Phlebotomy Class Notes - Venipuncture & Patient Care
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Questions and Answers

When collecting blood for a trough level using therapeutic drug monitoring, how long before the scheduled medication dose should the blood draw occur?

  • Immediately before
  • 15 minutes before (correct)
  • 1 hour before
  • 30 minutes before
  • Which of the following is a test that requires the blood sample to be kept at body temperature until the serum separates?

  • Lactic acid
  • Ammonia
  • Cryoglobulin (correct)
  • Bilirubin
  • For which test should the blood sample be protected from light using aluminum foil?

  • Carotene (correct)
  • Cryofibrin
  • Lactic acid
  • Ammonia
  • When is a PKU test typically performed on an infant?

    <p>Within 72 hours of birth (D)</p> Signup and view all the answers

    What special handling consideration is required for blood samples taken for lactic acid testing?

    <p>No tourniquet should be used (A)</p> Signup and view all the answers

    If additional information cannot be recorded on a chain of custody for a forensic specimen, what should you record?

    <p>Write 'N/A' (D)</p> Signup and view all the answers

    Which of the following blood tests require the blood sample to be chilled on ice?

    <p>Gastrin (D)</p> Signup and view all the answers

    During an Oral Glucose Tolerance Test (OGTT), how long should a patient fast before the initial blood draw?

    <p>10-12 hours (A)</p> Signup and view all the answers

    What action should a phlebotomist take if a patient declines a blood draw?

    <p>Report the refusal to their supervisor. (D)</p> Signup and view all the answers

    Which of the following actions is considered battery?

    <p>Taking physical action without implied or explicit consent. (C)</p> Signup and view all the answers

    A phlebotomist sees that they are about to poke the patient in the wrong area. What is the correct action to take?

    <p>Admit to the mistake and do not poke the patient (B)</p> Signup and view all the answers

    In what circumstances can you tell a patient what the tests you are performing are for?

    <p>You can explain in general what the tests will be, but not the results. (A)</p> Signup and view all the answers

    What is the primary reason for keeping the tourniquet on for less than 1 minute?

    <p>It minimizes the risk of skin irritation and other complications. (D)</p> Signup and view all the answers

    Why do you invert the tubes?

    <p>To thoroughly mix the blood with the additives in the tube. (D)</p> Signup and view all the answers

    What does a higher gauge number indicate in needles used for phlebotomy?

    <p>The needle is smaller. (C)</p> Signup and view all the answers

    Which of the following veins is NOT typically located in the antecubital area?

    <p>Dorsal (A)</p> Signup and view all the answers

    Which of these items would be considered a 'sharp' and require special disposal?

    <p>Gauze soaked with blood (A)</p> Signup and view all the answers

    Which of the following is the BEST first step when interacting with a patient?

    <p>Introduce yourself as the patient's phlebotomist (B)</p> Signup and view all the answers

    For an outpatient, which form of identification is required before performing a phlebotomy procedure?

    <p>State-issued photo ID with date of birth (D)</p> Signup and view all the answers

    According to the content, what does a hospital band provide for an inpatient?

    <p>Name, date of birth, medications, tests ordered, and test results (A)</p> Signup and view all the answers

    Which statement does NOT accurately reflect the concept of 'Communication=Consent' in phlebotomy?

    <p>If the patient doesn't verbally say 'yes', you should not proceed. (C)</p> Signup and view all the answers

    What is the primary focus of The Joint Commission (TJC)?

    <p>Looking out for the well-being and rights of patients (D)</p> Signup and view all the answers

    According to the provided content, what is one of the implications of the Health Insurance Portability and Accountability Act (HIPAA)?

    <p>Written permission is needed to disclose a patient's medical information (B)</p> Signup and view all the answers

    A blood sample for which of the following tests must be transported in an amber-colored bag?

    <p>Bilirubin (D)</p> Signup and view all the answers

    Which of the following tests requires the blood sample to be kept at 37 degrees Celsius (98.6 degrees Fahrenheit) until the serum separates?

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

    During a Glucose Tolerance Test, in what time period should the patient consume the glucose drink?

    <p>Within 5 minutes (A)</p> Signup and view all the answers

    For which of the following blood tests is it critical to avoid the use of a tourniquet?

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

    What is the required angle for needle insertion when collecting an Arterial Blood Gas (ABG) sample?

    <p>90 degree (A)</p> Signup and view all the answers

    What is the primary purpose of drawing blood for therapeutic drug monitoring?

    <p>To ensure medication is not causing toxicity (D)</p> Signup and view all the answers

    Which of the following substances can be analyzed in an Arterial Blood Gas (ABG) test?

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

    What does the term 'diurnal' refer to in the context of blood sample collection?

    <p>Samples drawn early in the day (B)</p> Signup and view all the answers

    What is the MOST basic form of Personal Protective Equipment (PPE) when performing phlebotomy?

    <p>Gloves (C)</p> Signup and view all the answers

    According to the guidelines, how long should hands be rubbed together during hand washing before being dried?

    <p>30 seconds (B)</p> Signup and view all the answers

    What does the term 'hemolysis' refer to?

