While Phlebotomist Seems Question & Answer Guide (With Explanation)

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This topic involves while phlebotomist seems. A strong answer should include explanation, application, and examples.

Original Question

1. While the phlebotomist seems to have properly performed the venipuncture on this blood donor, blood squirted all over the donor, which is NOT good practice. Now go to this website: https://www.who.int/publications/i/item/9789241599221 scroll down to paragraph 4.2 and review the procedures for drawing donor blood. What did the phlebotomist most likely do wrong to permit this blood to squirt? How could he (the phlebotomist) prevent this in the future? 2. The laboratory manual is very important to the phlebotomist. It explains what tubes to draw for each test, any special requirements, and how to handle the specimens. Look at this page from Glens Falls on Blood Bank specimens https://laboratory-tests.glensfallshospital.org/lab-test/crossmatch-type-and-cross-blood-bank/ The phlebotomist receives a STAT order to collect a specimen for a type and crossmatch from a patient in the ER. Several specimens on the same patient had been collected about an hour earlier, for a CBC, INR, and BMP. There was enough blood left from that collection for the new tests. Can any of the specimens collected earlier be used? Explain what should be done. 3. Explain the differences between the various glucose screening tests (2-hour PP, GTT, and OGCT). For which type of patients is each type of glucose test appropriate? (2 pts) 4. The phlebotomist is performing a 3-hour glucose tolerance test (GTT) on a patient suspected of having diabetes. The fasting blood specimen is collected at 0600 hours. The patient is given the glucose drink at 0610. The patient finishes the drink at 0615. At what times are the rest of the specimens collected? What should be done if the patient vomits soon after consuming the glucose drink? Look over the information from the Mayo Clinic https://www.mayoclinic.org/tests-procedures/glucose-tolerance-test/about/pac-20394296 5. A peak TDM level is ordered for 0900 hours. The phlebotomist draws the specimen 20 minutes late because of unavoidable circumstances. What additional action does this necessitate (include how to determine if the specimen can be used or not)? Explain the difference between a peak and trough TDM level. Why is it important to be punctual when collecting these blood samples? 6. A physician orders an ETOH on a patient in the ER. Your laboratory uses plasma for ETOH testing. What special procedures must you follow to properly collect and process this specimen? Why are these important? 7. Review this article from the National Institutes of Health https://pmc.ncbi.nlm.nih.gov/articles/PMC2556589/ (NIH), and then answer this question: New Point of Care instruments have recently been purchased for all areas of the hospital. The instruments have been enhanced with electronic QC that has internal checks to determine if the instrument is functioning properly as well as being able to detect clotting, short samples, and air bubbles. The Point of Care Coordinator notes at the required in-service that the nurses see the process as foolproof at last, but the Coordinator points out that the laboratory is still having problems with POC test results not matching well enough with results when drawn and processed by the laboratory. What could be the cause(s)? Explain the QC process for POCT (waived) testing and why it is important to achieve quality test results. 8. We all live in the electronic computer age now (you’re taking this course on a computer). As a phlebotomist, you will interact with a computer many times a day, accessing orders on a patient, accessioning laboratory samples, reading bar codes, and even managing your time sheets. But many students never think about all that goes into a computer network. For your first task, list and define all the parts of a computer and computer network, and describe how they interact with each other. Then briefly discuss how this is important to the phlebotomist (usage, troubleshooting, etc). 9. Quest Diagnostics Nichols Institute is a “Reference Laboratory”. Reference laboratories are like collection labs that receive specimens from health care centers throughout a specific region. This is Quest Lab’s specialty. Navigate to their laboratory manual website, https://www.questdiagnostics.com/healthcare-professionals/clinical-education-center and using this manual a. A chemistry test requires 5 mL of plasma. How much whole blood will you draw, and how will you process and package the plasma for shipping? b. What are some common causes for this plasma sample to be rejected? Be sure to define terms. c. Under Stool Collection, step #5 says to remove the required aliquot to a screw-cap plastic container and seal well. What is meant by the term “aliquot?” How would you go about accomplishing this step? d. You need to collect and ship a sample for coagulation studies from a patient with a normal hematocrit. What will you draw, and how will you ship? Be sure to include type of tube, volume, shipping requirements, etc. e. You receive a GenProbe Chlamydia swab for shipping to be tested for the virus Chlamydia on Friday afternoon. You know that the next shipment can’t go out to Quest Labs until Tuesday afternoon. What do you do? Can you even save this sample, or will you need a new one next week? 10. It is important to know temperatures related to specimen handling. State the acceptable temperature range for body, room, refrigerated, and frozen. 11. A phlebotomist collected specimens for the following tests: Bili, PT, Cold Agglutinin. One specimen was wrapped in foil. One was in a 37o heating block. And one was a normal draw light blue-top tube with no special handling, was about two-thirds full, and with a note attached stating that it was a difficult draw. All the specimens are correctly labeled. Assuming the specimens were otherwise handled properly, answer the following questions: a. Which specimen was wrapped in foil? Why? What process does the foil prevent? b. Which specimen was in the heating block? Why? c. Which specimen was in the light blue-top tube? Why? d. Should the light blue-top be accepted for testing? Why or why not?

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