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PLB 109 FINAL EXAM STUDY GUIDE
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PLB 109 FINAL EXAM STUDY GUIDEAnalyze procedural errors that lead to failure to obtain blood - ANSWER
Arrange the different levels of test status requests in the most logical order for
venipuncture - ANSWER STAT( 1st): Draw immediately before any other
test, Test results are urgently needed on critical patients. Timed( 2nd if near
time): Draw at a specific time. Timing is critical for accurate patients. ASPA
(2nd or 3rd): As soon as possible, the patient is in serious but not critical
condition, pre-op/ Post-op. Fasting (4th): The patient has not eaten recently.
Routine (Last) Used to establish a diagnosis or monitor a patient progress.
Collect promptly, but no urgency.
Define and identify the purpose of OSHA - ANSWER Occupational Safety
and health admin The patient station. Mandates and enforces safe working
conditions for employees. Bloodborne pathogens standard: protects employees
from accidental exposure to bloodborne pathogens
Define anticoagulant - ANSWER Oxalate. Use to treat or prevent Blood clot
Define buffy coat - ANSWER Middle thick layer: WBCS and platelets.
Define oedema and describe an edematous arm. - ANSWER Edema- Swelling,
increased fluid in the tissue, difficult to palpate, specimen contaminated with
fluid, specimen: specimen may cause erroneous results.
Define hemostasis and identify additional names for the process - ANSWER
Process by which the body stops the leakage of blood from the vascular system
after injury. It is also called the coagulation process or the clotting process
Define informed consent and provide an example - ANSWER Patient must
consent to the venipuncture. Part of informed consent is telling patient you are a
student
,Define plasma, describe how plasma is obtained, and identify tubes used to
obtain plasma - ANSWER Plasma is fluid from whole blood specimen. Whole
blood must be separated to get plasma. Green , Lavender, light blue and gray.
Define serum, describe how serum is obtained, and identify tubes used to obtain
serum - ANSWER Serum is the liquid portion of a clotted specimen. To obtain
serum: Use clot tubes -Red stopper. Use serum separator tube (SST)
Define Standard Precautions and describe when to use Standard Precautions -
ANSWER Standard precaution : treat every fluid as potentially infectious, hand
hygiene, gloves.
Define the term iatrogenic anemia and explain how to prevent it - ANSWER
Removal of blood on a regular basis for testing: causes anemia. Facilities should
have a mechanism to monitor the volume of blood: pediatric patients and
Critically ill patients. Limits to 1-5% of patient blood volume within 24 hours:
blood volume children 75-80 ml/kg
Define what is a fasting specimen - ANSWER When a patient hasn't eaten
anything for 12 hours to get their blood drawn
Demonstrate and discuss the proper technique for tying a tourniquet -
ANSWER Position the tourniquet around the arm. Each hand should grasp one
side of the tourniquet, several inches from the end. Apply small amount of
tension around by stretching the tourniquet around the arm. Maintain tension
and bring the two side of tourniquet together. Grasp the tourniquet between the
thumb and index finger of the right hand near the patient's arm.While securely
grasping the tourniquet, tuck a portion of the left side under the right side into a
loop.The ends of the tied tourniquet should point toward the shoulder
Describe how much blood should be discarded when drawing blood through an
indwelling vascular device - ANSWER 5ml
Describe how to handle a patient refusing a venipuncture - ANSWER Note if
patient refuses and notify nurse or doctor. Patient must consent to venipuncture
, Describe how to palpate veins and what veins feel like. - ANSWER Palpate:
press and release site several times. Vein has a bounce and resilience when
palpating with index finger
Describe how to respond to patient inquiries about testing - ANSWER Never
attempt to explain the purpose
Describe the 4 main steps in hemostasis - ANSWER 1.) vasoconstriction: of
blood and vessel occurs. 2.) platelets clumping together: and stick to portion of
vessels, called platelet plus, stop venipuncture site from bleeding. 3.)
coagulation/ clotting: clotting factors help form a fibrin meshwork. Platelet plug
become a stable blood clot. 4.) Fibrinolysis: Fibrin clot/scab disappears when
injury is completely healed
Describe the components of the ETS system, how each component is used, and
the purpose of each of the components - ANSWER
Describe the composition of whole blood - ANSWER Blood in the same form
as found in the body. Made up of formed elements suspended in plasma
Describe the different parts of a needle - ANSWER Bevel: Tip of needle, Cut
several time at a slant. Shaft: Most 1 in to 1 1/2 in, 1/2 to 3/4 for butterfly
needle. Hub: attaches to blood collection device
Describe the formed elements composing blood including the purpose of each
and alternate names for each - ANSWER Red blood cells: Also known as
erythrocytes, Most numerous- carry O2 from lungs to cells. White blood cells:
also called leukocytes, Fights infections. Platelets: Also called thrombocytes,
important in coagulation.
Describe the purpose of anchoring a vein during venipuncture and explain how
to anchor a vein. - ANSWER To keep the vein from rolling by pulling the skin
1-2 below site taunt with your thumb. Anchor in with the vein not to the side.
Describe the relationship between needle gauge and lumen size. - ANSWER
The larger the gauge number, the smaller the lumen of the needle. 22 or 23
gauge with 3/4 length for children or small veins. 21 or 22 gauge with 1 or 1.5
inch length is routine
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