Phlebotomy Essentials 4Th Edition, Chap 8

Front 1

Venipuncture is the term used to describe?

Back 1

the process of collecting or drawing blood from a vein

Front 2

blood collection procedures legally begin with

Back 2

the test request

Front 3

test requisition
definition?
why specific info required?

Back 3

form on which orders are entered(part of PTs medical record)
-ensure:
-right PT is tested
-physician's orders are met
-correct tests are performed at proper time under the required conditions
- Pt is billed properly

Front 4

manual requisitions
what are 3 parts used for?

Back 4

diff styles and types
3 parts are used for
request, report, and billing

Front 5

Computer requisitions
what prints with?
what special info on it?

Back 5

normally contain the actual labels that are placed on the specimen tubes
in addition to patient ID and test status info
many indicate the type of tube needed
special instructions (ie.. potential bleeder)

Front 6

when a computer generated label is used the phlebotomist is generally required to

Back 6

write the time of collection and initials on the lable after collecting the specimen

Front 7

bar code requisition

Back 7

manual requisition may contain a bar code that can be peeled off and placed on the specimens
computer requisitions typically have the bar code printed on each label
can be scanned into a computer
allow fast, accurate processing and have been shown to decrease laboratory errors associated with clerical mistakes

Front 8

who is it up to to make certain the required info is on the requisition

Back 8

personnel of the blood collection site

Front 9

review the requisition

Back 9

-check to see that all required info is present and complete
-verify the tests to be collected and time and date of collection
-identify diet restrictions or other special circumstances that must be met prior to collection
- determine test status or collection priority

Front 10

definition of accesssion

Back 10

is to record in the order received
to accession a specimen means to take steps to unmistakably connect the specimen and the accompanying paper work to a specific individual

Front 11

where do you find signs containing info concerning PT

Back 11

wall beside or behind PT's head
on door

Front 12

DNR and DNAR and AND
what do they mean

Back 12

do not resuscitate
do not attempt resusciatation
Allow natural death

Front 13

if a physician or member of clergy is in the room?

Back 13

do not interrupt
if STAT or timed excuse yourself, explain why there and ask permission to proceed

Front 14

if a visitor or family is in room?

Back 14

Ask them to step out
some will insist, okay to let stay

Front 15

Unavailable patien

Back 15

unable to obtain specimen..fill out form..one to nursing station other to lab

Front 16

Identify yourself?

Back 16

state your nam, title, why there
tell pt your a student
PT has the right to refuse to have blood draw by student or anyone else

Front 17

bedside manner?

Back 17

behavior of healthcare worker toward, or as perceived by, a PT

Front 18

most important step in specimen collection?

Back 18

verify PT's identity

Front 19

How to verify identity?

Back 19

ask pt to state full name and date of birth
check PT Id band or bracelet
verify to orders
ck against labels

Front 20

ID band has what info

Back 20

name
hosp Number (medical record number(MR number)
DOB
room number
bed designation
Physicians name

Front 21

what info on ID is allowed to differ

Back 21

room#, bed # phys

Front 22

What must you do before leaving room

Back 22

label tubes
raise bed rails
wash hands

Front 23

what is 3-Way ID

Back 23

PTs verbal statement
check ID band
visual comparison of labeled speciman with PTs ID band

Front 24

sleeping PT, what to do?
Not to do?

Back 24

wake gently
don't startle (bright lights)
speak softly
-never attempt to collect from sleeping PT

Front 25

Unconscious PT

Back 25

speak as if alert
identify yourself
inform of intent

Front 26

emergency room PT, no ID
what to do?

Back 26

special 3 part ID
all 3 contain same number
1. attach to PT
2. attach to specimen
3. attach to blood unit (if needed for transfusion)

Front 27

handling PT inquiries

Back 27

direct to Phys
NEVE attempt to expalin purpose of test
best to allow DR or Nurse explain

Front 28

PT objections?

Back 28

does have the right to refuse..let Nurse/dr know
fill out form stating why unable to collect

Front 29

addressing needle phobia

Back 29

intense fear of needles
Pt can experience "shock" type symptoms(pallor, profuse sweating, lightheadedness, nausa,fainting....severe..arrhythmia/cardiac arrest)
Never allow a PT to be standing
apply ice pack 10 to 15 min to numb before venipuncture
only most experienced should do it

Front 30

objects in PTs mouth

Back 30

do not allow anything in PTs mouth
(eat, drink, chew, thermometer, toothpick, other foreign objects)

Front 31

Diet restrictions

Back 31

verify that fasting instructions have been followed
if not PHYS or Nurse notified
if decision made to go ahead..must mark "nonfasting" on specimen label

Front 32

tourniquet application

Back 32

3-4 inches above site(too close may collapse vein)
restrict venous flow(allow arterial flow)
makes veins more prominent
walls thinner

Front 33

what levels do fist pumping affect?

Back 33

potassium & ionized calcium

Front 34

most prominent veins in H pattern?

Back 34

median cubital, cephalic, basilic

Front 35

most prominent veins in M pattern?

Back 35

median, median cephalic, median basilic

Front 36

palpate

Back 36

examine by touch or feel

Front 37

patency

Back 37

state of being freely open

Front 38

do not select veins that feel?
why?

Back 38

hard or cordlike
roll easily
hard to penetrate
no adequate blood flow

Front 39

concentric circles

Back 39

circles with a common center

Front 40

how to prevent contamination of site

Back 40

DO NOT:
dry alcohol with gauze
fan or blow to dry
touch site(if you must repalpate site sterilize finger)

Front 41

needle sheath

Back 41

cap or cover

Front 42

anchor the vein

Back 42

secure firmly (helps prevent rolling)

Front 43

degree angle needed to insert needle in cubital area?
in hand?
how to choose angle?

Back 43

15-30
10-15
shallow vein closer to 15 and deeper vein closer to 30

Front 44

what samples require cooling before transport(crushed ice)

Back 44

ammonia

Front 45

what samples require transport at body temp?

Back 45

cold agglutinin

Front 46

what samples require protection from light

Back 46

bilirubin

Front 47

how many tries before get someone else?

Back 47

2X only

Front 48

eutectic

Back 48

easily melted

Front 49

EMLA

Back 49

eutectic mixture of local anesthetic

Front 50

baby method of restraint?

Back 50

get a nurse to hold a baby

Front 51

capillary tubes..blood assumed in them?

Back 51

lab will assume capillary ..mark venous because reference ranges are different

Front 52

diseases that effect the elderly

Back 52

arthritis-osteoarthritis and rheumatoid
coagualtion problems-blood thinners
diabetes-circulation and healing
parkinsons-affect speach
pulmonary-colds and influenxa, more severe , wear a mask

Front 53

blood collection procedures

Back 53

know them

Front 54

hospice?

Back 54

type of care for PTs who are terminally ill

Front 55

NPO means

Back 55

nothing by mouth