Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GK > Basic Blood Collection and Handling > Flashcards

Basic Blood Collection and Handling Flashcards

1
Q

what are common reasons for specimen rejection or test cancellation?

A

collected in wrong tube or kept at improper temperature

QNS for analysis

improperly labelled

inappropriate container

leaked in transit

incorrect or expired transport media

incomplete or incorrect test requisition

test requisition without a specimen or specimen without test request

no specimen type or source provided

inappropriate specimen type or difficulty obtaining sample (Hemolysis, Clotted)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how many identifiers are required by the Joint Commission ?

A

Two patient identifiers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What should proper specimen labeling include?

A

Patients first and last name

unique identifying number

date, time, name of person who drew spcimen

tests requested

recommended to include specimen type or source on sample

labelling should occur in PRESENCE OF PATIENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Is it possible to use rejected sample for testing?

A

if re-collection is impossible or would compromise patient care, it may be possible to provide qualified result from original specimen

with understanding of ordering physician that validity may be questionable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What volume of blood does the average adult male have? How much is plasma vs cells?

A

5 quarts (4.75 liters)

3 quarts (2.85 liters) plasma and 2 quarts (1.9 liters) cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is hemolysis and how does it occur?

A

thin protective membrane encasing RBCs ruptures and allows hemoglobin to escape into plasma

caused by improper handling of blood specimen, dilution, exposure to contaminants, extremes in temperature, pathological conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How is serum obtained?

A

from clotted blood that has NOT been mixed with anticoagulant

clotted blood is centrifuged, yielding serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What two types of proteins are contained in serum?

A

albumin and globulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In what color tubes is serum collected?

A

marbled red/gray, red and or gold top

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is plasma obtained?

A

blood that has been mixed with anticoagulant in collection tube

mixed blood is centrifuged yielding plasma which contains albumin, globulin and fibrinogen

either plasma or serum may be separated from red blood cells by centrifugation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the components of blood?

A

plasma, cells

blood cells are suspended in plasma made up of water and dissolved materials including hormones, antibodies and enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the difference between plasma and serum?

A

plasma retains fibrinogen (clotting component)

fibrinogen is removed from the serum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what may be required for plasma specimens?

A

various antiocoagulants and preservatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how are the anticoagulants used in blood collection chosen?

A

based on test procedure ordered

must preserve features of sable necessary to work with test method

additives NOT interchangeable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 4 main steps for quality specimen for testing ?

A

1) preparation of paient

2) collection of sample

3) processing

4) storing or transporting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are pre-analytical errors?

A

occur during specimen collection, preparation, and submission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

errors are most common in which phase of testing?

A

pre-analytical that occur during specimen collection, preparation and submission

more common than errors arise during analytical phase during actual testing or examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the most common errors affecting all types of specimens during collection?

A

failure to label correctly and provide pertinent information on test request

insufficient quantity of specimen or QNS

failure to use correct container or tube for specimen preservation

failure to tighteen specimen lids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How is whole blood collected for testing?

A

drawn into tubes containing anticoagulant

tube inverted 8-10 times after filled to ensure adequate mixing and prevent clotting

submit entire tube for testing

NOT be frozen unless instruct4ed for specific test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some tubes used for whole blood?

A

Blue top: 3.2% sodium citrate

Purple/lavender: EDTA

Green top : heparin

Yellow Top: SPS (Microbiology)

Yellow Top: ACD Solution B (genetic/chromosome analysis, flow cytometry)

Navy Blue Top: EDTA

Gray top: potassium oxalate/ sodium fluoride

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is serum specimen prepared?

A

specimen drawn into tube containing no additives or anticoagulants

centrifuge sample afer allowed to clot

separate serum from RBC

ensure sample has completely clotted before centrifugation

failure to allow clotting may cause fibrin clots in sample

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What causes fibrin clots in serum sample and what is the potential impact?

A

fibrin clots interfere

problems pipetting, erroneous results especially in automated systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What can extended clotting time of serum samples cause?

