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These Question-and-Answer flashcards review key concepts, procedures, equipment, tube additives, patient preparation, and safety protocols for Week 2 of Phlebotomy 118, aligning with the lecture objectives and textbook material.
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What is the definition of phlebotomy?
An incision or cutting into a vein to obtain blood.
What is venipuncture?
The collection of blood through a tiny incision in a vein, typically using a hollow needle.
Which three main methods are used for venipuncture?
Evacuated Tube System (ETS), butterfly (winged-infusion) method, and syringe method.
Which venipuncture method is preferred for large antecubital veins?
The Evacuated Tube System (ETS).
Which venipuncture method is best for small or fragile veins in any body area?
The butterfly (winged-infusion) method.
Why might you choose a syringe draw over other methods?
It allows the phlebotomist to control pressure on small, fragile veins that collapse easily.
What gauge needles are commonly used with the ETS?
21- or 22-gauge needles.
What is the typical insertion angle for an ETS venipuncture in the antecubital area?
15°–30°.
List the three primary antecubital veins used for venipuncture.
Median cubital, cephalic, and basilic veins.
Which antecubital vein is most anchored and therefore preferred?
Median cubital vein.
Why must a tourniquet be removed within one minute?
To prevent venous stasis and hemoconcentration, which can alter test results.
How far above the puncture site should a tourniquet be placed?
Approximately 3–4 inches (7.5–10 cm).
What questions should you ask a patient before a draw?
Full name, date of birth, fasting status, medication use, and test preparation instructions.
What is the correct patient identification protocol?
Ask the patient to state full name and date of birth and verify against the specimen label.
Name two skin conditions or sites to avoid during venipuncture.
Hematomas, burns, scars, eczema, or areas proximal to a mastectomy or IV line.
If both arms have IVs running, where should you draw blood?
Below the IV site, or request that a nurse perform the draw.
Why should the needle bevel always face up?
To ensure smooth entry and reduce tissue trauma.
Which tube color contains no additive and is used for ABO blood typing?
Red tube.
What additive is in the light-blue tube, and what testing is it for?
Sodium citrate; used for coagulation studies such as PT/INR and aPTT.
How many inversions are required for a light-blue tube?
3–4 gentle inversions.
Which tube contains EDTA and what common test does it perform?
Lavender tube; Complete Blood Count (CBC).
What is the inversion requirement for a lavender tube?
8–10 inversions.
Which additive is in the gray tube and what test is it primarily used for?
Potassium oxalate/sodium fluoride; Glucose Tolerance Test (GTT) and blood alcohol levels.
What is the order of draw to prevent additive cross-contamination?
1) Yellow (SPS), 2) Light Blue, 3) Red/Gold/Tiger (serum), 4) Green, 5) Lavender, 6) Gray.
What does the SST tube contain and what panel is commonly run on it?
Clot activator and thixotropic gel; Complete Metabolic Panel (CMP).
Why must serum tubes clot before centrifugation?
To allow complete clot formation and prevent fibrin strands from interfering with serum yield.
What gauge butterflies are commonly used?
21-, 23-, and 25-gauge needles.
What is hemoconcentration?
Pooling of blood leading to higher concentration of cellular elements at the draw site, causing inaccurate results.
Which site is often chosen for venipuncture in obese patients?
The cephalic vein.
Which vein lies close to the brachial artery, requiring caution?
The basilic vein.
What immediate action is taken if an artery is accidentally punctured?
Apply firm pressure and report the incident.
What needle size should be paired with small-volume (low vacuum) tubes?
Smaller gauge needles, e.g., 25 g.
Why should tubes never be vigorously shaken?
Shaking can cause hemolysis of red blood cells.
What cleaning solution must replace alcohol when collecting a legal blood-alcohol specimen?
A non-alcoholic cleanser such as iodine or chlorhexidine.
Describe the two-step cleaning method for blood cultures.
First clean with alcohol, then apply iodine or chlorhexidine in concentric circles.
How many bottles are drawn for a blood culture set and why?
Two: one aerobic and one anaerobic to detect organisms that thrive with or without oxygen.
Which tube additive prevents glycolysis and preserves glucose?
Sodium fluoride (in gray tubes).
What laboratory tests require the patient to fast 12–14 hours?
Glucose tolerance test (GTT) and lipid panel.
What should be written on every specimen label?
Patient’s name, date of birth, collection date, and collector’s initials.
How is a chain-of-custody maintained for forensic alcohol testing?
Document every person handling the specimen and seal the sample in a tamper-evident bag.
Which green tube test must be transported on ice and analyzed STAT?
Arterial Blood Gas (ABG).
What is the purpose of the flange on a tube holder?
To stabilize the holder when inserting or removing tubes, preventing needle movement.
Define ‘additive’ in the context of blood collection tubes.
A substance placed inside a tube in small amounts to achieve a specific effect such as anticoagulation or clot activation.
Define ‘inversion’ in phlebotomy.
The gentle turning of a tube end-to-end to mix blood with an additive without shaking.
What is the recommended angle of insertion for butterfly needles in non-antecubital sites?
0°–10° to minimize vein collapse.
Name two tests run from a gray tube besides GTT.
Fasting Blood Sugar (FBS) and blood alcohol levels.
Which tube is preferred for DNA testing and what additive does it contain?
Yellow tube containing ACD (acid citrate dextrose).
What is the purpose of heparin in green tubes?
It acts as an anticoagulant to provide plasma for chemistry tests.
Which test screens for prostate cancer and what tube color is normally used?
PSA (Prostate Specific Antigen); SST (gold or tiger-top).
How is a GTT timed if a patient has a five-hour protocol?
Collect fasting specimens, then specimens at 1-hour intervals for five hours.
What is the main risk when transferring blood from a syringe to a tube?
Higher likelihood of accidental needle sticks.
Which color tube is collected first when the physician orders PT/INR, CMP, and CBC?
Light-blue tube (PT/INR) following the order of draw.
If a patient has a unilateral mastectomy, from which arm should blood be drawn?
The arm opposite the side of the mastectomy.
What is ‘glycolysis’ in serum specimens?
Destruction of glucose over time; prevented by prompt centrifugation or using gray tubes.
Which additive promotes clot formation in serum tubes?
Clot activator (often silica particles).
What term describes an abnormal connection between two hollow spaces, often avoided for draws?
Fistula.
What angle should be used for radial arterial blood gas draws?
30°–45°, but performed only by trained personnel.