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What is the slanted edge at the tip of the needle?
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bevel
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Why does petechiae typically occur?
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because the tourniquet is applied too tightly
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How long does it take blood to clot?
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30-60 minutes
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What should a patient do if blood is flowing into the vacutainer too slowly?
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make a fist and release once making a pulse rhythm
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What vacutainer tube has no additives and is used for serology and chemistry studies?
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red topped tube
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Which type of tube should be used to collect blood specimens during a glucose tolerance test?
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gray topped tube
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What is an anticoagulant that prevents platelets from clumping and preserves the appearance of blood cells for microscopic preparation?
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EDTA
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What size needle is most commonly used by the blood bank for donations?
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16 gauge
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What is used to collect venous samples?
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venipuncture
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What vacutainer tubes aid the coagulation of serum specimen?
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red-gray and yellow-gray topped tubes
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What ways can blood obtained via capillary puncture?
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Microtainer tubes, capillary tubes, microhematocrit tubes, or onto filter paper
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What needle size is most commonly used in infants and older adults?
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23 gauge
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A winged infusion set is also knows as what?
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butterfly needle
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Which veins can be used for routine venipuncture?
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cephalic, basilic, and medial veins
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The laboratory requisition indicates that you are to collect a venous blood specimen for hematology testing, serum chemistry testing, and coagulation studies. What is the proper order of collection for these tubes?
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light-blue topped tube, red topped tube, and lavender topped tube
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What is used when there is concern that the strong vacuum in a stoppered tube may collapse the vein?
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syringes
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Describe the post-exposure management of a needle-stick:
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wash injected site for 10 minutes, report the injury, and have a physician assessment and follow-up
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List the steps that medical assistants must take to protect themselves and co-workers against needle-stick injuries:
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use a SESIP, have a barrier between the needle and hand, don't recap the needle, have blood born pathogen training, and report all needlesticks
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List the information required on the laboratory requisition:
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patient name, DOB, name of physician, type of test requested, and test status
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What is the order of draw for a multi-tube procedure?
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yellow, light-blue, red, green, lavender, and gray
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What is the most common phlebotomy site in adults?
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anticubital space
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Why is important to remove the first drop of blood?
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the blood contains tissue that could alter test results
