3rd Test Flashcards
Glass side
Use for capillary method
The difference between serum and plasma
Plasma has fibrinogen. Serum doesn’t. Plasma is clear and yellow and makes up 55% of blood
45% of blood is formed of what
Rbc, wbc,serum,platelets
4 main valves of the heart
Atrioventricular valve(tricuspid)
Pulmonic(pulmonary) valve
Mitral valve(bicuspid)
Aortic valve
Arteries
Largest
Smallest
Are considered oxygenated.
Largest artery is aorta
Smallest artery is arterioles
Capillaries
Are made up of arterial,venous,and interstitial fluid
Three layers of vessels
1st tunica Adventia
2nd tunica media
3rd tunica intimia
H shaped veins
1st median cubical - located in center of arm
2nd cephalic-most often found in obese pt. On thumb side
3rd basilica next to brachial artery on pinky side
M shaped veins
1st median - in the middle of arm
2nd median cephallic - most common found in obese pt. On thumb side
3rd median basilic - near brachial artery near pinky
Intrinsic pathway
Blood runs within the vessels
APPT - blood test that determines if blood is functioning properly it monitors the medication Heparin (APPT - activated partial thromboplastin test
Extrinsic pathway
Pertains to the blood outside of the vessels. PT (prothrombin test) given to make sure medication is working (Coumadin)
DIC
Disseminated intravascular. Blood no longer clots in a timely fashion
BTT
(Bleeding time test). Is done to determine how long hemostasis takes. Bleeding time is 2-10min
Capillary/dermal puncture
Preferred method for children 2yr and under. If under 1yr use heel. Over a 1yr use finger. Always warm heel of infants prior to increase blood flow up to 7x . Puncture between 1/2 digit or 4/5 digit never puncture deeper than 2.0 mm
Micro tubes
Small plastic tubes that is used to collect small amount of blood for capillary puncture
Capillary method
Can be used on elderly pt’s for those whose veins may be weak/damaged(chemo pts as well)
Blood cultures
Are not recommended using dermal puncture method
Order of draw for capillary puncture
- CBG(capillary blood gas)
- EDTA
- Other additives
- Serum
Sectioning the skin
Skin should be warm,pink,normal in color,no scars,cuts,bruises,rashes,cyanosis, edema or infection
Bilirubin test
Deals with liver, causes jaundice, use a special microlight filtered tube or wrap an aluminum foil prior to drawing blood. Same apply for venipuncture (amber color tubes)
Main test for newborn screening test
- PKU(phenylketonuria) cause mental retardation of high
2, galactose - make sure body can break down galactose
3, cystic fibrosis - building up of secretions to form on organs - Hypothyroidism- low thyroid
- Sickle cells - cause RBC to have abnormal shape that doesn’t hold correct amount of oxygen
Newborn screening test
- Done using capillary puncture
- Filtered card is used card is applied to drop of blood so that circle can be completely filled let card dry air dry 3 hours before putting In envelope
- Done between 1-3 days life if not you have up to 2 weeks of
Life
FUO
Fever of unknown - the main reason Blood cultures are done to determine what type of infection Pt has
Puncturing to far can cause
Osteomyelitis - inflammation of the bone
Osteochronditis - inflammation of the bone and cartilage
4 steps of Hemostasis
- Vasoconstriction
- Platelets plug formation
3,Fibrin clot - Fibrinolysis
Vessels
Refer to the arteries, veins and capillaries
CLIA 88
Clinical Laboratory Improvement Amendment- it was established to assure that labs receive federal funds across the board regardless to the size, type or location
NHA
National Healthcare Association
JACHO
Joint Commission on Accreditation of Health Organization- Requires 3 steps of Pt indentification
WBCS
MAIN JOB?
AMOUNT OF ?
