Blood Collection Procedures and Guidelines

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Questions and Answers

How far above the draw site should the tourniquet be placed?

4-6 inches

Briefly explain the area in which to draw a PKU test on an infant.

Heel stick, medial and lateral portions of the plantar surface.

Define neonate.

Relating to the newborn and human infant during the first month after birth.

What do layperson terms mean?

<p>Words someone who is not an expert can understand.</p> Signup and view all the answers

What way should the bevel be facing when entering the arm?

<p>Bevel up.</p> Signup and view all the answers

What tube contains a preservative and an anticoagulant?

<p>Gray tube.</p> Signup and view all the answers

Who usually draws an arterial blood gas and what are the four things they are checking for in the blood?

<p>RN, respiratory therapist, physician; pH, CO2, oxygen, and bicarbonate.</p> Signup and view all the answers

OSHA permits the removal of gloves while putting on a patient's bandage/bandaid.

<p>False (B)</p> Signup and view all the answers

What is implied consent?

<p>The patient's action permits the procedure without verbal or written consent.</p> Signup and view all the answers

What two gloves may be used if latex gloves cause skin allergies for your patient?

<p>Vinyl and nitrile.</p> Signup and view all the answers

What is another word for a winged infusion set?

<p>Butterfly needle.</p> Signup and view all the answers

What is QNS defined as?

<p>Quantity not sufficient.</p> Signup and view all the answers

What is the creatinine clearance and how must it be stored?

<p>24-hour urine and serum test; handled and stored in a refrigerator or on ice.</p> Signup and view all the answers

Is cavicide used to cleanse an area on a patient for venipuncture?

<p>False (B)</p> Signup and view all the answers

If you get an accidental needle stick on your finger with a used butterfly needle, what is your next course of action?

<p>Wash for 15 minutes; report to the supervisor.</p> Signup and view all the answers

If the sharps container is overflowing when you come onto shift, what is the appropriate response?

<p>Report to supervisor.</p> Signup and view all the answers

All healthcare workers are required to vaccinate or sign a declination form for which virus?

<p>Hepatitis B.</p> Signup and view all the answers

What is ETOH?

<p>Blood ethanol test; alcohol in blood.</p> Signup and view all the answers

What is protective isolation?

<p>Keep susceptible patients isolated as not to infect them with disease and infection.</p> Signup and view all the answers

What is informed consent?

<p>The voluntary affirmation by the patient to allow touching, examination, and treatment.</p> Signup and view all the answers

What is the proper way to identify a patient?

<p>Patient ID number, name, and birthday.</p> Signup and view all the answers

What is LIS?

<p>Laboratory information system.</p> Signup and view all the answers

Can a patient decline medical treatment?

<p>False (B)</p> Signup and view all the answers

What is the correct way to end venipuncture?

<p>TTCC.</p> Signup and view all the answers

If a person is having a syncope episode, what is the most important thing the phlebotomist needs to do?

<p>TTCC; get the needle out of the patient's arm.</p> Signup and view all the answers

Define syncope.

<p>Passing out; loss of consciousness or fainting.</p> Signup and view all the answers

Raised, red blotches on the skin after tourniquet placement may be a sign of what? What should you do if you encounter this?

<p>Hives; stop the blood draw.</p> Signup and view all the answers

Define petechiae.

<p>Small, pinpoint hemorrhages.</p> Signup and view all the answers

A group of tests ordered as one is often described as what?

<p>Panels and profiles; comprehensive metabolic panel.</p> Signup and view all the answers

Name the three layers of the heart.

<p>Epicardium, myocardium, endocardium.</p> Signup and view all the answers

If a patient asks what tests their physician ordered, do you have to tell them?

<p>False (B)</p> Signup and view all the answers

What is the easiest and most effective way to break the chain of transmission?

<p>Washing your hands.</p> Signup and view all the answers

True or false: Eating in the lab is not an OSHA violation.

<p>False (B)</p> Signup and view all the answers

What is the most common cause for blood culture contamination?

<p>Improper site prep.</p> Signup and view all the answers

List the four types of OSHA compliance inspections.

<p>Complaint inspection, fatality and accident, programmed inspection, imminent danger.</p> Signup and view all the answers

Semen must reach the lab in what time frame?

<p>Within 1 hour; ASAP.</p> Signup and view all the answers

If you draw a sample for culture and sensitivity, what section of the lab would receive that?

<p>Microbiology.</p> Signup and view all the answers

CBCs should never be?

<p>Centrifuged.</p> Signup and view all the answers

List the white blood cells.

<p>Basophils, neutrophils, lymphocytes, eosinophils, monocytes.</p> Signup and view all the answers

What does an icteric specimen look like?

