Phlebotomy Certification EXAM

Capillary Puncture

3rd or 4th finger for adults, heel stick for infants; Lancet cut across ridges; hold the tube horizontal when filling. Don't sqeeze finger too tightly or milk the finger. Wipe off 1st drop.

The vein can collapse

If you pull on the plunger of the syringe too hard or too quickly during a draw or you use too strong of a vaccum for the vein, this can happen...

Anticoagulant

An agent used to preven blood clotting and to keep the specimen whole blood

Red top

NO ADDITIVE --- Clot Forms ----Serum used for Chemistries, Electrolytes, Thyroids (TSH, T4), Hormone, Liver, Kidney, Lipid stuidies, CMP, BMP.

Tiger top

Aka Red/Gray top: Clot activator additive - Clot Forms - SERUM STUDIES

Lavender top

EDTA additive - No Clot - WHOLE BLOOD for: Complete blood count (CBC), Blood smear, Blood banking (ABO/Rh), ESR, HCT, Hmg,Glyco Alc ***Must be filled sufficiently and inverted (gentle rocked) several times***

Gold Top

Clot activator additive - Clot Forms - SERUM Studies

Grey top

Sodium Fluoride/Potassium oxalate - Glucose, Alcohol, FBS

Light blue top

Sodium citrate additive - No Clot - Used for coagulation studies (PT, PTT) ***Tube must be filled to the proper level and inverted (gentle rocked) several times***

Wipe away the first drop

We do this to remove tissue juices, skin cells, alcohol, contaminates, avoid activating clotting process, avoid producing incorrect results, avoid diluting specimen.

The basilic, cephilic, and the median

What veins are in the antecubical area?

Hemoconcentration

This is the increase of the cellular/solid elements in direct ratio to plasma This can be caused by "pumping of the fist" and begins after the tourniquet is left on longer than 1 minute.

Provodine/iodine

Agent used on the skin to sterilize the area.

Tourniquet

Elastic device used ti restrict blood flow to distend veins for phelbotomy.

Wing infusion set

Aka butterfly - for small or fragile veins or difficult veins

Erythrocytes, leukocytes, and Thrombocytes (Platelets)

The solid portion of blood contains:

Plasma

The liquid portion of whole blood; contains all clotting factor

Serum

The liquid portion of clotted blood; contains NO clotting factors.

3-4 inches abouve the puncture site. 1 minute.

Where should the tourniquet be placed in regards to the draw site and how long should it be left on?

Immediately remove the tourniquet and needle and stop the patient from falling. Lower the patients head and arms. Put something cold on the back of the neck.

What should the MA do if the patient begins to feel dizzy during the blood draw?

Label tube, bandage patient, document the draw.

What the Phelbotimist to after the blood has been successfully draw and the needle has been properly disposed of:

Complete Blood Count

WBC, RBC, Hct, Hemoglobin (Hb), RBC indices ( MCV, MCH, MCHC), Blood smears, WBC Differential, Platelet count are all considered what kind of test?

Coagulation studies

Prothrombin time (PT) and Partial thromboplastin time (PTT) are considered this kind of test...

Lipid Studies

Cholesterol, Triglycerides, HDL, LDL, are considered this kind of test...

Chemistry panels

Sodium, Potassium, Chloride, CO2, Glucose, BUN, Creatinine, Calcium, Protein, Albumin, Globulin, Bilirubin, Alkaline Phosphotase, AST, ALT are all considered...

Thyroid Panel

TSH, T4 are considered...

MI studies

CPK, Tropin, Myo tests are all part of this...

Electrolytes

Sodium, Potassium, Chloride, CO2 are for this kind of test...

Spun Uncoagulated Blood

This type of blood sample has plasma on top, "Buffy coat" white blood cells and platelets in the middle, red blood cells on the bottom.

Spun Clotted Blood

This type of blood sample has serum on top, and clot on the bottom.

Hemolysis

Breaking apart of RBC's, causing serum or plasma to appear pink-red. This can be caused by a strong vaccum for the size of the vein, to small needle gauge, plunger pulled too quickly, pt has a hemolytic disorder, shaking the tube, taking to long to complete draw.

Blood Smear

For this you must clean the glass slide and use whole blood or capillary sample.

Erythrocyte Sedimentation Rate (ESR)

This is a Non-specific test for inflammation in the body. Use Whole Blood. Collected in lavender tube top.

Soap and water

When cleaning a site for a veinpuncture for alcohol test, use:

Spinning a centrifuge

You must always balance out, making sure euqally filled tubes are on each side when doing this:

Hematocrit (Hct)

% of RBC's to total blood volume

Bevel

Angle end of needle that is inserted into vein/skin

Hub

Holds needle

Gauge

Size of Lumen or hole in needle, the smaller the number/guage, the larger the lumen. -- 18g: large size, not often used for veinpuncture 21g: Used with vaccutainers 23g: used with butterfly system or syringes 0-5 ml in capacity 25g: smallest gauge needle, often causes hemolysis of blood.

Lumen

center of needle (hole)

Safety needles

needles with a mechanical cap attached for use after removal from pt.

blood cultures

need special training to draw these, so MA's usually don't draw them.

ETOH

ethyl alcohol, when drawing for this test, use soap and water to draw to insure no contamination of specimen