MEDCA PHLEBOTOMY EXAM 206 Questions with Verified Answers,100% CORRECT

MEDCA PHLEBOTOMY EXAM 206 Questions with Verified Answers Work duties of a phlebotomist technician can be categorized into 4 categories - CORRECT ANSWER Equipment Procedure Patient Care Patient Information Equipment - CORRECT ANSWER - phlebotomists must ensure that all equipment and areas used are sterile - equipment includes needles, bandages, gauzes, tubes, other collection devices, as well as labels for tubes - tracking supplies to ensure that proper amounts are always present - disposal of needles and other used supplies Procedure - CORRECT ANSWER - correct puncture or incision of patient's skin - collecting the correct amount of blood or other fluids - correct labeling of collection tubes/devices - completing and submitting documents needed to lab Patient Care - CORRECT ANSWER - reassuring patients, as some may have fear of needles - being able to answer questions that patients may have - verifying patient information to ensure accuracy of tests or procedure - monitoring patient during procedure to prevent movement or fainting Patient Information - CORRECT ANSWER - patients' rights must be respected - keeping patients' medical records confidential - accurate documentation of collection, ordered tests, and test results - providing accurate documentation to the laboratory to ensure performance of tests ordered by physician Quality Improvement Methods - CORRECT ANSWER Include the use of data-based methods in order to reach improvement Include flow charts and pareto charts Flowchart - CORRECT ANSWER - used to break out components into diagrams in order to understand a process Pareto Chart - CORRECT ANSWER - bar charts are made that show the frequency of problems What does quality improvement for specimen collection involve? - CORRECT ANSWER Technique of Phlebotomist Frequency of hematoma Recollection Rates What is included in quality control records - CORRECT ANSWER Expiration Date Stability Information Storage Information Proper Use Precision of testing supplies/reagents Accuracy of testing supplies/reagents Where can phlebotomists work? - CORRECT ANSWER Hospital Clinic Doctor's office Laboratories Blood Banks Research Firms Pharmaceutical Firms Hospital - CORRECT ANSWER institution which provides medical and surgical treatment Clinic - CORRECT ANSWER institution or hospital department focusing on diagnosis and care of outpatients Doctor's Office - CORRECT ANSWER suite/office where doctors receive and treat patients Laboratory - CORRECT ANSWER building or room where tests are performed to evaluate specimens in order to diagnose medical conditions Blood Bank - CORRECT ANSWER institution where blood is collected from donors, and then stored and prepared for transfusion Research Firm - CORRECT ANSWER institution equipped for scientific/medical research that may specialize in basic research or on specific areas Pharmaceutical Firm - CORRECT ANSWER institution that develops and markets drugs for use as medications How must all needles be discarded? - CORRECT ANSWER intact What does it mean if an infection is classified as nosocomical - CORRECT ANSWER A patient developed the infection while they were in the hospital that was not present before entering the hospital What is included in the chain of infection - CORRECT ANSWER source susceptible host poor isolation technique Hygiene - CORRECT ANSWER wash hands with soap and water if they are visibly dirty good hand-hygiene techniques reduce number of outbreaks of infections hand washing is the single most important way to prevent spread of infection Equipment used to control infections - CORRECT ANSWER gloves, masks, goggles, gowns, or coats autoclaves (instruments for sterilizing under pressure) Emergency Needle Stick Information - CORRECT ANSWER if exposed to blood due to a needle stick or other sharp object, wash needle stick and cut with soap and water flush mouth, eyes, and skin with water report the incident to a supervisor seek medical treatment Blood Pressure - CORRECT ANSWER pressure exerted by circulating blood upon the walls of blood