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Phlebotomy > Chapter 9 > Flashcards

Chapter 9 Flashcards

Capillary or Dermal Blood Specimens

1
Q

A 10-mL blood sample taken using a venipuncture method would represent 5% to 10% of the total blood volume in a ______’s body.

A

Neonate

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2
Q

True or False: Fingerstick procedures should be used when a patient requires coagulation studies.

A

False. Fingerstick procedures are not recommended for coagulation studies because of a dilution effect with interstitial fluid.

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3
Q

Give five example of situations in which a fingerstick procedure is preferred.

A

Thrombotic tendencies (thrombosis). Severe burns or scarring on the common venipuncture sites. Obese patients. When veins are being “save” for therapy (eg., for cancer patients). Patient has already had multiple unsuccessful venipunctures and tests require small amounts of blood.

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4
Q

True or False: A fingerstick procedure can be used in the case that a patient is fearful/anxious about venipunctures.

A

True

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5
Q

Dehydration

A

Lacking/loss of water from the body.

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6
Q

Peripheral Circulation

A

Blood flower near the outer surfaces of the body.

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7
Q

Capillary Blood

A

Blood from the capillaries. Acquired by skin puncture.

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8
Q

Interstitial (Tissue) Fluids

A

Fluids that form within tissue layers and gaps.

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9
Q

Does capillary blood have more arterial blood or venous blood? Why?

A

Arterial blood, because the arterial pressure in the capillaries is stronger than the venous pressure.

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10
Q

True or False: The first steps used for the venipuncture procedure differ from those of skin puncture procedure.

A

False. The first steps of both processes (preparing supplies, identification, allergy/fainting questions, hand hygiene, and cleansing puncture site) are the same. Only the subsequent steps (the steps after this) are different.

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11
Q

Should glass or plastic capillary tubes be used?

A

Plastic. Glass tubes should not be used because they break easily and can cause injury.

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12
Q

What capillary puncture site should be selected on a child or adult patient?

A

The third or fourth fingers.

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13
Q

What capillary puncture site should be selected for newborns?

A

The heel.

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14
Q

True or False: You should do a fingerstick procedure on the center of the distal phalanx.

A

False. There is a higher chance of hitting bone if you stick here. Instead, you should stick on the fleshy part of the finger, slightly off-center.

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15
Q

Is the pinky finger an acceptable site on children/adults? Thumb? Index finger?

A

None of these are acceptable sites.

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16
Q

Is the back of the heel or arch of the foot an acceptable capillary puncture sit for newborns and infants (<12m)?

A

No. Only the inner or outer surfaces/edges of the heel should be used.

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17
Q

Eponychium

A

Cuticle

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18
Q

Free Edge of Nail

A

The white portion at the end of your nail that is no longer touching the nail bed.

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19
Q

Lunula

A

The white semi-circle (moon-shaped) portion at the base of the nail

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20
Q

Nail Body

A

The visible hard nail area.

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21
Q

Nail Bed

A

Vascular epidermis on which most of the nail rests.

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22
Q

Nail Root

A

Where the nail starts; located at the proximal end of the nail

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23
Q

What is meant by “cyanotic” skin?

A

Having a bluish color due to a lack of oxygen.

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24
Q

Puncturing a cut, scarred, burned, callused, bruised, previously punctures, swollen, or infected site or site with a rash can cause _____________ or excess ____.

A

Contamination; pain.

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25
Q

Warming the skin puncture site helps facilitate phlebotomy by significantly increasing ________ blood flow to the area, thus “arterializing” the site.

A

Arterial.

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26
Q

Arterialized Capillary Blood

A

Capillary specimens drawn from warmed sites.

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27
Q

What does dangling the patient’s hand and pointing fingers towards the floor do?

A

This allows gravity to fill the capillary beds of the fingertips; more blood flows to the fingertips.

28
Q

What should the puncture site be cleaned with?

A

70% isopropyl alcohol.

29
Q

True or False: You can perform a fingerstick procedure before the alcohol has dried because it is a smaller procedure.

A

False. Alcohol can cause hemolysis and contaminate testing for glucose determinations. Additionally, it will sting the patient and prevent well-rounded drops of blood.

30
Q

Which is better for blood smears on microscopic slides? Well-rounded or running drops of blood?

A

Well-rounded drops of blood.

31
Q

What depth of a skin puncture should be performed on infants/newborns?

A

Less that 2.0 mm (to avoid injuring the bone).

32
Q

Is the dominant or nondominant hand preferred?

A

Nondominant. It is often less callused.

33
Q

Capillary Action

A

Blood flows freely into the tube on contact, without suction.

34
Q

True or False: In home settings, a patient may have a multiuse device in which only the lancet is changed after each use with a single patient.

A

True. However, it must be disposed of if it is ever contaminated.

35
Q

What is meant by an “on-contact” puncture device?

A

The puncture mechanism operates only when it is positioned and pressed against the skin.

36
Q

True or False: A pediatric puncture device can be used on an adult, if needed.

A

False. It is likely that the puncture will not be deep enough to collect enough blood for the collection.

