Phlebotomy Flashcards
Hemoconcentration
Condition which the concentration of blood cells is increased in proportion to the plasma
Hemolysis
The destruction or dissolution of red blood cells, with subsequent release of hemoglobin
Plasma
The liquid portion of blood that contains an active clotting agents.
Serum
The liquid portion of blood that remains after the blood has clotted
Thixotropic gel
Material that appears to be a solid until subjected to a disturbance, such as centrifugation, where it becomes a liquid
Smaller vessel branches
Arterioles
Near The surface where O2 ( oxygen) is released
Capillaries
Erythrocytes are ___. Leukocytes are _____.
Red blood cells. White blood cells.
______is the most common method of obtaining blood
Venipuncture
Phlebotomy is performed primarily for ______ and to _____ a pts condition
Diagnoses, monitor
In bloodletting, barbers advertised with red/white striped pole. Red represented____,and white represented the____
Blood, tourniquet
The circularly system consists of :
â¢heart, chambers and valvesâ¢blood vesselsâ¢blood
The heart, chamber & valves pumps to____from____.
To body, from ventricle
Blood vessels are 3 layers:
_⢠outter: tunica adventitia (connective tissue)â¢middle: tunica media(smooth muscle)â¢inner: tunica intima(endothelium)
Blood has liquid plasma of___% and solid plasma of____%
Liquid 55%Solid 45%
What is found in liquid plasma?
Proteins, amino acids, gases, electrolytes, sugars, hormones, minerals, vitamins and water(92%), and waste products
What is found in Solid form plasma
-Erythrocytes- red blood cells (99%formed elements- Leukocytes- white blood cells- thrombocytes- platelets
Blood vessels
â¢blood vessels:- Aorta- main artery leaving the heart- Arteries- oxygenated blood to body from heart- Arterioles- Smaller vessel branches - Capillaries- near surface where O2 is released- Venules- smaller vessel between capillaries and veins; starting return of deoxygenated blood- Veins- larger vessels returning deoxygenated blood to heart( Will go to longs for refill)- Superior & inferior vena cava- routes deoxygenated blood back into the atria from the body
_____ protects the body against infection
Leukocytes( White blood cells)
Normal Leukocytes ( WBC's) is ___ - ___per microliter
5,000 to 10,000
NPA
National phlebotomy association
ASPT
American society of phlebotomy technicians
IAPS
International Academy of phlebotomy sciences
ASCP
American Society of clinical pathologist
If a patient has a history of syncope, it is best to perform phlebotomy while the patient is?
Lying on in exam table
When performing venipuncture you will likely seat a patient in a _______, which has an adjustable locking armrest to protect the patient if he or she should faint
Venipuncture chair
When applying a tourniquet the vein should bulge, but it should not restrict__________.
Arterial flow
Leaving A tourniquet on for longer than one minute greatly increases the possibility of__________.
Hemoconcentration
The most commonly used anti-septic for Cleaning a site for venipuncture is ___%, ______________,( known as rubbing alcohol)
70% isopropyl alcohol(prep pads)
To be most effective alcohol should remain on the skin for ___to___ seconds before drawing venipuncture
30 to 60 seconds
What are the 4 antiseptics used for cleansing the skin before performing venipuncture
â¢alcohol pads( 70% isopropyl alcoholâ¢sterile soap pads⢠benzalkonium chloride⢠providone iodine ( betadine)
Equipment used in routine venipuncture
Gloves, bandages, gauze pads, alcohol swabs, marking pen, tourniquet, wing infused sets( butterfly needles), evacuated stopper tubes, double pointed safety needles, syringes, sharps container, needle holder
_______ is the most common collection system in use.
Evacuated tube ( vacutainer ) system.
Tube additives contain ______, _______.
Anticoagulants, clot activators/or gel
Tube volumes range from ____ to ____mL.
2mL to 15mL
_____ is a blood thinner.
Heparin
Without a clot activator, blood clots in ___ to ____ minutes, after which it must be_____.