vessels Usually refers to the arterial pressure of systemic circulation When does blood pressure decrease - CORRECT ANSWER decreases as the circulating blood moves away from the heart through the arteries Where does blood pressure drop most rapidly - CORRECT ANSWER along the small arteries and arterioles Decreases continuously as it moves through capillaries and back through veins to the heart What other factors can influence blood pressure in the body - CORRECT ANSWER valves in veins Gravity Pumping from contraction of skeletal muscles How is blood pressure measured - CORRECT ANSWER Systolic (maximum) over diastolic (diastolic) Systolic - CORRECT ANSWER Blood pressure at the time of contraction Specifically during contraction of the left ventricle Systolic contraction is contraction of the ventricles Heard during the normal first and second heart sound Diastolic - CORRECT ANSWER Blood pressure when the heart is in relaxation and expansion Minimum arterial pressure when the ventricles are filling with blood Heard during diastole, when the heart relaxes Pulse/ Heart Rate - CORRECT ANSWER rhythmical expansion of arteries due to contractions of the heart Recorded as beats per minute Where can a persons pulse be felt? - CORRECT ANSWER any place that will allow an artery to be compressed against a bone Radial Artery Carotid Artery Brachial Artery Popliteal Artery Posterior Tibial Artery Which finger can not be used to measure pulse? - CORRECT ANSWER Thumb: it has a pulse of its own Is a lower or higher pulse rate better? - CORRECT ANSWER Lower Although, 60 may be dangerous Newborn Pulse - CORRECT ANSWER 120 - 160 beats per minute 1 month-12 months Pulse - CORRECT ANSWER 80-140 1-2 years pulse - CORRECT ANSWER 80-130 2-6 years pulse - CORRECT ANSWER 75-120 6-12 years pulse - CORRECT ANSWER 75-110 13+ pulse - CORRECT ANSWER 60-100 adult athletes pulse - CORRECT ANSWER 40-60 What are blood cells called - CORRECT ANSWER hemaocytes Serum - CORRECT ANSWER fluid portion of blood What cells does blood circulate through - CORRECT ANSWER arteries arterioles veins venules capillaries Where is blood made - CORRECT ANSWER bone marrow: soft center of bones 95% of blood cells are produced here How does formation of blood cells begin - CORRECT ANSWER Begins in bone marrow as stem cells These cells will grow and mature into blood cells 3 Types of Blood cells - CORRECT ANSWER Erythrocytes (red blood cells) Leukocytes (white blood cells) Thrombocytes (platelets) What percentage do cells make up of blood - CORRECT ANSWER 45% What percentage does plasma make up of blood - CORRECT ANSWER 55% Blood makes up how much of our body weight - CORRECT ANSWER 8% ( 5 Liters) What is the blood pH level - CORRECT ANSWER 7.35-7.45 Function of blood - CORRECT ANSWER To carry materials to bodily tissues (hormones, oxygen, vitamines, antibodies, heat, electrolytes, nourishment) To carry materials away from bodily tissues ( carbon dioxide, waste) Red Blood Cells - CORRECT ANSWER most numerous blood cell in the body Have a shape similiar to biconcave lenses and have no nucleus These cells are our way of delivering oxygen to the body Have a life span of 100-120 days Hemoglobin - CORRECT ANSWER Iron containing pigment which gives red blood cells their color Helps bind to oxygen Anemic - CORRECT ANSWER Lower levels of red blood cells or hemoglobin 3 Stages of Red Blood Cell Life Cycle - CORRECT ANSWER Development (Erythropoiesis) Functional (functional development ) Senescent (Senescence) Erythopoiesis Stage - CORRECT ANSWER - process of development in which new red blood cells are produced - cells mature in about 7 days - about 2 million red blood cells per second are continuously produced in the bone marrow - developing cells are also known as reticulocytes, and make up around 1% of the red blood cells in the circulatory system Functional Lifetime - CORRECT ANSWER - red blood cells live between 100 days to 120 days - during this stage, red blood cells move continuously - blood flow pushes erythrocytes in arteries, pulls erythrocytes in veins, and squeezes erythrocytes through capillaries and other small vessels