Blood Collection Flashcards
1
Q
3 ways of collecting blood
A
- skin puncture
- venipuncture
- arterial puncture
2
Q
the most crucial step in blood collection
A
patient identification
3
Q
2 identifiers
A
- full name
2. birthdate
4
Q
factors to avoid preanalytic variables
A
physiological factors
5
Q
physiological factors affecting test results
A
- posture
- diurnal rhythm
- exercise
- stress
- diet
- smoking
- age
- altitude
- dehydration
- drug therapy
- gender
- pregnancy
6
Q
the hormone that inhibits erythropoiesis
A
estrogen
7
Q
used only when small quantities of blood are required
A
skin puncture
8
Q
unit for skin puncture
A
microliter
9
Q
skin puncture often performed in:
A
- newborns
- adults (severely burned)
- pediatric patients younger than 2 years old
- elderly patients with fragile veins
10
Q
indications for capillary puncture
A
- avaiable veins are fragile or must be saved for other procedures such as chemotherapy
- several unsuccessful veni
- patient has thrombotic or clot forming tendecies
- patient is apprehensive or has an intense fear of needles
- no accessible veins
- to obtain blood for POCT procedures such as glucose monitoring
11
Q
preferred method of obtaining blood from infants & very young
A
capillary puncture
12
Q
how many iron is remove every 10 mL of blood
A
4 mg of iron
13
Q
removal of 4 mg of iron can lead to
A
iatrogenic anemia
14
Q
- mixture of venous, arterial and tissue fluid
- preferred specimen for some tests such as newborn screening test
A
Capillary blood
15
Q
depth of lancet
A
not more than 2 mm
16
Q
more than 2 mm depth of lancet can lead to
A
osteomyelitis or bone environment
17
Q
pressure/squeezing in skin puncture can
A
increase tissue fluid
18
Q
milking the site in skin puncture can cause
A
tissue fluid & hemolysis
19
Q
1st drop of blood in skin puncture is contaminated with
A
- dead skin cells
- tissue fluid
- alcohol
20
Q
these parameters are lower in capillary blood
A
- RBC count
- hematocrit
- hemoglobin
- platelets
21
Q
____ compared to venous blood
A
higher WBC count (15-20%)
22
Q
puncture sites for infants
A
lateral surface of the plantar side of the heel
23
Q
CLSI policy states that _____ infants should not be puncture on the fingers
A
1 yr old below
24
Q
skin puncture site for children with too small fingers but have started walking
A
plantar surface of the big toe
25
puncture site older children & adults
palmar surface if the distal portion of the third (middle) or fourth (ring) finger
26
sites to avoid in skin puncture
1. swollen (edematous)
2. bruised
3. cyanotic
4. infected areas that have been punctured
27
equipment for skin puncture
1. microcollection container
2. microcollection tube
3. microtube
4. microbullet
5. lancet
28
OSHA required lancet safety feature
permanently retractable blade or needle point
29
function of warming devices
increases blood flow 7x
30
temperature of warming device
42 C
31
capillary blood closely resemble the
venous blood
32
order of draw for skin puncture
1. tube for blood gas analysis
2. slides, unless made from specimen in the EDTA microcollection tube
3. EDTA microcollection tube
4. Other microcollection tubes with anticoagulants
5. serum microcollection tube
33
order of draw for microcollection tube
1. lavender - k2edta - 10x
2. green - lithium heparin - 10x
3. mint green - lithium heparin and gel - 10x
4. Grey - Na2EDTA - 10x
5. Gold - Clot activator & gel - 5x
6. Red- no additive - 0x
34
additive for green/red band capillary tube
ammonium heparin
35
additive for light blue capillary tube
no anticoagulant
36
place that is required with blood collection equipment
blood drawing station
37
prevents or inhibit the growth & development of microorganism
Antiseptics
38
most commonly used antiseptic
70% isopropyl alcohol
39
antiseptic for person allergic to alcohol
chlorhexidine gluconate
40
antiseptic for blood culture specimen collection
povidone iodine
41
antiseptic for alcohol testing
benzalkonium chloride
42
used to remove or kill microorganisms on surface & instruments
Disinfectant
43
most recommended disinfectant
sodium hypochlorite
44
preferred dilution of sodium hypochlorite
1:100
45
contact time of sodium hypochlorite
10 mins
46
recommended size of gauze pad
2 by 2 inch folded in fourths
47
puncture resistant container for used needle
sharps container
48
leakproof plastic bags, used to transport blood other specimen from the collection site to the laboratory
Biohazard bags
49
how long can a tourniquet be in a patient's arm
not more than 1 minute
50
more than 1 minute application of tourniquet can cause
hemoconcentration
51
length of tourniquet from the venipuncture site
3-4 inches above
52
principle of vein-locating device
transillumination
53
inspect an organ by passing light through its walls
vein-locating device
54
hollow stainless steel shafts w. the bevel and cut at a slant to allow ease of entry through skin and vein
venipuncture needle
55
needle for ETS
multisample needle
56
needle for syringe
hypodermic needle
57
parts of the needle
1. plastic sheath
2. point
3. lumen
4. . shaft
5. hilt
6. hub
58
parts of syringe
1. barrel
2. flunger
3. hypodermic needle
59
angle of the tip of the needle, allows the needle to ease into the skin
Bevel
60
hole opening of needle
lumen
61
number that corresponds to the needle length
needle gauge
62
gauge for routine adult collection
21 g
63
gauge is _____ proportional to the bohr
inversely
64
gauge used for children & smaller fragile veins
23 g
65
gauge for scalp veins drawns on neonates & premature infants
25 g
66
gauge of pink
18 g
67
gauge of green
21 g
68
gauge of black
22g
69
gauge of light blue
23 g
70
for patients that are difficult to collect by conventional methods
Butterfly
71
advantage of butterfly
more blood sample wil get
72
length of butterfly tube
6-12 inches
73
venipuncture sites
1. cephalic vein
2. basilic vein
3. median cubital vein
74
most preferred venipuncture site
antecubital fossa
75
most preferred venipuncture vein
median cubital vein
76
least preferred venipuncture vein
basilic vein
77
unacceptable sites for venipuncture
1. arterial line
2. arteriovenous shunt, fistula or graft
3. iv lines
4. arteries, femoral and varicose veins
78
how many mL of blood will be discard in central vascular access devices
5 to 10 mL
79
most recommended tube to avoid breakage
plastic
80
expiration date of tubes
last day of the month
81
additive that inhibits the use of glucose by blood cells
antiglycolytic agent
82
antiglycolytic agent
sodium chloride & lithium iodoacetate
83
how long will the blood to clot
30-60 mins
84
how long will the blood to clot with clot activator
15 mins
85
how long will the blood to clot with thrombin
5 mins
86
- inert material that undergoes temporary change in viscosity during centrifugation process
- separated cellular to liquid components
Thixotropic gel separator
87
remove calcium by forming insoluble salts
EDTA, citrate, oxalate
88
prevents conversion of prothrombin to thrombin
heparin
89
recommended form of EDTA
spray dried
90
importance of order of draw in venipuncture
to avoid carry over or cross contamination
91
importance of order of draw in skin puncture
avoid clotting of the sample
92
open system in venipuncture
syringe method
93
close system in venipuncture, less exposure
evacuated tube method
94
escape of hemohlobin from RBC to plasma & serum
Hemolysis
95
overshaking of tube & using wrong gauge size can cause
hemolysis
96
placing tourniquet more than 1 min can cause
hemoconcentration
