Phlebotomy Essentials 4Th Edition, Chap 9 Study Guide

Front 1

What does preanalytical mean?

Back 1

before analysis
-phase of testing process that begins when a test is ordered and ends when the testing begins

Front 2

Basal state
definition?
what used for?

Back 2

the resting metabolic state of the body earl in the morning after fasting for a min of 12 hours
-ideal for establishing reference ranges

Front 3

what is a reference range?

Back 3

normal lab test values for healthy individuals
( not outpatient)

Front 4

what is hemoconcentration

Back 4

a condition in which blood componets that cannot easily leave the bloodstream become concentrated in the smaller plasma volume

Front 5

what is lipemic?

Back 5

specimen is cloudy
(remember fat lip or fat white cloud = fats in blood)

Front 6

what is icteric?

Back 6

dark yellow specimen
from jaundice

Front 7

what is a diurnal variation?
factors that affect it?

Back 7

happening daily
posture, activity, eating, daylight darkness, awake or asleep

Front 8

what is a circadian variation?

Back 8

having a 24 hour cycle

Front 9

jaundice
another name?
characterized by?

Back 9

-icterus(icteric means relating to or marked by Jaundice)

-bilirubin(product of breakdown of RBCs) -deposits of yellow bile in pigment in skin, mucous membranes and sclera

Front 10

Why should you avoid burns, scars and tattoos

Back 10

veins difficult to palpate or penetrate in these areas
may have impaired circulation
painful suscepitble to infection
dye can interfere with testing

Front 11

Why should you avoid damaged veins

Back 11

dificult to puncture impaired blood flow
( hard, cord like, lack resiliency because occluded or obstructed)

Front 12

what is sclerosed

Back 12

hardened

Front 13

what is thrombosed

Back 13

clotted

Front 14

Why should you avoid an Edema

Back 14

inaccurate results due to contamination with tissue fluid
or altered blood compisition due to swelling

Front 15

what is an edema

Back 15

swelling caused by to abnormal accumulatio of fluid in tissues
(alert appropriate personnel if caused by IV)

Front 16

what is a hematoma?

Back 16

swelling or mass of blood (often clotted) caused by blood leaking from a blood vessel during or following venipuncture

Front 17

Why should you avoid a hematoma

Back 17

-contamination with hemolyzed blood from outside the vein
-also painful
-obstruction of flow and effects of the coagulation process lead to inaccurate results
( never collect through a hematoma; no alternative perform distal to ensure free flowing blood)

Front 18

Why should you avoid same side as mastectomy?

Back 18

lymph node removal causes lymphostasis. (obstruction or stoppage of normal lymph flow)makes arm susceptible to swelling and infection

Front 19

should you do venipuncture on an arm with art line??

Back 19

NEVER!
special trained personnel only can access arterial line

Front 20

arteriovenous (AV) shunt/fistula/graft
definition?
common location?
venipuncture?

Back 20

permanent, surgical fusion of artery and a vein(provide access for dialysis)
-back of arm above wrist
-never do BP/tourniquet/ venipuncture on arm with a shunt

Front 21

Heparin or saline lock
what are they?
venipuncture?
why?

Back 21

catheter or cannula connected to a stopcock or cap with a diaphragm, provides access for admin of meds or blood draw
-specially trained personnel only
-flushed with saline or heparin(adheres to surfaces)
-

Front 22

Intravenous(IV)
definition?
IV line?
venipuncture?

Back 22

-pertaing to or within a vein
-a catheter in a vein to admin fluids
- use other arm..if not possible use capillary..or have nurse turn off for 5 min then draw below IV

Front 23

CVADs (central Vascular Access Devices)
also called?
definition?
used for?
venipuncture?

Back 23

-indwelling line
-tubing inserted into a main vein or artery
-admin fluids/meds/monitoring pressures/blood draw
-specially trained only

Front 24

what are some phlebotomy concerned allergies?

Back 24

adhesive
antiseptic
latex

Front 25

excessive bleeding

Back 25

if not stopped after 5 min
contact appropriate personnel

Front 26

fainting
another name?
definition?

