Phlebotomy Essentials 5Th Edition

Front 1

Why do evacuated tubes fill with blood automatically?

Back 1

because there is a vacuum (negative pressure)
the amount of vacuum is measured precisely by the manufacturer so that the tube will draw the exact volume of blood indicated on the label.

Front 2

What is Thixotropic Gel and what does it do?

Back 2

is an inert (nonreacting) synthetic substance initially contained in or near the bottom of certain blood collection tubes. When a specimen in a gel tube is centrifuged, the gel undergoes a change in thickness and moves to position between the cells and the serum or plasma, forming a physical barrier between them. This physical separation prevents the cells from continuing to metabolize substances such as glucose in the serum or plasma

Front 3

What is the primary duty of the phlebotomist?

Back 3

is to collect blood specimens for laboratory testing.

Front 4

What are the most common volumes of syringes used in phlebotomy?

Back 4

2, 5, and 10mL.

Front 5

What procedure can and must be done to reduce tourniquet contamination on the part of the phlebotomist?

Back 5

Good Hand Hygiene (wash hands before handling the tourniquet)

Front 6

How does Heparin prevent clotting? What color is the tube top? How many inversions are needed to mix the specimen after collection?

Back 6

By inhibiting thrombin formation. (Thrombin is an enzyme needed to convert fibrinogen into the fibrin necessary for clot formation).
Green tube top
5 to 10 inversions

Front 7

List the needle gauges from the smallest to the largest.

Back 7

23 Butterfly
22 Multisample Hypodermic
21 Multisample Hypodermic
20 Multisample Hypodermic
18 Hypodermic
15-17 Special needle attached to collection bag

Front 8

During a Blood Specimen collection when might a bed or padded table be needed

Back 8

if the patient has a history of fainting during blood collection or has a fear of needles

Front 9

Which additive in tubes has been the source to more carryover problems than any other additive?

Back 9

EDTA

Front 10

What gauge of butterfly needle is used most commonly for phlebotomy?

Back 10

21 guage

Front 11

What is a clot activator and what do they do?

Back 11

Is a Substance that enhances coagulation in tubes used to collect serum specimens.
they make the blood clot within 15 to 30 mins
red plastic tube tops
5 gentle inversions

Front 12

When is phlebotomy carts commonly used?

Back 12

Early morning hospital phlebotomy rounds

Front 13

What gauge of needle would be used on an elderly patient with thin bad veins?

Back 13

23 gauge

Front 14

Give 3 examples of a vein-locating device.

Back 14

1. Venoscope II
2. Neonatal Transilluminator
3. Accu Vein AV300

Front 15

What does the CLSI recommend for the proper order of draw?

Back 15

1. Sterile tube (blood culture)
2. Blue-top coagulation tube
3. Serum tube with or without clot activator, with or without gel
4. heparin tube with or without gel plasma separator
5. EDTA tube
6 Glycolytic inhibitor tube

Front 16

Sodium fluoride are used to collect __________ Specimens and why is this used to collect this certain kind of specimen?

Back 16

blood sugar
it preserves glucose for up to 3 days and also inhibits the growth of bacteria.

Front 17

What does the OSHA acronym SESIP stand for?

Back 17

Sharps with Engineered Sharps Injury Protection

Front 18

A syringe transfer device allows what?

Back 18

allows the safe transfer of blood into the tubes without using the syringe needle or removing the tube stopper.

Front 19

How do Oxalates prevent coagulation? Which one is the most widely used? How many inversions are required for proper mixing after specimen collection?

Back 19

By precipitating calcium. Potassium oxalate is the most widely used It is commonly added to tubes containing glucose preservatives to provide plasma for glucose testing.
8 to 10 inversions
gray plastic stopper

Front 20

What color of tube contains EDTA in a multi specimen draw? What order is it drawn in? How many inversions are normally required for proper mixing after specimen collection?

Back 20

Lavender
it is drawn last unless you need to draw a gray tube
8 to 10 inversions

Front 21

What are the clot activators in Serum-Separator tubes (SSTs)? What color are the tube tops? How many inversions are required for complete and rapid clotting to occur?

