EKG, Hemostasis, and Hematology Fundamentals Part 1
The provides a comprehensive review of essential cardiovascular and hematologic concepts. Topics include EKG interpretation (P-wave, RR interval, SA node function), stages of hemostasis, blood vessel anatomy, blood composition, and common laboratory procedures like electrophoresis and occult blood testing. Ideal for students in phlebotomy, nursing, or medical assisting programs preparing for clinical assessments or certification exams.
CC
Chief Complaint
Key Terms
CC
Chief Complaint
Segment
Line between two wave forms
P-wave
Atrial Depolarization
How many 1mm boxes are in a 6 second Rythm strip?
30 one millimeter boxes
The SA node represents which waveform on the ekg?
Only the P-wave
What is the reading you can get from the RR interval?
Ventricular Pulse
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| Term | Definition |
|---|---|
CC | Chief Complaint |
Segment | Line between two wave forms |
P-wave | Atrial Depolarization |
How many 1mm boxes are in a 6 second Rythm strip? | 30 one millimeter boxes |
The SA node represents which waveform on the ekg? | Only the P-wave |
What is the reading you can get from the RR interval? | Ventricular Pulse |
What is the primary stage of Hemolisis? | Vascular phase and platelet phase together |
What is Electophoresis? | Analyzation of the chemical components of blood e.g. hemoglobin, serum, urinem cerebrospinal fluid based on electrical charge. |
Positive testing for occult blood in a stool sample turn which color? | Turns Blue on a positive test for occult blood in feces. |
The stages of Hemostasis: | 1. Vascular 2. Platelet Phase 3. Coagulation Phase 4. Fibronolysis |
Blood Vessels | Aorta, arteries, arterioles, capillaries, venues, veins, superior and inferior vena cavae. |
Outer connective tissue layer of a blood vessel | Tunica adventitia |
Inner endothelial tissue layer of a blood vessel | Tunica Intima |
The inner smooth layer of a blood vessel | Tunica media |
The standards of right and wrong in a medical setting | Code of Ethics |
What do you find in capillaries? | A mixture of venous and arterial blood is found |
The average adult has how many liters of blood? | 5-6 liters |
What is the percentage of water in blood? | 92% |
Percentage of plasma in blood | 55% |
Percentage of Formed Elements in the blood | 45% |
99% of formed elements in blood | RBC's or Erythrocytes |
Where you find Hemoglobin | RBC's |
Where do all blood cells originate? | Bone Marrow |
How many RBC's per microliter of blood | 4.2-6.2 million |
What is the second most numerous WBC? | Lymphocyte with 20-40% |
Their numbers increase in intracellular infections and TB | Monocytes |
Their numbers increase in bacterial infections and often are first on scene | Neutrophils |
These WBC's play an important role in viral infection as well as in immunity. | Lymphocytes |
Number of leukocytes for average adult per micrometer | 5000-10000 |
Leukopenia | Decrease in WBC's seen with viral infection and leukemia |
Comprises 3-8% of wbc or leukocytes | Monocytes |
Largest in size of the leukocytes | Monocytes |
Carries Histamine | Basophil |
Injury to a blood vessel that causes it to constrict, slowing the clot of blood | Cascular phase of hemostasis |
Preferred site for venipuncture | Antecubital fossa |
Test used to evaluate the intrinsic pathway and monitor heparin therapy | APTT also know as PTT |
Test used to evaluate the extrinsic pathway and also used to monitor warfarin therapy | PT |
Fibrinolysis | Breakdown and removal of a clot |
Converts the temorary platelet plug into a stable fibrin clot | Coagulation phase |
2nd choice vein for venipuncture most often the only one palpatable in an obese pt | Cephalic vein |
Antiseptics used in Phlebodtomy | 70% isopropyl alcohol pads most common, provolone iodine for bc, s and chlorhexidine gluconate for patients that are allergic to betadine/ iodine |
Length of needle commonly used in venipuncture | 1 ince (up to 1.5") |
Guage of needle that can cause hemolysis | Smaller than 23 guage |
Average gauge of needle used for drawing blood | 21-22 |
3 skills of the phlebotomist | social, clerical, technical |
Analytical errors during collection of blood | extended tourniquet time, hemolysis, wrong order of draw, failure to invert tubes, faulty technique under filling tubes |
Analytical errors before collection of blood | Patient misidentification, improper time, wrong tube, not fasting, exercise (cortisol levels), PT posture, poor coordination with other treatments, improper side prep, medication interference |
Analytical errors after blood collection | Failure to separate serum from cell (glycolisis), improper use of serum separator (not inverting tubes or not spinning tubes) delays in processing, exposure to light, improper storage conditions, dimming clots |
Fistula | Permanent surgical connection between an artery and a vein, never used for venipuncture |
Edima | Accumulation of fluid in tissue |
Thrombophlebitis | Inflammation of a vein with a clot formation |
Explanation of Hemoconcentration | The increase in proportion of formed elements to plasma caused by leaving on the tourniquet for more than two minutes |
Consequence of insufficient pressure applied after withdrawal of needle | Thrombus |
additives in green top tube | heparin, sodium, litium, ammonium |
Why is the green top tube never used for hematology | Green tops additive heparin interferes with the Wright's stained blood test |
Common tests for the lifht blue sodium citrate tube | Coagulation studies, PT (extrinsic, warfarin) APTT, PTT (intrinsic, heparin) TT, BT, FDP |
Common tests for the lavendar edta tube | CBC, differential or diff., ESR, sickle cell screening |
Common tests for this color tube are chemistry tests performed on plasuma such as Ammonia, carboxyhemoglobin and STAT electrolytes | Green top tube (heparin) Tests |
How long does it take for blood to clot by normal coagulation process in the red top tube? | 30-60 mins |
The primary purpose is to provide reliable data about a patients health status by ensuring the accuracy of a test while detecting and eliminating error | What is quality control |
Common test for the red topped tube | Serum chemistry tests, serology tests, blood bank (glass only) |
Order of draw for cappilary specimens | lavender first, then tubes with other additives, then tubes with out additives |
Antiseptic not used on a dermal puncture site | Betadine (because it interferes with several tests like bilirubin, uric acid, phosphorus and potassium |
For which procedure would you warm the site for a minimum of 3-4 minutes to increase blood flow? | dermal punctures (heel sticks) |
Which are the preferred sites for dermal punctures | the distal segment of the third or fourth finger of the non-dominant hand |
heel sticks are performed on which patients? | infants less than 1 year old |
Where on the foot is the dermal puncture made on patients less than a year old | the medial and lateral areas of the plantar surface of the foot |
dermal puncture is made in | the fleshy portion of the finger slightly to the side of the center perpendicular to the lines of the fingerprints |
What will occur if you puncture the heel too deep? more than 2 mm | osteomyalitis |
What are the identification requirements for blood bank | Pt's full name and DOB, hospital id # or ssn for outpatient, date and time of collection as well as the phlebotomist's initials |
This section of the lab uses serum to analyze the presence | Serology (immunology) Section |
When checking for hormones in urine when do you collect the urine sample | first voiding in the morning |
Which urine specimen provides the clearest, most accurate results? | Clean catch midstream specimen |
Which urine sample requires aseptic technique? | Clean catch specimen |
Examination of urine consists of | physical, chemical, microscopic |
Physical examination of urine consists of | colume (adequate for testing, observing color and appearance, odor, specific gravity |
What amount of urine must you have to be sufficient for analysis? | 25ml |
What is the normal range of specific gravity of random collection | 1.005-1.030 |
normal range of specific gravity of urine in adults with normal diet and fluid intake | 1.015-1.025 |
Microscopic examination of urine requires this amount | 10-15ml |