Order Of Draw
Where would a tan topped tube go in the order of draw?
With the EDTA tube
Name the 3 most commonly used phlebotomy needles and their corresponding color
21-green, 22-black, 23-blue
What organ assists in temperature regulation?
The skin
What does PHI stand for?
Personal (or Protected) Health Information
Which non blood test is ordered to assist in the screening for Colorectal Cancer?
Occult Blood Tests (stool). Aka FOBT
What is interstitial fluid?
Fluid in the tissue space between the cells
Myoglobin helps detect disorders associated with this body system?
Muscular. (including heart muscle)
What does palpate mean?
to search for a vein with a pressure-and-release touch.
What is an aliquot tube?
used to pour off part of a whole sample that has been taken off for use or storage.
Your CA state license must be renewed how often?
Every two years
The ED calls and asks that you come draw a rainbow on the patient in bed 11. What tubes would you likely draw?
Light blue, Red, Green, Lavender. (some facilities may include a grey to their rainbow)
Name two components of a CBC?
WBC, RBC, Hgb, Hct, platelets... etc
What is a class B fire extinguisher used for?
Flammable liquids.
Tubes/order of draw for Liver test and ESR?
Gold, Lavender (or black topped tube)
The lab director is usually this type of physician?
Pathologist
Together, the bicuspid and tricuspid valves are also known as?
AV (atrioventricular) valves.
Explain what a Delta check is?
It compares current lab results with previous results on the same patient
What are the two non blood specimens that can be collected for H Pylori testing?
Breath, Stool
When would a capillary puncture be the safest choice on an adult?
severely burned patient, cancer patient with bad veins, obese patient with difficult veins, geriatric patients with fragile veins
What is the middle muscular layer of the heart?
Myocardium
You need 5mls of serum for testing. How much blood should you draw? and what tube?
10-12 ml Red/Gold/Tiger
The doctor orders two timed draws. One at 1800 and one at 2115. What times do you draw these specimens?
6pm, and 9:15pm
This agency accredits phlebotomy programs?
NAACLS
An ancient tool used for bloodletting was called a...?
Fleam
What department does a TSH go to?
Chemistry
What is the first thing you would do in the event of electrical shock?
Shut off the source of electricity
What color is a Lactic Acid test done in?
Grey
Name the three main superficial veins used in phlebotomy.
basilic, cephalic, median cubital
What is the fluid surrounding the heart?
Pericardial
Emergency care on an unresponsive person (such as CPR), falls under this type of consent
Implied
The ER delivers a specimen that was collected by aspirating fluid from a patients knee. What type of fluid is this called?
Synovial Fluid
What causes hemolysis in capillary punctures?
alcohol used to clean the skin was not allowed to dry, the finger or heel was squeezed too vigorously, blood was scraped off.
Blood flows from the Left ventricle to the ________?
Aorta
Another name for the butterfly needle
Winged infusion set
You draw tubes for PT, Lipid and a CBC. Which test does not require centrifugation?
CBC.
This organization establishes standards for the operation of hospitals and other health care related services?
TJC
You receive an electronic order for a PKU test. Where will you likely find this patient?
OB ward, Nursery
The doctor orders a Vitb6 level. You look it up and realized this test must be protected from light. What do you do?
Transfer the specimen into an amber tube with an amber bag or wrap it in tinfoil.
This BBP can survive in dried blood for up to one week?
HBV.
The doctor wants a Glucose and a CBC. What is the order of draw?
Lavender, Grey
Which department would you deliver Occult Blood stool cards to?
Microbiology.
Vitamin D and Calcium tests can assist in diagnosing disorders of this body system.
Skeletal system
Explain what ICD10 codes are
Diagnosis codes
This is the most commonly collected non blood specimen?
Urine
If the blood is drawn too quickly from a small vein, the vein has a tendency to?
collapse
What is Homeostasis?
Occurs when all parts of the body work together to form a steady state.
What are the two other names for the straight needle.
Multisample, vaccutainer, or ETS
Name two tests that require protection from light?
Vit A/B/C, Bilirubin, Folate, Beta-Carotene, PKU.
Federal regulations that establish quality standards for any facility that test human specimens used to diagnose, treat or assess health status?
CLIA '88
You are seeing a patients who is taking Warafin (Coumadin) What test will you likely be performing on this patient? Also include which tube and what department
PT... Light blue/Coagulation
A specimen requires that it be transported at 25 degrees Celsius. Explain how it would be transported?
Room temp
An inpatient is on Contact Precautions. When would you remove your gloves after completing a blood draw procedure?
Before leaving the patients room
The doctor orders two sets of blood cultures. How many times does the patient need stuck?
