PLEBOTOMY STUDY GUIDE

Carries oxygenated blood to body from heart?

-Arteries

Smaller vessel branches?

-Arterioles

Near The surface where O2 ( oxygen) is released?

-Capillaries

Erythrocytes are ___. Leukocytes are _____?

-Red blood cells. White blood cells.

______is the most common method of obtaining blood?

-Venipuncture

nearly ____% of physicians decisions are based on laboratory blood tests?

-80%

Phlebotomy is performed primarily for ______ and to _____ a PTS condition?

-Diagnoses, monitor

What is PTS?

-Post-thrombotic syndrome. Post-thrombotic syndrome (PTS), also called postphlebitic syndrome

and venous stress disorder is a medical condition that may occur as a long-term complication of
deep vein thrombosis
In bloodletting, barbers advertised with red/white striped pole. Red represented____,and white
represented the____?

-Blood, tourniquet

The circularly system consists of :

•Heart, chambers and valves

•Blood vessels

•Blood

Circulatory system consists of everything except_____?

-Capillaries

The heart, chamber & valves pumps to____from____?

-To body, -from ventricle

Blood vessels are 3 layers:

•Outer: tunica adventitia (connective tissue)

•Middle: tunica media(smooth muscle)

•Inner: tunica intima(endothelium)

Average adult has ___ to____ liters of blood?

-5 to 6

Blood has liquid plasma of___% and solid plasma of____%?

-Liquid 55%

-Solid 45%
All blood cells originate from stem cells in the ____ ____?

-Bone marrow

What is found in liquid plasma?

-Proteins, amino acids, gases, electrolytes, sugars, hormones, minerals, vitamins and water(92%),
and waste products

What is found in Solid form plasma?

-Erythrocytes- red blood cells (99%formed elements

- Leukocytes- white blood cells

- thrombocytes- platelets

•BLOOD VESSELS:

- Aorta- main artery leaving the heart

- Arteries- oxygenated blood to body from heart

- Arterioles- Smaller vessel branches

- Capillaries- near surface where O2 is released

- Venules- smaller vessel between capillaries and veins; starting return of

deoxygenated blood

- Veins- larger vessels returning deoxygenated blood to heart( Will go to longs for
refill)

- Superior & inferior vena cava- routes deoxygenated blood back into the atria from
the body

Erythrocytes carry oxygen by _______, to the body?

-Hemoglobin
Normal Erythrocytes (RBC's) is ___ to ___ million per microliter of blood?

-4.2 to 6.2

_____ is the average lifespan of erythrocytes (RBC's)?

-120 days

_____ protects the body against infection?

-Leukocytes( White blood cells)

Normal Leukocytes (WBC's) is ___ - ___per microliter?

-5,000 to 10,000

NPA

-National phlebotomy association

ASPT

-American society of phlebotomy technicians

IAPS

-International Academy of phlebotomy sciences

ASCP

-American Society of clinical pathologist

If a patient has a history of syncope, it is best to perform phlebotomy while the patient is?

-Lying on in exam table

Definition of Syncope:

-A temporary loss of consciousness caused by a fall in blood pressure

When performing venipuncture you will likely seat a patient in a _______, which has an
adjustable locking armrest to protect the patient if he or she should faint?

-Venipuncture chair

Keep in mind that the tourniquet should be tied for no longer than?

-One minute

Tourniquets are tied ____to_____ above the elbow before venipuncture?

-3 to 4 inches

A tourniquet prevents venous blood flow out of the site, causing the veins to _______?

-Bulge

When applying a tourniquet the vein should bulge, but it should not restrict__________?

-Arterial flow

Tie a tourniquet so it can be released with only?

-One hand

Leaving A tourniquet on for longer than one minute greatly increases the possibility
of__________?
-Hemoconcentration

The most commonly used anti-septic for Cleaning a site for venipuncture is ___%,
______________,( known as rubbing alcohol)?

-70% isopropyl alcohol(prep pads)

A rubbing alcohol prep pad used for venipuncture, is rubbed on the skin in a ________ motion,
and the alcohol is allowed to dry?

-Circular

To be most effective alcohol should remain on the skin for ___to___ seconds before drawing
venipuncture?

-30 to 60 seconds

What are the 4 antiseptics used for cleansing the skin before performing venipuncture?

•alcohol pads( 70% isopropyl alcohol

•sterile soap pads

• benzalkonium chloride

• providone iodine ( betadine)

Equipment used in routine venipuncture?

-Gloves, bandages, gauze pads, alcohol swabs, marking pen, tourniquet, wing infused
sets( butterfly needles), evacuated stopper tubes, double pointed safety needles, syringes, sharps
container, needle holder

_______ is the most common collection system in use?

-Evacuated tube (vacutainer) system.