    <p>The bursting of red blood cells. (B)</p> Signup and view all the answers

    In the context of phlebotomy, what is meant by 'inversion' of a blood collection tube?

    <p>Flipping the tube back and forth in a complete cycle. (D)</p> Signup and view all the answers

    What should a phlebotomist do if they notice a discrepancy in patient information?

    <p>Refrain from the poke until issue is resolved. (A)</p> Signup and view all the answers

    Which of the following best describes 'implied consent'?

    <p>Permission indicated by the patient's actions, such as extending their arm. (B)</p> Signup and view all the answers

    What is the significance of the 'wings' on a butterfly needle?

    <p>To help stabilize the needle and prevent wiggling. (B)</p> Signup and view all the answers

    What does a lower gauge number indicate about a needle used for phlebotomy?

    <p>The needle has a larger bore. (C)</p> Signup and view all the answers

    Which of the following is NOT considered a primary vein for venipuncture in the antecubital area?

    <p>Dorsal (C)</p> Signup and view all the answers

    According to the provided information, which of these items would be considered trash that does not require special disposal?

    <p>Used Tape (C)</p> Signup and view all the answers

    If a patient presents an insurance card without a state-issued ID, what information should be cross checked, according to provided content?

    <p>The patient's date of birth (B)</p> Signup and view all the answers

    For an inpatient, what is the primary purpose of the hospital identification band regarding phlebotomy procedures?

    <p>To verify the patient's identity before the draw. (C)</p> Signup and view all the answers

    What is the implication of a patient stating they 'Send Received Proceed Understood' according to the text?

    <p>It means the patient understands the procedure and give verbal consent (D)</p> Signup and view all the answers

    According to the provided content, what is a primary responsibility of The Joint Commission (TJC)?

    <p>To establish and maintain standards for patient care and safety. (D)</p> Signup and view all the answers

    When can a phlebotomist be allowed to leave a patient's room with their paperwork according to the provided content?

    <p>Under no circumstance. (B)</p> Signup and view all the answers

    According to the provided information, what is the best course of action when a patient requests that the needle be removed during a phlebotomy procedure?

    <p>Quickly and safely remove the needle ASAP. (A)</p> Signup and view all the answers

    Flashcards

    Informed consent

    A patient's voluntary and informed permission to receive medical treatment.

    Expressed consent

    Consent that is given verbally or in writing.

    Implied consent

    Consent that is implied through actions, like sticking out your arm for a blood draw.

    Battery

    The act of causing harm to a patient without their consent.

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    ICD-10

    A code used to diagnose a disease, based on a hierarchical system of codes.

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    Toutiquet

    A medical device used to temporarily stop blood flow in a vein.

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    Butterfly needle

    A needle with wings on the sides to help stabilize it during venipuncture.

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    Hemolysis

    The destruction of red blood cells, causing a pinkish and foamy appearance in blood.

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    Therapeutic Drug Monitoring

    Drawing blood samples at specific times to monitor medication levels in the blood

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    Trough Level

    Blood drawn right before the next dose is administered

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    Peak Level

    Blood drawn after a medication dose is given

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    Aliquoting

    The process of dividing a whole blood sample into smaller portions

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    Chilled Blood Samples

    Blood samples that need to be kept cold to prevent breakdown of analytes

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    Warmed Blood Samples

    Blood samples that need to be warmed to preserve specific analytes

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    Diurnal Blood Samples

    Blood samples drawn starting at the beginning of the day

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    Glucose Tolerance Test (GTT)

    A test to diagnose gestational or general diabetes by monitoring blood sugar levels after consuming a sugary drink

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    Median Cubital Vein

    A vein located in the inner elbow, commonly used for venipuncture.

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    Cephalic Vein

    A vein on the thumb side of the arm used for venipuncture.

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    Basilic Vein

    A vein on the pinky side of the arm used for venipuncture.

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    Dorsal Vein

    A vein on the top of the hand used for venipuncture.

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    CLSI (Clinical and Laboratory Standards Institute)

    A standard that establishes guidelines for patient care, developed by the healthcare industry.

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    Communication = Consent

    The act of obtaining informed consent from a patient before performing a procedure.

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    Paper Trail (Medical Documentation)

    The legal documentation of a medical procedure, outlining the steps taken and the patient's consent.

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    HIPAA (Health Insurance Portability and Accountability Act)

    The act of protecting patient privacy by managing and disclosing personal health information only with their permission.

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    Inversion

    The act of inverting blood collection tubes both back and forth to ensure proper mixing of the blood and additives.

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    Arterial Blood Gas (ABG)

    A blood test that measures the levels of oxygen, carbon dioxide and pH in the blood.

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    PKU (Phenylketonuria) Test

    A blood test performed on infants within the first 72 hours of birth to check for phenylketonuria, a metabolic disorder that can cause mental retardation if untreated.

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    Paper Trail

    The legal documentation of a medical procedure, outlining the steps taken and the patient's consent. It serves as a vital record for proof of informed consent and the procedure's details.

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    HIPAA

    An act that protects patient privacy by managing and disclosing personal health information only with their permission. It ensures confidential handling of sensitive medical data.

