1
Q
What is phlebotomy?
A
The process of withdrawing blood from a vein for laboratory testing
It assists in the proper diagnosis of disease and monitoring of a patient’s condition.
2
Q
Who typically performs phlebotomy procedures?
A
Medical Assistants
They may complete additional training to enhance career opportunities.
3
Q
What is a critical safety rule regarding moving a patient who may have a spinal injury?
A
Never move them unless their current location presents an immediate danger to their life
Moving a victim with a spinal injury may cause further harm.
4
Q
What are the patient preparation instructions for accurate test values?
A
- Fasting
- Medication restrictions
Fasting is the most common instruction, often requiring a 12-hour fast.
5
Q
What should patients be instructed not to do before a fasting blood test?
A
Eat or drink anything but water
This is to ensure accurate test results, especially for lipid panels.
6
Q
What should a Medical Assistant do if a patient has not completed the required preparations?
A
Explain that the procedure cannot be performed
Verify all preparation guidelines were followed before proceeding.
7
Q
What position should a patient be in for venipuncture?
A
Comfortable, with their arm extended out
If no phlebotomy chair is available, have them make a fist with the opposite hand.
8
Q
What should be done if a patient reports fainting during previous blood draws?
A
Position them in semi-Fowler’s or supine position
This reduces the risk of a fall during the procedure.
9
Q
What is the first step to beginning any phlebotomy procedure?
A
Obtaining the provider’s order for laboratory testing
Venipuncture should not be performed without this order.
10
Q
What two identifiers should be used when identifying a patient?
A
- Patient’s full name
- Date of birth
This ensures accurate patient identification.
11
Q
What information is included on the laboratory requisition form?
A
- Ordering provider’s name and contact information
- Test and test code
- Diagnosis code (ICD-10)
- Special specimen requirements
- Patient demographics
- Insurance or billing information
Each laboratory test requires a requisition form.
12
Q
Fill in the blank: The laboratory directory provides information on _______.
A
specimen requirements, patient preparation requirements, container type, and transport/processing requirements
It helps identify orderable tests and their specifications.
13
Q
What are the general supplies needed for blood draws?
A
- Alcohol wipes
- Gauze
- Adhesive bandages
- Biohazard sharps container
- PPE, including disposable gloves
- Tourniquet
- Collection tubes
- Needle system
Supplies and equipment needed vary depending on the type of venipuncture procedure being performed.
14
Q
What is the Evacuated System in blood draws?
A
A system consisting of a double-pointed needle, a plastic needle holder/adapter, and collection tubes that creates a slight vacuum to transport blood
This method allows obtaining multiple tubes of blood with one venipuncture stick.
15
Q
What is the typical gauge range for Vacutainer needles?
A
20 to 22 gauge
The needle length typically ranges from ¾ inch to 1 ½ inches, depending on the perceived depth of the vein and the size of the patient.
16
Q
What is the Winged Infusion Set also known as?
A
Butterfly System
This method is best for patients with small or fragile veins and tends to cause less trauma or bruising.
17
Q
What is the typical gauge range for Butterfly needles?
A
21 to 23 gauge
The needle length typically ranges from ½ to ¾ inch, depending on the size of the patient.
18
Q
What is the Needle Syringe System used for?
A
To draw blood from a vein
This method is not ideal as it can only obtain a small amount of blood.
19
Q
What is the lumen of a needle?
A
Hollow space inside the needle, also referred to as the gauge
The larger the gauge number, the smaller the diameter.
20
Q
What is the bevel of a needle?
A
Shaft at the end of the needle that creates a point
It is important for the insertion of the needle into the skin.
21
Q
What are the four main components of blood?
A
- Plasma
- White cells
- Red cells
- Platelets
Each component has specific functions in the body.
22
Q
What does plasma contain?
A
Water, waste products, gases, proteins, and nutrients
Plasma is the liquid portion of blood obtained after centrifuging.
23
Q
What is the role of white blood cells?