Be sure to match the _____gauge to the size of the tube?

-Needle

Tube additives contain ______, _______?

-Anticoagulants, clot activators/or gel

Tube volumes range from ____ to ____mL?

-2mL to 15mL

All tubes except the _____ topped one contain an additive?

-Red-topped

_________ an additive added to tubes to prevent blood from clotting?

-Anticoagulants

_______ is an additive that quickly promotes clotting and is used in tubes drawn for stat
chemistry testing or in the event a sample is needed from a PTtaking a prescribed anticoagulant?

-Thrombin

What is a PT and PTT test?

-Prothrombin time (PT) Partial thromboplastin time (PTT) test is a blood test that helps doctors
assess your body’s ability to form blood clots. Bleeding triggers a series of reactions known as the
coagulation cascade. (Light Blue Tube)

Difference between PST and SST?

The PST tube is used for STAT general chemistry orders and the SST tube is used for more
routine chemistry blood tests. The blood sample in an SST tube has to clot before the serum can
be used. This usually takes about 30 minutes. The PST tube offers a whole blood specimen that
can be used almost immediately, which is why it is used for STAT orders.

What does SST stand for?

-Serum Separator tube (Yellow or Red Tubes)

What does PST stand for?

-Plasma Separator Tube (Light Green/Lithium Heparin Tube)

_____ is a blood thinner?

-Heparin

Liquid portion of blood is called _____?

-Plasma

Without a clot activator, blood clots in ___ to ____ minutes, after which it must be_____?

• 30 to 60 minutes

• centrifuged

Order of draw
•Yellow- blood culture
•Light Blue-sodium citrate. Coag.
•Red-none, serum tests
•Green-Heparin
•Lavender- EDTA. CBC.
•Gray- sodium fluoride, and oxalate
-----------------------------------------------------------
YELLOW 5ml

ADDITIVE & FUNCTION--

•SPS, prevents blood from clotting & stabilizes bacterial growth.

LAB USE:

•blood or body fluid cultures

OPTIMUM VOL & MIN VOL-5ml/NA

LIGHT BLUE 4.5mL/4.5mL

ADDITIVE AND FUNCTION:

•Sodium citrate; removes calcium to prevent blood from clotting.

LAB USE:

•Coagulation testing

OPTIMUM VOL & MIN VOL: 4.5mL/4.5mL

RED 10mL/NA

ADDITIVE & FUNCTION:

•None

LAB USE:

• Serum tests, chemistry studies, blood bank, serology.

OPTIMUM VOL & MIN VOL: 10mL/NA

GREEN

ADDITIVE & FUNCTION:

• Heparin,( sodium/lithium/ammonium); inhibits thrombin formation to prevent clotting.

LAB USE:

•Chemistry

OPTIMUM & MIN VOL: 10mL/3.5mL

LAVENDER (used for complete blood counts)

ADDITIVE & FUNCTION:

•EDTA, removes calcium to prevent blood from clotting.

LAB USE:

Hematology testing .

OPTIMUM & MIN VOL: 7mL/2mL

GRAY

ADDITIVE & FUNCTION:

Potassium oxalate and sodium fluoride; remove calcium to prevent blood from clotting; fluoride
inhibits glycolysis.

LAB USE:

Chemistry testing, especially glucose and alcohol levels.

OPTIMUM & MIN VOL: 10mL/10mL

_____, is found in the lavender topped tube, removes calcium to prevent blood from clotting?

-EDTA

Needles have two parts?

-Hub and shaft

Shafts differ in length, ranging from ____ to ____ inches?

-3/4in to 1 1/2inches

The end of the shaft is cut at an angle and forms the ______?

-Bevel

The hole in the bevel is called the_____?

-Lumen

Lumen size is important in venipuncture and is referred to as the ____?

-Gauge

The gauge is designed by a numeric value; the higher the number gauge, the smaller the _____ is?

-Lumen

The smaller the number gauge, the bigger ____ is?

-Lumen

Normal adult draw is __ - __ size gauge?

-20-21 g

A pediatric draw is ___ gauge?

-23g

Blood donation gauge size ___?

-16g
The smallest gauge needle is the___gauge. It is used to collect the blood from small or fragile
veins?

-23g

Multisample needles are used when several tubes are to be drawn during a single venipuncture.
These needles are _____ ______. The point that enters the tube is sheathed with a rtractable
rubber sleeve that allows tubes to be changed?

-Double pointed.

Used when there is concern that the strong vacuum in a stopper tube might collapse the vein?

