phlebotomy chapter 1 and 2

Chemistry

Measures substances in blood/fluids (glucose, cholesterol)

What department tests for BMP, CMP, LFT, renal, lipd panels? (ALT, AST, glucose)

Chemistry

What tubes are used in chemistry for serum?

Red, gray, royal blue

What tubes are used in chemistry to collect plasma?

Green(heparin), gray, royal blue, white EDTA gel tubes

Hematology

Studies blood cells

preforms CBCs, reticulocyte counts, and sedimentation rates

hematology

What tube is used in hematology?

Lavender stopper containing EDTA (invert 8 times)

Coagulation

Assesses blood clotting and monitors anticoagulant therapy

preforms PT/INR, APPT, D-dimer

coagulation

What tube does coagulation use?

Light blue containing sodium citrate

Microbiology

Identifies pathogens(bacteria, fungi, viruses, and parasites)

preforms gram stains, blood culture, culture and sensitivity (C&S)

microbiology

Microbiology collects what samples

Stool, urine, and throat samples

Serology (immunology)

Tests immune responses (antigen/antibody reactions

Preforms RPR, ASO, RA, ANA, HIV

immunology

What tubes does serology use?

Red tubes

Blood bank

Provides blood products and ensures safe transfusions

preforms ABO/Rh typing, cross-matching, panels

blood bank

What tubes does blood banks use?

Plain red(serum), lavender, and pink

Cytology

Detects abnormal cells

Histology

Prepares tissue samples for pathologist evaluation

Cytogenetics

Studies chromosomes

Urinalysis

Assesses kidneys/metabolic disorders

preforms dipstick analysis, pH, glucose, hemoccult, gastroccult

urinalysis

Three Laws of Ethics

1. Do not harm intentionally

2. Perform competently with sound judgment

3. Respect patients’ rights

Three common procedures

venipuncture, skin puncture, arterial puncture

Venipuncture

Piercing a vein with a needle/syringe

Skin puncture

Using a lancet to collect capillary blood

Arterial puncture

Collecting blood from an artery

Traditional duty of a phlebotomist

to collect blood for diagnostic purposes

expanding duty of a phlebotomist

cross-train to preform basic patient care tasks

Professional characteristics for a phlebotomist to possess:

dependable, cooperative, committed, compassionate, courteous, respectful, have integrity, be honest, have competence, be organized, responsible, flexible, clean appearance, and good communication skills

Three components of communication:

verbal skills, listening skills, nonverbal skills

patients' physical handicaps, emotions, educaation level, age, and language proficiency

barriers to verbal communcation

How to overcome physical handicaps?

speak loudly or communicate in writing if hard of hearing or if visually impaired use large print or explain procedures fully

How to overcome patients' emotions?

speak calmy and slowly and not to appear rushed and disinterested

how to overcome patients' educational level?

use age-appropriate phrases

how to overcome language proficiency?

remain calm, cool, and collected and to locate hospital-based interprator or use hand signals

what are the correct listening skills expected of a phlebotomist?

look directly and attentively at the patient, encourage communication, be observant

what are the correct body language skills expected of a phlebotomist?

be relaxed, maintain eye contact, and maintain appropriate zone of comfort

What are the six rules of telephone etiquette?

1. answer the phone with stating the name of department and your name

2. make sure call is not an emergency before putting on hold

3. always try to help callers

4. always try to help callers

5. provide accurate and consistent information

6. Speak clearly and make sure both parties are understood

what is cultural diversity?

language, customs, beliefs, religion, and values

what is a compentency expected of a phlebotomist?

to become certified or licensed

requirements for people performing waived, provider-performed microscopy procedures (PPMPs), moderate-complexity testing, and high-complexity testing

The Clinical Laboratory Improvement Amendments (CLIA)

Development of written standards and guidelines for specimen collection, speciman handling and processing, and laborating testing and reporting

The clinical and laboratory standards institute (CLSI)

Accrediatation and certification fo health-care organizations (HCOs), (improve safety and quality of care)

The joint commission (TJC)

Accreditation of laboratories and provision of proficiency testing

the college of american pathologists (CAP)

accreditation of physician office laboratories (POLs)

the commission on laboratory assessment (COLA)

what are the different healthcare settings that a phlebotomist can work at?

