Challenges in Phlebotomy

Question 1

In venipuncture on children, there are 2 patients

Answer 1

Child & Parent

Question 2

The puncture site for children under 1 year of age

Answer 2

Foot (heel)

Question 3

Done by puncturing the skin and underlying capillaries

Answer 3

Capillary Puncture

Question 4

Why is capillary puncture on earlobe not recommended?

Answer 4

Blood flow is not adequate

Question 5

In warming the puncture site to increase the blood flow, how many times?

Answer 5

Seven times its normal blood flow (sevenfold)

Question 6

Ideal temperature in warming site

Answer 6

42-degree Celsius

Question 7

Why is the first drop of blood wiped away?

Answer 7

To avoid contamination with interstitial (tissue) fluid

Question 8

Amount of blood filled in capillary tube

Answer 8

.5 mL

Question 9

In micro collection order of draw, arrange in order
(other additive, lavender, blood gasses, red, green)

Answer 9

1. Blood Gasses
2. Lavender
3. Green
4. Other additive
5. Red

Question 10

Why can’t you perform capillary puncture in yellow tube?

Answer 10

Because the blood is exposed

Question 11

The optimal depth for capillary puncture for premature infants

Answer 11

0.85mm

Question 12

Optimal depth of capillary puncture for full-term infants

Answer 12

2mm

Question 13

Excessive crying can result to?

Answer 13

Elevated WBC count

Question 14

In heel stick collection, the heel should be warmed for _ minutes.

Answer 14

3 minutes

Question 15

Patients who are on anticoagulant therapy are susceptible to?

Answer 15

Bleeding and Hematoma

Question 16

What to do with resistant patients?

Answer 16

Convincing them will take time but they do have the right to refuse

Question 17

For patients with damaged / collapsing veins, this is the best way to obtain blood

Answer 17

Using a syringe

Question 18

For patient with damaged / collapsing veins, this works to draw blood but only small tubes can be used

Answer 18

Evacuated Tube System

Question 19

If the needle is pierced all the way through the vein, insertion of the needle must be_

Answer 19

Angle greater than 15 degrees

Question 20

If needle is only partially inserted into the vein, possibly because the needle is_

Answer 20

Inserted at less than 15-degree angle

Question 21

Probing excessively can result to_

Answer 21

Hemolyzing of RBC

Question 22

Patient should never be struck more than _ times by the same phlebotomist

Answer 22

2 times

Question 23

The medical term for fainting

Answer 23

Syncope

Question 24

Symptoms for syncope

Answer 24

1. Pallor (paleness)
2. Sweating
3. Hyperventilation

Question 25

The breaking open of RBCs and release of hemoglobin

Answer 25

Hemolysis

Question 26

Hemoglobin turns the serum / plasma from pink to_

Answer 26

Red

Question 27

What analytes are affected when hemolyzed blood releases chemicals into the plasma and serum?

Answer 27

KMFLPNT

1. Potassium (K)
2. Magnesium (Mg)
3. Iron (Fe)
4. Lactate Dehydrogenase (LDH)
5. Phosphorus (P)
6. Ammonia (NH3)
7. Total Protein

Question 28

Give 3 causes of hemolysis

Answer 28

1. Needle gauge are too small
2. Too much pressure on syringe / vacutainer
3. Vigorously shaking of filled tubes

Question 29

Patient usually stops bleeding in _ minutes

Answer 29

2 - 6 minutes

Question 30

Some medication may prolong the bleeding time

Answer 30

1. Blood thinners (heparin, warfarin)
2. Arthritis medication
3. Aspirins
4. Coagulation abnormalities (Petechiae present)

Question 31

Abnormal accumulation of fluid in interstitial spaces

Answer 31

Edema

Question 32

Do not use povidone-iodine solutions, it can elevate_

Answer 32

1. Potassium (K)
2. Uric Acid
3. Phosphorus (P)