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Clin Skills III > Clin Skills 2 Blood > Flashcards

Clin Skills 2 Blood Flashcards

1
Q

Blood is made up of two parts:

A

Fluid (plasma or serum)

Cell (RBC,WBC, platelets)

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2
Q

__ contains various substances including glucose, electrolytes, proteins, and water.

A

Plasma

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3
Q

__ is the fluid part that remains after the blood is allowed to clot in a test tube. It is the fluid part of blood after a substance called fibrinogen has been removed by clotting.

A

Serum

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4
Q

3 best sites for venipuncture

A
  1. Median cubital vein
  2. Cephalic vein
  3. Basilic vein.
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5
Q

7 inappropriate sites for venipuncture

A 
Arm on same side of mastectomy
Edematous/infectious areas
Hematomas
Arm in which blood is being transfused
Scarred areas
Arms with fistulas or vascular grafts
Sites above an IV cannula
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6
Q

go in with the bevel which direction?

A

bevel up

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7
Q

What gauge needle is used for venipuncture?

A

16 gauge

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8
Q

What gauge needle is -Used with evacuated tube systems?

A

21 gauge

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9
Q

What gauge needle is Used w/ butterfly system, or syringes 0-5 mL capacity?

A

23 gauge

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10
Q

very small needles (>25 gauge can cause:)

A

often causes hemolysis of blood.

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11
Q

Blood collection tubes must be drawn in a specific order to avoid

A

cross-contamination of additives between tubes

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12
Q

The recommended order of draw for tubes is: (4)

A
  1. Blood culture bottle
  2. Coagulation tube (light blue top).
  3. Non-additive tube (red top)
  4. Additive tubes - Contains a gel separator and clot activator.
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13
Q

6 additive tubes (in order of blood draw)

A
  1. SST (serum separating tube) (red-gray or gold top)
  2. Sodium heparin (dark green top)
  3. PST (plasma separator) (light green top)
  4. EDTA (lavender top)
  5. ACDA or ACDB (pale yellow top). Contains acid citrate dextrose.
  6. Oxalate/fluoride (light gray top)
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14
Q

Which tubes must be thoroughly mixed?

A

Tubes with additives

Erroneous test results may be obtained when the blood is not thoroughly mixed with the additive.

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15
Q

6 steps to PREPARE to perform venipuncture

A
  1. Identify patient. Name and date of birth. Confirm information matches requisition.
  2. Reassure patient.
  3. Assemble necessary equipment
  4. Wash hands. Apply gloves.
  5. Position patient - arm extended.
  6. Select appropriate vein
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16
Q

Do not attempt a venipuncture more than __.

A

twice

17
Q

4 steps of performing the venipuncture (after you’ve prepared)

A

Apply tourniquet 3-4 inches above site.

Clean puncture site - smooth circular motion with 70% alcohol pad. Allow skin to dry.
* Do not touch the puncture site after cleaning.

Perform venipuncture
After blood flows, release tourniquet.

18
Q

What type of injection: ( PPD) skin testing

A

Intradermal

19
Q

What type of injection: vaccines, insulin, heparin injections

A

Subcutaneous

20
Q

What type of injection: vaccines, pain meds, antibiotics

A

Intramuscular

21
Q

Angles you approach with intradermal, SQ, IM

A

ID: 5-10º
SQ: 45º
IM: 90º

22
Q

Contraindicationsfor Injections:(3)

A

Allery to any components of the injectate
Active infection or dermatitis at the injection site
Coagulopathy (IM injections)

23
Q

what gauge needle for PPD?

A

small: 25, 26, or 27 gauge

24
Q

How to perform Intradermal Injection:

A

Prep skin with alcohol pad. ( flexor surface of forearm- about 4in above elbow crease)
Introduce needle at 5-10 degree angle into upper layer of skin and inject antigen
If done properly a discrete white bleb or wheal will appear (10mm in diameter)
Bleb disappears soon (couple minutes)

25
Q

3 sites for subcutaneous injections

A
  1. Outer surface of upper arm
  2. Anterior surface of thigh
  3. Lower abdominal wall.
    (DM- rotate injection sites)
26
Q

How to perform Subcutaneous Injection:

A

Deposit drug into the fat but above muscle.
Clean area with alcohol pad. Bunch up skin with thumb and forefinger ( Ensures SQ tissue is off underlying muscle)
Insert 25-27 gauge ¾-1in needle with medication ( less than 5mL) at 45 degree angle ( Penetrates dermis)
Aspirate so not in blood vessel and inject slowly

27
Q

what size needle for subcutaneous injection?:

A

25-27 gauge needle

28
Q

4 IM injection sites:

A

Deltoid muscle
Ventrogluteal muscle
Dorsogluteal muscle
Vastus lateralis muscle

29
Q

What size needle for IM injection?

A

22 gauge

30
Q

How to Perform Intramuscular Injections:

A

Clean area with Alcohol pad. Penetrate skin at 90 degree angle. Advance needle 1in into muscle.( obese patient need longer needle)
Aspirate to ensure not in blood vessel.
Administer medication.
Massage site to promote absorption

31
Q

Complications from Injections: (3)

A

Nerve and arterial injury
Abscesses (sterile or septic)
Bleeding (controlled with pressure)

Clin Skills III (8 decks)

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