phlebotomy exam 1.txt

Occupational Saftey & Health Administration

• OSHA requires that all health care personnel exposed to blood and other
• bodily fluids must receive a vaccination against Hepatitis B

Fluid in the lungs

500 mL

• Under the Patient Bill Of Rights they always have the option to decline
• medical treatment and to know what tests are being performed on them.

Results or a diagnosis. Because you are not medically qualified to do so.

Failure to give appropriate care. DON'T BE NEGLIGENT!

Personal Protective Equipment

Hand Washing is one of the most important (and easiest) practices used to prevent transmission of bloodborne pathogens

recapped

puncture-resistent, leak proof on the sides and bottom and must be labeled or color-coded

Infectious agents that can cause bacterial, viral, fungal or parasitic infections

Needles, lancets and broken glass can puncture and cut, causing blood-borne pathogen exposure

Preservatives and chemicals used in the laboratory. Exposure to Toxin, Carcinogenic or caustic substances

bunsen burners, oxygen and chemicals can cause burns or dismemberment

wet floors, heavy lifting ance cause falls, sprains and strains

Latex sensitivity is a PHYSICAL reaction to care worker allergic reation to the patient

Person

Needle

Mode Of Transmission OR exit of infection

Mucas membrane

Person

Specific ways in which microorganisms travel from the reservoir to the suseptible host

• contact - direct and indirect (fomite)
• Droplet - Cold, Flu and sneezing
• Airborne - viral - breath in
• common vehicle - person, fomite and not handwashing
• vector borne - illness that is transmitted through an invertebrate, such as an insect

the point in the infection chain where we aim at preventing the spread of infectious disease

Infection control method designed to prevent direct contact with blood and other body fluids and tissues by using a barrier of protection and work control practices.

• Gloves - when collecting and handling body fluids, or tissue specimen
• Face shield - when danger of splashing on mucous membranes
• Disposal - dispose of all needles and sharp objests in punture-proof containers, WITH OUT RECAPPING
• Disinfectants - clean fluid spills, thus killing pathogenic organisms

This condition is best defined as "the destruction of pathogenic microorganisms after they leave the body". It also involves enviromental hygien measures such as equipment cleaning and disinfection procedures. Methods of medical asepsis are Standard Precautions and Transmission-based Precautions

• Masks
• Gloves
• Face Shields
• Resirator
• Gloves

• 1st - Gloves
• 2nd - Gown
• 3rd - Shield

Non-abrasive, antibacterial soap.

• Flush with warm water (hotter the better) for 15 minutes
• Report incident exposure to your supervisor ASAP!

a minor

introduce yourself, ask patient name and b-day. Explain what you will be doing. Chat with patient to keep mind off poke. ADVISE them WHEN you are poking! Speak to them on a first name basis

"pleasant with the patient and professional with the poke".

Downstream from the I.V.

Hands

Right side

artificial connections of veins

artificial artery connection to vein

Hard and cord like veins

Cephalic Vein is most likely to be the one you can palpate and draw blood from in an obese patient

Head

Hematoma

prevented if pressure is placed on the venipuncture site until bleeding stops

GET the needle out of the arm

fainting, dizziness before, during or after venipuncture

is todeliver oxyge, nutrients, hormones and enzymes to the cells. Transport cellular waste such as carbon dioxide and urea to the organs where they can be expelled from the body.

capillary level

• formed elements -
• Erythrocytes (red blood cells) = 99% of formed elements.
• Leukocytes (white blood cells) and Thrombocytes (platelets)

stem cells in the bone marrow

two pumps (right and left sides)

two circulations, with each pump equipped with two valves the function of which is to maintain a one way flow of blood

carries deoxygentated blood from the right ventricle to the lungs. (alveoli) and return oxygenated blood from the lungs to the left atrium

at the alveoli - sacks in the lungs

carries oxygentated blood from the left ventricle throughout the body

an atrioventricular valve, being situated between the right atrium and the right ventricle

semi lunar valve situated between the right ventricle and the pulmonary artery

bicuspid valve) is another atrioventricular valve, being situated between the left atrium and the left ventricle

semi lunar valve situated between the left ventricle and the aorta

one minute

approximately 5-6 liters of blood in their system.

7-9 percent of total body weight of a person

55% is plasma

a clear, pale yellow fluid

it carries nutrients, lipids, glucose, sodium, magnesium, calcium, potassium, oxygen, carbon dioxide, nitrogen, antibodies, as wells as vitamins and hormones ect.

