CLINICAL CHEMISTRY Flashcards
Common site for venipuncture
ANTECUBITAL FOSSA
Preferred vein for venipuncture
Median cubital vein
Second choice vein and often the only vein felt in obese patients
CEPHALIC VEIN
Last choice
Not well anchored and rolls easily
Increased risk of puncturing a median cutaneous nerve branch or the brachial artery
Not recommended unless no other vein in either arm is more prominent
BASILIC VEIN
T or F
veins on the back of the hand and wrist may also be used for venipuncture
TRUE
T or F:
veins on the underside of the wrist, however, should never be used for venipunciure.
Leg, ankle, and foot veins are sometimes used but not without permission of the patient’s physician, due to a potential for significant medical complications.
TRUE
The time it takes for SERUM to clot?
Centrifugation approx.______
30 minutes
10 minutes at an RCF of 1000-2000 g
What sample use for emergency cases? Why?
HEPARINIZED PLASMA
- Stat and other tests requiring a fast turnaround time (TAT) are often coilected in tubes containing heparin anticoagulant because they can be centrifuged immediately to obtain plasma.
Used for most hematology tests and many POCT’s
WHOLE BLOOD
Preferred method for venipuncture
ETS
Application of tourniquet must NOT BE LEFT on LONGER than ______
Tourniquet size________ wide and ______long
<1 minute
1 inch wide x 15 inch long
Gauge and bore relationship
INVERSELY related
Considered standard gauge for routine venipuncture
21 gauge
Preferred needle length
1 inch- provides better control
Preferred needle gauge for pediatric patients
23 gauge
handheld medical device that helps medical staff visualize veins before phlebotorny
AccuVein
Accuvein emits what light and held about _____ over the potential pheb site.
INFRARED light; 7 inches
Tube that can activate coagulation pathway (intrinsic)
Red (glass)- negatively charge
Preferred anticoagulant for PBS
K3 EDTA in liquid form
Preferred anticoagulant for hematology
K2 EDTA/ spray-dried
Tube in blood banking
Pink
Molecular diagnostics
White
What is the anticoagulant used in light blue top?
2 concentration:
______
______
What concentration has the risk for over-anticoagulation and used primarily to patients having hight HCT. ?
Inversion:______
Sodium citrate
3.2%
3.8%
3.8%
3-4x
Tube for ESR?
Blood to anticoagulant ratio
Black
4:1
Green, light green/black anticoagulant: ______
The universal anticoagulant
Sodium heparin, lithium heparin
—-can administer IV to patients
Least interferences
Contains sodium heparin, EDTA
For toxicology
Royal blue
Gray tube anticoagulant?
Gray tube additive?
Potassium oxalate
Sodium fluoride
Sterile containing sodium polyanetholsulfonate
Yellow
Binds Mg2+ thus inhibiting the Mg dependent enzyme, enolase
Sodium fluoride
Containes ACD, for blood banking, HLA phenotyping and paternity testing
Yellow
Tan (glass) contains?
Sodium heparin
- for plasma/lead testing
-Inhibits thrombin formation
Tan (plastic) contains?
K2EDTA
Plasma lead testing
Chelates(binds) calcium
Thrombin containing tube
A clot activator
Yellow/gray and orange
5 minutes-clotting
Preferred specimen for newborn screening test
Capillary blood
Length of lancet
<2.0 mm to avoid penetrating bone
Sites for capillary puncture?
- Palmar surface of 3rd and 4th fingers
- Lateral plantar heel surface (preferred for newborn)
- Earlobes
For blood gas analysis and pH measurements
Arterial puncture
Are used instead of evacuated tubes because of the pressure in an arterial blood vessel
Syringes
Preferred anticoagulant in arterial puncture
Heparin
Primary arterial sites (in order of preferences)
- Radial
- Brachial
- Femoral arteries
Major complications of arterial puncture
Thrombosis
Hemorrhage
Infection
Done before collection of arterial blood from radial artery
Modified allen test
Array of signs and symptoms resulting from increased cortisol
Cushing syndrome
Increased ACTH from the pituitary gland resulting to increased cortisol
Cushing disease