A

increased enzyme levels, increase in potassium and decrease in glucose levels due to prolonged exposure to RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

How are plasma samples prepared?

A

collection tubes contain anticoagulant

plasma contains fibrinogen and other clotting factors when separated from RBCs

draw whole blood specimen then centrifuge to separate plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the most common errors affecting tests utilizing serum?
failure to mix tube and allow clotting before centrigue failure to centrifuge at correct speed or time hemolysis loose container lids
26
What are the most common errors in preparing plasma samples?
collected using incorrect additive improper mixing with additive immediately after collection hemolysis incomplete filling of tube - incorrect dilution factor QNS failure to separate plasma from cells within 30-45 minutes of venipuncture failure to label tubes as plasma failure to indicate type of anticoagulant (EDTA/CITRATE ETC)
27
What is hemolysis?
red blood cells rupture and release hemoglobin and other intracellular components into serum or plasma hemolyzed serum or plasma is pinkish red rather than usual clear straw or pale yellow grossly or moderately hemolyzed blood specimens may not be acceptable for testing
28
what kinds of analytes are adversely affected by hemolysis?
glucose, potassium, lactate dehydrogenase (LDH), cholesterol, creatinine, iron, phosphorus, calcium, and most enzymes
29
what are some tips for avoiding hemolysis?
20-22 gauge needle replace vacuum tube if air leakage around needle or loss of vacuum use clean dry sterile needles syringes and tubes collect blood in room temperature containers if difficulty accessign vein or tube fills slowly then collect fresh tube with good flow or select new puncture site DO NOT remove needle from vein with vacuum tube engaged be as gentle as possible drawing blood evenly allow collection site to dry after cleaning - alcohol may cause contamination in a tube DO NOT collect specimen in hematoma allow specimen to clot completely before centrifuge do not centrifuge prolonged period
30
How much blood is required for coagulation tests?
full tube of blood ratio of anticoagulant is specific for volume of specimen (1:9) coagulation tests not performed on short draws
31
What kind blood is needed for hematology and coagulation tests?
anti coagulated blood clots will lead to errors for these tests
32
What may cause cloudy plasma or serum?
chronic or transient high lipid levels patients who consume high lipid foods within 12-16 hour period preceding collection may have temporarily elevated lipid levels -> cloudy or lipemic serum
33
How soon after collection should hematology samples be analyzed?
within 24 hours old samples will yield unreliable cell counts and distorted cell morphology
34
What is the recommended order of blood collection to avoid cross-contamination of additives and maintain sterility?
1) blood culture 2) coagulation tube (blue) 3) serum tube with our without clot activator with or without gel (red) 4) heparin with or without gel (green) 5) EDTA with or without gel separator (lavender) 6) Glycolytic inhibitor (gray)
35
Why should plastic or glass serum tubes containing a clot activator be drawn after coagulation testing tubes?
clot activator may cause interference with coagulation testing
36
What is Lithium Heparin used for in collection tubes?
tubes typically contain spray-coated lithium heparin and a gel for PLASMA separation used for PLASMA determinations in chemistry eliminate need to wait for clot to form ideal for STAT procedures and patients receiving anticoagulant therapy
37
What are K2 EDTA and K3 EDTA tubes used for?
whole blood hematology determinations and blood bank testing require 8-10 inversions for through mixing of blood with ANTICOAGULANT K2 EDTA is anticoagulant of choice in specimen collection and blood cell counting according to CLSI and ISCH
38
What is the anticoagulant of choice in specimen collection and blood cell counting according to CLSI and ISCH? and why?
K2 EDTA chosen over K3 EDTA because K3 EDTA results in greater RBC shrinkage K3 EDTA produces more significant increase in cell volume K3 EDTA is a liquid additive and dilutes specimen
39
When is serum (silica) used in collection tubes?
serum determinations in chemistry, serology and blood bank used for tests where gel-serum separator interferes with test methodology
