ORDER OF DRAW, TUBES & ADDITIVES
What tube is a CBC collected in?
Lavender Tube
What does FBS stand for?
Fasting blood sugar
What agency is responsible for the health and safety of workers?
OSHA
Where is the proper place for the tourniquet to be placed during a venipuncture?
3 to 4 inches above the site
When should a phlebotomist wash their hands?
Before and after the draw
What does warming the site do?
Increases localized blood flow
What test do you draw without a tourniquet?
Lactic acid
What tube Is an Erythrocyte Sedimentation Rate (ESR) drawn in?
Lavender
What two analytes are included in an electrolyte panel?
Sodium and potassium
Why is it important to ask for feedback when communicating with a patient?
To make sure they understand what is being said
If the processing lab is backed up on resulting, what will you do with your samples?
Send them anyway
What is the recommended disinfectant to clean up blood, or other bodily fluid contamination?
Sodium Hypochlorite (bleach)
When drawing blood from a hemophiliac patient, instruct them to…
Hold pressure on the site for 2 minutes
Is it okay to use 70% isopropyl alcohol for cleansing the site when drawing blood for ethanol testing?
NO
Out of Red, green, light blue, and lavender top tubes which will produce serum?
Red
What equipment is needed for a urine C&S?
Sterile cup and alcohol wipe (towelette)
If a patient extends his or her arm, this is an example of what type of consent?
Implied consent
When drawing multiple tubes, when would the tourniquet be released?
As soon as blood flow is established
What PPE is required when drawing blood and handling blood products?
Gloves
When drawing from a patient who has had a mastectomy where is the appropriate place to draw?
Opposite side in the hand
What can be caused by leaving the tourniquet on too long?
Hemoconcentration
If asked to draw a red, light blue, blood cultures and lavender. Which is last?
Lavender
How do you collect a POC glucose test?
Strip and a drop of blood
Informed consent is required for?
Invasive surgery and Biopsy
How do you explain a phlebotomy procedure to a young child?
In simple terms
What uses heat, steam, and chemicals?
Sterilization
If a hematoma starts to form and the patient says it hurts, what should the Phlebotomist do?
Stop the draw, apply pressure, reassess
What does the term hematoma mean?
Blood leaking from the vessel under the skin
Red top is used for the following tests...
Blood Pregnancy and Hepatic Panel
What test will you collect in an amber colored tube?
Bilirubin
What agency mandates a written exposure plan and what contains documentation of chemical safety & precautions
OSHA & SDS log
What department is responsible for sterile supplies?
Central Supply
What is the FIRST thing you will do in case of an accidental needle stick?
Wash the site for 30/60 seconds with soap and water
If a patient is on blood thinners or an aspirin regimen what should be used after the blood draw?
Coban wrap
What would be a reason for a light blue top to be rejected for processing?
QNS (quantity not sufficient)
Tiger top is used for a
Thyroid panel
What is the normal range for a fasting glucose for an adult?
Anything under 100
If a coworker comes back late from lunch and asks you to cover for him or her, what will you do?
Tell them you cannot cover for them.
What are the special handling requirements for an ammonia sample?
Place on ice
When drawing from an HIV patient, what extra precautions do you need to take?
None, always wear gloves
If you have an order to collect a Prothrombin Time (PT) specimen from a patient with IVs in both arms, where would you draw?
The hand
If a specimen is lipemic, what can this be an indication of?
A Patient not fasting
If a Dr. orders a CMP, CBC, PT and blood cultures what is the correct order of draw? Blood cultures, Lt blue, SST(Gold) and lavender
Blood cultures, Lt blue, SST(Gold) and lavender
OR
Blood Cultures PT, CMP, CBC
What is used to collect DNA samples by swabbing the inside of the cheek?
Buccal Swab
What is it that states that a patient has the right to refuse medical procedures and be informed of all consequences in doing so?
Patient bill of rights
What are the special handling requirements for a vitamin B12?
Protect from light
What Bloodborne Pathogen can remain on surfaces for up to 7 days if not properly disinfected?
HBV (Hepatitis B)
What step is NO LONGER recommended for patients who pass out?
Ammonia inhalants
If a patient presents to the lab for a fasting glucose blood draw but indicates he or she is NOT fasting, what should the Phlebotomist do?
Draw anyway and document “non-fasting.”
What is the additive in a dark green tube?
Sodium Heparin
When performing a bleeding timed test, how high should the blood pressure cuff be inflated to?
40mm Hg
What agency mandates a written exposure plan?
OSHA
At what age and weight will you no longer perform a heel puncture?
Older than 12 months and more than 21 pounds
What is the #1 way to prevent cross contamination of micro-organisms from one patient to another?
Hand washing (Hand decontamination)
If a patient faints during a blood draw, what is the vital sign that must be checked before you let them leave?
Pulse
What is the normal BP for an adult?
120/80
What is the substance at the bottom of a serum separator tube?
Thixotropic gel
Which coagulation tests can be performed at bedside using a point of care instrument?
PTT and INR
If a patient comes in asking for results, what should you do?
Advise them to make an appt with their Dr.
Where does FDP (fibrin degradation products) go for processing?
Coagulation Department
What type of isolation requires special handling and ventilation?
Airborne Isolation
What is outside of the normal range for BP on an adult?
139/94 (high)
What color top would an aluminum be drawn in?
Royal blue
When instructing a patient to collect a stool sample, make sure that you instruct the patient to…
Do not mix stool and urine
If you draw blood from a patient without his or her consent what can the Phlebotomist be charged with?
Battery
Once the blood draw is complete, what is the next step?
Dispose of the needle into a puncture resistant container (sharps container)
What is the most important part of blood culture collection?
Aseptic procedure (cleansing of the site)
What can happen if you draw an EDTA tube before a serum tube?
Cross contamination resulting in high potassium levels, and false low calcium levels
What color tubes are used to draw a Hemoglobin A1C, and a PT/PTT, and what is the correct order of draw?
1. Light blue
2. Lavender
How many tubes are needed for a 3-hour GTT?
4 tubes
If you suspect child or elder abuse or neglect, what should you do?
Notify your supervisor
When do you change out the sharp’s container?
3/4 full
According to OSHA why do we activate the safety feature on a needle?
To prevent accidental needle sticks
Sweating, looking pale, and complaining of blurred vision can be signs of what?
Vasovagal Syncope
What is the proper blood to additive ratio for a light blue top tube?
9:1 (The blood to additive ratio is 9 parts blood to 1 part sodium citrate)
How much urine would an adult female patient need to produce for STD testing?
20/30 ml
What is the purpose of patient ID numbers being on the tube labels?
Avoiding confusing patients with the same first and last name
What is the special handling required for paternity testing?
Chain of custody
What contains documentation of chemical safety and precautions?
SDS log
How long should a specimen drawn in an SST tube be allowed to sit and clot before centrifugation?
30 to 60 minutes
How long do you rotate a NP swab in each nostril when collecting a covid screening test?
15 seconds
What is the purpose of checking the arm band on an in-patient who has lab orders?
Avoiding patient identification errors
How often does a centrifuge need to be calibrated?
Every 6 months
How long can plasma sit at room temperature?
8 Hours
How long should a patient fast for a fasting blood sugar?
8 hours
What kind of checks need to be performed on POC equipment in a Dr.’s office?
Quality Control Checks
According to CLSI standards what is the maximum time a specimen (plasma or serum) can be left at room temp before centrifugation?
2 hours