17-2 Flashcards
What are the 2 methods of blood collection?
Capillary and Venipuncture
Capillary Puncture method of choice for:
- pediatric patients
- extreme obesity
- severe burns
- thrombotic tendencies
Capillary puncture is collected from what 4 sites?
- heel
- finger
- earlobe
- toe
First choice of capillary puncture for older infants and elderly is the _______.
middle or ring finger
common site for a capillary puncture in infants?
plantar surface of the heel perpendicular to the big toe
What is the best method of blood collection?
Venipuncture
Can you draw from IV sites?
No
Why can you not draw from IV sites?
- Dilutes specimen
* Alters test results
What are the 5 pieces of equipment for Capillary puncture?
- Sterile gauze pads
- 70% ETOH or Betadine solution
- Lancet
- Capillary tubes or QBC Star tube
- Bandage
How many times do you milk the finger?
5-6 times
You can clean the finer with either ______.
alcohol pad or povidone-iodine
Any alcohol left on site can cause blood to?
Hemolyze
Where do you stab the finger?
side of the finger (off center), across the striations of the fingertip
Max depth of lancet should not exceed
2mm
Why do you wipe away the first drop of blood?
avoid dilution of the specimen with tissue fluid.
Obtain specimen with a capillary tube placed _____
horizontally 15 degrees to the fingertip
When collecting blood in the capillary tube what are you trying to avoid?
air bubbles
What are the 6 pieces of equipment for Venipuncture method?
1 Sterile gauze 2 alcohol pad 3 latex tourniquet 4 vacutainer needle 5 vacutainer holder 6 vacutainer collection tube
Never perform a venipuncture with a patient standing up.
True
How far up do you apply the tourniquet from the antecubital area?
2-3 inches
Use enough compression to compress the vein but not the ______
artery
When using a blood pressure cuff instead of a tourniquet how many mm/Hg?
30mm/Hg
What angle is the needle for venipuncture?
15 degrees & bevel up
Have the patient hold pressure after venipuncture for how long?
3 min
Gently invert the tubes to prevent ______
clotting
Do you label specimens before or after collection?
after
To obtain a whole blood specimen for testing what must be used?
anticoagulant
What is EDTA?
Ethylene Diamine Tetracetic Acid
EDTA is an anticoagulant used in what color tubes?
purple
What tube is typically used in hematology studies?
Purple
What 4 hematology studies are purple tops used for?
1 CBC
2 Differential WBC
3 ESR
4 A1C
What is the most widely used anticoagulant?
EDTA
What is a chelating agent that binds calcium so blood cannot clot?
EDTA
Does EDTA effect cellular morphology?
No
How long can purple top specimens be refrigerated?
24 hours
Sodium Citrate is what tube color?
Light blue
What is the liquid anticoagulant used in light blue tops?
Sodium Citrate
What is typically used for coagulation studies?
Light blue/Sodium citrate
What 4 coagulation studies are light blue top?
1 Prothrombin Time (PT)
2 Partial Thromboplastin Time (PTT)
3 Fibrinogen (Fib)
4 D-dimer
How does sodium citrate work?
chelating agent that binds calcium
How long are light blue tops good for after collection?
4 hours
Heparin is what color tube?
green
What is a liquid or powder anticoagulant found in green tops?
Heparin
What color tubes are typically used for plasma studies and chemistry testing?
green tops
What tube color is used for Ammonia and Adrenocorticotropic hormone (ACTH)?
green
What anticoagulant works by inhibiting the clotting enzyme thrombin, by creating antithrombin?
Heparin
Does a red tube top have anticoagulant?
No
What tube is used for chemistry and serology?
red tube
Does a gold top/tiger top contain anticoagulant?
No
What does a gold top/tiger top contain?
serum separator gel
Which tube is primarily used for chemistry testing?
Gold top/Tiger top
What tube color uses sodium fluoride?
grey tube
Which tube is used primarily for glucose studies?
grey
What inhibits glycolysis in a grey top?
Sodium fluoride
What color tube is used for ETOH level analysis?
grey
Why can you not pull blood from an IV site?
dilution of the sample with IV fluids
Prolonged application of a tourniquet will produce an increase in what?
blood cell concentration
Using the wrong tube type can result in what?
inability to perform the test
Using the wrong draw order can result in what?
possible contamination
Which is drawn first tubes with additives or without?
without additives
What could a short fill cause?
quantity not sufficient to preform test
improper anticoagulant/blood ratio
What does not mixing the tube result in?
blood clots
What are 4 blood draw complications?
1 Syncope
2 Infection
3 Continual bleeding
4 Hematoma