Phlebotomy Essentials 4Th Edition, Chap 7 Study Guide

Front 1

disinfectants definition of?

Back 1

chemical substances or solutions used to remove or kill microbes on surfaces and instruments
corrosive
not safe human skin

Front 2

hand sanitizers reccommended?

Back 2

CDC
alcohol based hand sanitizer
if no wash fal avil to remove organic materials use detergent containing wipes followed by alcohol based sanitizer

Front 3

bandages types used?

Back 3

paper
cloth
knitted tape over folded gauze squareself adhesive gauze placed over gauze pad used more now(PTs allergic to adhesive bandages)(also is used to form a pressure bandage following arterial puncture in pt's with bleeding problems)
latex free avil for PTs with latex allergies
adhesive bandages not used on <2y/o because danger aspiration and suffocation

Front 4

needles/lancets/sharp objects disposed of where?

Back 4

Sharps container
variety size and style
most are RED
Biohazard symbol
rigid/puncture resistant/leak proof/disposable/locking lids

Front 5

in venipuncture tourniquet is used for

Back 5

apply or tie around PTs arm prior to venipuncture to restrict blood flow(distends or inflates veins making them larger and easier to find; stretches vein walls so they are thinner and easier to pierce with needle)

Front 6

proper application of a tourniquet

Back 6

tight enough to restrict venous flow but not so tight to restrict arterial flow

Front 7

why no longer than 1 min with tourniquet on?

Back 7

can change blood componets must release during collection

Front 8

do what before opening a needle package

Back 8

check packaging for broken seal
discard if no longer sterile

Front 9

what does the needle part "bevel" refer to?

Back 9

end that pierces the vein
(because cut on a slant)
allows needle to easily slip into vein without coring(removal of portion of skin or vein)

Front 10

what does the needle part "shaft" refer to?

Back 10

long cylindrical portion

Front 11

what does the needle part "hub" refer to?

Back 11

end that attaches to blood collection device

Front 12

what does the needle part "lumen" refer to?

Back 12

internal space of needle

Front 13

why inspect needle before use?
what to look for?

Back 13

-mass produced, damaged could cause pain or venipuncture failure
-blocked/blunt/bent tips
rough bevels or shaft

Front 14

what does needle gauge refer to?

Back 14

diameter of the lumen

Front 15

what does inverse(opposite) gauge mean?

Back 15

larger the number the smaller the actual lumen is

Front 16

what is needle type for gauge 18 ?
typical use?

Back 16

-syringe
-transfer needle..saftey issues reduced use

Front 17

what is needle type for gauge 20?
typical use?

Back 17

-multisample syringe
-sometimes used when large volume tubes collected or large volume syringes used on PTs with normal size veins

Front 18

what is needle type for gauge 21?
typical use?

Back 18

-multisample syringe
-standard for routine venipuncture with PTs normal veins

Front 19

what is needle type for gauge 22?
typical use?

Back 19

-multisample syringe
-used on older children, adult with small veins or difficult draws

Front 20

what is needle type for gauge 23?
typical use?

Back 20

-butterfly
-infants, children and difficult or hand veins of adults

Front 21

how do you select needle gauge?

Back 21

size and condition of vein, type of procedure, type of equipment

Front 22

what guage needle is considered standard for most routine situations

Back 22

21 gauge

Front 23

why important to choose correct guage?

Back 23

too large gauge may damage vein needlessly
too small may hemolyse the specimen

Front 24

what makes identification of gauges easier?

Back 24

color coding
traditional colors
yellow 20
green 21
black 22
colors may vary by manufacturer

Front 25

needle lengths
multisample?
syringe?
butterfly?

Back 25

multisample 1" or 1.5"
syringe many lengths
butterfly 0.5 to .75 (1/2 to 3/4 in)

Front 26

what is an evacuated (ETS)tube?

Back 26

fill with blood automatically because of Vacuum(neg pressure)

Front 27

how is evacuated tube selected

Back 27

age of PT
condition of vein
amount of blood needed for test

Front 28

why will a evacuated tube fail to fill properly?

Back 28

designed to reach stated volume..if lost all or part of vaccume will fail to properly fill

Front 29

what can cause a "short draw" (partial draw)?

Back 29

-premature loss of vacuum
(improper storage, opening tube, dropping tube)
-advancing tube too far onto needle
-pulling needle bevel partially out of skin during procedure
-removing tube before vacuum is exhausted
-stoppage of blood flow during the procedure

Front 30

What is the purpose of a "short draw tube"

Back 30

designed to partially fill without compromising test results

Front 31

when do you use a "short draw tube"

Back 31

in situations when difficult or inadvisable to draw larger quantities

Front 32

what are non additive tubes used for?

