MLAB 147 - UNIT 2 better
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129 Terms
Q: What are preanalytical variables?
A: Factors that occur before testing that can affect laboratory results.
Q: What are the four main sections of Unit 2?
A: Patient condition and preparation, site selection and complications, sample integrity, and troubleshooting collection.
Q: What is basal state?
A: A patient condition after 12 hours of fasting and no exercise.
Q: What two things define basal state?
A: 12 hours of fasting and no exercise.
Q: What is the quiz definition of basal state?
A: The body state after a 12
Q: What are the five key preanalytical variables?
A: Fasting, posture, medications, exercise, and altitude.
Q: How does fasting affect laboratory testing?
A: It helps control changes caused by food intake before testing.
Q: How does posture affect laboratory results? 1
A: It shifts body fluids and can change certain test values. 1
Q: What types of results can posture affect?
A: Proteins and lipids.
Q: How does exercise affect laboratory results?
A: It can shift body chemistry and alter test values.
Q: How can medications affect laboratory results?
A: They can interfere with or change test results.
Q: How can altitude affect laboratory results?n
A: It can influence certain physiological values.n
Q: What should you do if a patient is missing for a timed draw?
A: Document the delay, contact the nurse/physician, and reschedule.
Q: What is the correct action if a timed draw patient is at X
ray?
Q: What is iatrogenic anemia?
A: Anemia caused by excessive blood collection.
Q: What causes iatrogenic anemia?
A: Drawing excessive amounts of blood from a patient.
Q: Why should the mastectomy side be avoided?
A: It increases the risk of lymphostasis and lymphedema.
Q: What is lymphostasis?
A: Reduced movement of lymph fluid.
Q: What is lymphedema?
A: Swelling caused by lymph fluid accumulation.
Q: What is required before drawing from a mastectomy side?
A: Physician permission.
Q: What is the rule for a mastectomy side?
A: Never draw from the same side unless physician permission is given. 1
Q: What are sclerosed veins?
A: Hard, thickened veins that feel cordlike.
Q: How do sclerosed veins feel? bounce
A: Hard, cordlike, and have no bounce.
Q: Why should sclerosed veins be avoided?
A: They have poor blood flow and increased infection risk.
Q: What is a hematoma?
A: A swelling filled with blood caused by blood leaking into tissue.
Q: What should you do if a hematoma forms during collection?
A: Stop, remove tourniquet, remove needle, and apply pressure.
Q: What is the hematoma response sequence?
A: Tourniquet off, needle out, pressure.
Q: What causes hematoma formation?
A: Excessive probing, leaving tourniquet on during needle withdrawal, and needle passing through both sides of the vein.
Q: Does applying pressure with the arm straight cause a hematoma?
A: No, it helps prevent hematoma formation.
Q: What is edematous tissue?
A: Tissue swollen with excess fluid.
Q: Why should edematous tissue be avoided?
A: It can dilute the blood sample.
Q: What is hemolysis?
A: Rupture of red blood cells.
Q: Why is hemolysis important? affect
A: It can affect laboratory results.
Q: Which electrolyte is most affected by hemolysis?
A: Potassium (K+).
Q: Which enzymes are affected by hemolysis?
A: AST and LDH.
Q: Which coagulation test is affected by hemolysis?
A: PTT.
Q: What is a prevention method for hemolysis during difficult draws?
A: Use a winged infusion set (butterfly).
Q: Why use a butterfly for difficult draws?
A: It helps reduce trauma to blood cells and prevent hemolysis.
Q: What is lipemia?
A: A condition where plasma appears cloudy or milky due to fats.
Q: What causes lipemia?
A: High fats such as triglycerides and cholesterol or recent fat ingestion.
Q: What does lipemic plasma look like?
A: Cloudy or milky.
Q: What is the memory trick for lipemia?
A: Lipemia = Latte (milky).
Q: Why should povidone iodine not be used for certain tests?
A: It can interfere with laboratory results.
Q: Which tests are affected by povidone iodine?
A: Bilirubin, uric acid, and phosphorus.
Q: Can povidone iodine be used for dermal punctures?
A: No.
Q: What can be used instead of povidone iodine?
A: Isopropyl alcohol or chlorhexidine.
Q: What happens during an arterial puncture?
A: Bright red blood appears with a pulse or spurt.
Q: What color is arterial blood?
A: Bright red.
Q: What is the action after an arterial puncture?
A: Apply extra pressure.
Q: What is the arterial puncture memory trick?
A: Arterial = Bright & Color (Red) → Abort draw.
