Chapter 9

Question 0

Capillary blood

Answer 0

Acquired by skin puncture is different from that if venous or arterial blood samples acquired by other methods

Question 1

Lab tests commonly performed using Capillary Blood Soecimens

Answer 1

• blood smears fir white cell differential (manual blood spears on microscope)
• CBC, H&H
• Electrolytes
• Neonatal bilirubin
• Neonatal blood gas
• Neonatal screening (using filter paper or blood spot testing)
• Point of care testing (POT) and/ or home testing (blood glucose monitoring) etc

Question 2

Capillary is more of a mixture composed of blood from

Answer 2

• arterioles
• venules
• capillaries
• intracellular and interstitial(tissue) fluids(fluids that form from within tissue layers and gaps

Question 3

Warming the skin puncture site

Answer 3

• Helps increase arterial blood flow to the area arterializing the site
• Can be warmed with a heated surgical towel or a washcloth heated with warm water to 42 degrees celcius won’t burn skin

Question 4

Cleansing skin puncture site

Answer 4

• Should be gleaned with a 70% aqueous solution of isopropyl alcohol before being punctured
• If alcohol drips or pools at site it can cause hemolysis and contaminate testing for glucose determination

Question 5

Average depth of a skin puncture should be

Answer 5

• 2 to 2.5mm for adults
• less than 2.0mm for small children and infants avoids hitting the bone
• Laser devices are also available as alternative (250 um wide and 1-2mm deep)

Question 6

Cyanotic

Answer 6

Cold (blue in color due to O2 depletion or swollen

Question 7

Warming hand to increase blood flow

Answer 7

Wrap it in a warm towel for 3 to 5 minutes or use warning device/ heating pack

Question 8

Order of collection

Answer 8

• Blood gases
• EDTA specimen for hematology tests
• Other tubes with additives
• Serum tubes

Question 9

Microcollection tubes

Answer 9

• Must be adequately filled and if contain additives should be mixed gently
• If takes to long to fill tube microclots may form
• hemolysis of capillary blood specimen is a complication
• excessive amounts cause clot formation
• inadequate amounts cause cells to change morphologically cause to much anticoagulant

Question 10

Controlling the depth of the skin puncture prevents

Answer 10

Osteomyelitis

Question 11

The fleshy central palmar surface if the distal phalanx ( fingertip section)

Answer 11

Of the third or fourth finger of the nondominant hand is the preferred site for puncture

Question 12

For infants less than 1 year old or neonates the recommended site for skin puncture is

Answer 12

Lateral or medial plantar surface of the heel

Question 13

Skin puncture is most useful in which if the following conditions

Answer 13

Fragile veins

Question 14

Plastic Microcollection tubes should be filled with blood in which of the following ways

Answer 14

Using capillary action to fill itself

Question 15

Controlling the depth of the skin puncture prevents

Answer 15

Osteomyelitis

Question 16

What does feathered edge refer to

Answer 16

Edge of the blood smear on a microscope tube

Question 17

Blood films for microscopic slides

Answer 17

From fresh drops of blood perform finger puncture in the usual way wipe first drop of blood away

Touch the slide to the second drop at 0.5-1 inch ;1.3-2.5cm from the end of the slide

Question 18

Not recommended for routine skin punctures

Answer 18

• Earlobe
• central arch area of infants heel
• fingers of a newborn or infant less than 1 year old
• the pinky ( risk of hitting bone)
• the thumb ( has a pulse)
• the index finger (more sensitive likely to be callused)
• fingers on side of a mastectomy (removal of lymph nodes during surgery may result in excessive lymph fluid on the side of the surgery
• swollen,infected,callused,burned,cut,scared,bruised,rash,previously punctured sites (because accumulated fluid may contaminate the specimen and site may be bruised causing more pain if punctured again)