Chapter 7-9 Terms to Know Flashcards
Chemicals that inhibit blood
clotting or “blood thinners.”
Anticoagulant
Any substance placed within a tube other than the tube stopper or if the tube is glass, the silicone coating.
Additive
Substances used to prevent sepsis, which is the presence of microorganisms or their toxic products within the bloodstream. ______________ prevent or inhibit the growth and development of microorganisms but do not necessarily kill them.
Antiseptics
The end of the needle that pierces the vein. The _________ allows the needle to easily slip into the skin and vein without coring (removing a portion of the skin or vein).
Bevel
Is the transfer of additive from one tube to the next. It can occur when blood in an additive tube touches the needle during ETS blood collection or when blood is transferred from a syringe into ETS tubes.
Carryover/cross-contamination
A substance that enhances coagulation in tubes
used to collect serum specimens.
Clot Activator
Chemical substances or solutions regulated by the
Environmental Protection Agency (EPA) that are used to remove or kill microorganisms on surfaces and instruments.
Disinfectant
Ethylenediaminetetraacetic acid
EDTA
Closed system in which the patient’s blood flows through a needle inserted into a vein directly into a collection tube without exposure to air or outside contaminants. Most common, efficient, and CLSI-preferred system for collecting blood samples.
ETS (Evacuated Tubes System)
Used with both the ETS and the syringe method of obtaining blood specimens. (With the syringe method, blood is collected in a syringe and must be immediately transferred into the tubes.)
Evacuated Tubes
Needle __________ is indicated by a number that is related to the diameter of the lumen.
Gauge
The internal space of a blood vessel through which the blood flows.
Lumen
Refers to the order in which tubes are collected during
a multiple-tube ETS draw, or filled with blood from a syringe.
Order of Draw
Used needles, lancets, and other sharp objects must be disposed of immediately in special containers referred to as
Sharps Containers
Used for coagulation tests. Tubes have light-
blue stoppers.
Sodium Citrate
The most common antiglycolytic agent. It preserves glucose and also inhibits the growth of bacteria. Tubes have gray top.
Sodium Fluoride
Securing a patients arm to find vein.
Anchor
The behavior of a healthcare provider toward or as perceived by a patient.
Bedside manner
The cover or cap of a needle
Needle Sheath
To examine the vein by touch or feel
Palpate
Skin is pulled tight without slack.
Taut
Step 1: Receive, Review, and Accession Test Request
Step 2: Approach, Greet, and Identify the Patient
Step 3: Explain the Procedure and Obtain Consent
Step 4: Verify Collection Requirements, and Identify
Sensitivities and Potential Problems
Step 5: Sanitize Hands and Put on Gloves
Step 6: Position Patient, Apply Tourniquet, and Ask the
Patient to Make a Fist
Step 7: Select a Vein, Release the Tourniquet, and Ask
the Patient to Open the Fist
Step 8: Clean and Air-Dry the Site
Step 9: Prepare Collection Equipment
Step 10: Reapply the Tourniquet, and Uncap and Inspect
the Needle
Step 11: Ask the Patient to Remake a Fist, Anchor the
Vein, and Insert the Needle
Step 12: Establish Blood Flow, Release the Tourniquet,
and Ask the Patient to Open the Fist
Step 13: Fill, Remove, and Mix Tubes in Order of Draw,
or Fill Syringe
Step 14: Withdraw the Needle, Place Gauze, Activate the
Needle Safety Feature, and Apply Pressure
Step 15 (ETS): Discard Blood Collection Unit
Step 15 (Syringe System): Discard Needle, Attach
Transfer Device, Transfer Blood, and Discard Syringe
and Transfer Device Unit
Step 16: Label and Prepare Tubes for Handling and
Transport
Step 17: Check the Patient’s Arm, and Apply a Bandage
Step 18: Dispose of Used Materials, and Reposition
Moved Items
Step 19: Thank the Patient, Remove Gloves, and Sanitize
Hands
Step 20: Transport Specimen to the Lab Promptly
Venipuncture Steps
This type of patient may object to being tested at first, but will often come around, especially if given a sense of control over the situation by a reminder that he or she has the right to refuse testing. Remain calm and professional and treat the patient in a caring manner under all circumstances.
Handling Difficult Patients
Also called altered state of consciousness or state of mind. Conditions can cause problems with blood collection, including verifying patient identification, explaining procedures, obtaining informed consent for procedures, and trying to safely obtain specimens if the patient is combative or unaware of what is happening. Consent for specimen collection may need to be obtained from an authorized relative or guardian.
Handling Patients in Altered Mental Status
Explain why you are there, and ask the
patient for permission to collect the specimen.
Obtaining Consent
Apply the ______________ snugly but loose enough to avoid damaging the patient’s skin. A tourniquet that is too tight can cause the vein to collapse when it is released or the tube is engaged. It can also distend the vein so much that it splits open on needle entry, resulting in hematoma formation.
Tourniquet Application
If both AC areas are bruised, select a needle entry point below the bruising. Be aware that some elderly patients may not be able to make a fist because of muscle weakness. If no suitable vein can be found, gently massage the arm from wrist to elbow to force blood into the area or wrap a warm, wet towel around the arm or hand for a few minutes to increase blood flow.
Selecting Vein
Patient Identification
Equipment Selection
Tourniquet Application
Site Selection
Cleaning the Site
Performing the Venipuncture
Holding Pressure
Proper Venipuncture Steps
Swelling or mass of blood (often clotted) that can be
caused by blood leaking from a blood vessel during or following venipuncture.
Hematoma
Condition in which blood components that cannot easily leave the bloodstream become concentrated in the smaller plasma volume.
Hemoconcentration
Results when RBCs are damaged or destroyed and the
hemoglobin they contain escapes into the fluid portion of the specimen.
Hemolysis
Relating to or marked by jaundice and is used to describe serum, plasma, or urine specimens that have an abnormal deep yellow to yellow-brown color due to high bilirubin levels.
Icteric
Described as a loss of consciousness and postural tone (ability to maintain an upright posture) resulting from insufficient blood flow to the brain. It can last for as little as a few seconds or as long as half an hour.
Syncope
Starts as soon as test is ordered. Things to consider:
Reference Ranges/Intervals
Basal State
Age
Altitude
Dehydration
Diet
Diurnal/Circadian Variations
Preexamination/preanalytical