Back 21

Silica particles are the clot activators
Red Plastic tube tops
5 gentle inversions

Front 22

What is a resheating device?

Back 22

Shields that cover needle after use; blunting devices; and equipment with devices that retract the needle after use.

Front 23

What must be done if the first butterfly tube contains an additive on a draw? What is this referred to as?

Back 23

collect a few mL in a nonadditive tube or another additive tube of the same type and discard it prior to collecting the first tube. to clear the air out of the line.

Front 24

State the memory jogger for the order of draw.

Back 24

Stop, light, Red, Stay, Put, Green, Light, Go
(sterile) (Lt. blue) (red) (SST) (PST) (Green) (Lavender) Gray)

Front 25

Name the slanted tip of the needle that pierces the vein easily?

Back 25

Bevel

Front 26

What is used? Then folded in what to hold pressure over a site following blood collection procedures?

Back 26

clean 2x2 gauze pads folded in fourths

Front 27

By what 2 methods is clotting prevented?

Back 27

by chelating (binding) or precipitating calcium so it is unavailable to the coagulation process

Front 28

What factors determine the needle gauge to be used for venipunctures?

Back 28

the size and condition of the patients vein

Front 29

Define an antiglycolytic. What is the most common antiglycolytic agent? What color is the tube top? How many inversions is needed for proper mixing after a specimen is collected?

Back 29

: A substance that prevents glycolysis, the breakdown or metabolism of glucose (blood sugar) by blood cells—e.g., sodium fluoride.
gray stopper between 5 and 10 inversions

Front 30

When using the antiseptic povidone iodine for blood culture collection what information about the patient and patient's history should be obtained from the patient before cleansing the site?

Back 30

Make sure they are not allergic to it

Front 31

What length of needle is most commonly used for venipuncture?

Back 31

1 to 1.5

Front 32

Who regulates glove quality? what are their initials?

Back 32

Food and Drug Administration (FDA)

Front 33

A _________ is a device that is applied or tied around a patients arm prior to venipuncture to restrict blood flow.

Back 33

Tourniquet

Front 34

List the 4 most common types of anticoagulants.

Back 34

Oxalates
Acid Citrate Dextrose
Citrate Phosphate Dextrose
Sodium Polyanethol Sulfonate

Front 35

It is always important to fill tubes until what happens?

Back 35

the amount of vacuum is used up for evacuated tubes
or if not evacuated tube make sure you draw exactly the right amount of blood to compensate for additive or for the test being done

Front 36

What are the reasons nonaddictive tubes are used?

Back 36

for clearing and discarding purposes only
nonadditive tubes yield serum samples

Front 37

List 4 parts of a needle.

Back 37

bevel, shaft, hub, lumen

Front 38

What EPA registered disinfectant is preferred?

Back 38

sodium hypochlorite (house hold bleach)

Front 39

List the 3 things that a typical blood drawing station includes.

Back 39

a table for supplies, a special chair where the patient sits during the blood collection procedure, and a bed or reclining chair for patients with a history of fainting.

Front 40

When using the syringe method for collecting a specimen what must be done immediately after blood is collected?

Back 40

resheath it and dispose of it in a sharps container

Front 41

What antiseptic is most commonly used for routine blood collection?

Back 41

alcohol

Front 42

What type of container should needles, lancets and other sharp objects be disposed in?

Back 42

Sharps container

Front 43

What do royal-blue stoppers on specimen tubes indicate?

Back 43

indicates a tube that is as free of trace element contamination as possible

Front 44

List the 2 parts of a syringe.

Back 44

barrel and plunger

Front 45

What type of tourniquet can be used more than once, but must be discarded if dropped or contaminated with blood or other visible contaminants.

Back 45

Strap touniquet

Front 46

An under filled tube is called a __________ __________.

Back 46

Short Draw

Front 47

List 3 forms that additives are available in.

Back 47

Liquid, powder, or spray-dried coating

Front 48

How does Citrates prevent coagulation? What color are the tube tops? What test are they used for? How many inversions are required for adequate mixing after collecting a specimen?