40
When is heparin used in collection tubes?
either lithium heparin or sodium heparin PLASMA determinations in chemistry
41
When is citrate used in collection tubes?
Routine coagulation studies typically have 3.2% buffered sodium citrate solution used for coagulation testing and must be filled to required volume to maintain appropriate concentration of citrate anticoagulant in plasma to be tested
42
When is fluoride added to blood collection tube?
glycolytic inhibitor and used for glucose determinations on plasma where delay in processing is expected serum or plasma separator tube may be used if centrifuging is available or glucose is analyzed soon after blood draw also used for ETOH determination
43
What is a red-stopper tube?
NO anticoagulant or preservative Uses: serum or clotted whole blood serum must be separated from cells within 45-60 minutes of venipuncture
44
What is marbled red/gray or red-stopper, gold top, serum-separator tube (SST)?
Contains clot activator and gel for separating serum from cells NO anticoagulant Use: serum must be separated from cells within 45 minutes serum may remain in centrifuged tube with intact barrier between cells and serum or in plastic transport tube DONT use for therapeutic drug monitoring unless manufacturer determines serum-separator is acceptable
45
What is a lavender-stopper tube?
contains liquid k3 EDTA or spray coated K2 EDTA use: EDTA whole blood or PLASMA sample should be labelled Plasma, EDTA
46
What is gray-stopper tube?
contains sodium fluoride (perservative) and potassium oxalate (anticoagulant) use: sodium fluoride whole blood or plasma sample should be labelled "Plasma, Sodium Fluoride"
47
What is the blue-stopper tube?
sodium citrate (3.2%) use: citrated whole blood or plasma A protime (PT) test can be performed on a sample if kept unopened and uncentrifuged at room temp and delivered to lab within 24 hours
48
What is green-stopper tube?
sodium heparin or lithium heparin Use: heparinized whole blood or plasma Should be labelled "plasma, Sodium heparin"
49
What is yellow stopper tube ACD?
1 ml acid citrate dextrose (ACD) solution ACD whole blood for genetic and chromosome analysis and flow cytometry
50
What is yellow-stopper tube SPS?
SPS (Sodium polyanethol sulfonate) use: blood culture microbiology blood collected in tubes may remain 2-4 hours before transfer to blood culture bottle
51
What is royal blue-stopper tube?
contains sodium EDTA for trace metal studies use: EDTA whole blood or plasma should read plasma EDTA
52
When and why are plastic tubes used for blood collection?
safe method reduce potential for tube breakage and spillage may not be appropriate for all tests with Hemogard (BD) closure to protect personnel from blood, which might splatter when tube is opened -rubber stopper is recessed inside plastic shield preventing exposure to blood present on the stopper
53
Where is the preferred venipuncture site?
antecubital fossa or back of hand not underside of wrist
54
what are examples of tests requiring specimen chilling? what is the effect?
gastrin ammonia lactic acid catecholamines pyruvate parathyroid hormone (PTH) SLOW METABOLIC PROCESSES
55
What are tests requiring transportation at 37 C? What is the purpose?
cold agglutinin cryofibrinogen cryoglobulins PREVENT PRECIPITATION OR AGGLUTINATION
56
what are tests requiring protection from light? what is the purpose?
bilirubin vitamin A vitamin B6 beta carotene porphyrins AVOID ANALYTE BREAKDOWN
57
what are examples of timed tests that must be collected at specific intervals?
glucose tolerance testing, cortisol, therapeutic drug monitoring
58
Whta is CLSI?
Clinical Laboratory Standards Institute Formerly NCCLS
59
What is CBC?
complete blood count information about kinds and numbers of cells in the blood especially RBC, WBC and platelets evaluate symptoms and diagnose conditions
60
What is Icterus?
presence of increased bilirubin in the blood
61
What is lipemia?
excess lipid in the blood
62
what is Prothrombin time test?
measures how long it takes blood to clot screen for bleeding abnormalities also monitor treatment with medication that prevents formation of blood clots
63
What is partial thromboplastin time PTT test?
measures time it takes blood to clot used to screen for bleeding abormalities
64

GK (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions