Phlebotomy National Exam Study Guide Part 2

Arteria Blood Gas (ABG) sample must be run within

15 minutes of collection

Arterial blood is used to determine

blood gas levels and blood PH. Usually collected by a nurse or respiratory therapist

Basal state is

When the patient has fasted and not excersiced in 12 hours

Do you note if a patient has not fasted?

YES!

2nd order of draw tube color is

Light blue

Light blue tube has what additive

Sodium Citrate
Different ratios

Light blue tubes MUST be inverted how many times

5 to 10

Light blue tubes are used to test

coagulation determinations on plasma specimens.
Certain test require chilled specimens
Always fill to MAX fill line

3rd order of draw tube color is

Tiger top or gold top (gold in Utah)

Tiger top / Gold top tubes have what additives

Clot activator - (silica in Utah) or glass particles
Fixotropic gel

Blood cagulates with additive in

15 to 30 minutes

4th order of draw tube color(s) are

Green top
Mint top
Hash marks on label

Green top tube has what additives

Heparin combined with sodium, lithium or ammonium ion

Mint green top tube has what additive

PST - Plasma Seperator tube

Hash marked tube has what additive

Sodium Heparin

Common tests for Green tubes are

Ammonia
Carboxyhemoglobin ( HCg preg test)
STAT Lytes

LYTES are

electoliytes - potassium, sodium

BMP Panel is

Basic
Metobolic
Panel

A Panel is

A group of tests ordered together

Sodium additive tubes test for

Lithium

5th order of draw tube color is

Lavendar

Lavendar tube has what additive

EDTA - Ethylenediaminetetraacetate

BMP - chem 8 Tiger/Gold tube

Basic Metobolic Panel

CMP - chem 14 Tiger/Gold tube

Comprehensive Metobolic Panel

Drk purple tube has

7. mL of EDTA - calcium binding agent

Lt purple tube has

3.6 mL of EDTA - calcium binding agent

Pink top tubes are used for

Blood banks / transfusion - for blood typing

Lavendar top tubes are used for

CBC = Complete Blood Count
CBCAN = Complete Blood Count Automatice Differential
CBCDN - Complete Blood Count Manual Differential

ESR - Lavendar top tub

Erythocyte Sedimentation Rate

ESR tests for

Sickle Cell Screening

EDTA

inhibits coagulation by binding to calcium in the specimen

What tube is used for coagulation studies?

Light Blue

Tubes must be filled

at least two-thirds full

Tubes must be inverted

8 times

Hematocrit measures

the percentage of the RBC's (Red Blood Cells) in a given volume of whole blood

What test is ALWAYS given before blood donation

Hematocrit

1- blood enters the heart

Superior & Inferior Vena Cava (V-C)

2- goes to

Right Atrium

3- from there to

Tricuspid Valve

4- then onto

Right Ventricle

5- and now out to the

Pulmonary Artery - and lungs

6- back into the

Pulmonary Veins

7- then onto the

Left Atrium

8- moves onto the

Bicusped Valve

9- down to the

Left Ventrical

10- finally to your hot bod via the

Aorta

Veins have

Valves

ABG (Arterial Blood Gas)

Analyes arteial blood for oxygen, carbon dioxide and bicarbonate content in addition to blod PH
* used to determine the effectiveness or respiration

Aseptic

The absence of microoganisms or by contrast, something that just discourages the growth of microoganisms is antiseptic

Basilic Vein

The large vein on the inner side of the bicep and is often chosen for tntravenous injections and blood drawing

Battery

The basis of tort in this case the unprivileged touching of one person by another.

Informed Consent

Patient gives consent for a procedure to be performed in full knowledge of the procedure and the risk it entails

Bleeding Time

A test done to ascertain platelet function.

A Plug is

A special paper applied to a wound (small incision) in the forearm. The paper is applied and then timed to see how long it takes for platelets to form a "plug" and stop the bleeding

Asprin will affect

bleeding time results

Blood Clot

The conversion of blood from a liquid form to solid through the process of coagulation

Thrombus is

a clot which forms inside of a blood vessel

an embolism is

a clot that moves inside the vessel it is referred to as an embolus

Blood borne infection

an infection transmitted from blood to blood

Butterfly

a small needle with two plastic wings attached which are squeezed together to form a tab that is used to manipulate the needle. A long 6-12" plastic tubing is attached which again offers better manipulation. This assembly is then attached to a syrings or Vacutainer holder for the purpose of drawing a blood sample

CDC

Centers for Didease Control and Prevention

Circulation

movement of fluid in a regular or circuitous cource. Heart failure is and example of a problem with circulation

Citrate

A compound that is an intermediate in the citric acid cycle (krebs cycle)
Citrate chelates (binds) calcium ions, preventing blood clotting and thus is an effective anticoagulant

Coagulation Factors

Group of plasma protein substances (Factor I-XIII) contained in the plasma which act together to bring about blood coagulation

Complete Blood Count

The number of RBC's (red blood cells), WBC's (white blood cells) and platelets (per cubic millimeter) that are present in the patient's sample of blood is determined.
Also included is the HEMOTACRIT (%), hemoglobin concentration (gm%) and the differential.
Most common test done on the blood

Contamination

The soiling of pollution by inferior material, as by the introduction of organisms into a wound

Coumadin

Trademark for the preparation of warfarin sodium

Cyanotic

Bluish skin color due to lack of Oxygen

Defamation of character

Consists of injury to another person's reputation, name or character through spoken (slander) or written (libel) words.