Senescence - CORRECT ANSWER - as erythrocytes, they go through changes in their plasma membrane - these changes make the cells more recognizable for removal of old and defective cells, a process called eryptosis - eryptosis takes place at the same rate as production of cells, therefore keeping a balance in the amount of red blood cells Leukocytes - CORRECT ANSWER cells of the immune system and help the body defend against diseases and foreign materials Have a nucleus What cell to leukocytes develop from in bone marrow - CORRECT ANSWER hematopoietic stem cell Two types of leukocytes - CORRECT ANSWER Granulocytes Lymphoid Granulocytes - CORRECT ANSWER Have granules in cytoplasm Neutrophil Eosinophil Basophil Lymphoid Cells - CORRECT ANSWER Lymphocytes and monocytes Order of most abundant to least abundant white blood cells - CORRECT ANSWER NEVER LET MONKEYS EAT BASIL neutrophil 50 - 70 % lymphocyte 20 - 40 % monocyte 3 - 8 % eosinophil 2 - 4 % basophil 0.5 - 1 % Neutrophile - CORRECT ANSWER - defend against fungal or bacterial infection - unable to renew the lysosomes used in the defense against infection, these cells die and, in large numbers, form pus Lymphocyte - CORRECT ANSWER - although present in blood, lymphocytes are common in the lymphatic system - produce antibodies that bind to pathogens - grouped into B cells, T cells, and NK cells Monocyte - CORRECT ANSWER - forerunners of macrophages - larger cells that enter the circulatory system for about 24 - 36 hours before becoming macrophages Eosinophils - CORRECT ANSWER - main function is the defense against parasites Basophils - CORRECT ANSWER - responsible for antigen and allergic response by releasing histamine Platelet Function - CORRECT ANSWER to sop blood loss due to wounds to maintain homeostasis They release factors that promote blood coagulation Have a lifespan of about 5-9 days How long does it take for normal blood to clot - CORRECT ANSWER 30-60 min What cells to platelets develop from in bone marrow - CORRECT ANSWER megakaryocyte Each cell can produce 5,000-10,000 platelets How is platelet development regulated - CORRECT ANSWER regulated by a hormone called thrombopoietin hormone is produced in liver and kidneys Destruction of platelets - CORRECT ANSWER Takes place by phagocytosis in the spleen and Kupffer cells in the liver Reserve platelets are kept in the spleen How to platelets clump together - CORRECT ANSWER fibrinogen vWF (von Willebrand factor) Once activated, platelets will attach to exposed collagen and clumping and attachment will form a clot Clumped platelets secrete chemicals to urge fibroblasts into the wound to heal 3 Major Types of Blood Vessels - CORRECT ANSWER Arteries Veins Capillaries Arteries - CORRECT ANSWER Carry blood away from the heart Oxygen Rich Main arteries of body - CORRECT ANSWER Ascending aorta Arch of aorta External Carotid Internal Carotid Subclavian Axillary Brachial thoracic Abdominal Gonadal Lumbar Inferior Mesenteric Median Sacral Common Iliac External Iliac Veins - CORRECT ANSWER Carry blood towards the heart Oxygen deprived Less muscular and closer to the skin than arteries Contain valves Can be obstructed due to blood clots Two layers of veins - CORRECT ANSWER Tunica adventitia (connective tissue) Tunica Media (smooth muscle) Inside of veins is tunica intimate Pulmonary Veins - CORRECT ANSWER right superior left superior right inferior left inferior Systemic Cardia Veins - CORRECT ANSWER Great cardiac Oblique Vein of left atrium Left marginal Small cardiac middle cardiac Posterior vein of left ventricle Capillaries - CORRECT ANSWER Exchange of chemical and water between blood and tissue Systemic Head Neck Veins - CORRECT ANSWER - frontal vein - supraorbital vein - angular vein - anterior facial vein - posterior facial vein - occipital vein - superficial temporal vein - posterior auricular vein - internal maxillary vein Systemic Neck Veins - CORRECT ANSWER - anterior jugular vein - posterior external jugular vein - internal jugular vein - external jugular vein - vertebral vein Systemic Diploic Veins - CORRECT ANSWER - anterior temporal vein - posterior