Back 32

discard or "clear" tubes
these tubes will clot, only yeild serum samples

Front 33

what does the color of the stopper identify?

Back 33

type of additive in tube
or special property of the tube
(generally universal)

Front 34

why is expiration date and proper handliing of tube important

Back 34

-guaranteed reliability until expired(provided handled and stored proper
-can affect additive integrity and tube vacuum(can lead to compromised test results or improper filling)

Front 35

stopper color
light blue
additive?
department?

Back 35

Sodium Nitrate
Coagulation

Front 36

stopper color
Red(glass)
additive?
department?

Back 36

none
chemistry
blood bank
serology/immumology

Front 37

stopper color
Red(plastic)
additive?
department?

Back 37

clot activator
chemistry

Front 38

stopper color
red/light gray (plastic)
additive?
department?

Back 38

nonadditive
NA (discard tube only)

Front 39

stopper color
red/black (tiger)
Gold
Red/Gold
additive?
department?

Back 39

clot activator and gel seperator
chemistry

Front 40

stopper color
green/gray
light green
additive?
department?

Back 40

lithium heparin and gel separator
chemistry

Front 41

stopper color
green
additive?
department?

Back 41

lithium heparin,sodium heparin
chemistry

Front 42

stopper color
lavender
pink
additive?
department?

Back 42

EDTA
hematology, blood bank

Front 43

stopper color
gray
additive?
department?

Back 43

sodium floride & potassium oxalate, sodium floride and EDTA, sodium floride
chemistry

Front 44

stopper color
orange
gray/yellow
additive?
department?

Back 44

thrombin
chemistry

Front 45

stopper color
royal blue
additive?
department?

Back 45

None(red label), EDTA (lavender label), Sodium Heparin (green label)
chemistry

Front 46

stopper color
Tan (glass tube)
Tan(plastic)
additive?
department?

Back 46

Sodium heparin, EDTA
chemistry

Front 47

stopper color
yellow
additive?
department?

Back 47

Sodium Polyanethol sulfonate(SPS)
microbiology

Front 48

stopper color
Yellow
additive?
department?

Back 48

Acid citrate destrose(ACD)
blood bank/immunohematology

Front 49

What type patient is a syringe system used for

Back 49

PTs with small or difficult veins

Front 50

Winged infusion blood collection set (butterfly)
what PTs used for

Back 50

small difficult veins (hands
elderly
pediatric

Front 51

why should you not use a needle that is too small?

Back 51

may hemolyze specimen

Front 52

Butterfly
1st tube
Why

Back 52

Air in tubing(use clear/discard tube to clear draw few mL and discard)

Front 53

why should you never transfer blood collected in an additive tube to another additive tube?

Back 53

will create excess additive in specimen and interfeer with testing

Front 54

most common anticoagulants?

Back 54

ethylenediaminetetraacetic acid (EDTA)
citrates
heparin
oxalates (*IMPT* use correct Anitcoagulant for type test collected)

Front 55

Anitcoagulant
ECHO

Back 55

most common Anitcoagulants
E(EDTA) C(citrate) H(heparin) O(oxalate)

Front 56

EDTA prevents coagulation by?

Back 56

binding or chelating calcium

Front 57

Why should an EDTA tube never be underfilled

Back 57

causes the RBCs to shrink and changes the CBC results

Front 58

citrates prevent coagulation by?

Back 58

binding or chelating calcium

Front 59

citrates inversions?
reason for not vigorously mixing

Back 59

3-4 gentle inversions
vigorous or excessive number can activate platelets and shorten clotting times

Front 60

Heparin prevents clotting by?

Back 60

inhibiting thrombin formation

Front 61

Thrombin is a?

Back 61

enzyme needed to convert fibrinogen into the fibrin necessary for clot formation

Front 62

what color are heparin tubes?

Back 62

green stoppers and royal blue top tubes with green on the label

Front 63

oxalates prevent coagulation by?

Back 63

precipitating calcium

Front 64

Potassium oxalate is commonly added to what tubes?

Back 64

those containg glucose preservatives to provide plasma for glucose testing

Front 65

oxalate inversions?

Back 65

8 eight
mix immediately to prevent clot formation and fibrin generation

Front 66

Acid Citrate Dextrose (ACD)
Solution aviliable in how many formulas?
Name them
what tests used for?

