Blood Collection and Specimen Considerations Flashcards

1
Q

liquid portion of clotted

A

serum

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2
Q

anticoagulated blood

A

plasma

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3
Q

preferred for most clinical chemistry tests

A

serum

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4
Q

serum value > plasma value

A

glucose
potassium
PO4
HCO3-
albumin
CK
AST
ALP

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5
Q

liquid portions of clotted or anticoagulated blood prepared by centrifugation at ____ g(RCF) for ___min

A

1000-2000
10min

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6
Q

Plasma value > serum value

A

TP
Calcium

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7
Q

anticoagulated venous, capillary, arterial blood

A

whole blood

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8
Q

WB value < plasma value

A

glucose (↓10-15%)

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9
Q

CB value > VB value

A

glucose
potassium

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10
Q

VB value > CB value

A

TP
calcium

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11
Q

separate serum or plasma from cells within __hours of collection (except centrifuged gel tubes)

A

2

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12
Q

samples should be analyzed within __hours; otherwise, refrigerate for __hours or freeze at -___degC for longer storage

A

4 hours
48 hours
-20degC

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13
Q

select veins in the ____

A

antecubital fossa

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14
Q

what are the veins in the antecubital fossa

A

median cubital vein
cephalic vein
basilic vein

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15
Q

most preferred puncture site, as it is well-achored

A

medial cubital vein

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16
Q

preferred puncture site for obese patients

A

cephalic vein

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17
Q

least preferred puncture site because there are nerves and arteries near

A

basilic vein

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18
Q

puncture site: veins in the dorsal part of the h___, w___, a___, f___.

A

hand
wrist
ankle
foot

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19
Q

tourniquet application:
___inches above the puncture site;
should not be left longer than ___min

A

3-4 inches
1 minute

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20
Q

tourniquet application: if blood pressure cuff is used, inflate to BP:___mmHg

A

40-60 mmHg

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21
Q

routine antiseptic

A

70% isopropyl alcohol

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22
Q

culture antiseptic

A

70% isopropyl alcohol
iodophor/povidone iodine
chlorhexidine

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23
Q

for patients with iodine sensitivity

A

chlorhexidine

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24
Q

ethanol assay antiseptic

A

benzalkonium chloride
zephiran

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25
Q

angle between vein and needle

A

15-30 deg

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26
Q

Venipuncture method:

not recommended by CLSI due to safety and specimen quality issues

A

needle and syringe

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27
Q

Venipuncture method:

for infants and children, hand veins, and difficult-draw situations

A

butterfly/winged infusion set

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28
Q

angle for butterfly/winged infusion set

A

<15deg

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29
Q

Venipuncture method:

for multi-sample collection
consists of double-headed needle, adapter, color-coded evacuated tube

A

evacuated tube system (ETS)

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30
Q

__ gauge number __ lumen diameter

A

↑ gauge number ↓lumen diameter

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31
Q

gauge 20 color

A

yellow

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32
Q

gauge 21 color

A

green

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33
Q

gauge 22 color

A

black

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34
Q

gauge 23 color

A

blue

35
Q

gauge 25 color

A

orange

36
Q

smallest number with largest diameter
for large volume syringes

A

gauge 20

37
Q

gauge __
standard, for routine venipuncture

A

gauge 21

38
Q

gauge __ butterfly set

A

gauge 23

39
Q

used to collet blood from scalp or tiny veins of premature infants

A

gauge 25

40
Q

needle length:

hypodermic (needle/syringe)
ETS
provides better control

A

1-1.5 inches

41
Q

needle length:

butterfly set

A

0.5-0.75

42
Q

what are the tube additives for ANTICOAGULANTS and their respective tube top colors

A

EDTA - lavender
citrate - light blue
oxalate - gray
heparin - green

43
Q

tubes that binds calcium and prevents coagulation

A

EDTA
citrate
oxalate

44
Q

inhibits thrombin by activating anti-thrombin III

A

heparin

45
Q

CLOT ACTIVATORS and tube top color

A

silica - red (plastic)
thrombin - orange

46
Q

THIXOTROPIC GEL SEPARATORS

gel + silica ___
gel + heparin ___

A

SST
PST

47
Q

ANTIGLYCOLYTIC AGENTS

A

sodium fluoride /iodoacetate - gray

48
Q

Order of Draw using ETS

A

Blood Culture
Coagulation
Serum Tubes
Heparin
EDTA
Oxalate/fluoride

49
Q

Stop
Light
Red
Stay
Put
Green
Light
Go

A

Sterile/SPS (yellow)
citrate (Light blue)
Red
SST (gold)
PST (light green)
Green
Lavender
Gray