Q: What is the maximum temperature for capillary warming?
A: 42°C.
Q: What is the purpose of capillary warming?
A: To increase blood flow for collection.
Q: What is the highest STAT priority?
A: A patient bleeding out from trauma.
Q: What is the STAT priority order?
A: 1. Bleeding out/Trauma, 2. Chest pain/Troponin, 3. Routine testing.
Q: Why is trauma the highest STAT priority?
A: It is an immediate life
Q: What specimens can be rejected by the laboratory?
A: Mislabeled, hemolyzed, clotted, or wrong tube specimens.
Q: Why are mislabeled specimens rejected?
A: Because they create a patient safety risk.
Q: Why are hemolyzed specimens rejected? cuz
A: Because they can alter laboratory results.
Q: Why are clotted EDTA or heparin specimens rejected?
A: Because clotting affects accurate testing.
Q: Why are wrong tube specimens rejected?
A: Because the specimen may not contain the correct additive for testing.
Q: What is the STAT priority after trauma/bleeding out?
A: Chest pain with troponin testing.
Q: What is the third STAT priority?
A: Routine testing.
Q: Why is chest pain considered STAT?
A: It may indicate a cardiac emergency requiring troponin testing.
Q: What should you do if a patient is sleeping before collection?
A: Wake the patient before drawing blood.
Q: Why must a sleeping patient be awakened?
A: They cannot provide consent while asleep.
Q: What should you do when collecting from an unconscious patient?
A: Speak to them, explain the procedure, and treat them respectfully.
Q: Why should you speak to an unconscious patient?
A: They may still be able to hear you.
Q: What is the rule for language barriers?
A: No consent means no draw.
Q: What should be done if a patient cannot understand the procedure due to language barriers?
A: Use a translator or appropriate assistance.
Q: Can you draw blood without consent because a family member explains?
A: No, proper consent must be obtained according to policy.
Q: What should you do if visitors or clergy are present during collection?
A: Come back later unless the collection is STAT or timed.
Q: What should you do if a STAT or timed collection is required and visitors are present?
A: Respectfully interrupt and perform the collection.
Q: What is syncope?
A: Fainting or temporary loss of consciousness during blood collection.
Q: What are signs of syncope?
A: Sweating, clammy skin, and sudden silence.
Q: What is the immediate action for syncope? STOP
A: Remove tourniquet, remove needle, apply pressure, and document.
Q: What should you do after a syncope event?
A: Document everything that occurred.
Q: What is the STOP protocol used for?
A: Seizure, syncope, or hematoma situations.
Q: What does STOP stand for?
A: Strip tourniquet, Take out needle, Observe/Pressure, Provide documentation.
Q: What is the first action during a seizure?
A: Remove the tourniquet and needle immediately.
Q: What should you never do during a seizure?
A: Never put anything in the patient's mouth.
Q: Why should the needle be removed during a seizure?
A: To prevent injury and complications.
Q: What is the rule for collecting from an IV site?
A: Always use the opposite arm if possible.
Q: If an IV arm must be used, where should the sample be collected? Distal to the IV SITE
A: Distal to the IV site.
Q: What does distal mean in phlebotomy?
A: Below or farther away from the IV site.
Q: What is the IV memory trick?
A: Distal = Down/Below.
Q: Why should the IV arm usually be avoided?
A: IV fluids can contaminate or dilute the sample.
Q: What is prolonged bleeding?
A: Bleeding that continues longer than 5 minutes after collection.
Q: What should you do if bleeding continues for more than 5 minutes?
A: Notify the nurse.
Q: Why is prolonged bleeding concerning?
A: It can lead to compartment syndrome.
Q: What is compartment syndrome?
A: Pressure buildup causing nerve and muscle damage.
Q: What is reflux?
A: Anticoagulant flowing back into the patient.
Q: How can reflux be prevented?
A: Keep the tube lower than the needle during collection.
Q: Why is tube position important during collection?
A: It prevents anticoagulant from flowing backward.
Q: What is icterus?
A: A condition where plasma appears dark yellow or brown due to increased bilirubin.
Q: What color is icteric plasma?
A: Amber or dark yellow/brown.
Q: What causes icterus?
A: High bilirubin levels, often related to liver issues.
Q: What is the memory trick for icterus?
A: Icterus = Intense Gold.
Q: What does lipemic plasma look like?
A: Milky or cloudy.
Q: What causes lipemia?
A: High fats such as triglycerides and cholesterol.
Q: What does hemolysis look like?
A: Cherry red plasma.