Phlebotomy Chapter 9 Review
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Questions and Answers

Which analyte peaks around 0800 hours?

  • Cortisol (correct)
  • Creatinine
  • Glucose
  • Triglycerides
  • Which of these tests are most affected if the patient is not fasting?

  • Both A and B (correct)
  • Triglycerides
  • Glucose
  • Cholesterol
  • What term describes veins that feel hard and cord-like when palpated?

    Thrombosed

    What do tiny red spots that appear on a patient's arm when the tourniquet is applied indicate?

    <p>Site may bleed excessively.</p> Signup and view all the answers

    What is the condition called when the arm of the patient is swollen with excess fluids?

    <p>Edema</p> Signup and view all the answers

    What does a chest with several short lengths of IV-type tubing protruding indicate?

    <p>CVC</p> Signup and view all the answers

    Which of the following would most likely allow reflux to occur during venipuncture?

    <p>Filling the tube stopper end-first</p> Signup and view all the answers

    What should you do if a patient complains of extreme pain during a venipuncture and blood is flowing?

    <p>Discontinue the draw and attempt collection at another site.</p> Signup and view all the answers

    Which of the following situations can result in hemoconcentration?

    <p>Leaving the tourniquet on for over 1 minute</p> Signup and view all the answers

    What most likely occurs when you hear a hissing sound during venipuncture?

    <p>Tube vacuum escaped.</p> Signup and view all the answers

    Most test results reference ranges are values for:

    <p>Healthy individuals</p> Signup and view all the answers

    If a venipuncture fails to draw blood and there is a slight vibration of the needle, what does this indicate?

    <p>Is up against a valve</p> Signup and view all the answers

    A bariatric phlebotomy chair is designed for individuals who are:

    <p>Overweight</p> Signup and view all the answers

    What is the primary use of an AV fistula?

    <p>Dialysis access</p> Signup and view all the answers

    What does an arm that is paralyzed mean?

    <p>Has no muscle function</p> Signup and view all the answers

    What is the medical term for fainting?

    <p>Syncope</p> Signup and view all the answers

    According to CAP guidelines, when should drugs that interfere with blood tests be stopped?

    <p>4 to 24 hours prior to the test.</p> Signup and view all the answers

    Which test is affected the most if collected from a crying infant?

    <p>WBC count</p> Signup and view all the answers

    What can result in a hematoma?

    <p>All of the above</p> Signup and view all the answers

    What test has a direct correlation with the patient's age?

    <p>Creatinine clearance</p> Signup and view all the answers

    What specimen condition would lead you to suspect that the patient was not fasting?

    <p>Cloudy white serum</p> Signup and view all the answers

    Where is the best place to collect a plasma specimen for a coagulation test if a patient has an IV in the left arm and a hematoma in the right arm?

    <p>Distal to the hematoma.</p> Signup and view all the answers

    What might you feel if there is a loop under the skin between the wrist and the elbow?

    <p>AV graft</p> Signup and view all the answers

    What should you do if your patient starts to faint during a blood draw?

    <p>Quickly release the tourniquet and remove the needle.</p> Signup and view all the answers

    Where is the best place to perform a venipuncture for a patient with a mastectomy on the left side and an IV on the right arm?

    <p>Below the IV on the right arm (distal)</p> Signup and view all the answers

    What is blood loss to a point where life cannot be sustained called?

    <p>Exsanguination</p> Signup and view all the answers

    Which specimen would most likely be rejected for testing?

    <p>A hemolyzed potassium specimen</p> Signup and view all the answers

    What clue indicates you have accidentally punctured an artery instead of a vein?

    <p>The blood spurts in the tube</p> Signup and view all the answers

    How would the serum or plasma of a hemolyzed specimen likely appear?

    <p>Pinkish to red</p> Signup and view all the answers

    What tube's underfilling will most likely result in a hemolyzed specimen?

    <p>Gray top</p> Signup and view all the answers

    Which activity can contaminate a blood specimen?

    <p>All of the above</p> Signup and view all the answers

    Which activity is least likely to lead to failure to draw blood?

    <p>Choosing a vein that has patency</p> Signup and view all the answers

    What is the best way to keep a vein from rolling?

    <p>Make certain to anchor it well.</p> Signup and view all the answers

    What should you do if no blood flows into the tube after engaging the needle properly?

    <p>Try a new tube, in case it is a vacuum problem.</p> Signup and view all the answers

    Which condition is most likely to affect test results?

    <p>Edema</p> Signup and view all the answers

    Study Notes

    Analytes and Testing Conditions

    • Peak cortisol levels occur around 0800 hours.
    • Non-fasting patients significantly affect glucose and triglyceride test results.
    • Hemoconcentration can occur if a tourniquet is left on for more than 1 minute.

    Venipuncture Techniques and Complications

    • Thrombosed veins feel hard and cord-like when palpated.
    • Excessive bleeding is indicated by tiny red spots appearing when a tourniquet is applied.
    • Edema is the condition where an arm is swollen with excess fluids.

    IV and Catheter Knowledge

    • CVC (central venous catheter) is characterized by multiple short lengths of tubing protruding from the chest.
    • For a phlebotomy procedure, avoid filling the tube from the stopper end-first to prevent reflux.

    Patient Management During Phlebotomy

    • If a patient experiences extreme pain when the needle is inserted without numbness, discontinue the draw to attempt collection at another site.
    • Apply pressure to the site after venipuncture to prevent a hematoma, which can result from insufficient pressure or using an oversized needle.
    • Quick actions like releasing the tourniquet and removing the needle are crucial if a patient begins to faint during blood collection.

    Specimen Collection and Handling

    • Specimens collected from crying infants often show elevated WBC counts.
    • Cloudy white serum may indicate that the patient was not fasting at the time of blood collection.
    • Carefully choose collection sites to avoid veins near IV sites or areas of hematoma.

    Identification of Conditions

    • An AV fistula is primarily used for dialysis access; similarly, an AV graft would feel like a buzzing or loop under the skin.
    • Syncope is the medical term for fainting, an important condition to be aware of during blood draws.

    Test Results and Influential Factors

    • Most test result reference ranges apply to healthy individuals, while certain tests, like creatinine clearance, have direct correlations with patients' age.
    • Activities such as improperly cleaning the site can contaminate specimens, affecting test outcomes.

    Blood Specimen Integrity

    • Hemolyzed specimens can be recognized by pinkish to red serum/plasma, especially in potassium tests.
    • Underfilling a gray top tube is a common cause of hemolyzed specimens.

    Best Practices in Phlebotomy

    • Properly anchoring a vein is crucial to prevent it from rolling during the drawing process.
    • Make sure to use a new tube if no blood flows into it after subtle needle adjustments, as this may indicate a vacuum issue rather than needle placement.

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    Description

    Test your knowledge with these flashcards focused on Chapter 9 of Phlebotomy. Covering key concepts like cortisol peak levels, fasting effects on tests, and recognizing thrombosed veins, this quiz will help reinforce your understanding. Perfect for students looking to solidify their learning in this critical area of healthcare.

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