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Chapter 8
Study Guide questions
150
Medical
Professional
05/09/2014

Additional Medical Flashcards

 


 

Cards

Term
It is unlikely that misidentifying a patient specimen would result in
Definition
No reprimand if no one was hurt
Term
Basic step to minimize any trauma associated with a venipuncture
Definition
Choose the most skilled phlebotomist available to perform the venipuncture
Term
Seat the needle
Definition
Thread part of the needle within the lumen
Term
Test ordered "timed" to
Definition
Draw it at the best time for accurate results
Term
Timed tests
Definition
Blood cultures, Cardiac enzymes, and Cortisol
Term
Unique number assigned to a specimen request
Definition
Accession number
Term
Individual who has legal authority to authorize patient testing
Definition
Patient's physician
Term
Test recquisition info must include
Definition
Ordering physician
Term
Info represented by patient ID band typically include
Definition
Medical record number and name
Term
Inpatient recquisitions are sorted by
Definition
Collection priority, date and time, and patient location
Term
Steps taken to unmistakably connect a specimen and the accompanying paperwork
Definition
Accessioning the specimen
Term
Priority of tmed test
Definition
Second
Term
Test commonly ordered stat
Definition
Lytes
Term
When test is ordered ASAP
Definition
Results are needed soon for an appropriate response
Term
Tests are classified as routine if they are ordered
Definition
In the course of establishing a diagnosis
Term
Test commonly ordered fasting
Definition
Glucose
Term
Common post-op test
Definition
H&H
Term
Patient says, OK, but I would rather not
Definition
Determine what the problem is and get the patients permission before proceeding
Term
Test used to identify protein disorders that lead to nerve damage
Definition
SPEP
Term
In collecting from an unconscious patient
Definition
Move the patient to a special phlebotomy collection area
Term
Misidentification of specimen for this test will have fatal consequences
Definition
Type and Screen
Term
Recquisition info must match info on patient's band
Definition
Medical record number
Term
System of choice to identify lab specimens from unconscious patient in ER
Definition
Use a three-part identification band with special tube labels
Term
Inpatient most likely to have more than one ID band
Definition
Newborn
Term
Patient least likely to need their identity confirmed by nurse
Definition
Geriatric patient
Term
Part of informed consent for specimen collection
Definition
Informing the patient you are a student
Term
Proper arm position for routine veil-puncture
Definition
Downward in a straight line from shoulder to wrist, palm up
Term
Action prohibited during the vein selection process
Definition
Patient pumping their fist
Term
How to tell a vein from an artery
Definition
Artery has a distinct pulse
Term
Sclerosed vein feels like
Definition
Hard and cord-like
Term
Will help you to avoid puncturing and artery
Definition

Avoid drawing basilic vein in antecubital area

Do not select a site near a pulse

Do not select a site that overlies or close to an artery

ALL OF THE ABOVE

Term
Patient with IV in left wrist and dermatitis all over right arm and hand
Definition
Apply a tourniquet on right arm over a towel and draw
Term
Best thing to do if the vein can be felt but not seen, even with tourniquet on
Definition
Look for visual cues on the skin to remind you where the vein is
Term
Correct order of steps for venipuncture
Definition
Clean the site, prepare equipment, put on gloves, apply tourniquet
Term
Analytes least affected by prolonged tourniquet application
Definition
Prothrombin
Term
Important to mix anticoagulation tubes immediatiely after filling them
Definition
Avoid microclot formation
Term
How many times do you mix a non-additive tube
Definition
None
Term
Use several layers of gauze when removing needle
Definition
Pressure is adequete and bruising is prevented
Term
Applying pressure on the gauze as the needle is removed can cause
Definition
Skin to be split
Term
Specimen requiring routine handling
Definition
Cholesterol
Term
Butterfly needle
Definition
Winged infusion set
Term
Specimen hemolysis can result from
Definition
Using a large-volume tube with a 23-gauge needle
Term
Success of pediatric blood collection most dependent on
Definition
Patient immobilization
Term
Least effective way to immobilize a pediatric patient
Definition
Allowing child to sit with one arm bracing the other
Term
Drawing patient from older child, most important thing
Definition
Explaining the importance of holding still
Term
Diabetic patient had mastectomy on right arm and cannot straighten left arm from arthritis
Definition
Left forearm or hand, using butterfly
Term
Proper procedure when dealing with an elderly adult patient
Definition
Refrain from drawing if you have a cold, or wear a mask
Term
Most common reason a patient undergoes dialysis
Definition
End stage of renal disease
Term
According to CLSI, it is not necessary to attempt to locate median cubital in both arms before considering alternative location
Definition
FALSE
Term
Patients need to understand the procedure before giving informed consent
Definition
TRUE
Term
Once a patient consents to a procedure they can not change their mind
Definition
FALSE
Term
When properly anchoring a vein
Definition
Thumb is 1 to 2 in. below the intended site and is pulling the skin toward the wrist
Term
Action unlikely to help a phleb gain patient trust
Definition
Collecting specimen before requested time
Term
Needle phobia
Definition
Intense fear of needles and being stuck
Term
Symptoms of needle phobia
Definition