Red blood cells, White blood cells and Platelets. Known as the formed cellular elements

6 to 8 weeks if you donate the maximum of 500 mL

• Endocardium
• Myocardium
• Epicardium

the endothelial inner layer lining of the heart

the muscular middle layer. This is the contractile element of the heart

the fibrous outer layer of the heart. The coronary arteries, which supply blood to the heart are found in this layer

Aorts, arteries, arterioles, capillaries, venules and veins, superior and inferior vena cava

Red blood cells or RBC's

hemoglobin, the oxygen-carrying protein.

enters the blood as an immature reticulocyte where in one to two days, it matures into erythrocyte.

4.2 to 6.2 million RBC's per microliter of blood.

is 120 days

provide the body protection against infection.

5,000 to 10,000

an increase in WBC's, is seen in the case of infection and leukemia.

a decrease in WBC's, is seen with viral infection or chemotherapy

Five

determines the percentage of each type

phagocytic cells, meaning, they engulf and digest bacteria. Their number increase in bacterial infection.

40 to 60% of the WBC population

their numbers increase in viral infection, they also play a role in immunity.

20 to 40% of the WBC population

Increase in intracellular infections and tuberculosis

3 to 8%, they are also the largest WBC's

they are active against antibody-labeled foreign molecules.

in allergies, skin infections and parasitic infections

first in allergic reactions. During an allergic reaction it would show an increase in Eosinophil count

release histamine

0 to 1% in the blood

blood coagulation

platelets are small irregularly shaped packets of cytoplasm formed in bone marrow

in the antecubital fossa

• Median cubital vein
• Cephalic vein
• Basilic vein

Red topper tube

plain vacume tube and contains no additive or anticoagulant.

30 minutes

No

Serum chemistry, Serology, Blood bank

15 minutes of collection

blood gas levels and blood PH. Usually collected by a nurse or respiratory therapist

When the patient has fasted and not excersiced in 12 hours

YES!

Light blue

• Sodium Citrate
• Different ratios

5 to 10

• coagulation determinations on plasma specimens.
• * Certain test require chilled specimens*
• Always fill to MAX fill line

Tiger top or gold top (gold in Utah)

• Clot activator - (silica in Utah) or glass particles
• Fixotropic gel

15 to 30 minutes

• Green top
• Mint top
• Hash marks on label

Heparin combined with sodium, lithium or ammonium ion

PST - Plasma Seperator tube

Sodium Heparin

• Ammonia
• Carboxyhemoglobin ( HCg preg test)
• STAT Lytes

• electoliytes -
• potassium, sodium

• Basic
• Metobolic
• Panel

A group of tests ordered together

Lithium

Lavendar

EDTA - Ethylenediaminetetraacetate

• chem 8 Tiger/Gold tube -
• Basic Metobolic Panel

• chem 14 Tiger/Gold tube -
• Comprehensive Metobolic Panel

• 7. mL of EDTA -
• calcium binding agent

• 3.6 mL of EDTA -
• calcium binding agent

• Blood banks / transfusion -
• for blood typing

• CBC = Complete Blood Count
• CBCAN = Complete Blood Count Automatice Differential
• CBCDN - Complete Blood Count Manual Differential

• Lavendar top tub -
• Erythocyte Sedimentation Rate

Sickle Cell Screening

inhibits coagulation by binding to calcium in the specimen

Light Blue

at least two-thirds full

8 times

the percentage of the RBC's (Red Blood Cells) in a given volume of whole blood

Hematocrit

• Superior & Inferior Vena Cava (V-C)
• 2- goes to - Right Atrium
• 3- from there to - Tricuspid Valve
• 4- then onto - Right Ventricle
• 5- and now out to the - Pulmonary Artery - and lungs
• 6- back into the - Pulmonary Veins
• 7- then onto the - Left Atrium
• 8- moves onto the - Bicusped Valve
• 9- down to the - Left Ventrical
• 10- finally to your hot bod via the - Aorta

Valves

Analyes arteial blood for oxygen, carbon dioxide and bicarbonate content in addition to blod PH* used to determine the effectiveness or respiration

The absence of microoganisms or by contrast, something that just discourages the growth of microoganisms is antiseptic

The large vein on the inner side of the bicep and is often chosen for tntravenous injections and blood drawing

The basis of tort in this case the unprivileged touching of one person by another.

Patient gives consent for a procedure to be performed in full knowledge of the procedure and the risk it entails

A test done to ascertain platelet function.