<p>High amount of bilirubin in the blood; green and brownish serum and plasma.</p> Signup and view all the answers

What does a lipemia specimen look like?

<p>High amounts of lipids in the blood; serum or plasma appears milky or white.</p> Signup and view all the answers

What does a hemolyzed specimen look like?

<p>Pink or reddish tint in the serum; usually caused by the phlebotomist.</p> Signup and view all the answers

What kind of consent is required for an underaged minor patient?

<p>Parental consent.</p> Signup and view all the answers

What does OSHA stand for and what do they do?

<p>Occupational Health and Safety Administration; enforce safety and health regulations in the workplace.</p> Signup and view all the answers

What does CLSI stand for and what do they do?

<p>Clinical and Laboratory Standards Institute; develops and uses voluntary lab standards and guidelines.</p> Signup and view all the answers

What is an H. pylori test and what are the steps and process?

<p>Breath test; 1. Two weeks no antibiotics; 2. Swallow urea substance; 3. Positive bacteria convert urea to CO2; 4. Don't talk or consume anything between first and final test; 5. Identifies H. pylori if infection is clear.</p> Signup and view all the answers

What is the preferred site for venipuncture?

<p>Antecubital fossa.</p> Signup and view all the answers

Which vein is most commonly used for venipuncture?

<p>Median cubital.</p> Signup and view all the answers

Define neutrophils.

<p>A type of white blood cell that engulfs invading microbes and contributes to the nonspecific defenses of the body against disease.</p> Signup and view all the answers

Define lymphocytes.

<p>A type of white blood cell that makes antibodies to fight off infections, viral.</p> Signup and view all the answers

Define monocytes.

<p>An agranular leukocyte that is able to migrate into tissues and transform into a macrophage.</p> Signup and view all the answers

Define eosinophils.

<p>A white blood cell containing granules that are readily stained by eosin.</p> Signup and view all the answers

Define basophils.

<p>A circulating leukocyte that produces histamine.</p> Signup and view all the answers

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Study Notes

Tourniquet and Draw Site

  • Place the tourniquet 4-6 inches above the draw site.
  • For PKU tests on infants, perform a heel stick at the medial and lateral portions of the plantar surface.
  • Neonate refers to a newborn within the first month after birth.
  • Layperson terms are words understandable by someone without expertise.
  • Implied consent allows procedures based on patient actions rather than verbal or written consent.
  • Informed consent is the patient’s voluntary agreement to allow treatment.

Blood Collection Procedures

  • The bevel of the needle should be facing up during venipuncture.
  • Gray tubes contain preservatives and anticoagulants.
  • Ensure proper patient identification using their ID number, name, and birthday.

Healthcare Guidelines

  • OSHA prohibits the removal of gloves while putting on a bandage.
  • Hepatitis B vaccinations or declination forms are mandatory for healthcare workers.

Handling Blood Samples and Lab Procedures

  • An RN, respiratory therapist, or physician usually draws arterial blood gas, checking pH, CO2, oxygen, and bicarbonate levels.
  • Proper handling is essential for semen samples, which must reach the lab within 1 hour.
  • Blood culture contamination most commonly occurs due to improper site preparation.

Specimen Analysis

  • Hemolyzed specimens appear pink or reddish due to phlebotomist error.
  • Icteric specimens have a high bilirubin content, showing green or brownish serum.
  • Lipemic specimens appear milky white due to high lipid content.

Safety and Compliance

  • Emergency protocols: wash needle sticks for 15 minutes and report to a supervisor.
  • If sharps containers are overflowing, notify the supervisor immediately.
  • Four types of OSHA compliance inspections include complaint, fatality and accident, programmed, and imminent danger.

Blood Components

  • White blood cell types include basophils, neutrophils, lymphocytes, eosinophils, and monocytes.
  • Neutrophils are responsible for engulfing microbes; lymphocytes produce antibodies; monocytes transform into macrophages.

Additional Important Information

  • Protective isolation keeps susceptible patients safe from infections.
  • The term "QNS" denotes quantity not sufficient.
  • Parental consent is required for medical procedures on minors.
  • Clinical and Laboratory Standards Institute (CLSI) sets laboratory standards and guidelines.

Venipuncture Techniques

  • End venipuncture correctly using TTCC (Tourniquet release, Tube removal, Pressure, and Clean up).
  • The preferred site for venipuncture is the antecubital fossa, primarily using the median cubital vein.

Miscellaneous

  • Proper hand hygiene is the most effective way to break the chain of infection transmission.
  • The acronym "ETOH" refers to blood ethanol tests, indicating alcohol levels.
  • Panels and profiles signify groups of combined tests, often seen in clinical lab orders.

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