Arrythmia

Fainting

Light-headedness

 

ALL OF THE ABOVE

Term
Proper use of hand sanitizer
Definition

Allowing the alcohol to evaporate completely

Rubbing it in between and around the fingers

Using a very generous amount of sanitizer

 

ALL OF THE ABOVE

Term
Examine by touch or feel
Definition
Palpate
Term
Needle insertion should be performed
Definition
Using a smooth, steady motion forward
Term
Going without food or drink except water for 8-12 hours
Definition
Fasting
Term
Test ordered "fasting" to
Definition
Eliminate effects of diet on test results
Term
Bending arm up to apply pressure to the site has not been shown to
Definition
Enable the site to quickly stop bleeding after needle removal
Term
Failure of patient to to follow required diet restrictions before specimen colelction could lead to
Definition

Compromised patient care and treatment

Erroneous and meaningless test results

Misinterpreted test results by the physician

 

ALL OF THE ABOVE

Term
Type of recquisition often serves as a test request, report, and billing form
Definition
Manual
Term
Outpatient recquisitions are typically of this type
Definition
Manual
Term
Test ordered stat
Definition
Collected immediately, without any hesitation
Term
If test ordered stat, could mean patient is in
Definition
Critical condition
Term
Preop patient
Definition
Will soon be going to surgery
Term
Means same as stat
Definition
Med emerg
Term
Patient NPO
Definition
Cannot have any food or drink
Term
Liquid acceptable to drink when fasting
Definition
Plain water
Term
Inpatient door closed
Definition
Knock lightly, open door slowly, and ask whether it is all right to enter
Term
Patient door reads "No blood pressure or venipuncture right arm"
Definition
Collect specimen from left hand by finger puncture
Term
Code is a way to
Definition

Convey important information without alarming the public

Transmit messages over the facility's public system

Use numbers or words to represent important info

 

ALL OF THE ABOVE

Term
DNR
Definition
Do not resuscitate
Term
Inpatient asleep when arrive
Definition
Call out patient's name softly and shake bed gently
Term
Lab results negatively affected if phleb
Definition
While preparing specimen, startles a patient who is asleep
Term
Physician is with patient and specimen ordered stat
Definition
Introduce yourself and ask permission to draw specimen
Term
Family or visitors with a patient
Definition
Ask them to wait outside of room until finished
Term
Patient out of room and not available for several hours for timed specimen
Definition
Fill out delay slip stating unable to collect specimen
Term
How to verify patient in 302B is John Doe
Definition
Ask him for his name and DOB and match it to recquisition
Term
ID number matches but name is spelled differently
Definition
Do not collect specimen until difference is resolved
Term
Unconscious inpatient has no ID band
Definition
Do not start any procedure until nurse attaches ID bracelet
Term
Most critical error phleb could make
Definition
Misidentify patient's specimen
Term
Patient not wearing ID band and its taped to nightstand
Definition
Ask patient's nurse to attach ID band and proceed when attached
Term
Woman only patient in waiting room
Definition
Ask her to state her complete name and DOB to confirm identity
Term
Cheerful, pleasant bedside manner and exchange of small talk unlikely to
Definition
Keep the patient from fainting during the venipuncture procedure
Term
Patient is cranky and rude
Definition
Be as professional as you can and collect specimen in normal way
Term
Patient asks if test you are drawing is for diabetes
Definition
Explain it is best to discuss the test with the physician
Term
Inpatient vehementely refuses to allow you to collect
Definition
Notify patient's nurse and document patient's refusal
Term
Arrive to draw fasting specimen and patient just finished breakfast
Definition
Check with nurse to see if it should be drawn or rescheduled
Term
If you assemble equipment after selecting and cleand site
Definition

Be more apt to allow alcohol to dry

Have better idea of what equipment to use

Waste less equipment by knowing exactly what is needed

 

ALL OF THE ABOVE

Term
When performing venipuncture, hand decontamination is required
Definition
Before and after each patient
Term
Hands visibly contaminated
Definition
Wash with soap and water
Term
Collect on 6 year old and child is fearful
Definition
Explain what you are going to do to the child in simple terms
Term
Patient asks if procedure will hurt
Definition
Might hurt just a little, but only for a short time
Term
Outpatients who have previously fainted
Definition
Asked to lie down, or sit in a reclining chair
Term
Can lead to liabiity issues
Definition
Lowering a bed rail to make access to patient's arm easier
Term
Never leave tourniquet on more than
Definition
1 minute
Term
Best place to apply tourniquet
Definition
3-4 in. above venipuncture site
Term
If tourniquet too tight
Definition

