Ch 13 - Preanalytic Variable and Venipuncture Complication Flashcards
____ _____ occur before analysis of specimen and the phlebotomist is the most responsible
preanalytic variables
____ _____ can affect test outcomes
preanalytical variables
age alcohol consumption altitude dehydration smoking diurnal variation stress exercise fasting sex medications and medical treatment posture pregnancy obesity
What are all of these factors?
preanalytical variables
if a patient is ______, still communicate everything as you normally would
unconscious
occluded
blocked
sclerosed
hardened
veins that are occluded or sclerosed feel hard/cordlike and lack _____
resiliency
_____/_____ can be caused by inflammation, disease, chemotherapy, prolonged IV therapy, or repeated venipuncture
occluded/sclerosed
caused by needle going through the vein, failing to apply enough pressure after withdrawal, or by having the bevel opening only partially in the vein
hematoma
arm may appear swollen because of accumulation of tissue fluid with this condition
edematous tissue
the removal of lymph tissue on the side of the mastectomy causes ____
lymphostatis
lack of lymph fluid movement
lymphostasis
massage the arm gently from wrist to elbow
dangle arm downward to promote blood flow
apply heat
rotate wrist to increase prominence of cephalic vein
pump hand/make a fist
What are these useful for?
enhancing vein prominence
70% isopropyl alcohol, methanol, ethyl alcohol, or tincture of iodine cannot be used to clean the site for ___ ___ test
blood alcohol
povidone-iodine or benzalkonium chloride are used to clean the site in the ____ ____ test
blood alcohol
benzalkonium chloride cannot be used in children under the age of __
2
medical term for fainting
syncope
patient’s skin feels cold, damp, and clammy
beads of sweat may form
may state they aren’t feeling well or stop talking
eyes may start to roll back
head could tilt forward or backward
What are these symptoms of?
syncope
medical term for nausea and vomiting
emesis
too much pressure on a small/weak vein causes _____ vein
collapsed
destruction of Red Blood Cells, which causes the release of hemoglobin and cellular contents into the plasma
hemolysis
serum or plasma is ___ in a hemolyzed sample
pink/red
- blood frothing caused by needle improperly attached to a syringe
- drawing blood too quickly into a syringe
- excessively shaking blood
- failing to allow the blood to run down the side of the tube when using a syringe to fill the tube
- using too small of needle relative to vein size or vacuum tube size
- mishandling and improper specimen transport
- readjustment of the needle in the vein
What are these causes of?
hemolysis
aspartate aminotransferase
potassium
lactate dehydrogenase
These chemistry and hematology tests are ____ affected by hemolysis
seriously
alanine aminotransferase
CBC
serum iron
thyroxine
These chemistry and hematology tests are ____ affected by hemolysis
moderately
acid phosphate magnesium albumin phosphorus calcium total protein
These chemistry and hematology tests are ____ affected by hemolysis
slightly
flow of blood from collection tube back into patient’s vein
reflux of anticoagulant
albumin bilirubin calcium cell counts cholesterol enzymes hemoglobin or hematocrit high-density lipoprotein iron lipids protein triglycerides
These are tests affected by:
patient position
anemia caused by excessive removal of blood at the physician’s request
iatrogenic anemia
pressure within the tissue prevents blood from flowing freely in the blood vessels
compartment syndrome
iatrogenic anemia
compartment syndrome
infection
nerve damage
potential long-term complications associated with ____
venipuncture
timed specimens are useful to monitor ___ ___
cardiac enzymes
if an IV is in place and there are no accessible sites, where should the blood specimen be collected?
distal to the IV
avoid the ____ vein to avoid nerve damage
basilic
body’s state 8-12 hours of fasting
basal state