A
Defending the body against bacteria and viruses
They are a crucial part of the immune system.
24
Q
What is the function of red blood cells?
A
Carrying oxygen to tissues and carbon dioxide to the lungs
They are essential for respiration and maintaining oxygen levels in the body.
25
What do **platelets** do?
Limit the loss of blood when a blood vessel is damaged or leaking
## Footnote
They play a key role in blood clotting.
26
What is **serum**?
The liquid portion of blood obtained after a serum sample tube has clotted and centrifuged
## Footnote
It is different from plasma, which is obtained with anticoagulants.
27
What is the difference between **plasma** and **clotted blood**?
Plasma is obtained with anticoagulant; clotted blood is obtained without it
## Footnote
Plasma has three layers after centrifugation: plasma, buffy coat, and red blood cells.
28
What is **whole blood**?
Blood obtained when a tube is used with an anticoagulant, inhibiting clotting
## Footnote
It contains all components of blood in their natural state.
29
What identifies **vacuum stopper tubes**?
The color of the top of the tube
## Footnote
The color also indicates any additive within the tube.
30
Why is the **order of draw** important during venipuncture?
To avoid errors and cross-contamination of additives
## Footnote
The additive from one tube can carry over to another and affect test results.
31
What happens if vacuum tubes are not drawn in the **correct order**?
Additives could inadvertently affect laboratory results
## Footnote
This can lead to inaccurate test outcomes.
32
What is the **best practice** for filling vacuum tubes?
Allow blood to fill the tube until blood flow stops
## Footnote
This ensures the tube is filled completely for accurate test results.
33
How many inversions are required for the **light blue top tube**?
3 to 4
## Footnote
This tube contains sodium citrate, which removes calcium to prevent blood from clotting.
34
What is the additive in the **yellow top tube**?
Sodium polyanethol sulfonate
## Footnote
It prevents blood from clotting and stabilizes bacterial growth for cultures.
35
What is the purpose of the **red/gray marbled tube**?
Serum separation
## Footnote
It contains silica particles to enhance clot formation.
36
What does the **green top tube** contain?
Heparin
## Footnote
Heparin inhibits thrombin formation to prevent clotting.
37
What is the function of the **lavender top tube**?
Hematology test
## Footnote
It contains EDTA, which removes calcium to prevent blood from clotting.
38
What is the additive in the **gray top tube**?
Potassium oxalate and sodium fluoride
## Footnote
This combination removes calcium to prevent clotting and inhibits glycolysis.
39
Fill in the blank: The **number of inversions** for the **gray top tube** is _______.
8 to 10
## Footnote
This tube is used for chemistry testing, especially glucose and alcohol levels.
40
What factors influence the selection of a **phlebotomy method**?
* Condition of the patient’s veins
* Age
* Skin conditions
* Overall health
* Professional experience and judgment
## Footnote
The chosen method should provide the greatest chance for successful blood collection and limit patient discomfort.
41
What is the **preferred vein** within the antecubital space for phlebotomy?
Median cubital vein
## Footnote
This vein tends to cause less pain and is least likely to roll during the procedure.
42
Name two alternative veins if the **median cubital vein** is not accessible.
* Cephalic vein
* Basilic vein
## Footnote
These veins are found on either side of the median cubital vein but have a higher risk of rolling.
43
True or false: Blood draws from the **foot** should be performed without supervision.
FALSE
## Footnote
Blood draws from the foot should only be performed under the supervision of a provider due to the risk of deep vein thrombosis (DVT).
44
What method is optimal when drawing from **small/thin veins** in the antecubital space?
Butterfly method
## Footnote
This method is best for drawing from the hand or small/thin veins.
45
What is the purpose of applying a **tourniquet** during phlebotomy?
To make the vein easier to palpate and more accessible
## Footnote
The tourniquet impairs blood flow, promoting successful phlebotomy.
46
How long should a **tourniquet** be left in place?
No longer than 1 minute
## Footnote
Leaving it on longer can cause hemoconcentration and alter test results.
