Blood Collection Flashcards

1
Q

Angle between skin and needle in venipuncture

A

<30 degrees

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2
Q

Effects of prolonged tourniquet application

A

SHH

  1. Hemoconcentration
  2. Hemolysis
  3. Shortened coagulation times (PT, APTT)
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3
Q

Order of preference in venipuncture

A
  1. Median cubital vein
  2. Cephalic (for H) / Cephalic Accessory vein (for M)
  3. Basilic vein
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4
Q

Order of draw in skin puncture

A

TSEOS

  1. Tube for blood gas analysis
  2. Slides
  3. EDTA microcollection tube
  4. Other microcollection tubes with anticoagulant
  5. Serum microcollection tubes
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5
Q

Recommended depth of skin puncture for infants and adults

A

Infants <2mm

Adults 2.0-2.5mm

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6
Q

Test results affected by posture

A

PIC

  1. Protein
  2. Iron
  3. Cholesterol
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7
Q

Treat all body fluids and unfixed tissues as potentially infectious

A

Standard precautions

–> originally called as Universal Precautions

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8
Q

What is the most common needle size for adult (give the bore and length)

A

Bore: 21 G
Length: 1 inch

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9
Q

Which has a larger bore? 19G / 21G

A

19G

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10
Q

The most common cause of needle puncture

A

Improper disposal of sharps

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11
Q

When to replace the sharps container?

A

When they are no more than three-quarters full.

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12
Q

Flat, purplish discoloration of the skin

A

Ecchymosis

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13
Q

Bulging, purplish, discoloration

A

Hematoma

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14
Q

How many minutes should you wait to draw the blood of the patient if there is a prolonged application of the tourniquet?

A

2 minutes

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15
Q

Where will you draw the blood of patients undergoing IV therapy if both arms are unavailable?

A
  1. Ask the nurse to stop the IV infusion for 2 min.
  2. Draw blood BELOW the IV site
  3. Discard the first 5mL of blood collected
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16
Q

BF cuff used as a tourniquet for obese patients should NOT be inflated for how many mmHg?

A

> 40 mmHg and NOT left on the arm for more than 1 min

17
Q

Anemia caused by blood loss for testing

A

Iatrogenic anemia / Physician induced-anemia/ Nosocomial anemia

18
Q

Skin puncture is a technique of choice to obtain blood specimens from the ff. EXCEPT

a. Newborns and Pediatric patients
b. Severely burned patients
c. Patients whose veins are reserved for therapeutic purposes
d. Extremely obese patients
e. Elderly patients

A

All of the above

19
Q

The puncture site for infants who are <1 y/o is the _

A

Medial / lateral side of the heel

20
Q

Why is it necessary to discard the first drop of blood?

A
  1. To discard excess tissue fluid
  2. To discard dead epidermal cells
  3. To facilitate flow of blood
21
Q

The ideal puncture site for children (>1 y/o) and adults

A

Palmar surface of the non-dominant hand, 3rd/4th finger, distal portion (perpendicular to the fingerprint)

22
Q

Warming the puncture site can increase the blood flow _ fold

A

sevenfold

23
Q

The site can be warmed using a warm wash cloth of (_ to _ C) for no longer than _ min

A

40-42C for no longer than 3-5 min.

24
Q

What is the first tube to be collected for skin puncture?

A

Tube for blood gas analysis

25
Q

What is the first microcollection tube to be collected for skin puncture

A

EDTA microcollection tube

26
Q

What is the most common skin antiseptic

A

70% Isopropyl alcohol

27
Q

What is the most common site for venipuncture

A

Superficial veins of the antecubital fossa

28
Q

It is the condition wherein venous flow is slowed

A

Stasis

–> results in the local accumulation of Factor VIII and vWF

29
Q

Distance of tourniquet above the venipuncture site

A

3-4 inches / 7.5-10 cm

30
Q

A phlebotomist must never puncture a patient _

A

twice

–> Endorse the patient to another phlebotomist if failed to collect 2x

31
Q

Patients should not pump the fist as it may elevate _ concentration

A

Potassium

32
Q

Areas to avoid in venipuncture

A

VVFAIE

  1. Veins in the inner wrist
  2. Veins in the feet
  3. Fistula
  4. Arteries
  5. Inflamed sites
  6. Edematous sites
33
Q

What is NOT a cause of specimen hemolysis?

a. Application of tourniquet for 45 sec.
b. Moisture from alcohol
c. Contamination in the collection tube
d. Needles with TOO SMALL bores
e. Excessive agitation
f. Frothing of the sample

A

A

34
Q

Sharps containers must be replaced when they are no more than _ full

A

Three-quarters full

35
Q

It is the most common complication encountered in performing venipuncture

A

Ecchymosis

36
Q

A short lapse in consciousness

A

Syncope/ Fainting

37
Q

What should be done if a patient experiences syncope?

A

Call a physician immediately and give patient sufficient air