temporal vein - frontal vein - occipital vein Systemic Veins of brain - CORRECT ANSWER - superior cerebral vein - inferior cerebral vein - middle cerebral vein - basal vein - terminal vein - choroid vein - great cerebral vein - superior cerebral vein - inferior cerebral vein Systemic Veins of Eye and SKull - CORRECT ANSWER - superior ophthalmic vein - inferior ophthalmic vein - two transverse sinuses - occipital sinus - straight sinus - superior sagittal sinus - inferior sagittal sinus Upper Extremity systemic Veins - CORRECT ANSWER - dorsal digital vein - volar digital vein - dorsal metacarpal vein - intercapitular vein - cephalic vein - accessory cephalic vein - basilic vein - median antibrachial vein - axillary vein - subclavian vein Systemic Veins of Thoracic - CORRECT ANSWER right innominate vein - left innominate vein - internal mammary vein - superior phrenic vein - inferior thyroid vein - highest intercostal vein - superior vena cava - hemiazygos vein - accessory hemiazygos vein - bronchial vein - external vertebral venous plexus - internal vertebral venous plexus - postvertebral vein - invertebral vein - vein of the medulla spinalis Portal System Systemic Veins - CORRECT ANSWER - portal vein - lineal vein - short gastric vein - left gastroepiploic vein - right gastroepiploic vein - pancreatic vein - inferior mesenteric vein - hemorrhoidal vein - sigmoid vein - left colic vein - superior mesenteric vein - pancreatic duodenal vein - coronary vein - pyloric vein - cystic vein - parumbilical vein How many layers do arteries have - CORRECT ANSWER 3 How many layers do veins have - CORRECT ANSWER 2 Arterial Vessels - CORRECT ANSWER carry blood away from the heart Venous Vessels - CORRECT ANSWER Carry blood towards the heart Exceptions to arterial and Venous Vessels - CORRECT ANSWER Pulmonary Vein: carries oxygen rich blood Pulmonary Artery: carries oxygen deprived blood Where does arterial system develop? - CORRECT ANSWER aortic arches (and dorsal aorta) at 4 weeks of human development Where do venous system develop - CORRECT ANSWER 3 bilateral veins between 4 and 8 weeks of human development (umbilical, cardinal, vitelline ) Arterioles - CORRECT ANSWER - small blood vessels in microcirculation - extend and branch out from arteries and lead to capillaries - like arteries, arterioles carry blood away from the heart to tissues - arterioles play an important role in blood pressure regulation - arterioles generally have one to two layers of smooth muscle Venules - CORRECT ANSWER - small blood vessel in microcirculation - carry oxygen-deprived blood from the capillaries back to the veins - have 3 layers 3 Layers of Venules - CORRECT ANSWER -the endothelium (inner layer) is made up of squamous endothelial cells that act as a membrane - the middle layer is made up of elastic tissue - the outer layer is made up of fibrous connective tissue Capillaries - CORRECT ANSWER - smallest of the blood vessels in microcirculation - connect arterioles and venules - enable the exchange of oxygen, water, carbon dioxide, waste, and other nutrients between blood and body tissues - capillaries don't function on their own but as a "supply cell" Two main capillary types - CORRECT ANSWER Continuous Fenestrated Continous - CORRECT ANSWER - endothelial cells provide continuing lining, therefore allowing only small molecules to spread through junctions of intercellular clefts (unjoined membrane) Fenestrated - CORRECT ANSWER - pores in the endothelial cells are present - these pores allow small molecules and restricted amounts of protein to spread through Supine Position - CORRECT ANSWER patient is lying face-up on their back Prone Position - CORRECT ANSWER patient is lying face-down on their stomach What is important to remember about glucose testing - CORRECT ANSWER patient must be fasting for 12 hours 3 Types of blood draws - CORRECT ANSWER Venipuncture Capillary Puncture Arterial Puncture Venipunture - CORRECT ANSWER collection of blood through needle or syringe Used when large amounts of blood are needed What type of veins lack resistance - CORRECT ANSWER thromboses How can blood be forced