Phlebotomy NHA, CPT NHA EXAM 2023/2024

What is Hematology? - ANSWER Hematology is the study of blood and its components, fluids and cells. Also includes the study of blood forming organs and blood disease What is Phlebotomy? - ANSWER Phlebotomy is the practice of drawing blood for diagnostic purposes What does the medical term "Phlebos" mean? - ANSWER Veins What does the medical term "tome" mean? - ANSWER Incision What are two other names for capillary puncture? - ANSWER Dermal or skin puncture What does POCT mean? - ANSWER Point-of-Care What is Point-of-Care? - ANSWER Tests that can be at the patients bed side and results can be obtained right away. Examples: Blood Glucose, Hematocrit, Hemoglobin What are capillaries? - ANSWER Microscopic, one cell-thick vessels that connect arterioles and venules What is the purpose of a capillary? - ANSWER Capillaries are the site of gas exchange between blood & bodily tissues What is the preferred locations for venipuncture? - ANSWER 1. Antecubital Fossa 2. Upper aspect of the forearm 3. Posterior aspect of the wrist 4. Dorsum (back) of the hand 5. Ankle and foot veins (Dorsalis Pedis) What does the medical term "ante" mean? - ANSWER Before What are the three superficial veins located in the Antecubital Fossa? - ANSWER 1. Median Cubital Vein: Large and fixed 2. Cephalic Vein: Preferred in obese 3. Basilic Vein: Close to the brachial artery and median nerve What is plasma composed of? - ANSWER 90% water, 7% proteins, the rest is all 1% (proteins, amino acids, gases, electrolytes, sugars hormones, lipids & vitamins) What color is plasma? - ANSWER Straw color What is the difference in appearance of plasma and serum? - ANSWER They both look the same, the only way to differentiate them is by looking at the tube top color What is the buffy coat composed of? - ANSWER Leukocytes and platelets What is the percentage of plasma in the blood by volume? - ANSWER 55% What is the percentage of formed elements? - ANSWER 45% What are formed elements? - ANSWER Erythrocytes, Leukocytes, and Platelets What do these abbreviations mean "RBCs" "WBCs"? - ANSWER Red blood cells and White blood cells (erythrocytes and leukocytes) Another name for thrombocytes? - ANSWER Platelets Where are erythrocytes formed? - ANSWER In the red bone marrow What is the life span of erythrocytes? - ANSWER 120 days What purpose does hemoglobin have? - ANSWER It transports oxygen Fact: White blood cells have different size, shape, color and nucleus - ANSWER ... What is the life span of a leukocyte? - ANSWER Approximately 24 hours What is the purpose of white blood cells? - ANSWER Protect body against infection and disease Number of leukocytes pet cubic millimeter - ANSWER 5000 - 10,000 There are two different types of white blood cells, what are they? - ANSWER Granular or Agranular leukocytes (Granular Leukocytes - perform phagocytosis) (Agranular Leukocytes - produce antibodies) Fact: Granular Leukocytes are polymorphonuclear Examples of them are: Neutrophils, Eosinophils, and Basophils Their job is to perform Phagocytosis They usually react to inflammation - ANSWER ... Fact: Lymphocytes and monocytes are examples of Agranular Leukocytes They produce antibodies Examples are: T cells and B cells - ANSWER ... What are the differentials and their percentages? - ANSWER Neutrophils: 40% - 60% - Never Lymphocytes: 20% - 40% - Let Monocytes: 2% - 8% - Monkey Eosinophils: 1% - 4% - Eat Basophils: 0.5% - 1% - Bad Band: 0% - 3% - Bananas Fact: Thrombocytes are the smallest formed element Size: 1-4 micrometers - ANSWER ... What is the function of a thrombocyte? - ANSWER Stoppage of bleeding What is the life span of a thrombocyte? - ANSWER 9-12 days Which gloves are used to perform a venipuncture? - ANSWER Nonsterile, disposable latex, nitrile, neoprene, polyethylene and vinyl examination gloves are acceptable. A good fit is essential. Where should the tourniquet be placed? - ANSWER Tied 3 to 4 