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    What are considered sharps?

    Sharps are medical instruments that can pierce or cut the skin. These include needles, hubs, tubes, lancets, and other pointed objects.

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    What is considered trash?

    Trash in a medical setting includes discarded materials like gauze, tape, and non-reusable items. Proper disposal of trash is crucial for hygiene and safety.

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    The Joint Commission (TJC)

    The Joint Commission is an independent organization that sets standards for healthcare organizations to ensure patient safety and quality of care.

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    Clinical and Laboratory Standards Institute (CLSI)

    The Clinical and Laboratory Standards Institute develops standards for healthcare, particularly in laboratory testing. They aim to ensure accurate and reliable laboratory results.

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    What is required for outpatient identification?

    A state-issued ID card with a date of birth is required to identify outpatients before any medical procedure or interaction.

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    Study Notes

    Phlebotomy Class Notes

    • Venipuncture Sites:
      • Antecubital (median cubital, cephalic, basilic)
      • Cephalic (thumb)
      • Basilic (pinky)
      • Dorsal
    • Sharps:
      • IV needles
      • Hubs
      • Tubes
      • Lancets
      • Glass Slides
      • Capillary Tubes
      • Gauze (if soaked)
    • Trash: Gauze, Tape, Band-Aids
    • Patient Introductions:
      • Introduce yourself as the phlebotomist.
      • Ask for patient's name and DOB.
      • Have them spell their name.
      • Pay attention to body language and verbal cues.
    • Patient Identification:
      • Photo ID is required for outpatients to verify information before touching them and is required to include DOB.
      • Hospital band is required for inpatients.
      • If there is a discrepancy, do not proceed with the draw.
      • Always pay attention to details.
    • Communication and Consent:
      • Follow joint commission (TJC) standards and clinical/ lab standards.
      • Maintain necessary documentation and policies to protect patient information.
      • Always have a paper trail of patient communication in the room, do not leave the room with the chart or documents out.
      • Obtain patient consent before collecting or sharing any information.
    • Incident Reports:
      • Record incidents according to patient rights in incident reports.
    • Test Questions/Patient Rights:
      • Patients can always know what tests are being done and decline treatment.
    • Consent and Implied Consent:
      • Expressed written or verbal consent
      • Implied consent without verbal or written consent (e.g., a patient extending their arm)
      • Parental consent required for minors.
    • PPE (Personal Protective Equipment):
      • Proper use of PPE, including clean glasses, is critical.
      • If outside scope of practice, do not touch or poke patient.
      • Attention to patients allergies and blood thinners, etc.
    • Tourniquet Time Limit:
      • Tourniquets shouldn't remain on longer than one minute. Blood pressure cuffs are an alternative to tourniquets when longer application is necessary.
    • Venipuncture Technique:
      • Be aware of hemolysis(breaking down of red blood cells, also consider if the blood is close to the vein wall.)
      • Always pay attention to the patient's allergies and blood thinners, etc.
    • Homeostasis:
      • Three stages: vascular, platelet, and coagulation phases.
      • BTT (bleeding time test) checks primary stages.
    • Blood Collection via Tube:
      • Different tubes are used for various tests.
      • Tubes have different additives.
      • Tubes should be labeled correctly.
    • Blood Collection via Butterflies:
      • Proper use of butterfly needles.
      • Precautions to be taken drawing from the Basilic vein.
    • Anticoagulants:
      • Use appropriate anticoagulants for different tests. (e.g. EDTA, Heparin, etc)
    • Transporting Specimens:
      • Warm tubes prior to draw as needed.
      • Proper chilling/warming procedures as per test requirements.
      • Use appropriate containers (like amber or brown bags).
      • Labeling requirements of specimens.
      • Light sensitivity requirements
    • Patient Preparation:
      • Fasting guidelines/instructions for certain tests.
      • Instructions for blood samples not requiring fasting.
      • Instructions for testing time, such as windows for OGTT samples etc
    • Medical Tests and Procedures:
      • PKU (infant blood test for mental retardation)
      • Arterial Blood Gas (ABG)
      • Diagnostic tests using a heel poke.
      • Blood cultures, blood tests (such as basic metabolic tests, etc)
      • Different types of swabs: nasal, buccal, throat, etc.
      • Specimens: urine, stool (such as GUAIAX and fecal fat studies), etc
    • Blood Borne Pathogen Precautions:
      • Treat all blood and bodily fluids as if they contain infectious agents.
      • Use proper infection control procedures.
    • Specimen Handling and Transportation:
      • Chain of custody for forensic specimens.
      • Labeling procedures for specimens.
    • Additional Information
      • Safety Compliance: Adherence to OSHA, HIPAA, and TJC standards. Compliance with federal procedures.
      • Types of Procedures: Venipuncture, Capillary sticks, other special collection procedures.
      • Equipment: Mention equipment used for collection and handling, including centrifuge techniques and use of various tubes.

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    Description

    Explore essential phlebotomy techniques and patient care protocols with this quiz. Gain insights into venipuncture sites, patient identification, and effective communication strategies. Perfect for aspiring phlebotomists to test their knowledge.

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