into veins - CORRECT ANSWER massaging arm from elbow to wrist tapping site with finger applying warm cloth lowering extremity over bedside Elements of requisition form - CORRECT ANSWER Patients full name and ID number DOB and sex of patient name of physician requesting procedure source of specimen Date and Time of collection and initials of phlebotomist Labels - CORRECT ANSWER Patients full name Patients ID number Date and Time of Collection Initials of phlebotomist Capillary puncture - CORRECT ANSWER Also known as dermal puncture Used on infants are anemic patients Penetration should be less than 2.0mm Often performed for white blood cell differential Most accessible surface for capillary puncture - CORRECT ANSWER palmar/lateral surface of finger Ear lobe Big toe Heel (infants) Monoject Monoletter - CORRECT ANSWER safety device for capillary function What is blood collected from capillary puncture composed of? - CORRECT ANSWER blood from capillaries, arterioles, veins, and tissue fluid Blood Smear - CORRECT ANSWER performed right after wiping away the first drop of blood A spreader (two glass slide) is positions and a small drop of blood is placed on the slide. The top glass is pulled back into the blood drop to spread it along the back side of the glass. The slide is then pushed left quickly What is the best angle for blood smear spreading - CORRECT ANSWER 30 degrees Arterial Puncture - CORRECT ANSWER usually performed for further analysis of blood gas Should be done with no exposure to air Why should arterial pressure not be done in exposure to air - CORRECT ANSWER to prevent the escape of gas from the liquid At what angle should artery be punctured - CORRECT ANSWER 90 degreed Gloves - CORRECT ANSWER - disposable gloves used in phlebotomy to help prevent contamination - can be made of latex, nitrile rubber, neoprene, or vinyl - there are two types of gloves: exam gloves and surgical gloves - surgical gloves are better sized and made to a higher standard Goggles - CORRECT ANSWER - although not commonly used, goggles are frequently recommended for use - protect eyes from exposure due to splashing of blood-borne pathogens Antiseptic - CORRECT ANSWER - antimicrobial substances used to clean puncture sites before procedure in order to reduce the risk of possible infection - most common antiseptic is alcohol Tourniquet - CORRECT ANSWER - compressing device that is used to control blood circulation - usually resembling a rubber tube, it is wrapped around the arm during the procedure - more modern devices are available with contour cuffs attached to wire Collection Tube - CORRECT ANSWER - made of glass or plastic (plastic being preferred in use) - tubes are attached to a needle and a hub - tubes contain vacuum so that they fill automatically to a certain level - some tubes contain anticoagulants (additives) - anticoagulants are substances that prevent blood clotting - in tubes with anticoagulants, it is important to fill the tube with the correct amount of blood to provide an accurate blood-additive ratio Heparin - CORRECT ANSWER preferred in clinical chemistry Lithium Heparin - CORRECT ANSWER preferred to study glucose levels Acid Citrate dextrose - CORRECT ANSWER used in blood donations Syringe - CORRECT ANSWER - medical syringes are usually fitted with needles - consists of a plunger and a tube (plunger fits exactly into tube) - design makes it possible for fluid to be pulled in and pushed out of the syringe Needles - CORRECT ANSWER needle sizes vary, as do the gauges (openings) of needles - larger gauge sizes refer to smaller openings (diameters) of needles - the butterfly needle refers to a winged needle (infusion) set - butterfly needles are used when conventional methods are too difficult - needles have a color coding system which indicates the gauge size We Yell Good Bye Because People Orange 19 Gauge - CORRECT ANSWER White 20 Gauge - CORRECT ANSWER yellow 21 gauge - CORRECT ANSWER green 22 gauge - CORRECT ANSWER black 23 gauge - CORRECT ANSWER blue 24 gauge - CORRECT ANSWER purple 25 gauge - CORRECT ANSWER orange Disposable Unit - CORRECT ANSWER - also known