Twice
Surgery brings down an amputated arm. What department does this belong in?
Pathology/Histology
The muscular layer that separates the left and right side of the heart is called?
Septum
The state of CA requires this many CEU hours every two years?
6
The doctor orders a Rapid Strep test. What specimen are you collecting?
Throat swab(also accept NP swab)
Why must the first drop of blood from a capillary puncture be wiped away?
To remove the interstitial fluid
Name the largest artery leaving the heart
Aortic
The test requirements state that you need 2ml serum from non gel barrier tube. What tube do you use?
Red top
Per CLSI, you should not stick the patient more than ___?
twice
This organization develops clinical and laboratory practices and promotes their use worldwide?
CLSI
Explain the difference between antisepsis and disinfection?
Antiseptics are used on humans, disinfectants are for surfaces
List the order of draw.... using correct test names instead of tube colors
Answers will vary
Yellow- Blood culture
Light Blue- PT, PTT, D-dimer, Lupus...
Red- Testosterone, PSA, hormone levels
SST- CMP, BMP, Lipid, TSH
Heparin- Stat Chemistry tests
Lav- CBC, A1C, Hgb, H&H
Grey- Glucose, ETOH, Lactic acid
There are 5 types of methods of transmission. Name 3 of them
Contact (direct/indirect), droplet, vehicle, airborne, vector
What additive does a PST contain?
Lithium Heparin/gel seperator
Which tube and which department for a Hemoglobin A1C test?
Lavender/Chemistry
A patients blood pressure reads 115/75. The doctor asks you what the patients systolic number is. What is your reply?
115
The normal level of skill and care that a HCW would be expected to adhere to is called?
The standard of care
What does O&P stand for, and what type of specimen does it require?
Ova and parasites/stool.
What is one thing you must never tell a child about the blood draw procedure?
That it wont hurt
Which chamber of the heart pumps blood into our lungs?
Right Ventricle
What are your trace element tubes?
Royal blue. they are metal free. One contains EDTA, one contains heparin, while the other contains nothing.
You go to draw a middle aged woman and she tells you she had a mastectomy on her right side. What do you do?
Go to her left arm, you are unable to use the right arm.
Name two examples of quality control measures required by the phlebotomist?
Checking the online lab database to ensure proper testing requirements, patient identification using two identifiers, checking expiration dates on equipment, checking sterility/construction of needles, following proper venipuncture technique etc....
When would you draw a patient if the testing requirements were to draw during the basal state?
In the early morning (when a patient first wakes up) and after they have been fasting
A patient appears to have jaundice. What lab tests will likely be ordered?
Liver panel, or bilirubin test
Name two things you must do when you encounter a patient that is in shock?
Maintain open airway, call for emergency assistance, keep the patient lying down, elevate the legs if you are able to do so safely, stop any bleeding if required, keep the patient warm, keep the patient safe.
The time is currently 14:20, You have a trough TDM test to draw at 14:25 in room 203, and an ASAP CBC in OB ordered ... which do you draw first?
Trough (Timed) draw, then CBC
There is a trauma alert in the Er. The patient is bleeding out and they need an emergency transfusion. They ask you to call the lab and let them know. What department do you call?
Blood Bank
These connect the arterioles and venules?
Capillaries.
Provides guidelines to keep a patient's medical information private and secure.
HIPAA
What instructions would a patient be given regarding how to collect a 24 hour urine specimen?
Do not collect first morning, write down time, collect every sample for 24 hours. Keep container cool and away from light. Return to lab as soon as possible
How many times is a patients poked during a 3hour GTT?
4 times
Name two of the four heart valves.
Tricuspid, Bicuspid (Mitral), Pulmonary, Aortic
Leaving the tourniquet on a patient's arm for an extended length of time before drawing blood may cause?
Hemoconcentration
Which two arteries are occluded when performing the Allen test?
radial and ulnar
The physical copy of the book that contains all laboratory tests and each of their requirements is called a....?
Reference Manual
The patient in ICU has IVs in both arms. You will need the nurse to turn off the IV so you can draw blood on the patient (below the IV site). How long must you wait after the IV has been turned off before you can draw blood?
2 minutes. and IMMEDIATELY tell the nurse when you are done so they can restart the IV medication
A doctor orders a CMP and CBC on an infant which you will be collecting by dermal puncture. What order will you be collecting the tubes?
Lavender, gold/green
A phlebotomist ca be exposed to BBP through accidental needlesticks. Name two other ways a phlebotomist could be exposed to BBP
Skin is pierced with dirty needle or sharp object.
Blood or body fluid splashes (into eye, nose or mouth)
Blood or body fluid comes in contact with cut, abrasion, or scratch
Human bite breaks the skin