37
Q

True or False: If blood does not flow freely, the site should be gently squeezed and massaged to promote blood flow.

A

False. A free flow of blood is essential to obtain accurate test results.

38
Q

Osteomyelitis

A

Inflammation of the bone caused by bacterial infection.

39
Q

Osteochondritis

A

Inflammation of the bone and cartilage.

40
Q

What is the order of collection for microcollection tubes (by purpose)?

A

1) Blood gases
2) EDTA specimen for hematology tests
3) Other tubes with additives
4) Serum tubes

41
Q

What is the order of collection for microcollection tubes (by color/additive)?

A

1) Lavender (EDTA)
2) Green (Lithium Heparin)
3) Mint Green (Lithium Heparin and Gel for plasma separation)
4) Gray (NaFV or Na2EDTA)
5) Gold (Clot Activator and Gel for serum separation
6) Red (No additive)

42
Q

Patients having increased blood cell fragility and high-packed cell volume (eg., newborns and infants) can cause _________.

A

Hemolysis.

43
Q

If the bone is repeatedly punctured, it can lead to _____________ or _______________.

A

Osteomyelitis; osteochondritis.

44
Q

White Blood Cell Differential (diff)

A

A hematological laboratory test to approximate percentages and determine morphology of the WBCs. RBCs and platelet morphology can also be assessed.

45
Q

Blood Films for Microscopic Slides

A

Microscopic slides are prepared with a blood drop placed onto a glass slide between 1/2 and 1 inch from the end. The blood is smeared using another glass slide to achieve a feathered edge.

46
Q

Feathered Edge

A

Blood placed on a blood slide has a visible curved edge that thins out smoothly and resembles the tips of a bird’s feather.

47
Q

True or False: A blood film is still usable if there is only one ridge at the very end of it, but the rest of the smear is uniform.

A

False. A smear should contain no ridges, lines, or holes at all.

48
Q

Blood slides must be _______ by the phlebotomist.

A

Labeled

49
Q

When starting to PULL the blood drop using the second slide, how far should you let the blood drop spread?

A

You should allow the blood to spread along the width of the slide, allowing it to spread almost to the edges.

50
Q

When pressing the slide forward when making a blood film, what angle should you hold the top slide at?

A

Approximately 30 degrees.

51
Q

Name three ways to start a blood smear (place a blood drop on a slide).

A

Directly from the patient’s finger, after wiping the first drop of blood away.
From a hematology, anticoagulated (EDTA), lavender-top tube, use an applicator stick to place the drop on the slide.
Use a commercially available device that can be inserted into the EDTA tube and touched to the slide to release a drop.

52
Q

Used disposable puncture devices or lancets should always be placed into a rigid, ________-_________ biohazard container with a lid.

A

Puncture-Resistant

53
Q

Why are bandages not recommended for infants and young children?

A

There is a chance of possible irritation and the potential of swallowing or aspirating the bandage.

54
Q

Hand hygiene must be performed against after contact with ____ patient.

A

Each

55
Q

True or False: An adult puncture device can be used on an infant or newborn.

A

False. The risks of puncturing bone are increased.

56
Q

If the sample is inadequate and blood has stopped flowing from the puncture site, use a new sterile device to puncture the (same/different) site.

A

Different. Avoid excessive puncture on one finger and/or hand.

57
Q

Lancets with a 30 G needle and a depth of 1.5 mm are used for ___ flow fingersticks and are colored ______.

A

Low (single drop); purple.

58
Q

Lancets with a 21 G needle and a 1.8 mm puncture depth are used for ______ flow fingersticks and are colored ____.

A

Medium; pink.

59
Q

Lancets with a blade width of 1.5 mm and a depth of 2.0 mm are used for ____ flow fingersticks and are colored ____.

A

High (500microliters from single puncture); blue.

60
Q

Quikheel Lancets with a blade width of 1.75 mm and a depth of 0.85 mm are used for ___ flow heel sticks on premature infants and are colored ____.

A

Low; pink.

61
Q

Quikheel Lancets with a blade width of 2.5 mm and a depth of 1.0 mm are used for ____ flow heelsticks on infants and are colored ____.

A

High; teal.

62
Q

How many times can the puncture apparatus (lancet or sharp) be used for fingersticks on the same patient?

A

Once

63
Q

A phlebotomist is going to collect a blood specimen for hemoglobin and hematocrit from a hospitalized patient. The patient has a full cast on both arms extending to the wrist. What should the phlebotomist do?

A

Perform a fingerstick and document the collection site.

64
Q

When filling multiple microcollection tubes with capillary blood, which of the following should be completed LAST? Serum tubes, EDTA specimens for hematology tests, blood gases, or other tubes with additives?

A

Serum tubes.

65
Q

A phlebotomist was supposed to perform a skin puncture on a patient but the patient had very cold hands. What should the phlebotomist do next?

A

Warm the hand.

66
Q

Skin puncture procedures are NOT recommended for blood ________.

A

Cultures.

67
Q

POCT stands for:

A

Point-of-Care Testing

Phlebotomy (4 decks)

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