as a Sharps Container - needles and other sharp objects/instruments are disposed into it - there are two different types of disposal units: - single use (container will be disposed with contents inside) - reusable (automatically emptied and sterilized for safe reuse) Centrifuge - CORRECT ANSWER - device/machine with fast rotating container which applies radial force - used to separate fluids of different densities (as in spinning blood) - if blood has a separation device, it should be centrifuged once Labels - CORRECT ANSWER - small piece of paper or plastic attached to the collection tubes/containers - labeling collected specimen/tubes must be accurate Bar Codes - CORRECT ANSWER - Codes that are machine Readable - Usually consists of numbers and patterns of lines printed on labels - Handwritten information can not be converted into bar codes Identification Tags - CORRECT ANSWER - small take, worn on bracelet with information on medical conditions - tags allow us for fast medical attention in emergencies - newer forms of tags are USB alert tags Requistion Form - CORRECT ANSWER - forms to properly identify blood samples - each specimen collected needs to be accompanied by requisition paper Order of Draw - CORRECT ANSWER Yellow light Blue Gold Red Orange Green Purple White Gray Yellow Tube Top - CORRECT ANSWER Blood Culture Additive: ACD Mode of Action: complement inactivation Uses: paternity tests, DNA studies Light Blue Tube Top - CORRECT ANSWER Citrate Tube Additive: sodium citrate Mode of Action: forms calcium to remove salts Uses: coagulation tests *Full draw required* Gold Tube Top - CORRECT ANSWER Gel Separator Tube Additive: none Mode of Action: serum separator tube, gel at the bottom to separate blood from serum when centrifuged Uses: immunology, serology, chemistry Red Tube Top - CORRECT ANSWER Serum Tube Additive: none Mode of Action: blood cots (serum separated through centrifuge Orange Tube Top - CORRECT ANSWER Rapid Serum Tube Green Tube Top - CORRECT ANSWER Heparin light and green Purple Tube Top - CORRECT ANSWER EDTA Additive: EDTA liquid Mode of Action: form calcium salts to remove calcium Uses: blood bank and hematology CBC *REQUIRES FUL DRAW* White Tube Top - CORRECT ANSWER Separator Tube with Gel Additive: Potassium EDTA Mode of Action: forms calcium salts Uses: molecular PCR and bDNA testing Gray Tube Top - CORRECT ANSWER Glucose/ Fluoride Additive: potassium oxalate and sodium fluoride Mode of Action: antiglycolytic agent, preserves glucose levels for up to 5 days Uses: glucose Requires full draw, short draw may lead to hemolysis Dark Blue Tube Top - CORRECT ANSWER Additive: EDTA Mode of Action: designed to contain no contaminating metals Uses: trace elements Light Green Tube Top - CORRECT ANSWER Additive: Plasma Separating Tube with lithium heparin Mode of Action: anticoagulants with lithium heparin Uses: chemistry Dark Green Tube Top - CORRECT ANSWER Additive: sodium/lithium heparin Mode of Action: inactivate thrombin or thromboplastin Uses: ammonia level use sodium or lithium heparin, for lithium levels use sodium heparin Pink Tube TOp - CORRECT ANSWER Additive: Potassium EDTA Mode of Action: forms calcium salts Uses: immunohematology Light Brown Tube Top - CORRECT ANSWER Additive: Sodium Heparin Mode of Action: inactivates thrombin and thromboplastin Uses: serum leads determination Black Top Tube - CORRECT ANSWER Additive: buffered sodium citrate Mode of Action: forms calcium salts to remove calcium Uses: sedimentation rate REQUIRES FULL DRAW Yellow/Black Top Tube - CORRECT ANSWER Additive: broth mixture Mode of Action: preserves viability of microorganisms Uses: microbiology What color tube tops require full draw - CORRECT ANSWER Light Blue Purple Black Gray Regulations for Specimen transport - CORRECT ANSWER - all specimens must be placed in leak-proof containers (tubes) - tubes must be bagged in special biohazard specimen bags - requisition slip must be placed on outside pocket of bag Pneumatic Tube System - CORRECT ANSWER Safest and most efficient methods of transport - place tubes in biohazard bag and seal - attach requisition slip - place biohazard bag in pouch - completely seal pouch - load pouch into pneumatic tube and send to lab Which samples must be sent to lab immediately - CORRECT ANSWER Blood and Urine - increase the chance of pathogen detection How long should serum specimens be sent to lab - CORRECT ANSWER within 2 hours Allergic Reaction - CORRECT ANSWER - some patients may be allergic to supplies used during puncture, such as latex gloves - patient records should always be checked for known allergies - if patient has allergic reactions that were unknown, be prepared to provide or call for medical attention Bleeding Does not Stop - CORRECT ANSWER - in some cases, such as patients with bleeding disorders, the bleeding does not stop - if this occurs, the patient should be instructed to lift the arm above the shoulder and apply pressure - if bleeding does not stop after 10 minutes, contact the supervisor - patients whose bleeding does not stop should not be left alone until bleeding has stopped Fainting - CORRECT ANSWER - if the patient is known to faint, the patient should be laid down for the procedure - if patient faints, the procedure should be stopped immediately - patient's head should be lowered to their knees - keep patient in sight for 15 minutes before releasing them - contact supervisor or physician if patient is unresponsive Hematoma - CORRECT ANSWER - occurs as blood that pools in tissue around veins is collected - may result in bruising and may be painful - to prevent hematoma, surface veins should be chosen and puncture should be at the accurate angle Hemolysis - CORRECT ANSWER - complication that occurs in the collected blood sample - if sample is not collected or handled properly, blood cells may start to break apart - to prevent this, the phlebotomist should collect and handle samples with care - tubes that contain additives should be inverted Hemoconcetration - CORRECT ANSWER - increased amount of large molecules and formed elements - causes may be prolonged tourniquet application or occluded veins Indwelling Lines/ Catheters - CORRECT ANSWER - this can be a source for potential errors - to prevent complications, samples should be discarded three times the amount of the line before the specimen is collected for further testing or analysis Infection - CORRECT ANSWER - when performing phlebotomy, the skin barrier is broken, allowing germs or bacteria to enter the body - to prevent infection, skin must properly be cleaned/sterilized, and gloves should always be used Prolonged tourniquet Application - CORRECT ANSWER - tourniquets should not remain on a patient for more than two minutes - if left on longer, integrity of blood and health of patient may be at risk - prolonged tourniquet applications may lead to tissue or nerve damage - if no vein can be found, the phlebotomist should try an alternate site Bleeding Time - CORRECT ANSWER a test that identifies function disorders of platelets Lastin gor prolonged bleeding may take place as a result of abnormal function or insufficient amount of platelets Causes of prolonged bleeding may be what? - CORRECT ANSWER Platelet disorder Fibrinogen Disorder Medications like aspirin Decreased platelet number Scurvy Selected site for bleeding time test - CORRECT ANSWER dorsal side of mid forearm Blood Alcohol Testing - CORRECT ANSWER measures the amount of alcohol within the body When is there the highest level of alcohol in the blood? - CORRECT ANSWER about one hour after having an alcoholic beverage Where is alcohol broken down - CORRECT ANSWER the liver In Blood donor testing each donor unit provides - CORRECT ANSWER - red blood cells (erythrocytes) - plasma - platelets (thrombocytes) - blood typing reagents - blood clotting factors - proteins and immunoglobulin In Blood Donation testing donor candidates - CORRECT ANSWER - be between 17 and 66 years of age - give permission or have written parental consent - be in overall good health - weigh a minimum of 110 pounds - have sufficient amount of hemoglobin and/or hematocrit Autologous Donations - CORRECT ANSWER - person donates blood for their own future use - if blood is donated