⢠30 to 60 minutes⢠centrifuged
Order of draw
â¢Yellow- blood cultureâ¢Light Blue-sodium citrate. Coag.â¢Red-none, serum testsâ¢Green-Heparinâ¢Lavender- EDTA. CBC.â¢Gray- sodium fluoride, and oxalate
ADDITIVE AND FUNCTION:â¢Sodium citrate; removes calcium to prevent blood from clotting.LAB USE:â¢Coagulation testingOPTIMUM VOL & MIN VOL: 4.5mL/4.5mL
Light Blue 4.5mL/4.5mL
ADDITIVE & FUNCTION:â¢EDTA, removes calcium to prevent blood from clotting.LAB USE:Hematology testing .OPTIMUM & MIN VOL: 7mL/2mL
Lavender( used for complete blood counts)
Needles have two parts
Hub and shaft
Shafts differ in length, ranging from ____ to ____ inches.
3/4in to 1 1/2inches
The gauge is designed by a numeric value; the higher the number gauge, the smaller the _____ is.
Lumen
Used when there is concern that the strong vacuum in a stopper tube might collapse the vein.
Syringe
Designed for use on small veins, such as those in the hand or in pediatric patients.
Butterfly Needle
The most common needle size for a butterfly needle is
23g, 1/2 to 3/4 inches long.
These devices, which are attached to the phlebotomy needle or to a winged infusion needle, are manually engaged after the needle has been removed from the vein.
Hinged or sliding safety mechanism.
All blood collections begin with a form from the patient's physician requesting a test. They may be computer-generated or hand written.
Requisition Form
What information must be included on a requisition form.
-patients name-date of birth-identification number-name of the physician making the request-type of test requested-test status(Timed, fasting, stat, etc)
Which venipuncture site is first choice and runs at a slight angle in the antecubital area
Median cephalic vein
Which venipuncture site is second of choice and runs lateral or to the outside of the antecubital area on thumb side.
Cephalic Vein
What are the 5 unsuitable veins.
- sclerosed veins-thrombotic veins-trotuous veins- arms with Iv's- arms w/shunts(dialysis pt.)
___ veins feel hard and cordlike. May be damaged from disease, inflammation, chemotherapy, or repeated venipunctures.
Sclerosed veins
___ veins contain clots
Thrombotic
Name two patient identifiers
Name, DOB
___ is the laboratory procedure most frequently ordered for blood specimens.
CBC, ( complete blood count)
A CBC routinely includes the following
-RBC COUNT- WBC COUNT- Hemoglobin determination- hematocrit determination- differential WBC count- estimation platelet numbers- red cell indices
Leukocytosis
Bacterial infection and leukemia
Leukopenia
Viral infections and chemotherapy
In hematocrit testing, two or three drops of blood are collected from a capillary puncture in two capillary tubes and are placed in a ____.
Microhematocrit centrifuge
What test is based on The principle of separating the cellular elements from plasma by centrifugation
Spun microhematocrit test
What machine is used to test hemoglobin
Stat-site system
Inflammation of a vein with formation of a clot
Thrombophlebitis
Factors to consider when drawing venipuncture
- fasting- edema - swelling- fistula- surgical connection between artery and vein,( dialysis pt )
When should you label tubes
After draw at pts. side
Glass or plastic tubes that draw blood by capillary action, the blood fills into these tubes without the need for section
Capillary tubes
Equipment needed for capillary punctures
- alcohol pad- gauze- lancet- capillary tube
Depth of capillary puncture for infant and adult
Infant - 0.85 to 2.0Adult- 0.85 to 3.0
____ contains tissue fluid
Capillary samples
Order of draw for capillary specimens
-lavender- additives- without additives
Restraints for children
Papose boards
____ samples is a mixture of venous and arterial blood
Capillary samples
Hemoglobin and glucose are higher in?
Capillary blood