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Immunohematology Lab > EXPERIMENT 2, 3, 4 > Flashcards

EXPERIMENT 2, 3, 4 Flashcards

1
Q

Activity 4:
= POSITIVE FOR HEMOLYSIS
= NEGATIVE FOR HEMOLYSIS

A

5% RCS + Distilled water

5% RCS + NSS

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2
Q

Tourniquet Application

A

3 to 4 inches (7.5 to 10 cm)

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3
Q

Tourniquet Alternative: (?) not more than 1 min (hemolysis, hemoconcentration, patient discomfort)

A

blood pressure cuff (40-60 mmHg)

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4
Q

Venipuncture Site Cleansing:
Allow the area to dry for at least

A

30 seconds

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5
Q

Vein Anchoring and Needle Insertion:

A
  1. Median
  2. Cephalic
  3. Basilic
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6
Q

Post-Procedure Steps:
Apply pressure stop bleeding: inadequate pressure causes hematoma for at least

A

2 mins

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7
Q

Mix and Invert anticoagulant tubes
 EDTA:
 Blue top:

A

 EDTA: 8
 Blue top: 3-4

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8
Q

WASTE DISPOSAL
Black –
Green –
Yellow -

A

Black – Non-infectious Dry Waste
Green – Non-infectious Wet Waste
Yellow - Infectious and Pathological Waste

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9
Q

The quality of each test will always begin with how the (?) is collected.

A

specimen

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10
Q

Presence of (?) may lead to error

A

clot

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11
Q

• Various factors prior to testing can be considered as an (?), which can cause false readings during the test.

A

interference

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12
Q

•Anything related to the collection of specimens for testing is considered as a

A

pre-analytical procedure.

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13
Q

can arise from factors that could alter the quality of the specimen used.

A

• Pre-analytical errors

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14
Q

• is the main specimen used in the Blood Bank laboratory.

A

Blood (as whole blood)

 Anticoagulated tube

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15
Q

• Other specimens can be produced from a single (?) that can be used for immunologic testing for blood bank procedures.

A

whole blood sample

 Whole blood - plasma, RCS

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16
Q

• Prior to collecting blood samples, an MLS must check first the conditions for extracting samples from a patient.

A

 Lab form/request

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17
Q

• An MLS is given a (?) that would contain the information of the patient.

A

laboratory test requisition form (a.k.a. lab request form)

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18
Q

• The request form will contain the following information:

A

 Patient name, age/sex, hospital/case number
 Patient Diagnosis
 Urgency of test result (Routine, STAT)
 Tests to be done, or test requested
 Fields for date and time of specimen collection

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19
Q

•The list of tests requested will give you an idea on what equipment should you bring.

A

 Basic phlebotomy kit
 PPEs (Gloves, mask, etc.)
 Cleansing sets (alcohol, iodine, benzalkonium chloride, swabs and cotton balls)
 Disposal containers

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20
Q

must allow for the proper collection of blood samples for testing.

A

• The phlebotomy kit/materials

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21
Q

is more preferrable over a syringe for multiple tube collections.

A

• A multisample needle (a.k.a. 2-way needle)

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22
Q

 Less risk for needle pricking
 Samples are less exposed to environmental contaminants

A

• multisample needle (a.k.a. 2-way needle)

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23
Q

is advisable only if the patient requires a needle that is “different” from the size of the routine gauge needle.

A

syringe

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24
Q

• Routine needle gauge sizes range from (?), with a length of

A

21G - 23G

1” - 1 ½”

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25
Q

may also be used for small, friable veins.

A

• A butterfly needle setup

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26
Q

• OSHA mandates that safety features must be present in phlebotomy devices to minimize phlebotomy-borne injuries:
 (safety)
 (attached to adapter)
 (green; ejection of the tube)

A

Re-sheathing devices for needles

Flanges on tube holders

One-press release mechanisms on tube holders

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27
Q

are the main containers for blood samples.

A

• Evacuated tubes

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28
Q

• Tubes contain additives that would preserve the following:

A

• State of fluidity (clotted, clot-free)
• Soluble contents of blood (e.g. glucose, calcium, proteins)
• Various blood cells
• Volume of blood sample

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29
Q

• Evacuated tubes also have (?) within that would aspirate blood without the need for manual aspiration.

A

negative pressure (vacuum)

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30
Q

• Vacuum within the tubes would collect the required amount of blood, considering the amount of (?) within the tube.

 Unsuccessful: altitude may be a factor

A

additive

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31
Q

• Tube Hemogard® and, sometimes the (?), are colored, to easily note the phlebotomist the contents of the tube.

A

rubber stopper

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32
Q

• This can also aid the phlebotomist in the (?) for blood samples with the tubes.