47
What should be avoided when selecting a site for blood draw?
* Scar tissue
* Injuries
* Burns
* Wounds
## Footnote
These conditions can complicate the blood draw and affect specimen quality.
48
What physiological changes in **older adults** affect venous access?
* Muscular atrophy
* Loss of vein elasticity
* Venous insufficiency
## Footnote
These changes make veins more prone to rolling and fragile.
49
What is the correct angle of needle insertion when drawing from the **arm**?
15-30 degrees
## Footnote
The angle depends on the depth and position of the vein.
50
What should be done after cleansing the site with antiseptic?
Allow the site to air-dry
## Footnote
The tourniquet should be reapplied after the site is dry.
51
What is the first step to begin the **phlebotomy procedure**?
Anchor the vein by grasping the skin firmly
## Footnote
This stabilizes the vein for the needle insertion.
52
What should be done once proper blood flow is established during a blood draw?
Release the tourniquet
## Footnote
This should be done with the nondominant hand after inserting the evacuated stopper tube.
53
What should be done with the needle after all tubes are filled?
Close the needle safety guard and dispose of it in the biohazard sharps container
## Footnote
This ensures safety and compliance with biohazard protocols.
54
What is the **preferred method** of blood collection for infants and young children?
Capillary puncture
## Footnote
It can also be utilized with adults.
55
What is **capillary blood** composed of?
* Blood from arterioles
* Venules
* Capillaries
* Intracellular and interstitial fluids
## Footnote
Due to this mixed composition, not all testing should be performed using capillary blood.
56
List the **supplies** needed for capillary puncture.
* Gloves
* Automatic retractable lancet
* Disinfectant pads
* Clean gauze pads
* Bandage
* Blood collection device
* Biohazard sharps container
## Footnote
Specific devices include micropipettes, small glass tubes, micro-collection devices, glucometers, and testing strips.
57
What is the **preferred puncture site** for obtaining a capillary puncture in adults?
Middle or ring finger of the nondominant hand
## Footnote
This procedure is commonly referred to as a fingerstick.
58
Where should an **infant capillary puncture** be performed?
Outer edge of the underside of the heel
## Footnote
Never perform capillary puncture on the finger of an infant due to the risk of bone damage.
59
What should be done if the **patient's hands are cold** before a capillary puncture?
Warm the patient's hands
## Footnote
This can be done by having the patient rub them together or run them under warm water.
60
What is the **first step** in preparing the site for a capillary puncture?
Cleanse the area with a 70% isopropyl alcohol pad
## Footnote
Allow the site to air-dry completely and avoid touching it after cleaning.
61
What should be done with the **first drop of blood** collected during a puncture?
Wipe away the first drop
## Footnote
This is to obtain a clean sample without any tissue or fluid contaminants, unless performing a prothrombin time (PT) test.
62
What is the **recommended order of draw** for capillary blood collection?
* Blood gases
* EDTA tubes
* Other additive tubes
* Serum tubes
## Footnote
This order differs from blood specimens drawn by venipuncture.
63
What should be applied over the puncture site after a capillary puncture?
A clean gauze pad
## Footnote
Ask the patient to apply pressure to the area until bleeding stops.
64
What should be done if there is **excessive blood flow** from the puncture site?
Elevate the arm above the level of the heart
## Footnote
This aids in hemostasis.
65
True or false: Patients should leave the bandaging in place for a minimum of **15 minutes** after a capillary puncture.
TRUE
## Footnote
This helps ensure proper healing and prevents bleeding.
66
What is the **key step** in proper specimen handling after blood collection?
Labeling of specimen containers
## Footnote
Laboratory errors can occur due to mislabeling of specimens.
67
When should blood collection tubes be labeled?
Immediately after the procedure is completed
## Footnote
This should be done before the tubes are moved away from the area where the procedure takes place.
68
What information should be included on a **handwritten specimen label**?