Differential

A count made on a strained blood smear of the proportion of the different leukocytes (WBC's) and express as a percentate.
A differential is a normal part of a complete blood count (CBC)

Ecchymosis

The skin discoloration caused by a bruise (contusion)

EDTA

Ethylenediaminetetraacete. A calcium chelating (binding) agent that is used as an anticoagulant for laboratory blood specimens

Electrolyte

A substance that will acquire the capacity to conduct electricity when put into solution. Electrolytes include sodium, potassium, chloride, calcium and phosphate. informally know as "LYTES"

Embolus

A sudden blockage of a blood vessel by a blood clot or some other obstruction which has been transported through blood vessels and lodged at a site to small for passage.
Examples of emboli are detached blood clot, a clump of bacteria or other foreign material such as air.
Contrast to thrombus

Fibrin

A protien formed during normal blood clotting tht is the essence of the clot

Fibrinogen

The protein form which fibrin is formed/generated in normal blood clotting

Flash

Relative to venipuncture, the appearance of a small amount of blood in the neck of a syringe or the tubing of a butterfly. This is a sign the the vein has been properly accessed.

Fomite

An inanimate object that transports microoganisms

Formed Elements

Red Blood Cells, White Blood Cells and platelets

Gauge

Needle Diameter is measured by gauge; the larger the needle diameter, the smaller the gauge.
For example, a very large diameter needle (16 ga) may be used to hemodialysis, whereas a much smaller needle (23 ga) would be used to draw blood for laboratory testing

Germicide

An agent that kills pathogenic microoganisms

Good Samaritan Law

This law deals with the rendering of first aid by health care professionals at the scene of an accident or sudden injury. It encourages health care professionals to provide medical care within the scope of their training without fear of being sued for negligence

Glucose

The sugar measured in the blood an urine specimens to determine the presences or absence of diabetes.

Glucose is the end product of carbohydrate metabolism and is the cheif source of energy for all living organisms

Heparin

An anticoagulant that acts to inhibit a number of coagulation factors, especially factor Xa. Heparin is formed in the liver

Hematocrit

The ratio of the total RBC (red blood cell) volume to the toal blood valume and expressed as a percentage

Hematoma

A localize collection of blood within tissued due to leakage from a wall of a blood vessel, producing a bluish discoloration (ecchymosis) and pain

Hemoconcentration

A decrease in the fluid content of the blood (plasma), resulting in an increase concentration. This is determined by an increase in the hematocrit. Caused by a filtration of plasma into the body tissue and often created by dehydration

Hemoglobin

The oxygen carrying pigment of the RBC's (red blood cells)

Hemolyze

The breakin of the RBC's (red blood cells) membrane releasing free hemoglobin into the cirulating blood. In phlebotomy, this is usually a result of mechanical damage due to poor technique

Hyerglycemia

Abnormally high blood sugar level

Hypoglycemia

Abnormally low blood sugar level

Indirect Infection

An infection transmitted through body fluids to blood

Informed Consent

Giving the patient adequate information concerning the method, risk and consequences to a specific procedure, it's reisks, expected outcome and alternatives

Invasion of privacy

This is the release of medical records without the patient's knowledge and permission

Lipemic

After blood is spun and seperated in a centerfuge the serum/plasma portion is milky in apprearance. Hyperlipidema would cause the blood to be lipemic

Lymphedema

Lymphedema is a type of swelling wich occurs in lymphatic tissue when excess fluid collects in the arms or legs because the lymp nodes or vessels are blocked or removed. Regarding Phlebotomy, this can be a major complication of mastectomies

Multi-Sample Adapter

A device used with a butterfly and Vacutainer holder to allow for then withdrawl of multiple tubes of blood during a venipuncture

Negligence

This is the failure to exercise the standard of card that a resonable person would give under similar circumstances and someone suffers injury because fo another's failur to live up to a required duty of care

Four elements of negligence

1-Duty of care
2-Derelict: breah of duty if care
3-Direct cause: legally recognizable injury occurs as a result of breach of duty of care
4-Damage: wrongful activity must have been caused the injury or harm that occurred

Nosocomial

Healthcare setting acquired infections