Back 48

it prevents coagulation by binding or chelating calcium.
sodium citrate, which is used for coagulation tests (PT and aPTT) because it does the best job of preserving the coagulation factors
light blue stoppers
3 to 4 gentle inversions

Front 49

When must lithium heparin not be used, and when should sodium heparin not be used?

Back 49

lithium heparin must not be used to collect lithium levels. Sodium heparin must not be used to collect sodium specimens or electrolyte panels because sodium is part of the panel.

Front 50

What gauges and lengths of syringe needles is appropriate for phlebotomy procedures?

Back 50

20 to 23 gauge 21 is the most common
1 to 1.5 lengths

Front 51

What substances are used to prevent sepsis and inhibits growth and development of microorganisms, but does necessarily kill them?

Back 51

Antiseptics

Front 52

The gauge of a needle is related to the ___________ of the lumen.

Back 52

diameter

Front 53

What type of bandage should not be used on babies younger than 2 years of age because of the danger of aspiration and suffocation.

Back 53

No bandage should be used!
hold pressure on wound until it stops bleeding

Front 54

What chemical substances or solutions regulated by the EPA that are used to remove or kill microorganisms on surfaces and instruments.

Back 54

sodium hypochlorite (bleach) products are preferred

Front 55

What factors are considered when using syringes to obtain a blood specimen.

Back 55

if the patient has small or difficult veins

Front 56

What elements are in EDTA which prevents coagulation by binding or chelating to what other element?

Back 56

Calcium

Front 57

The Most common and efficient system for collecting blood that the CLSI prefers is? list name and initials.

Back 57

evacuated tube system (ETS)

Front 58

Define hemolysis.

Back 58

The destruction of red blood cells which leads to the release of hemoglobin from within the red blood cells into the blood plasma

Front 59

Define anticoagulants.

Back 59

A substance that prevents blood from clotting.

Front 60

List the types of phlebotomy needles.

Back 60

Multisample needles
hypodermic needle
butterfly needle

Front 61

Where are phlebotomy carts parked at on morning draw?

Back 61

Outside in the Hallway.

Front 62

List 2 things that need to be inspected before using a needle for venipuncture.

Back 62

defects such as blocked , blunt or bent tips
rough bevels or shafts

Front 63

Define carryover or cross-contamination and how does it occur?

Back 63

transfer of additive from one tube to the next.
Blood remaining on or within the needle can be transferred to the next tube drawn or filled Contaminating that tube with additive from the previous tube and possible affecting test results on the specimen

Front 64

what gauge of needle is considered the standard for most routine antecubital venipunctures?

Back 64

21 gauge

Front 65

Whole blood or plasma must be collected in a tube that contains a/an _____________

Back 65

Anticoagulant

Front 66

List the three heparin formulations.

Back 66

ammonium, lithium, and sodium heparin.

Front 67

What type of gloves are acceptable for most phlebotomy procedures?

Back 67

Nonsterile, disposable latex, nitrile, neoprene, polyethylene, and vinyl

Front 68

List the basic components of and ETS.

Back 68

Multisample needle, Tube holder, Evacuated tube

Front 69

Blood is collected by several methods list 3.

Back 69

arterial puncture, capillary puncture, and venipuncture

Front 70

What is the most common reason for using an additive?

Back 70

preventing clotting or preserving certain blood components. Blood in additive tubes may or may not clot depending on the additive type

Front 71

why are ETS tubes called multisample needles?

Back 71

because they allow multiple tubes of blood to be collected during a single venipuncture

Front 72

Define a winged infusion blood collection set or butterfly.

Back 72

an indispensable tool for collecting blood from small or difficult veins such as hand veins and veins of elderly and pediatric patients as it allows much more flexibility and precision than a needle and syringe

Front 73

Define additive and list 2 functions of an additive.

Back 73

: A substance (other than the tube stopper or coating) such as an anticoagulant, antiglycolytic agent, separator gel, preservative, or clot activator placed within a tube or collection container. An additive can be a liquid, powder, or spray-dried coating.
it can prevent clotting or help with clotting