* Patient’s full name
* Date of birth
* Date and time of collection
* MA’s initials
## Footnote
This is necessary if printed labels are not available.
69
What is the purpose of **adhesive numbered labels** on lab requisitions?
To affix to all specimen containers associated with the requisition
## Footnote
This serves as a verification step to help avoid errors.
70
What should be done when placing specimen tubes in a biohazard transport bag?
Match each specimen tube with the laboratory requisition form
## Footnote
This ensures proper tracking and handling of specimens.
71
What must be done to **serum** before being centrifuged?
Allow to stand upright at room temperature for 30 to 45 min
## Footnote
This allows the blood to clot, producing more serum from the specimen.
72
How long should blood specimens not be allowed to stand to maintain integrity?
Longer than 1 hour
## Footnote
This prevents leaching of substance changes and maintains serum integrity.
73
What are some **specific handling instructions** for specimens?
* Centrifugation requirements
* Proper storage temperature
* Guidelines regarding exposure to light
## Footnote
Consult the laboratory directory for specific handling instructions.
74
What are **preanalytical errors**?
* Mislabeling of specimens
* Errors in patient identification
* Sample collection errors
* Insufficient quantity for testing
* Incorrect handling or transporting processes
## Footnote
These errors can occur prior, during, or immediately after performing venipuncture procedures.
75
What can **postanalytical errors** include?
* Failure in reporting results
* Improper data entry
* Misinterpretation of results
## Footnote
These errors occur after the specimen has been processed.
76
What is the importance of **timed specimens**?
Crucial for therapeutic drug level monitoring and assessing glucose levels
## Footnote
Examples include monitoring medication dosage adherence and oral glucose tolerance tests.
77
What is required for **blood cultures** to ensure specimen integrity?
* Specific preparation of the skin
* Multiple tubes
* Specific specimen labeling
## Footnote
Failure to adhere to these requirements will render a specimen unsuitable for testing.
78
What must be followed for specimens needed as **evidence in court cases**?
Guidelines established by law requiring a chain of custody
## Footnote
This includes documented signatures of every individual that has contact with the specimen.
79
Why is **proper handling of blood specimens** essential?
To preserve the viability of the sample and ensure reliable test results
## Footnote
Mishandled or compromised samples may lead to unreliable testing.
80
What is the role of **medical assistants** in blood specimen handling?
Familiarizing themselves with proper specimen handling and storage techniques
## Footnote
They must also perform blood collection procedures correctly.
81
What happens during the **centrifugation** of blood specimens?
Heavier elements are pulled to the bottom, separating from lighter elements
## Footnote
This occurs when blood collection tubes rotate at high speeds.
82
What must be confirmed before starting the **centrifuge**?
The amount of time a specimen needs to be centrifuged
## Footnote
Refer to the laboratory reference manual for specific times.
83
How should the **weight in the centrifuge** be balanced?
Place tubes of the same size and similar amounts across from one another
## Footnote
Use water-filled tubes to balance if there are size or fill differences.
84
What is an **aliquot** in the context of blood specimens?
Dividing a single specimen into multiple tubes for testing
## Footnote
This is necessary for testing on different equipment.
85
What should be used for the transfer of serum during aliquoting?
A single-use pipette
## Footnote
This prevents contamination and ensures safety.
86
What precautions should be taken when transferring blood specimens?
* Wear face and eye protection
* Use a tube rack for holding tubes upright
* Never pour blood specimens
## Footnote
Always use a disposable pipette to avoid splashes and spills.
87
When is **calibration** of medical equipment required?
* Depending on use
* Working order
* Manufacturer requirements
## Footnote
Avoid using equipment overdue for calibration to prevent errors.
88
What should be done if a piece of equipment is overdue for **calibration**?
Notify the office manager or lab supervisor and place the unit out of service
## Footnote
This ensures safety and accuracy in testing.
89
What should be arranged as soon as possible after **collection** of samples?
Transportation of the samples
## Footnote
Many reference labs use a courier service to pick up specimens from clinics.
