Phlebotomy essentials 8th Edition ch 7,8,9 review

Which additive prevents glycolysis?

Sodium Flouride

List the supplies for a routine venipuncture.

Gloves

Alcohol or iodine

Tourniquet

Tube(s)

Needle

Tape and/or bandaids

Gauze

Which of the following can be used to collect a serum specimen

Red top tube

A tourniquet is used in a venipuncture to?

find and enter veins more easily

You are about to preform a routine venipuncture on a patient with no know allergy to antiseptics. What should you use to clean the site?

70% isopropyl alcohol

what needle has the largest diameter?

18 gauge

What causes evacuated tubes to fill with blood automatically?

Premeasured tube vacuum

Lavender top tubes are commonly known to collect

Hematology tests.

What tube is filled last in the recommended order of draw?

Lavender top

A butterfly needle is typically used for

Difficult veins and hand veins

The additive in a purple top tube is

EDTA

blood in which type of tube normally clots within 5 minutes

RST

List three types of biocide

70% isopropanol, hydrogen peroxide, povidone-iodine

Mixing an additive correctly involves turning the wrist this many degrees and back again.

180

If a CBC, PT, plasma potassium, and glucose (drawn with a glycolysis inhibitor) are all to be collected during a multiple-tube draw on a patient, which of the following choices shows the correct stopper colors to use in the correct order of draw?

light blue, green, lavender, gray

A green stopper indicates that the tube contains

Heparin

A trace-free tube stopper is

Royal blue

Which tubes contain EDTA and thixotropic gel

PPT's

A transillumination device is used to

locate veins

The ratio of blood to anticoagulant is most critical for

Light-blue-top tubes

NPO means

nothing by mouth

Which of the following is required requisition information

Patient specific identifier

The following test orders for different patients have been received at the same time. Which test would you collect first?

STAT glucose in the ED

A member of the clergy is with the patient when you arrive to collect a routine specimen. What should you do?

Come back after the clergy person has gone

You're asked to collect a blood specimen an impatient. ID bands are required at the facility, but the patient is not wearing one. What is the best thing to do?

Ask the patients nurse to attach an ID band before you draw that patient

If a patient adamantly refuse to have blood drawn you should

Notify the patients nurse or physician

An inpatient is eating breakfast when you arrive to collect a fasting glucose. What is the best thing to do?

Consult with the patient's nurse to see if the specimen should be collected

After cleaning the venipuncture site with alcohol the phlebotomist should

Allow the alcohol to dry completely

The tourniquet should be released

As soon as blood flow is established, before needle removal from the arm, within 1 minute of its application

What is the recommended angle of needle insertion when performing venipuncture on an arm vein and on a hand vein respectively

30 degree angle or less

After inserting a butterfly needle, the phlebotomist must "seat" it, meaning the phlebotomist will

Slightly thread it within the lumen of the vein

Blood collection tubes are labeled

Immediately after specimen collection

What is the best approach to use on a 8 year old child who needs to have blood drawn

Explain the draw in simple terms, ask for the child's cooperation

Which type of patient is most likely to have an arteriovenous fistula or graft?

dialysis patient

What is the proper procedure when dealing with an elderly patient

Make certain to hold adequate pressure after the draw until bleeding stops.

Where is the tourniquet applied when drawing a hand vein?

Proximal to the wrist bone.

Specimen hemolysis is most likely to result from

Using a large volume tube with a 23- gauge needle

What is the least effective way to immobilize a pediatric patient before a blood draw

Allowing the child to sit with one arm bracing the other.

Criteria used to decide which needle gauge to use for venipuncture include:

Size and condition of the vein

What are the correct steps for a venipuncture after tube(s) have been filled

remove needle, place gauze, activate safety device

What are some ways to handle a needle-phobic patient

Ask the most skilled phlebotomist do the draw, Have the patient lie down for the procedure, Place an ice pack to the site before the draw

How long should the site be examined to determine if the bleeding has stopped

5-10 seconds

Examples of timed tests include:

Blood cultures, cardiac enzymes, and cortisol

Bending the arm up to apply pressure to the site after venipuncture has been shown to do all of the following EXCEPT:

Enable the site to quickly stop bleeding after needle removal

The unique number assigned to a specimen request by a lab is called the

Accession number

Peak levels of analyte typically occur around 0800 hours

Cortisol

What test results are most affected if the patient is not fasting

Glucose and triglycerides

Veins that feel cordlike when palpated may be

Thrombosed

Tiny red spots that appear on the patients arm when the tourniquet is applied are a sign that the

The site may bleed excessively

When the arm of the patient is swollen with excess fluids, the condition is called

Edema

A patient has several short lengths of IV-type tubing protruding fro the chest. This is most likely a (n)

CVC

What situation could allow reflux to occur during venipuncture

Filling the tube stopper end first

A patient complains of extreme pain when you insert the needle during a venipuncture attempt. The pain does not subside, but the patient does not feel and numbness or burning sensation. You know that the needle is in the vein because the blood flowing into the tube. You have only two tubes to fill, and the first one is almost full. What should you do?

Discontinue the draw and attempt collection at another site

What can result in hemoconcentration

Leaving the tourniquet on for 2 minutes

You are in the process of collecting a specimen by venipuncture. You hear a hissing sound, there is a spurt of blood into the tube, and blood flow stops. What has most likely happened

Tube vacuum escaped

Most test results reference ranges are values for

Healthy individuals

If a venipuncture fails to draw blood and the phlebotomist senses a slight vibration of the needle, the could be a sign that the needle

Is up against a valve

An arm that is paralyzed

Has no muscle function

A bariatric phlebotomy chair is designed for individuals who are

overweight

An AV fistula is most commonly used for

Dialysis access

What can hemolze a specimen

Drawing a large tube with a 23-gauge needle, forceful aspiration of the blood with a syringe, horizontal transpiration of tubes of blood

Whattype of drug therapy can increase bilirubin level

Acetaminophen pills

Pseudoanemia can be caused by

A change in position from standing to lying down

Creatinine clearance is a measure of

kidney function

If a patient has IV's in both arms, the best place to draw the specimen is:

Distal to one of the IV's

A vein may be s eroded if it

Feels hard

What is the best way to tell if you are accidentally drawing blood from a artery, while you are drawing the specimen?

Blood pulses into the tube

A specimen collected in this tube is not affected if the tube is under filled

Red-top tube

Drawing this tube before a chemistry tube can result in false hypocalcemia

EDTA tube

What dietary supplement can interfere with laboratory immunoassays

Biotin

List the order of additives

Citrate

Heparin

EDTA

Oxalate & Fluoride

List the order of draw (test/method)

Blood cultures

Coagulation studies

Non-additives

Additives

List the order of Draw (tube color)

Red tube

Lavender tube

Green tube

Black tube

Grey tube

Blue tube

Yellow tube

Orange tube

Serum gel tube

Red tube test & additive

Biochemistry tests and no additives

Lavender tube test & additive

Hematology tests & EDTA

Green tube test & additive

Biochemistry tests & sodium heparin

Black tube test & additive

Hematology, ESR tests & sodium citrate

Grey tube test & additive

Glucose, chemistry tests & sodium fluoride

Blue tube test & additive

PT, PTT coagulation tests & sodium citrate

Yellow tube test & additive

Whole blood determination tests & SPS, ACD

Orange tube test & additive

Chemistry tests & thrombin

Serum gel tube test & additive

Various lab tests & clot activator and serum gel separator