1,To fight infection
2. We have 5,000 - 10000 per cubic ml
ACA
American Certification Agency
3 Reason you dont get blood while drawing blood
1, Not going far enough into vein
- Going through the vein
- Bevel of needle against the vein wall (bevel up always)
Petechiae
Red raised spots on the arm - broken cappilaries cause by tying the tourniquet to tight
Fistula (shunt)
A device that is surgically implanted between the artery and vein and is used for dialysis
Random UA
Can be done at anytime and no special instruction
Midstream/cleaning catch UA
Give pt antiseptic wipe and a cup have them wipe front to back begin urinating the stop place cup under area begin urinating again into cup stop remove cup
24 hour UA
2 jugs are giving to Pt instructed to get a cooler urine must be kept cold (urine bad after 1 hr if not refrigerated) Pt begins in the am(next day) 1st urine of the day mark time then discard then place hat hat in toilet the urinated hat and place urine in jugs every time no BM or tissue
Double Void Urine
2 cups marked A and B tell pt to drink water urinate in cup A then wait 30 min and then urinate into cup B if both are obtained then send cup B to lab if not send cup A
Suprapubic Specimen
a sterile needle with syringe is inserted directly into bladder for UA sample
POCT
Point of care test ex glucose
19 - 21 g
is the most common gauge needle use(range) 21 is the most common #
16 -18 g
most common gauge for blood banks 16g is the largest used in phlobotomy
23g /25g
23 g is the most common butterfly
25 g is the most common used in peds
Butterfly/winged needle
infusion needle
3 steps of Pt identification
1, introduce your self (name/title)
2. ask pt state name(first and last) DOB
3 compare the info given to requisition sheet/id band
What not to do in a hospital about blood draw
if pt doesnt have wrist band(check ankle to) do not draw blood
Implied consent
is given when pt extends arm for blood draw
informed consent
all the risk involved in procedure has been explained and pt signed consent
Signed consent form
gives written permission for procedure to be done
10 credits(CEU)
Continuing educational units- credits required to maintain each certification every 2 yrs
AMT
American Medical Technologist
Steps of a strep test
- 4 drops of yellow and red in tube
- swab the throat
- put in the vial swirl 10x
- squeeze liquid out
- then put in test strip in for 1-3 ,min then check
Main components of blood
RBC,WBC, platelets, serum, plasma
Average amount of blood
5-6 liters
men 5-6 liters
women 4-6 liters
Main job of RBC
carry oxygen and nutrients through the out the body
RBC
erythrocytes
Heart structure
r/l atrium r/l ventricle septum divides into left/right
antecubital space
the crease directly in front of the elbow used for drawing blood all major veins for drawing are here
pericardium
is the outer sac that covers the heart and filled w//liquid to protect the heart
Platelets plug formation
Platelets adhere to one another to create plug
Fibrinolysis
last stage the clot is destroyed
DVT
Deep vein thrombosis blood clot that forms in a larger vein in the leg
laterogenic anemia
cause by removing to much blood from infants at once all blood taking from infants must be logged
1st drop of blood
always wipe the 1st drop of blood it is considered contaminated w/alcohol and skin tissue
3 ways Hemolysis can occur
- not allowing the alcohol to dry
- shaking tube
- using a gauge needle that is to small for vein
2 reason that you can not get blood prior to drawing blood
- Manufacturer defect
- crack in the ets tube
- expired ets tube
6 different types of UA
- random
- 1st morning void
- midstream.clean catch
4.double voided urine - suprapubic specium
6 24 hour
needle point
allows the needle to smoothly enter the skin
bevel
the larger than the number the smaller the gauge(diameter) the opening at the end of the needle
bevel is the gauge
ph level of blood
7.35 -7.45
platelets
- main job?
- lives?
Aka thrombocytes
1/. helps blood clot
2. lives up to 10 days
serum
is the unclotted portion of blood after it has set for 30 - 60 min
what happens to blood in centifuged
separates into plasma buffy coat(wbc,platelets) rbc
Fibrin clot0
more stable clot
Lancet
a sterile blade that is used to puncture the skin
finger prick
use middle finger or ring finger only use medial point not to close to tip or side do not milk pump only
3/40
most common length used in a butterfly needle