-Syringe

Designed for use on small veins, such as those in the hand or in pediatric patients?

-Butterfly Needle

The most common needle size for a butterfly needle is?

-23g, 1/2 to 3/4 inches long.

Double pointed needles must be firmly placed into a needle adapter or?

-Tube Holder

These devices, which are attached to the phlebotomy needle or to a winged infusion needle, are
manually engaged after the needle has been removed from the vein?

-Hinged or sliding safety mechanism.

- immediately after injury, the wound is inspected for foreign material which is removed. The site
is washed for 10 minutes with an antimicrobial soap, 10% iodine solution, or chlorine based
antiseptic
- The injury is reported to the supervisor and an incident report is completed.

- The employee is referred to a physician for confidential assessment and follow up

Postexposure management of needlesticks

All blood collections begin with a form from the patient's physician requesting a test. They may
be computer-generated or hand written?

-Requisition Form

What information must be included on a requisition form?

-patients name

-date of birth

-identification number

-name of the physician making the request

-type of test requested

-test status

(Timed, fasting, stat, etc)

Which venipuncture site is first choice and runs at a slight angle in the antecubital are?

-Median cephalic vein

Which venipuncture site is second of choice and runs lateral or to the outside of the antecubital
area on thumb side?

-Cephalic Vein

Which vein lies on the inside antecubital pinky side and is last of choice?

-Basilic vein
What are the 5 unsuitable veins?

- sclerosed veins

-thrombotic veins

-trotuous veins

- arms with Iv's

- arms w/shunts(dialysis pt.)

___ veins feel hard and cordlike. May be damaged from disease, inflammation, chemotherapy, or
repeated venipunctures?

-Sclerosed veins

___ veins contain clots?

-Thrombotic

___veins are winding crooked veins. Blood flow will be impaired?

-Trotuous veins

Name two patient identifiers?

-Name, DOB

___ is the laboratory procedure most frequently ordered for blood specimens?

-CBC, ( complete blood count)

A CBC routinely includes the following:

-RBC COUNT

- WBC COUNT

- Hemoglobin determination

- hematocrit determination

- differential WBC count

- estimation platelet numbers

- red cell indices

Larger veins that returns deoxygenated blood back to the heart(goes to lungs or refill)?

-Pulmonary Veins

Leukocytosis?

-Bacterial infection and leukemia

Leukopenia?

-Viral infections and chemotherapy

___ is a measurement of the percentage of packed red blood cells in a volume of blood?

-Hematocrit

The ____ determination is a rough measurement of the oxygen carrying capacity of blood?

-Hemoglobin

Is A large painful bruised area at the puncture site caused by blood leaking into the tissue, which
causes the tissue around the puncture site to swell?

-Hematoma
In hematocrit testing, two or three drops of blood are collected from a capillary puncture in two
capillary tubes and are placed in a ____?

-Microhematocrit centrifuge

What test is based on The principle of separating the cellular elements from plasma by
centrifugation?

-Spun microhematocrit test

What machine is used to test hemoglobin?

-Stat-site system

Inflammation of a vein due to repeated venipuncture?

-Phlebitis

Blood clot at site, usually not applied enough pressure?

-Thrombus

Inflammation of a vein with formation of a clot?

-Thrombophlebitis

Systemic infection ( organisms ), introduced during venipuncture?

-Septicemia

Injury to underlying tissues caused by excess of probing?

-Trauma
Ruptured capillaries due to tourniquet left on too long?

-Petechia

Factors to consider when drawing venipuncture?

- fasting

- edema - swelling

- fistula- surgical connection between artery and vein,( dialysis pt )

When should you label tubes?

-After draw at pts. side

Glass or plastic tubes that draw blood by capillary action, the blood fills into these tubes without
the need for section?

-Capillary tubes

Equipment needed for capillary punctures?

- alcohol pad

- gauze

- lancet

- capillary tube

Depth of capillary puncture for infant and adult?

-Infant - 0.85 to 2.0

-Adult- 0.85 to 3.0

For a heel puncture do not go deeper than____mm?

-2.0

____ contains tissue fluid?

-Capillary samples

Order of draw for capillary specimens?

-lavender

- additives

- without additives

Restraints for children?

-Papose boards

____ is a legal term that refers to the ability to guarantee the identity and integrity that the
specimen from collection to reporting of test results. May be used for drug and alcohol testing,
DNA analysis, or parentage testing in court?

-Chain of custody

part of the whole specimen that has been taken off for use or storage and transferred from one
tube to another?

-aliquot

____ samples is a mixture of venous and arterial blood?

-Capillary samples

Hemoglobin and glucose are higher in?

-Capillary blood