90
What is the consequence of not having specimens ready for **pickup**?
Delay in processing could compromise the specimen
## Footnote
Confirm specimen pickup before leaving the clinic each day.
91
Specimens that are to be stored and transported at **room air temperature** do not typically require what?
Any special management
## Footnote
Extra care should be taken during extreme outdoor temperatures.
92
What should be done with specimens that need to be stored **frozen**?
* Kept in a medical-grade lab freezer
* Used only for specimens
* Stored in a cooler bag with ice packs for transport
## Footnote
A specimen should never be moved to the cooler bag until it is completely frozen.
93
What is required for specimens that must be protected from **light**?
* Keep lights in the lab low or off
* Wrap in foil or use an amber transport tube
## Footnote
This prevents changes to the specimen that could impact results.
94
What must each specimen tube be labeled with?
The appropriate laboratory requisition with the patient’s name and identification information
## Footnote
Each tube must be contained within the same biohazard bag.
95
True or false: Specimen bags should be **leakproof** and free from punctures or tears.
TRUE
## Footnote
This ensures the safety of the transporter while handling the specimen bags.
96
What type of bag should be used for transporting specimens?
A clear bag with a red biohazard symbol
## Footnote
This indicates the contents are biohazardous.
97
What should be done with specimens that will be left in a **lockbox** for pickup?
* Wait to place labs in the lockbox until just before pickup
* Insulate the lockbox during cold weather
* Add ice packs during high heat
## Footnote
These accommodations help maintain specimen integrity.
98
What are the **methods** laboratories can use to send patient laboratory report results?
* Email
* Fax
* Directly to the electronic medical record
## Footnote
Providers must review and acknowledge all results prior to their inclusion in the medical record.
99
What is the role of the **medical assistant** regarding patient laboratory results?
* Notifying patients of their results
* Instructing or educating patients on changes due to laboratory results
* Scheduling follow-up appointments for patients
## Footnote
The medical assistant acts under the direction of the provider.
100
True or false: Medical assistants can provide medical information or advice to patients based on previous situations.
FALSE
## Footnote
Each patient encounter can have unique considerations that the medical assistant may not be aware of.
101
What should medical assistants do to confirm patient understanding of lab preparation or results?
Ask them to repeat the information back
## Footnote
Address any questions they may have.
102
What are **critical lab results**?
* Indicate a life-threatening emergency
* Require immediate intervention
## Footnote
The Joint Commission allows organizations to define what is considered critical.
103
How should **abnormal or out-of-range laboratory results** be handled?
* Immediate notification of the ordering provider
* Documentation that the provider was notified
## Footnote
Many laboratories flag or highlight abnormal results.
104
What is essential for maintaining the integrity of the blood specimen during **venipuncture**?
* Correct venipuncture techniques
* Correct handling and transport
## Footnote
These are vital responsibilities of the medical assistant.
105
What is crucial for effective **time management** and prioritization of the patient?
Understanding the impact on the patient of any delays
## Footnote
This is important when reporting critical lab values.
106
What is the importance of **specimen collection and handling processes** for medical assistants?
Ensures the accuracy of the tests ordered
## Footnote
Providers rely on medical assistants to be knowledgeable in these processes.
CCMA NHA Study Guide
flashcards
Decks in class (13)
# Cards
-
Module 1 - Foundational Knowledge And Basic Science304
-
Module 2 - Anatomy & Physiology273
-
Module 3 - Patient Intake And Vitals137
-
Module 4 - General Patient Care Part 1201
-
Module 5 - General Patient Care Part 2136
-
Module 6 - Infection Control And Safety78
-
Module 7 - Point Of Care Testing And Laboratory Procedures72
-
Module 8 - Phlebotomy106
-
Module 9 - EKG And Cardiovascular Testing81
-
Module 10 - Patient Care Coordination And Education75
-
Module 11 - Administrative Assisting112
-
Module 12 - Communication And Customer Service58
-
Module 13 - Medical Law And Ethics103