Back 26

syncope (sin'ko-pea)
-loss of consciousness and postural tone that results from insufficent blood flow to brain

Front 27

signs to watch for in PT when drawing blood

Back 27

pallor
perspitation
hyperventilation
indication fron PT of vertigo
dizziness
light headedness
nausea

Front 28

what is probing?
should you do it?

Back 28

excessive, deep, blind,or lateral redirection on needle
-NO

Front 29

what are the indications of nerve involvement?
what to do?

Back 29

marked or extreme pain
numbness of arm
burning or electrick shock sensation
radiating pain
(if pain persists after needle removal notify appropiate personell)
remove needle immediatley and apply Ice pack

Front 30

what are Petechiae?
indication of?

Back 30

tiny, nonraised red spots on PTs skin when tourniquet is applied
-may bleed excessively

Front 31

Hematoma formation
identification
results?

Back 31

most common complication of venipuncture
-rapid swelling at or near venipuncture site
-bruising
compression injuries to nerves
lawsuit

Front 32

Hematoma formation
situations that can trigger??

Back 32

-vein fraginle or too smalll for needle
-needle penetrates all the way through vein
-needle only partially inserted into vein
-excessive or blind probing used to locate vein
-needle removed when tourniquet is still on
-pressure not adequate following venipuncture

Front 33

Iatrogenic
what is it?
iatrogenic blood loss?
iatrogenic anemia?

Back 33

-adjective used to describe an adverse condition brought on by the effects of treatment
-blood loss as a result of blood removed for testing
-rmeoving blood on a regular basis or in large quanitys (especially infants)

Front 34

what is exsanguination

Back 34

blood loss to the point where life cannot be supported

Front 35

arterial puncture
how to reconize?
what to do

Back 35

bright red blood or spurts/pulses into tube
-withdraw and hold pressure for full 5 min

Front 36

what is reflux?
how to prevent?
why prevent?

Back 36

-backflow
-PT arm in downward position
-adverse reaction to tube additives

Front 37

what is venous stasis or venostasis?
result?

Back 37

stagnation of normal venous blood flow (trapping of blood in an extremity by compression of veins)
-hemoconcentration (decrease in fluid content of blood with a subsequent oncrease of nonfilterable large molecule or protien based componets)

Front 38

what can fist pumping cause in test results

Back 38

increase in blood potassium levels

Front 39

how to prevent hemoconcentration

Back 39

- ask PT to release fist upon blood flow
-choose appropriate vein
-do not allow to pump fist
-do not excessive massage area
-do note probe
-release tourniquet within 1(one min

Front 40

what is hemolysis?

Back 40

when RBCs are damaged or destroyed and he Hgb escapes into fluid portion of specimen
- serum appears pink to lt red

Front 41

what causes hemolysis

Back 41

- blood draw from vein with hematoma
-failure to wipe 1st drop (may contain alcohol) during capillary puncture
-forcing blood from syringe into evac tube
-frothing(caused by improper fit of needle on syringe
-mixing too vigorously
-partial fill a normal sodium floride tube
-pulling plunger too quick on syringe
-rough handling or hroizonal transport
-squeezing site during capillary collection
-needle too small
-too large tube with small diameter butterfly needle

Front 42

what does a short hissing sound with a sputrt of blood before flow stops indicate?

Back 42

needle bevel not completely under the skin or bevel backs out of skin sllightly

Front 43

troubleshooting failed venipuncture?

Back 43

-Tube position-proper seat..reseat
-tube vacuum- bevel under skin(hissing sound), tube dropped or cracked or pushed too far onto needle
-needle position- against vein wall..pull needle back slightly or rotate/ too deep..angle too steep or tube holder not held steady/ nor deep enough.. partly through vein wall..very slow fill, hematoma/ beside vein..roll if not anchored..withdraw slightly, anchor and redirect into vein/ undetermined needle position..pull back slightly feel with finger above point of insertion (not too close) relocate, pull taunt, reinsert. (if lateral movement needed withdraw and coose another site)
-collapsed vein..vacuume of tube or syringe too great will tem collapse vein or if tourniquet too tight/ also can collapse if tourniquet removed during blood draw..remove tube wait few seconds for blood to reestablish flow or retighten tourniquet(if not poss apply pressure with finger) if does not reestablish, withdraw and coose another site