chapter 8

iatrogenic anemia

anemia caused by medical treatment, most often resulting from frequent, excessive blood draws for lab tests

when should you label a blood collection tube

immediately after collection, in front of the patient

patient specific identifier

a number / other set of characters that are unique to a patient

test requisition form

document that formally orders laboratory tests, containing patient details, ordering provider info, billing data, diagnosis, collection time/date, and specific tests requested, acting as a critical instruction sheet and legal record

STAT priority

first priority

STAT and med emerg indicates what?

that the tests are urgently needed on critical patients

“timed” status meaning

collect specimen at a specific time

what does this warning sign indicate?

loss of a newborn

what does ASAP status indicate?

that the test results are needed soon to respond to a serious situation- but the patient is not critical

what is the total time a patient needs to refrain from eating before blood should be drawn for a fasting test?

8-12 hours

why should the tourniquet not be placed closer than 3-4 inches to the site on the arm

the vein may collapse as the blood is withdrawn

what is the first tube to be drawn when using a butterfly needle for a coagulation tube?

discard tube

how does venous blood flow into a syringe

by slowly pulling back on the plunger

a doctor has ordered a blood draw for a 2 year old patient with a clinical condition; what is the maximum draw in volume per day in mL/kg

1.75

what is the term for a vein that is tender and warm with a red area around it?

phlebitic

what is the term for a vein that is hard inflexible and narrow

sclerotic

A phlebotomy technician is preparing to collect a specimen from a 3-year-old patient to perform a coagulation test. Which of the following collection methods should the technician use?

winged safety butterfly

A phlebotomy technician is collecting a specimen to test a patient's lithium level following a recent dose of medication. Which of the following levels should the technician collect?

peak

A phlebotomy technician is processing the blood sample of a patient who ate a meal of meat and cheese prior to the draw. Following centrifugation of the sample, what finding should the technician expect?

the specimen is lipemic

lipemic

cloudy or milky white due to an excess of fats in the blood

a urine culture and sensitivity is typically ordered to detect…

urinary tract infections

recommended procedure for collecting a 24 hour urine sample

void the first morning specimen, start the timing, and collect all other specimens, including the next morning’s specimen

what may happen if you mix a specimen too vigorously?

hemolysis

when should an additive tube be inverted

as soon as it is removed from the holder

NPO meaning

nothing by mouth

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

an inpatient is eating breakfast when you arrive to collect a fasting glucose. what is the best thing to do in this situatin?

consult with the patient’s nurse to see if the specimen should be collected

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

slightly thread it within the lumen of the vein

Which type of patient is most likely to have an arteriovenous fistula or graft:
a. arthritic
b. dialysis
c. hospice
d. wheelchair-bound

B

Where is the tourniquet applied when drawing a hand vein?

proximal to the wrist bone

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

5-10 seconds

Examples of timed tests include:
a. basic metabolic panel, potassium, and glucose
b. blood cultures, cardiac enzymes, and cortisol
c. calcium, ferritin, and CBC
d. creatinine, lactic acid, and reticulocyte count

B

The unique number assigned to a specimen request is called the…

accession number

if a patient is not wearing an ID band on their wrist (in a setting where ID bands are required) where else should the phlebotomist check?

patient’s ankle for patient identity information