A

Order of Draw

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33
Q

Glycolysis -
refrigerate -

A

lowers 7mg/hr

lowers 2 mg/dL/hr

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34
Q

are advisable to be worn whenever confronting a patient.

A

• Personal Protective Equipment (PPE)

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35
Q

• This must first protect the wearer, then must protect the patient second.

A

• Personal Protective Equipment (PPE)

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36
Q

will ensure that the user will have better protection than if it is not donned.

A

• Proper donning of PPEs

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37
Q

require wearing of gloves when performing phlebotomy.

A

• OSHA Bloodborne Pathogen Standard

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38
Q

• A new pair must be worn when handling each patient.

A

• Personal Protective Equipment (PPE)

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39
Q

as a nonrecommended material for medical practice

A

latex gloves

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40
Q

can also cause contamination and even allergies, thus it is not recommended.

A

• Powdered gloves

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41
Q

• Materials commonly used in gloves are the following:

A

 Nitrile
 Neoprene
 Polyethylene
 Vinyl

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42
Q

must fit the hands of the wearer snuggly

A

• Gloves

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43
Q

must also be used prior and after the patient has been handled.

A

• Disinfectants and antiseptics

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44
Q

must not interfere with the test that will be done on the sample.

A

proper disinfectant

45
Q

is considered the routine for antiseptic procedures.

A

• 70% isopropyl alcohol

46
Q

is used for a higher degree of antisepsis.

A

Povidone iodine

47
Q

used for blood culture

A

Povidone iodine

48
Q

Examples of Antiseptics Used in Blood Collection

A

• 70% Ethyl alcohol
• 70% isopropyl alcohol (isopropanol)
• Benzalkonium chloride (eg. Zephran chloride)
• Chlorhexidine
• Hydrogen peroxide
• Povidone-lodine (0.1% to 1% available iodine)
• Tincture of iodine

49
Q

must always be at the ready when collecting samples.

A

• Disposal containers

50
Q

• Containers must be labelled with the (?) to determine the nature of waste within.

A

biohazard symbol

51
Q

• must also be present to dispose of sharp materials.

A

Sharps containers

52
Q

• Most have a red-colored body.

A

• Sharps containers

53
Q

• It must not be overfilled as well.

A

• Sharps containers

54
Q

• Must be leak-proof, rigid, puncture-resistant, and must have a locking mechanism.

A

• Sharps containers

55
Q

are also necessary when labelling samples.

A

•Pens

56
Q

• Must be indelible.

A

Pens

57
Q

are also helpful when determining the time the sample was collected

A

• Watches

58
Q

• Helpful for time-sensitive tests as well.

A

• Watches

59
Q

must be available as well should there be a need to produce blood smears/films.

A

• Precleaned slides

60
Q

is very crucial in specimen collection.

A

• Patient identification

61
Q

• The phlebotomist must correctly identify the patient to be collected from to provide accurate results.

A

• Patient identification

62
Q

can directly ask the patient (and if possible, ask to verify) name and other info.

A

• Phlebotomists

63
Q

must also build rapport with the patient to provide a good and pleasing service.

A

• Phlebotomists

64
Q

What if the patient is unconscious?
• Check if the patient has a (?). Ask the watcher for the patient’s info and verify. Ask for any identifications to accurately identify the patient.
• (?) can also be used to identify patients.
• If still in doubt, ask the (?) attending to the patient.
• Always inform the patient of the (?) done to him/her; explain what is the purpose of collecting blood at the moment.
• Ask the patient as well of any (?) concerning the materials that you are using.

A

watcher

ID wrist bands

nurse

procedure/s

allergies

65
Q

• If fasting procedures are needed, ask the patient if they had adhered to the recommended

A

fasting time.

66
Q

• After gaining the trust of the patient, get the (?) of the patient; ask if you can get blood from them.
• If the patient hesitates, convince the patient of the need to collect blood but convince calmly.
• If the patient still hesitates, it’s best to stop convincing. Inform the nurse of the situation.

A

consent

67
Q

is the primary site for blood collection.

A

antecubital fossa

68
Q

Three major veins may be accessed at this site:

A

 Median vein/Median Cubital vein (most preferred)
 Cephalic vein
 Basilic vein – nerves

69
Q

• Veins can be made more prominent and palpable by using a

A

tourniquet

70
Q

• After choosing the vein, assemble and check the phlebotomy set and (?) the site to be punctured

A

cleanse

71
Q

• It is preferrable to (?) first before assembly.

A

cleanse

72
Q

• The most important aspect of cleansing is applying (?).

A

friction

73
Q

• Needles must be free from (?). Check the syringe plunger can be pulled.

A

burrs

74
Q

• Note that after (?), do not touch the site again with your fingers.

A

cleansing

75
Q

• If you are prepared, you may (?) the patient that you will begin with the procedure.

