Phlebotomy Lecture Review

Comprehensive vocabulary flashcards covering phlebotomy basics, lab operations, tube additives, legal issues, and venipuncture procedures based on the lecture notes.

Provider

The individual who orders the bloodwork.

Facility

The location where healthcare is administered.

Long-term care facility

A setting that produces skilled care $24$ hours per day; mobile phlebotomists typically work here.

Clinical laboratory

A facility that collects and analyzes specimens to provide healthcare professionals with information.

CLIA (Clinical Laboratory Improvement Amendments)

A federal agency that establishes requirements for staffing and operation of clinical labs operating in the $US$.

Specimen

A portion or sample of something larger collected for study, such as blood, urine, stool, or sputum.

Reference lab

A facility that primarily analyzes specimens sent from other locations.

Joint Commission

An independent organization that can accredit laboratories.

Hematology

The laboratory department that studies properties, diseases, or disorders of the blood and blood cells.

Microbiology

The study of bacteria, viruses, fungi, and other microorganisms.

Culture

The process of causing microorganisms to multiply to help determine what is causing an infection.

Antibody

A protein made to fight against foreign substances.

Blood bank

The department responsible for preparing blood for transfusion.

Pathology

The study of the causes and effects of diseases.

Phlebotomy

The surgical opening or puncture of a vein to withdraw blood, introduce a fluid, or let blood out.

Venipuncture

The puncture of a vein with a hollow needle for extracting a specimen.

Capillary puncture

The puncture of skin with tiny needles to collect a few drops of blood from capillaries.

Requisition

An order for diagnostic tests to be completed, containing patient info, insurance, and specific tests requested.

Quality assurance

In healthcare, ensuring that care is being provided according to facility policy and procedures.

Quality control

Processes put into place to document that standards are being met so that machinery and results can be trusted.

CLSI (Clinical Laboratory Standards Institute)

A nonprofit organization that develops standards of practice for laboratories worldwide.

Continuing education (CE) credits

Credits required for phlebotomy certification renewal, which expires every $2$ years without them.

Blood culture

A test for the presence of bacterial or fungal pathogens in blood, always drawn before any other tubes.

Aerobic

A blood culture bottle with air, represented by a blue cap, which is drawn first when using a butterfly needle.

Anaerobic

A blood culture bottle without air, represented by a brown cap.

Preanalytical errors

Errors that occur before the specimen is analyzed; these comprise the majority of testing errors.

Fasting status

Refraining from eating or drinking anything for $8-12$ hours before collection, required for glucose and cholesterol tests.

Basal state

A rested state in which no food or beverage except water has been consumed for the last $12$ hours and no strenuous exercise has been performed.

Order of draw

The standard sequence in which collection tubes are filled during a blood draw to prevent cross-additive contamination.

Hemolysis

The destruction of red blood cells ($RBCs$), which can be caused by a tourniquet that is too tight or a needle that is too small.

Isopropyl alcohol ($70\%$)

The most common antiseptic used for site cleaning.

Chlorhexidine gluconate

The second choice antiseptic, specifically used for blood culture collection.

Tourniquet

A band used to restrict the return of venous blood to help make veins easier to locate.

Evacuated tube system

A multi-collection vacuum system that allows for multiple samples from a single stick.

$$21-gauge$$

The most common needle gauge for venipuncture in adults, usually color-coded green.

Winged collection set (butterfly needle)

A shorter needle, usually $\frac{3}{4}-1$ inch, with plastic wings for better control.

Analyte

A substance measured or studied in a diagnostic test, such as sodium or cholesterol.

Serology

The study of blood serum.

SST (Serum separator tube)

A gold tube containing no anticoagulant but a gel to separate liquid serum from the solid components after centrifugation.

Serum

The liquid portion of blood without clotting factors, obtained from blood that was allowed to coagulate.

Sodium citrate tube

A light blue tube containing an anticoagulant that prevents the action of calcium.

Heparin

An anticoagulant in green tubes (or $PSTs$) that prohibits thrombin.

Plasma

The liquid part of blood with the clotting factors still intact, obtained from anticoagulated blood.

EDTA

An anticoagulant in lavender tubes that prevents the action of calcium and helps preserve cells.

Glycolysis

The deterioration of glucose, which is prevented in grey tubes by sodium fluoride.

Sodium fluoride and potassium oxalate

The additives in a grey tube used for glucose and lactic acid tests.

Discard tube

A tube drawn but not tested to ensure additives from one tube do not carry over or to clear air from a line.

Stat draws

Tests that must be performed immediately, no later than $10$ minutes after the order is issued.