50
Q

Yellow, SST, PST, Green, Lavender, Gray top number of inversions

A

8-10x

51
Q

Light Blue top number of inversions

A

3-4x

52
Q

Red top number of inversions

A

5x

53
Q

For newborn screening, POCTS, DM monitoring, absence of palpable veins

A

Capillary Puncture

54
Q

Sites of capillary puncture

A

lateral plantar surface (heel)
3rd/4th finger
big toe
ear lobe

55
Q

length of lancet blade for heel sticks
adults:
neonates:

A

adults: 2.4mm
neonates: 1.74-<2.0

56
Q

consequences of squeezing the site

A

dilutions with tissue juices
hemolysis

57
Q

Capillary Order of Draw

A

Blood gas spx
slides/smears
EDTA
Other additive tubes
serum tubes

58
Q

puncture for arterial blood gas analysis, absence of palpable veins; done by trained personnel/physician

A

arterial puncture

59
Q

arterial puncture sites and its angle:

A

radial, brachial: 45-60deg
femoral: 90 deg

60
Q

T/F. Modified Allen Test should be done before using the radial artery

A

True

61
Q

T/F. anticoagulant used in arterial puncture is heparin (lyophilized/liquid)

A

True

62
Q

T/F.
a. lyophilized heparin - powdered/dry
b. liquid heparin - 0.05 ml per ml of blood

A

both true

63
Q

use opposite arm or perform fingerstick, if possible; otherwise, have nurse turn off IV for 2 mins

A

IV

64
Q

indwelling catheter, blood culture, additive tubes, clot tubes

A

CVA (Central Venous Access) Collection

65
Q

what will you do as a medtech in the presence of : cannula/fistula, mastectomy

A

use opposite arm

66
Q

what will you do as a medtech in the presence of : burns, edema, scars, sclerosed veins, tattoos

A

select another site

67
Q

what will you do as a medtech in the presence of : hematoma

A

draw blood below

68
Q

bleeding from the venipuncture site and hematoma formation

a. vascular
b. infections

A

a. vascular

69
Q

second most common complications

a. vascular
b. infections

A

b. infections

70
Q

results from blood loss for testing; particular problem with pediatric patients

a. anemia
b. neurologic

A

a. anemia

71
Q

post-phlebotomy seizure or pain

a. anemia
b. neurologic

A

b. neurologic

72
Q

syncope, orthostatic hypotension, cardiac arrest

a. cardiovascular
b. dermatologic

A

a. cardiovascular

73
Q

allergic reaction to iodine, adhesive or latex

a. cardiovascular
b. dermatologic

A

b. dermatologic

74
Q

ambient temperature:

  • high temp = ___ draw volume
  • low temp = ___ draw volume
A
  • high temp = DECREASE draw volume
  • low temp = INCREASE draw volume
75
Q

High altitude (>5000 ft) = ___ draw volume

A

INCREASE

76
Q

____ = migration of water vapor inside a tube
____ = escape of water vapor from a tube containing wet additive

A

high humidity
low humidity

77
Q

light affects:

A

CTAD

78
Q

CTAD meaning

A

citric acid
theophylline
adenosine
dipyridamole

79
Q

age
gender
race
underlying conditions

a. uncontrollable factors
b. controllable factors

A

a. uncontrollable factors

80
Q

physiological (diet, stress)
biological
technical

a. uncontrollable factors
b. controllable factors

A

b. controllable factors

81
Q

Diurnal Variation:

what increases in the morning?

A

cortisol
ACTH
iron
aldosterone

82
Q

Diurnal Variation:

what increases in the evening?

A

GH
PTH
TSH

83
Q

Activity:

what increases in ↑ exercise?

A

lactate
creatinine
K
PO4
CK-MM
AST
LD4,5
aldolase

84
Q

Activity:

what decreases in ↑exercise?

A

glucose
TG
cholesterol