phlebotomy chapter 7 & 8

What colored tubes are used with oxlates in them?

Gray

oxlates are used mainly for what levels?

Glucose or lactate

Oxalates prevent coagulation by binding to what?

Calcium

Why’s are oxalates not used for hematology?

They distort cellular morphological features

Oxalates may contain what to prevent breakdown of glucose by inhibiting glycolysis?

Sodium fluoride

What destroys enzymes

Fluoride

What tube do you not have to invert if they don’t have an anticoagulant?

Red tubes

Red top tubes that have a clot activator should be inverted how many times?

Several

SST (serum separator tubes) should be inverted how many times?

5

How many times should normal tubes be inverted?

8 times

What tubes are yellow or speckled/mottled topped?

Serum separator tubes (SST)

What tubes contain no anticoagulant but contain a clot accelerator to increase platelet activation, thereby shortening time required to clot?

Serum separator tubes (SST)

SSTs have what gel in the bottom of the tube that will act as a barrier between rbc’s and the serum after centrifugation?

Thixotropic

SSTs are used most often in?

Chemistry tests

SSTs cannot be used in what because of the gel?

Blood banks or therapeutic drug levels

What tube usually contain no anticoagulant, clot accelerator, or gel?

Red

Red tubes are used in what?

Blood bank, chemistry, and therapeutic drug levels

What tube is used for trace elements, nutrients, and toxicology studies?

Royal blue

What tube may contain heparin or no anticoagulant?

Brown

Brown tubes are used for?

Blood lead levels

Besides brown tubes, what other tubes may be used for blood lead levels?

Purple

What tube has a buffered sodium citrate anticoagulant in it?

Black

Black top tubes have a ratio of blood to sodium citrate of

4 to 1

Black top tubes are used for?

Sedimentation rates (ESRs or WSRs)

What tubes have a light yellow top that contains the anticoagulant sodium polyanetholesulfonate (SPS)

Blood culture tubes

Blood cultures are used to determine if a patient has what?

Bacteremia

What colored tube contains lithium heparin and a separation gel?

Light green

Light green tubes are used in what?

Chemistry

What are light green tubes called?

Plasma separator tubes (PST)

What colored tubes are used for ACD tubes (just like SPS tubes)

Light yellow

What tube contains the rbc preservative acid citrate dextrose?

ACD tubes

What tubes are used for cellular studies such as HLA testing? Paternity testing, and flow cytometry

ACD tubes

The extrinsic pathway of the coag cascade is initiated by the presence of tissue thromboplastin. What test?

Coag

What tube should not be drawn first?

Light blue

What do you do if you only need to do a coag test?

Use a discard tube first

What tubes should not be drawn prior to tubes for chemistry tests?

EDTA tubes

Syringes consist of what

Barrel and plunger

Blood will appear where when a vein is successfully entered?

The hub

What will cause hemolysis (rupture of RBCs)

Forcing blood into the tube

Points to remember about syringes are:

Don’t accidentally withdraw the needle while pulling back on the plunger and do not pull so hard that you cause hemolysis or collapse the vein

Why would you choose a syringe over a vacutainer system?

For babies, elderly, or veins that collapse easily

A reclining phlebotomy chair is part of a:

A. Phlebotomy collection tray

B. Mobile phlebotomy workstation

C. Phlebotomy drawing station

D. Portable infant phlebotomy station

Phlebotomy drawing station

Which of the following is but routinely carried by a phlebotomist’s tray?

A. Evacuated tubes

B. Tourniquets

C. Syringes

D. Urine collection cups

Urine collection cups

Which of these needles has the smallest diameter?

A. 16-gauge needle

B. 22-gauge needle

C. 22-gauge needle

D. 23-gauge needle

23-gauge needle

Before disposing of a contaminated needle, you must

A. Recap the needle

B. Remove the needle from the ETS holder

C. Activate the safety device

D. Always use two hands

Activate the safety device

The advantage of an ETS system is that

A. Blood is directly collected into the evacuated tube

B. Blood is places in the tube using a transfer device

C. You can control the suction pressure on the vein

D. The angle of the needle can be lowered

Blood is directly collected into the evacuated tube

The winged blood collected set is used primarily for

A. Heel sticks

B. Large antecubital veins

C. Finger sticks

D. Hand veins

Hand veins

Which of the following tubes contains an anticoagulant that inhibits thrombin?

A. Tube with a lavender stopper

B. Tube with a white stopper

C. Tube with a light blue stopper

D. Tube with a green stopper

Tube with a green stopper

EDTA, sodium citrate, and potassium oxalate anticoagulants prevent blood clotting in blood collection tubes by

A. Binding calcium

B. Binding fibrinogen

C. Acting as an antithrombin agent

D. Releasing heparin

Binding calcium

Which of the following can be used to obtain a serum specimen?

A. PPT

B. PST

C. SST

D. EDTA tube

SST

Which tube additive preserves glucose?

A. Sodium citrate

B. Sodium heparin

C. Sodium polyanethol sulfonate

D. Sodium fluoride

Sodium fluoride

Which tube must always be filled to the correct ratio?

A. Light blue stopper tube

B. Light green PST

C. Gold SST

D. Tan stopper tube

Light blue stopper tube

According to the CLSI, which of the following is an acceptable order of tube draw?