Peak

The point when a medication is at its highest level in the bloodstream.

Trough

The point when a medication is at its lowest level in the bloodstream.

Glucose tolerance test

A test measuring fasting blood glucose and changes after ingesting a sweet beverage to check for diabetes.

Bilirubin

An analyte associated with liver function; excess in the blood causes jaundice and specimens require light protection.

HIPAA (Health Insurance Portability and Accountability Act)

Federal standards to protect health information ($PHI$) from disclosure without patient consent.

CLIA waived test

A diagnostic test involving little risk of error that phlebotomists can often perform, such as a glucometer or pregnancy test.

Point-of-care test

A diagnostic test performed near or in the presence of the patient for quick results.

Tort

A violation of civil law, such as negligence.

Negligence

An action or failure to provide proper care that results in unintended injury.

Assault

The use of words or actions to cause a person to feel fearful of being harmed.

Battery

The intentional touching of another person without permission.

Informed consent

Consent where the patient receives information about the procedure before agreeing.

Implied consent

Assumption that the patient agrees, such as a patient rolling up their sleeve or in emergency situations.

Accession number

A unique number printed on all specimen labels and documents associated with a specific requisition.

Panel

A group of related tests, such as a lipid panel or hepatic function panel.

CBC (Complete Blood Count)

A test that determines the total number of each type of blood cell.

Hemoconcentration

The buildup of blood cells relative to the liquid concentration of the blood, often caused by leaving a tourniquet on too long.

Antecubital fossa

The area inside the elbow where the most accessible veins for venipuncture are located.

Median cubital vein

The first priority vein for venipuncture located in the middle of the fossa; least likely to strike a nerve.

Hematoma

An injury caused by leaked blood beneath the skin, often if the tourniquet is not removed before the needle.

Iatrogenic anemia

Excessive removal of a patient's blood, a risk in intensive care wards.

Lymphedema

Faulty lymphatic draining; why phlebotomy is avoided on the side of a mastectomy.

Petechiae

Small, flat red or purple dots caused by leaking capillaries.

QNS

Stands for "quantity not sufficient," meaning the specimen is too small for the required tests.

Chain of custody

A protocol for specimens where there is incentive to tamper, such as forensic or paternity testing.

Lipemic

A cloudy or milky appearance of plasma or serum due to lipids from recent meals.

Icteric

A dark yellow appearance of plasma or serum due to high bilirubin.

OSHA (Occupational Safety and Health Administration)

Federal agency responsible for ensuring safe and healthy working conditions by setting and enforcing standards.

Ergonomics

The study of designing equipment and tasks to fit the worker's needs for safety and efficiency.

Hazard Communication Standard

OSHA standard that requires identification and communication of potential hazards in the workplace.

Safety Data Sheet (SDS)

A document that outlines the composition, potential hazards, and safe handling of chemicals.

Pictograms

Visual symbols used on labels to convey specific hazards associated with chemicals.

Engineering controls

Physical modifications to the workplace that reduce risk (e.g., safety guards, ventilation systems).

Administrative controls

Policies and procedures set by an organization to reduce risk and ensure safety.

Personal Protective Equipment (PPE)

Gear worn to minimize exposure to hazards that cause serious workplace injuries and illnesses.

Centrifuge

A device used for separating substances in a liquid by spinning rapidly.

PASS (Fire Extinguisher Method)

Acrostic for the steps to use a fire extinguisher: Pull, Aim, Squeeze, Sweep.

RACE (Fire Emergency Protocol)

Acronym for: Remove anyone in danger, Activate alarm, Contain fire, Extinguish fire or Evacuate.

Capillaries

Small blood vessels where the exchange of oxygen, carbon dioxide, and nutrients occurs.

Hemostasis

The process of stopping bleeding, which involves clot formation.

Fibrin

A protein that forms a mesh to create a clot at the site of a blood vessel injury.

Thrombosis

The formation of a blood clot within a blood vessel.

Hemophilia

A genetic disorder that causes excessive bleeding due to a lack of clotting factors.

Thrombus

A blood clot that forms within a blood vessel, obstructing blood flow.

Pulmonary embolism

A condition in which a blood clot travels to the lungs, blocking blood flow.

Buffy coat

The middle layer of blood in a centrifuged specimen that contains white blood cells and platelets.

Blood composition

The makeup of blood, consisting of plasma (55%) and formed elements (45%).

Antigen

Substances that can induce an immune response, important in blood typing.

CBC (Complete Blood Count)

A common blood test used to assess overall health and detect a variety of disorders.