Back 66

two(2) formulations
Solution A
Solution B
for hematology tests
(DNA testing, human leukocyte antigen(HLA), phenotyping used in paternity evaluation and determine transplant compatibility

Front 67

Acid Citrate Dextrose (ACD)
how does each part work?

Back 67

acid citrate prevents coagulation bu binding calcium(little effect on cells and platelets)
Dextrose acts as a RBC nutrient and preservative (by maintaining red cell viability)

Front 68

ACD tubes
color of top?
inversions?

Back 68

Yellow top
eight (8) immed after collection to prevent clotting

Front 69

citrate-phosphate-dextrose (CPD)
used for what tests?
how does each part work?

Back 69

- collecting units of blood for transfusion
-citrate-chelating calcium
-phosphate-stabilizes pH
-dextrose- provide cells with energy and helps keep them alive

Front 70

sodium polyanethol sulfonate (SPS)
how does it work?
used for What tests?

Back 70

prevents coagulation by binding calcium
reduces the action of a protien called Complement that destroys bacteria
slow down phagocytosis
reduces activity of certain antibiotics
used for blood culture collection

Front 71

SPS
color tube stoppers?
inversions?

Back 71

Yellow
eight (8) to prevent clotting

Front 72

Antiglycolytic agent
definition?

Back 72

substance that prevents glycolysis(the breakdown or metabolism of glucose (blood sugar) by blood cells)

Front 73

sodium floride
what does it do?

Back 73

preserves glucose for up to 3 days
also inhibits the growth of bacteria

Front 74

sodium floride tubes
stopper color
inversions

Back 74

gray stoppers
8 eight for proper mixing

Front 75

what is Thixotropic gel seperator
used for?

Back 75

density of gel is between cells and serum or plasma, forms a physical barrier between them

Front 76

stopper color normally indicates a type of additive
what doesroyal blue indicate?

Back 76

trace-element-free tubes
Label color indicates the additive

Front 77

what is order of draw?

Back 77

a special sequence of tube collection that is intended to minimize contamination of the specimen by additive carryover, tissue thromboplastin or microbes

Front 78

blood cultures require?
collected when in order of draw?
why?

Back 78

special site-cleaning measures prior to draw?
-first(not often because typically drawn separately)
-to prevent microbial contamination of the needle from unsterile tops of tubes used to collect other tests

Front 79

order of draw (memory Jogger)
Stop Light Red. Stay Put. Green Light Go.

Back 79

Stop (yellow) Sterile
Light (light blue)
Red (red)
Stay (yellow) PST
Green (green)
Light (lavender)
Go (gray(places the red top before SST and PST before green top for convenience in memorization

Front 80

Blood cultures (sterile collections)
-tube stopper color?
-rationale for collection order?

Back 80

yellow SPS
sterile media bottles
-minimizes chance of microbial contamination

Front 81

Coagulation tubes
-tube stopper color?
-rationale for collection order?

Back 81

light blue
-first additive tube in the order because all other additive tubes affect coagulation

Front 82

glass nonadditive
-tube stopper color?
-rationale for collection order?

Back 82

red
-prevents contamination by additives in other tubes

Front 83

plastic clot activator tubes
Serum sparator tubes (SSTs)
-tube stopper color?
-rationale for collection order?

Back 83

red
r-ed&gray rubber
gold plastic
-filled after coagulation tests because silica particles activate clotting and affect coagulation tests(carry over of silica into subsequent tubes can be overridden by anticoagulant in them

Front 84

plasma separator tubes PSTs
heparin
-tube stopper color?
-rationale for collection order?

Back 84

Green & gray rubber
light green plastic
green
-heparin aggects coagulation tests and interferes in collection of serum specimens; causes the least interference in tests other than coagulation tests

Front 85

EDTA tubes
plasma preparation tubes PPTs
-tube stopper color?
-rationale for collection order?

Back 85

Lavender
pink
-pearl top
-responsible for more carrover problems than any other additive: elevates Na and K+ levels...chelates and decreases calcium and iron levels, elevates PT and PTT results

Front 86

oxalate/flouride tubes
-tube stopper color?
-rationale for collection order?

Back 86

gray
-sodium floride and potassium oxalate affect sodium and potassium levels, respectively. After hematology tubes, because oxalate damages cell membranes and causes abnormal RBC morphology. Oxalate interfers in enzyme reactions

Front 87

Alternate syringe order of draw (memory jogger)
Silly ladies Love Green & Gray Roses

Back 87

Silly (yellow) sterile
Ladies (lt blue)
Love (lavender)
Green (green/PST)
Gray (gray)
Roses (red/sst)