inches above elbow immediately before venipuncture. A tourniquet on for longer than 1 minute may alter test results. Why is the tourniquet used? - ANSWER To prevent venous flow out of the site, causing veins to bulge. The tourniquet makes veins easier to locate and puncture. What is the most common antiseptic used for venipuncture? - ANSWER 70% isopropyl alcohol (alcohol does not sterilize skin; it inhibits reproduction of bacteria that might contaminate the sample) How long should you let the 70% isopropyl alcohol dry for? - ANSWER 60 seconds (it should not be used when drawing blood alcohol test, instead use soap pads, benzalkonium chloride or povidone-iodine which is also known as BETADINE) Fact: Blood is about half cells and half liquid; for a test requiring 3 mls of serum 6 mls of blood must be collected - ANSWER ... What is an additive? - ANSWER Any substance placed within a tube Functions of additives are: - ANSWER 1. Preventing clotting/anticoagulant 2. Preserves certain blood components 3. Clot activator/promotes clotting Where is EDTA found? - ANSWER Lavender topped tube (prevents platelet clumping and preserves appearance of blood cells for microscopic examination) What is the full name for EDTA? - ANSWER Ethylenediaminetetracetic What are the following abbreviations "SST" and "PST" - ANSWER SST: Serum separating tube PST: Plasma separating tube What is thixotropic gel? - ANSWER Forms a barrier between red cells and plasma when centrifuged (It is found in the green-gray marbled topped tubes) What is the order of draw? - ANSWER Yellow, light blue, red/red gray, green, lavender, gray, dark/royal blue top tube Mnemonic to easily remember it: STOP, LIGHT, RED, GREEN, LIGHT, GO AND DONT RUN! Yellow top tube - ANSWER Additive: sodium polyanetholsulfonate SPS or Acid Dextrose. Purpose: it tests blood culture for aerobes and anaerobes/2 VIALS *** SPS aids in the recovery of microorganism by inhibiting the action of complement, phagocytosis and certain antibiotics *** Sterile tube AEROBE FIRST ANAEROBE SECOND FILL 8-10 MLS Light blue top tube - ANSWER Additive: Sodium Citrate *** Fill completely Purpose: PT, Extrinsic pathway and Coumadin therapy and aPTT ( Activated partial thromboplastin time) RATIO: 9:1 Red top tube - ANSWER Additive: None Purpose: Serum separator tube Green top tube - ANSWER Additive: Sodium, Lithium or Amonium Heparin Purpose: STAT electrolyte or ammonia Lavender/Purple top tube - ANSWER Additive: EDTA Purpose: CBC, ESR (erythrocyte sedimentation rate) and sickle-cell screening *** Tube has to be filled at least two thirds Gray top tube - ANSWER Additive: Antiglycolytic agent sodium fluoride Preserves glucose for 72 hours - lithium iodoacetate Preserves glucose for 24 hours - potassium oxalate / anticoagulant by binding with calcium Dark royal blue tube top - ANSWER Additive: EDTA or sodium heparin Purpose: Test toxicology and trace elements, zinc and copper and lead What does STAT mean? - ANSWER As soon as possible, IMMEDIATELY What is the bevel of a needle? - ANSWER The shaft of the needle with one end cut at the angle which is called the bevel Fact: Gauge is designated by a numeric value * The higher the number, the smaller the lumen ** 16, 19, 20, 21, 22 and 23 MOST COMMON USED GAUGE: 21 BLOOD BANKING GAUGE: 16 - ANSWER ... What is another name for butterfly needle? - ANSWER Winged infusion set Needle size is 23 gauge Tue or false, needles should always be recapped ... - ANSWER FALSE! needles should never be recapped THE SAFETY NEEDLE DEVICE SHOULD BE ACTIVATED NHA steps for venipuncture: 1. Greet and ID the patient/verbal and/or wrist band 2. Obtain consent from a patient 3. Ask if the patient has had any problems with venipuncture (syncope) 4. Ask if the patient is on blood thinner/aspirin, Coumadin,plavix 5. Check for the order form and the patients chart 6. Have the patient sit down or lie down; do not perform venipuncture if the patient is standing