Principles of Medical Laboratory Science Practice 2: Phlebotomy Troubleshooting

These flashcards cover key concepts related to phlebotomy troubleshooting and best practices in medical laboratory science.

What are the three phases of sample processing according to CLSI guidelines?

Preexamination, Examination, and Postexamination.

What is the first step in the preexamination process?

Doctor's request.

How should a phlebotomist ensure correct patient identification?

Make the patient state his/her name.

What is one critical aspect of proper sample collection?

Correct use of all equipment.

What must be maintained until the examination process can begin?

Sample integrity.

What can happen during the sample examination phase?

Sample testing and maintaining testing equipment and reagents.

What is one responsibility during the postexamination phase?

Reporting of results.

What should be done following unsuccessful blood draw attempts?

Have another phlebotomist draw the sample.

What technique can cause a vein to collapse during blood draw?

Using vacuum from an evacuated tube.

What should be checked if blood flow is slow during a draw?

Tube position and vacuum.

What does it indicate if the needle is all the way through the vein?

A sign of a careless or inexperienced phlebotomist.

What does a hematoma signify during blood draw?

An accumulation of blood that clots to form a solid swelling.

Which areas should be avoided when choosing a venipuncture site?

Extensive scars, upper extremity on the side of a mastectomy, hematoma, and IV therapy.

What is the proper action if unable to find a vein after multiple attempts?

Request someone else to draw the blood.

How should the IV be managed before drawing blood?

Turn off the IV for at least 2 minutes.

What is hemoconcentration?

An increased concentration of larger molecules and formed elements in the blood.

Identify one cause of hemoconcentration during phlebotomy.

Prolonged tourniquet application.

How can overcentrifugation affect specimens?

It can cause cellysis of cells.

What is the consequence of failing to cap specimens before testing?

Evaporation

What should be done with serum after centrifugation?

Remove serum from the tube as soon as possible.

What condition must be avoided to prevent hemolysis?

Drawing blood from a hematoma.

What is the effect of prolonged tourniquet application?

It can significantly increase non-filterable elements such as proteins.

How should specimens be transported?

Done as soon as possible.

What is a key consideration when choosing veins in the hands?

Avoiding veins under the wrist.

What is the protocol for blood draws from a foot?

It should really be a last resort.

What must be avoided to prevent microbial contamination in samples?

Using clean and dry pipets and sample cups.

When obtaining blood using a vacuum-collection system, what is crucial in the order of draw?

Serum collection tubes must be filled before anticoagulant tubes.

What indicates that the bevel of the needle is not properly positioned?

Blood does not flow.

What is a quick fix if the needle bevel is against the wall of the vein?

Move the needle slightly back or rotate it until blood begins to flow.

What should a phlebotomist do if they notice a hematoma forming?

Withdraw the needle slightly to prevent further blood leakage into tissue.

How should anticoagulant tubes be handled after collection?

Mix gently 5-10 times.

What common error can leading to hemolysis during specimen processing?

Excessive turbulence of the sample.

What can affect cortisol test results related to specimen collection?

Specimen collection time.

What is considered an acceptable number of attempts at drawing blood before referring to another phlebotomist?

Two attempts.

What should be done if a patient refuses to have their blood drawn?

Inform the doctor and document the situation.

What effect can multiple blood draws have on test results?

They can lead to contamination and erroneous results.

How does a properly prepared aliquot contribute to sample integrity?

It helps maintain sample quality for testing.

What is the protocol surrounding indwelling lines or catheters in hospitals?

Consult a physician before drawing.

What problem arises from test error due to improper specimen handling?

Microbial or anticoagulant contamination.

What condition also leads to erroneous test results, aside from proper collection techniques?

Samples that are not stored correctly.

What must be done when the tourniquet is applied?

Remove it before withdrawing the needle.

What is the general procedure when drawing blood from a difficult site?

Use optimal pressure and technique for successful blood collection.

Why should you only try to locate a vein twice?

To prevent excessive poking and damage to skin.