Arterial flow below it may be stopped

Blood below it may hemoconcentrate

Pressure can cause the arm to ache

 

ALL OF THE ABOVE

Term
Acceptable to use ankle vein
Definition
Physician gives permission
Term
Release tourniquet as soon as blood flow established
Definition
Decrease hemoconcentration of specimen
Term
CLSI way to clean venipuncture site
Definition
Cleanse with circular motion from center to periphery
Term
Least important reason to wait 30 seconds for alcohol to dry
Definition
Allow phleb time to prepare equipment and supplies
Term
Advanced tube past guideline on holder before needle insertion
Definition
Tube will fail to fill with blood because of vacuum loss
Term
Visual inspection of needle unable to detect
Definition
Needle is out of date
Term
Touch needle to skin but change your mind and pull away
Definition
Stop and obtain a new needle before trying again
Term
Best angle to use for needle insertion
Definition
30 degrees or less
Term
Needle inserted
Definition
Bevel facing up
Term
How to tell needle is in vein
Definition
Feel a slight "give"
Term
Best time to release tourniquet
Definition
As soon as blood begins to flow into tube
Term
Improper specimen collection technique
Definition
Position arm so tubes fill stopper end first
Term
Important to fill anticoagulant tubes to proper level
Definition
Proper ratio of blood to anticoagulant additive
Term
Filled EDTA before green-top
Definition
Draw several milliliters into discard tube, then fill green
Term
Mix tubes too vigorously
Definition
Hemolysis
Term
Better to use gauze
Definition
Cotton balls may pull platelet plug away from site
Term
Needle safety feature, other than blunting needle
Definition
Immediately after needle is withdrawn
Term
Right venipuncture procedure order
Definition
Establish blood flow, release tourniquet, fill and mix tubes, remove needle
Term
Proper needle disposal involves
Definition
Disposing of needle and tube holder in sharps container as one unit
Term
Label of routine specimens should take place
Definition
At the bedside immediately after collection
Term
Information on specimen label considered optional
Definition
Patient room number and bed
Term
Patient's ID number included on tube to
Definition
Avoid confusing specimens from patients with same name
Term
Information unnecessary to be given after venipuncture
Definition
Do not drink or eat for 2 hours after collection
Term
Not a valid reason for failure to obtain blood
Definition
Didn't have right equipment on tray
Term
Made two unseccessful attempts to collect
Definition
Ask another phleb to collect fasting specimen
Term
Where tourniquet applied when drawing hand
Definition
Proximal to wrist bone
Term
Advantage of using butterfly
Definition
Butterflies make it easier to draw difficult veins
Term
May be necessary to use syringe when
Definition
Patient's veins are very fragile
Term
How to tell when in a vein using a syringe
Definition
A "flash" of blood will appear
Term
Doing this before obtaining blood from child is bad idea
Definition
Telling the child it will not hurt
Term
Butterfly and 23-gauge needle best choice for young child
Definition
Flexible tubing allows for arm movement
Term
Transferring blood from syringe to evacuated tubes
Definition
Use specially designed engineering device called syringe transfer device
Term
Criteria do decide which gauge needle to use
Definition
Size and condition of vein
Term
Additive should be mixed
Definition
As soon as it is removed from tube holder
Term
Tremors associated with this disease can make collection difficult
Definition
Parkinson's
Term
Care for patients who are terminally ill
Definition
Hoospice care
Term
Always ask patient to state their name, never offer name
Definition
TRUE
Term
Never verify patient's identity from ID band they're not wearing
Definition
TRUE
Term
Phleb that lowers bed rail is responsible if patient falls out of bed
Definition
TRUE
Term
Veins on underside of wrist are ideal location
Definition
FALSE
Term
Once cap is removed, do not allow needle to touch anything, otherwise it will become contaminated
Definition
TRUE
Term
Butterfly is inserted at 30 degree angle
Definition
FALSE
Term
ETS is inserted at 10 degree angle
Definition
FALSE
Term
If patient does not stop bleeding after 5 minutes, phleb should consult with nurse
Definition
TRUE
Term
Studies show bending an arm after venipuncture in antecubital area increases chance of bruising
Definition
TRUE
Term
If tube holder not securely anchored, needle can push through back of vein or pull out
Definition
TRUE
Term
Once site has been decontaminated it is ok to repalpate the area before inserting needle
Definition
FALSE
Term
Site is cleaned forming concentric circles outward working inward
Definition
FALSE
Term
Dialysis patient most likely to have an Arteriovenous fistula or graft
Definition
TRUE
Term
Labeling of tubes can be done back at nurse's station
Definition
FALSE
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