POLs, health management organizations, reference laboratories, home health care agencies, off-site clinics, and specimen collection facilites

HIPPA stands for

Health Insurance Portability and Accountability Act of 1996

considered easy to preform by following instructions and have little risk error

waived testing

microscopy tests preformed by a physician, midlevel practicitioner, or dentist

provider-preformed microscopy

tests that require documentation of training in test principles, instrument calibration, periodic proficiency testing, and on-site inspections (automated CBC)

moderate-complexity tests

tests that require sophisticated instrumentation and a high degree of interpretation. Proficiency testing and on-site inspections are required (urine culture and susceptibility)

high-complexity tests

What are the national patient safety goals?

-Improve the accuracy of patient identification

-improve the effectiveness of communication around caregivers

-reduce the risk of healthcare associated infections

accredits educational programs in cinical laboratory sciences

National accrediting agency for clincal laboratory sciences (NAACLS)

what are the two divisions of the laboratory

anatomical and clincial

anatomical areas consist of

cytology, histology, and cytogenetics

clinical areas consist of

hematology, coagulation, chemistry, blood bank, serology, microbiology, and UA

what is the liquid portion of anticoagulated blood

plasma

what does plasma contain that serum does not?

fibrinogen

what is the liquid portion of blood that is allowed to clot?

serum

hemoglobin electrophoresis and protein electrophoresis on serum, urine, and cerebrospinal fluid

electrophoresis

theraputic drug monitoring + drug abuse

toxicology

preforms genetic testing for a diagnosis and treatment

molecular diagnostics

uses enzyme immunoassay techniques to measure substances

immunochemistry

who is the laboratory director

pathologist (MD)

what does a pathologist do?

autopsies, interprets test results, and analyzes anatomical speciments

Medical technologists (MT/CLS) have

bachelors

medical laboratory technicians (MLT/CLT) have

associates degree and are supervised by MTs

who processes and prepares blood specimens for testing?

MLAs

what is not a component of a complete blood count (CBC)?

hemoglobin

The laboratory employee with a 2-year associate degree who performs clinical testing is the:

medical laboratory technician

Sodium (Na), potassium (K), chloride (Cl), and carbon dioxide (CO2) are components of the test called?

electrolytes

which test would a physician order on a patient with a suspected infection?

Complete blood count CBC

The difference between plasma and serum is that

plasma contains fibrinogen

An elevated bilirubin might indicate a disorder of the

liver

The histology department is included in:

Anatomical pathology

An anemia is detected by a

complete blood count

The laboratory employee with a 4-year college degree who preforms clinical analysis is the:

Medical laboratory scientist (MLS)

What can't a medical technologist serve as?

pathologist

a competent professional demeanor is shown by

neatness, cleanliness, courtesy, cheerfulness, and pleasantness

A phlebotomist who takes an examination offered by a professional phlebotomy organization is seeking what

certification

Why should a phlebotomist minimize his or her use of perfumes and colognes?

patients may be allergic to certain fragrances

What department do phlebotomists not have to observe radiation precautions in?

physical therapy

upon the successful completion of a structured phlebotomy education program, the phlebotmist will have the opportunity to become:

certified

A phlebotomist who is teaching members of the nursing service how to correctly perform phlebotomy is participating in:

cross-training

the goal of patient-focused care is to?

increase the efficiency of personnel

The department of the hospital that is the consultant on drug therapy is

pharmacy

A phlebotomost working in a laboratory that has decentralized the phlebotomy department may be required to

work primarily on a patient-care unit and perform point of care testing

what is an additional duty of phlebotomists in today's health-care system?

performing patient vital signs

which of the following represents a professional behavior by a phlebotomist?

organizing requisitions and supplies before leaving the laboratory

what makes a patient feel that you care about them?

acknowledging them

Providing feedback to the patient is what component of effective communcation?

active listening

which of the regulatory agencies classifies laboratory tests by their complexity?

CMS

A phlebotomist working for an organization that preforms highly specialized testing is employed by a

reference laboratory

The implementation of DRGs has

increased the need for home health care

what laboratory personnel is an MD

pathologist

A laboratory professional with a bachelor's degree and 1 year of training in an accredited laboratory and who has passed the American Society for Clinical Pathology (ASCP) Board of Certification examination is a(n)

MLS

A phlebotomist reports first to the

Phlebotomy supervisor