NHA Phlebotomy Certification EXAM Graded A+
1. Semen Transport Temperature: - 36-38 degrees C.
2. Ammonia Specimen Handling: - Place specimen in an ice water slurry or cup of ice.
3. Arterial Blood Gases: - Must be placed on ice within 30 minutes after collection.
Blood Collection Procedu...
- Place specimen in an ice water slurry or cup of ice.
3. Arterial Blood Gases:
- Must be placed on ice within 30 minutes after collection.
Blood Collection Procedures and Consent
1. Grossly Hemolyzed Specimen:
- Caused by incorrect needle gauge.
2. Phlebotomist's Actions After Seizure During Draw:
- Discontinue the draw.
3. Implied Consent:
- Indicated when a patient extends their arm and turns away their head.
4. Documentation of Blood Volume Drawn:
- Prevents iatrogenic anemia from excessive blood draws.
5. Patient with Down's Syndrome:
- Speak with the patient’s guardian to ensure understanding before performing venipuncture.
,6. Labeling Specimens:
- Proper labeling should be done at the time of collection in front of the patient.
Blood Collection Techniques
1. Capillary Tubes for Tests:
- Use lavender and red tubes for WBCs, RBCs, electrolytes.
2. Hematoma Development:
- Release the tourniquet and stop the draw.
3. Needle Angle for Ante-cubital Area:
- 15-30 degrees for insertion.
4. Preferred Sites for Difficult Draws:
- Use a syringe and butterfly assembly for older adults with fragile veins.
5. Order of Draw for Capillary Specimens:
- Lavender first, then tubes with additives, then tubes without additives.
Quality Control and Safety
1. Quality Control in Point of Care Tests:
- Perform external liquid controls when a new lot number opens.
2. Sharps Container Filling Rule:
- Only fill to ¾ full before using a new container.
3. Personal Protective Equipment (PPE):
, - Essential for safety during blood draws.
Blood Flow Through the Heart
Correct Order of Blood Flow Through the Heart:
1. Vena Cava (superior/inferior)
2. Right Atrium
3. Tricuspid Valve
4. Right Ventricle
5. Pulmonary Valve
6. Pulmonary Artery
7. Lungs
8. Pulmonary Veins
9. Left Atrium
10. Mitral Valve (Bi-Cuspid)
11. Left Ventricle
12. Aortic Valve
13. Aorta
Patient Rights and Legalities
1. Informed Consent:
- Explained procedure with verbal or written permission.
2. Implied Consent:
- Patient gestures indicating permission without verbal agreement.
3. Patient’s Bill of Rights:
- Initiated in 1973 by the American Hospital Association.
, 4. Sentinel Event:
- An unanticipated death or permanent loss of function unrelated to the patient's condition.
Regulatory and Ethical Issues
1. Licensure for Phlebotomists:
- Required in Louisiana and California.
2. Criminal vs. Civil Lawsuits:
- Criminal is initiated by the government; civil is between private parties.
3. Assault vs. Battery:
- Assault is the threat of harm; battery is the actual harmful contact without consent.
4. Aseptic Techniques:
- Prevent infection and contamination in the phlebotomy environment.
General Knowledge
1. Phlebotomy Definition:
- An incision into a vein.
2. Accreditation Agencies for CLIA:
- Centers for Medicare/Medicaid Services (CMS) and FDA.
3. Best Protection Against TB:
- N-95 respirator mask during a blood draw.
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