A. Light blue, light green, and lavender

B. Red, light blue, and lavender

C. Lavender, red, and yellow

D. Yellow. Green. And light blue

Light blue, light green, lavender

A tourniquet is used in routine venipuncture to

A. Impede venous blood flow

B. Impede arterial blood flow

C. Harden the vein

D. Flatten the vein

Impede venous blood flow

The primary antiseptic for routine venipuncture is

A. Iodine

B. Chlorhexidine gluconate

C. Isopropyl alcohol

D. Soap and water

Isopropyl alcohol

Using evacuated tubes past their expiration date may result in

A. Clotted anticoagulant tubes

B. Completely filled tubes

C. Secure gel barriers

D. Clotted serum tubes

Clotted anticoagulant tubes

Unacceptable or acceptable?

A vein in the left hand; there is an Iv in the left antecubital area

Acceptable

Unacceptable or acceptable?

A vein under scar tissue?

Unacceptable

Unacceptable or acceptable?

A vein that you cannot feel.

Unacceptable

Unacceptable or acceptable

A vein in the left antecubital area; the patient’s armband does not match your requisition

Unacceptable

Unacceptable or acceptable

A vein in the right antecubital area; an IV is in the right hand

Unacceptable

Unacceptable or acceptable

A vein in the right arm of a woman who has had a right mastectomy

Unacceptable

Unacceptable or acceptable

A vein on the back of the hand

Acceptable

Unacceptable or acceptable

A foot vein on a diabetic

Unacceptable

Unacceptable or acceptable

A vein that feels hard or cord-like

Unacceptable

A vein that you cannot see

Acceptable

Blood cultures should be collected in tubes containing what anticoagulant?

SPS

How does heparin prevent blood clotting?

Inactivates thrombin

What is the anticoagulant found in green top tubes?

Heparin

Black top tubes are used to preform what?

SED Rates

Centrifugation of blue top tubes will yield what two things?

Plasma and cells

A CBC is drawn in a tube containing what anticoagulant?

EDTA

Purple top tube contains what anticoagulant?

EDTA

What anticoagulant is found in gray top tubes?

Oxalates

The ratio of blood to anticoagulant in a black top tubes should be _ to one

4

Which of the following test is routinely preformed on royal blue top tubes?

A. CBC

B. Glucose

C. Trace metals

D. Sed. Rate

Trace metals

Correct order of draw is?

Blood cultures

Red glass

Light blue

Red plastic

SST (red/gray, gold and orange)

Green

Light green

Lavender and pink

Gray

Name the anticoagulant/additive, sample type, and laboratory use that goes with the yellow stopper tube:

SPS - whole blood - microbiology blood cultures

ACD - whole blood - blood banks

Name the anticoagulant/additive, sample type, and laboratory use that goes with the light blue stopper tube:

Sodium citrate - plasma - coagulation

Name the anticoagulant/additive, sample type, and laboratory use that goes with the red plastic stopper tube:

Clot activator - serum - chemistry, serology

Name the anticoagulant/additive, sample type, and laboratory use that goes with the red glass stopper tube:

None - serum - chemistry, serology, blood bank

Name the anticoagulant/additive, sample type, and laboratory use that goes with the red/gray, gold or red with yellow ring stopper tubes:

Clot activator and gel - serum - chemistry

Name the anticoagulant/additive, sample type, and laboratory use that goes with the orange SST stopper tube:

Thrombin and gel - serum - chemistry

Name the anticoagulant/additive, sample type, and laboratory use that goes with the royal blue stopper tube:

Clot activator/ sodium heparin/ EDTA - serum or plasma - chemistry trace elements, toxicology, and nutrients analyses

Name the anticoagulant/additive, sample type, and laboratory use that goes with the light green, green/black or green with yellow ring stopper tube:

Lithium heparin and gel - plasma - chemistry

Name the anticoagulant/additive, sample type, and laboratory use that goes with the green stopper tube:

Ammonium, lithium, sodium heparin - whole blood/plasma - chemistry

Name the anticoagulant/additive, sample type, and laboratory use that goes with the lavender stopper tube:

EDTA - whole blood/plasma - hematology

Name the anticoagulant/additive, sample type, and laboratory use that goes with the pink stopper tube:

EDTA - whole blood/plasma - blood bank

Name the anticoagulant/additive, sample type, and laboratory use that goes with the tan stopper tube:

Spray coated EDTA - plasma - chemistry lead tests

Name the anticoagulant/additive, sample type, and laboratory use that goes with the white stopper tube:

EDTA and gel - plasma - molecular diagnostics

Name the anticoagulant/additive, sample type, and laboratory use that goes with the gray stopper tube:

Potassium Oxalate and sodium fluoride - plasma - chemistry glucose tests, alcohol, and lactic acid tests

List the required information on a test requisition:

Patients name and identification number, date of birth or age, patients location, name of health-care provider ordering the tests, tests requested, requested date and time of specimen collection, number and types of tubes, status of specimen, special collection information, special patient information, and billing information

Correct identification procedure for inpatients are?

Asking patient to state their full name, spell their last name, and give date of birth. Then look at patients wrist ID that should have their name, hospital identification number, date of birth and age, and physician

Correct identification procedure for outpatient are?

Asking patient to state full name, spell their last name, and give address, birth date, or UIN

What is the preferred site for venipuncture?

Antecubital fossa

What are the three major veins?

Median cubical, cephalic, and basilic

What is the vein of choice for venipuncture?

Median cubital

Why is the median cubital vein the first choice?

It’s large and tends not to move when needle is inserted

What vein is the second choice?

Cephalic

Where is the cephalic vein located?

Thumb side of arm