before surgical procedure, the following criteria must be met: - written order of physician - patient must be capable of regenerating red blood cells - level of hemoglobin must be at least 11 grams - surgical procedure cannot be within 72 hours after donation Blood Donation Procedure - CORRECT ANSWER - two-step cleansing process using iodine preparations - selection of large vein, generally the antecubital area - 16-gauge needle and evacuated tube system are used - the anticoagulant in tubes is citrate phosphate dextrose - if tube does not fill completely, the sample must be discarded and the procedure repeated Aftercare in Blood Donation Processes - CORRECT ANSWER - in any blood donation procedure, patient must be monitored for any side effects such as dizziness and/or nausea that may occur - if side effects occur, make sure to keep patient in a supine position (lying face-up on back) with the head lower than the heart Requirements for Forensic Testing - CORRECT ANSWER - specimens must always be stored/kept in a locked container - the legal document must state: - person's name specimen was received from - person's name collecting the specimen - person's name specimen was given to - length of time each person handled the specimen Specimens collected for forensic testing - CORRECT ANSWER - blood - hair - saliva - sperm - sweat - skin - nails - teeth - bones - vegetation Guidelines for forensic testing - CORRECT ANSWER - gloves must be worn at all times - specimen must be collected as soon as possible - accuracy in packing, storing, and transporting the specimen is essential - specimen must be labeled properly - all handling of specimen must be recorded What does blood glucose measure - CORRECT ANSWER amount of sugar in the blood Why are blood glucose tests ordered? - CORRECT ANSWER If patient shows signs of diabetes or look diabetic Symptoms of diabetes - CORRECT ANSWER frequent urination blurred vision lightheadedness persistent thirst Blood Glucose tolerance test - CORRECT ANSWER ability of patient to metabolize a large dose of oral glucose Patients that receive a glucose tolerance test have been fasting and are therefore susceptible to fainting when given large amounts of glucose. Procedure of Blood Glucose Tolerance Test: Initial Procedure - CORRECT ANSWER collect initial fasting blood and urine samples - no further testing is required if blood glucose level is above 200 mg/dl - patient is given a large dose of glucose solution to drink if blood glucose level is below 200 mg/dl - make sure all of the solution is swallowed in 5 minutes without vomiting 3 Hr Blood Glucose Tolerance Test - CORRECT ANSWER collect fasting blood and urine samples at: - 30 minutes - 1 hour - 2 hours - 3 hours label each blood and urine sample with the time collected patients are not allowed to: - eat, drink (except water), chew gum, smoke, consume alcohol, or leave the facility Therapeutic Phlebotomy - CORRECT ANSWER a prescribed amount of blood withdrawn in order to treat blood disorders Hemochromatosis - CORRECT ANSWER - disorder where the body absorbs too much iron from the foods eaten - extra iron is mainly stored in the liver, pancreas, and skin - condition leads to diabetes, cirrhosis of the liver, enlarged heart with congestive heart failure, higher skin pigmentation, or irregular heart beat Polycythemia - CORRECT ANSWER - condition of an increase of circulating red blood cells and blood volume Porphyries - CORRECT ANSWER - metabolic disorder that is associated with enlargement of spleen and liver, pigmentation and red color in urine, and sensitivity to light Timed Specimen - CORRECT ANSWER a measurement of the concentration of a substance in the blood, such as cretin, glucose, or sodium, over a specific period of time, usually between 8 and 24 hours. Common timed Specimen - CORRECT ANSWER glucose levels iron levels cortisol levels peak and depression of medication levels cardiac enzyme levels hormone assays potassium sodium Toxicology - CORRECT ANSWER a branch of chemistry, biology, and medicine that focuses on the study of the adverse effects of chemicals on living organisms.