A special paper applied to a wound (small incision) in the forearm. The paper is applied and then timed to see how long it takes for platelets to form a "plug" and stop the bleeding

bleeding time results

The conversion of blood from a liquid form to solid through the process of coagulation

a clot which forms inside of a blood vessel

a clot that moves inside the vessel it is referred to as an embolus

an infection transmitted from blood to blood

a small needle with two plastic wings attached which are squeezed together to form a tab that is used to manipulate the needle. A long 6-12" plastic tubing is attached which again offers better manipulation. This assembly is then attached to a syrings or Vacutainer holder for the purpose of drawing a blood sample

Centers for Didease Control and Prevention

movement of fluid in a regular or circuitous cource. Heart failure is and example of a problem with circulation

• A compound that is an intermediate in the citric acid cycle (krebs cycle)
• Citrate chelates (binds) calcium ions, preventing blood clotting and thus is an effective anticoagulant

Group of plasma protein substances (Factor I-XIII) contained in the plasma which act together to bring about blood coagulation

• The number of RBC's (red blood cells), WBC's (white blood cells) and platelets (per cubic millimeter) that are present in the patient's sample of blood is determined.
• Also included is the HEMOTACRIT (%), hemoglobin concentration (gm%) and the differential.
• *Most common test done on the blood*

The soiling of pollution by inferior material, as by the introduction of organisms into a wound

Trademark for the preparation of warfarin sodium

Bluish skin color due to lack of Oxygen

Consists of injury to another person's reputation, name or character through spoken (slander) or written (libel) words.

• A count made on a strained blood smear of the proportion of the different leukocytes (WBC's) and express as a percentate.
• A differential is a normal part of a complete blood count (CBC)

The skin discoloration caused by a bruise (contusion)

Ethylenediaminetetraacete. A calcium chelating (binding) agent that is used as an anticoagulant for laboratory blood specimens

A substance that will acquire the capacity to conduct electricity when put into solution. Electrolytes include sodium, potassium, chloride, calcium and phosphate. informally know as "LYTES"

• A sudden blockage of a blood vessel by a blood clot or some other obstruction which has been transported through blood vessels and lodged at a site to small for passage.Examples of emboli are detached blood clot, a clump of bacteria or other foreign material such as air.
• Contrast to thrombus

A protien formed during normal blood clotting tht is the essence of the clot

The protein form which fibrin is formed/generated in normal blood clotting

Relative to venipuncture, the appearance of a small amount of blood in the neck of a syringe or the tubing of a butterfly. This is a sign the the vein has been properly accessed.

An inanimate object that transports microoganisms

Red Blood Cells, White Blood Cells and platelets

• Needle Diameter is measured by gauge; the larger the needle diameter, the smaller the gauge.
• For example, a very large diameter needle (16 ga) may be used to hemodialysis, whereas a much smaller needle (23 ga) would be used to draw blood for laboratory testing

An agent that kills pathogenic microoganisms

This law deals with the rendering of first aid by health care professionals at the scene of an accident or sudden injury. It encourages health care professionals to provide medical care within the scope of their training without fear of being sued for negligence

The sugar measured in the blood an urine specimens to determine the presences or absence of diabetes.

is the end product of carbohydrate metabolism and is the cheif source of energy for all living organisms

An anticoagulant that acts to inhibit a number of coagulation factors, especially factor Xa. Heparin is formed in the liver

The ratio of the total RBC (red blood cell) volume to the toal blood valume and expressed as a percentage

A localize collection of blood within tissued due to leakage from a wall of a blood vessel, producing a bluish discoloration (ecchymosis) and pain

A decrease in the fluid content of the blood (plasma), resulting in an increase concentration. This is determined by an increase in the hematocrit. Caused by a filtration of plasma into the body tissue and often created by dehydration

The oxygen carrying pigment of the RBC's (red blood cells)

The breakin of the RBC's (red blood cells) membrane releasing free hemoglobin into the cirulating blood. In phlebotomy, this is usually a result of mechanical damage due to poor technique

Abnormally high blood sugar level

Abnormally low blood sugar level

An infection transmitted through body fluids to blood

Giving the patient adequate information concerning the method, risk and consequences to a specific procedure, it's risks, expected outcome and alternatives

This is the release of medical records without the patient's knowledge and permission

Lymphedema is a type of swelling wich occurs in lymphatic tissue when excess fluid collects in the arms or legs because the lymp nodes or vessels are blocked or removed. Regarding Phlebotomy, this can be a major complication of mastectomies

A device used with a butterfly and Vacutainer holder to allow for then withdrawl of multiple tubes of blood during a venipuncture

This is the failure to exercise the standard of card that a resonable person would give under similar circumstances and someone suffers injury because fo another's failur to live up to a required duty of care

• 1-Duty of care
• 2-Derelict: breach of duty if care
• 3-Direct cause: legally recognizable injury occurs as a result of breach of duty of care
• 4-Damage: wrongful activity must have been caused the injury or harm that occurred

Healthcare setting acquired infections

The study and treatment of cancer

Hemoglobin that has be bound with oxygen in the lungs for the purpose of transport of oxygen to cells of the body. In the cells oxygen is exchanged for carbon dioxide

To examine of feel by the hand. The technique is used to help determine the size, depth and direction of a vein

Any microorganism that produces disease

Having the capability of producing disease

Blood obtained from the circulation away from the heart, such as from the fingertip, heel pad and earlobe or from an antecubital vein

These are tiny non-raised red spots that appear on the skin from rupturing of the cappillaries due to the tourniquest being left on to long or to tight

Inflammation of a vein as a result of repeated venipuncture on that vein

A glass or transparent plastic tube used to accurately measure small amounts of liquid

The fluid protion of the blood in which the cellular components are suspended. PLASMA IS DIFFERENT FROM SERUM!

Also known as a thrombocyte, this is a particulate component of the blodd, approximatley 2-4 microns in diameter and known for it's invlovement in blood coagulation.

from 150,000 - 450,000/cm3

• Defined as diagnostic testing near the dite of patient care. The driving notion behind POCT is to bring the test conveniently and immediately to the patient.
• this increased the likelihood that the patient will receive the results in a timely manner.

• One of the solid components of the blood which is normally a biconcave disc without a nucleus. This is the component of the blood that contains hemoglobin with is responsible for oxygen and carbon dioxide exchange.
• A Red Blood Cell count is performed as part of a complete blood count and ranges from 4,200,00 - 5,00,000 RBC's per cubic millimeter

A hardening; especially from inflammation and certain disease states. Though sclerosis may occur in many areas of the body, the term is most often associated with blood vessels.

This is systemic infection associated with the presence of pathogenic organism introduces during a venipuncture

Referring to blood, the clear liquid portion of blood that separates out after clotting has taken place. Since clotting has accurred, the serum is fibrinogen deficient.Contrast to plasma.

This is injury to underlying tissues caused by probing of the needle

Inflammation of a vein with formation of a clot

This is blood clot usually a consequence of insufficient pressure applied after the withdrawl of the needle.

Tort is a wrongful act that results in injury to one person by another

In regards to venipuncture, a constrictive band, placed over an extrenity to disten veins for the purpose of blood aspiration or intravenous injectons. Materials used may be rubber, latex or synthetice elastic material. Blood pressure cuff may also be used.

• The name used to describe a prevention strategy in which all blood and potentially infectious materials are treated as if they are, in fact, infectious, regardless of the perceived status of the source individual. In other words, wether or not you think blood/body fluid is infected with blood borne pathogens, you treat it as if it is.
• This approach is used in all situations where exposure to blood or potentially infectious materials is possible. This also means that certain engineering and work practice controls shall alsy be utilized in situations where exposure may occur

• Vacutainer is a federally and internationally registered trademark owned by BD (Becton, Dickinson and Company) that is used in connection with a complete system of tubes, needles and needle holders, sharps collectors and safety devices in blood collection.
• The Vacutainer evacuated tube, for example, automatically aspirates the correct aount of blood into a tube. It is used indtead of a syringe. Despite the fact that BD owns the Vacutainer trademark, the term has become so widley used to describe similar blood collection tubes and devices, that it has become a generically used term

A cylindrical shaped holder that accepts a Vacutatiner tube on one end and Vacutainer needle on the other, The holder tube and needle comprise the Vacutainer system used to draw multiple tubes of blood with one venipuncture

The needed is used to attach to a Vacutainer holder. The needle has a male thread on one end which screws into the holder. The threaded end also has a large guage needle, enclised by a rubber sheath. This needle will puncture the stopper of a Vacutainer tube allsoing blodd to enter the tube. Upon withdrawal of this needle from the tube, the rubber sheath covers the needle bevel, stopping the flow of blood. Thus, any number of tubes may be drawn with ony one single venipuncture

The sodium salt of warfarin, one of the synthetic coumarin anticoaulants. Coumadin

The number of white blood cells (leukocytes) found in the peripheral blood and measure per cubic millimeter