A

inform

76
Q

• Re-apply the tourniquet, tout the skin below the site to (?) the vein.
• Estimate a (?) angle from the skin to the needle.
• With a (?), insert the needle.
• Establish (?). If the needle is equipped with a flashback or clear hub, check if blood went in the hub.

A

anchor

15° - 45°

single, smooth, quick motion

blood flow

77
Q

• Slowly pull back the syringe plunger to aspirate blood. If using an (?), equip the evacuated tube at the other end of the multisample needle.

A

POST-LAB ETS

78
Q

• REMEMBER THE ORDER OF DRAW, ESPECIALLY WHEN USING THE (?)!

A

ETS

79
Q

• Make sure that the (?) within the tube is exhausted before removing. Do not overfill, do not underfill.

A

vacuum

80
Q

• (?) the tubes once filled with blood according to the recommended number of inversions

A

Invert

81
Q

• Once the procedure is finished, remove the (?) first (if not yet removed), followed by the (?) (if using ETS), then the (?) with a smooth but quick motion.

A

tourniquet

tube

needle

82
Q

• If any (?) is present on the needle, apply it ASAP.

A

safety device

83
Q

SPECIMEN COLLECTION: NOTES
• Always treat your patients like one of your (?).
• Ensures better interaction now and even on future interactions.
• Make sure that when collecting, (?) are avoided (can be a sign that the needle is not inserted well; can cause hemolysis on the sample)

A

relatives

bubbles

84
Q

• The order of draw must be followed to avoid carry-over of additives.
 Most:
 least:

A

 Most: EDTA
 least: Heparin

85
Q

• may be necessary on patients who are uncooperative or have impulsive movements.

A

Restraints

86
Q

• Avoids injury on the patient that can cause legal problems in the future.

A

Restraints

87
Q

are rarely, if not, unused in blood banks.

A

• Icteric samples

88
Q

Presence of bilirubin

A

• Icteric samples

89
Q

• As well as (?) and samples with observable hemolysis.

A

lipemic

90
Q

• Some analytic procedures in the blood bank (i.e. hemoglobin determination) are read spectrophotometrically, thus (?) are not advised.

A

icteric and lipemic samples

91
Q

• As for hemolysis, some tests would consider hemolysis as (?).

A

positive reactions

92
Q

Ensure an amount of blood is drawn corresponding to the volume of the

A

additive/anticoagulant.

93
Q

Anticagulated (EDTA) Optimum Blood-to-Additive Ratio =

A

1:9

94
Q

(?) to the line indicated on the evacuated tube label. Do not overfill

A

Fill the tube

95
Q

In the Blood Bank laboratory, various samples derived from blood are used for (?).

A

immunologic purposes

96
Q

The following are the different samples used in the Blood Bank laboratory, together with its sources and uses.

A

 Serum - clotted
 Plasma - unclotted/anticoagulated

97
Q

SERUM AND PLASMA
Collected by:

A

Routine venipuncture (mixed with anticoagulant)

98
Q

SERUM AND PLASMA Uses:

A

 Detecting antibodies
 ABO Reverse typing
 Antibody Screen and Identification
 Screening for Transfusion
 Transmissible Infections (TTI’s)

99
Q

RED CELL SUSPENSION Prepared by:

A

 Washing RBCs from tube segments or centrifuged whole blood samples
 Makes use of normal saline solution (NSS) as a washing and a suspending liquid (0.85-0.9%)
 Conventional RCS preparations for tube method testing would have a characteristic “tomato red” color.

100
Q

RED CELL SUSPENSION Uses:

A

 As reagent cells
 As sample cells
 Crossmatch procedures (Tube and card)

101
Q

 As reagent cells

A

o ABO Reverse typing (Tube and card method)
o Antibody screen
o Antibody Identification

102
Q

 Crossmatch procedures (Tube and card)

A

o ABO Forward Typing and Rh Typing (Tube and card method)

103
Q

RED CELL SUSPENSION Concentrations:

A

 2% - 5%
 0.8%

104
Q

: for tube method procedures; allows for better visualization in test tube procedures

A

 2% - 5%

105
Q

: for gel card methods; often commercially made

A

 0.8%

106
Q

RCS Requires the following reagents:

A

o 0.85% Physiological Saline Solution
o Centrifugated anticoagulated whole blood

107
Q

RCS Vessels that may be used:

A

o Graduated centrifuge tubes
o Test tube
o Reagent antiserum vial with droppers

108
Q

varies per protocol, but must meet standards

A

RCS concentration

109
Q

RCS
 Determine first the (?)
 Consider the (?) of the containment vessel before preparing
 It’s best to (?) first before preparing
 (?) may require CLS to determine first the antigens present

A

percentage

capacity

calculate

Reagent RCS

Immunohematology Lab (3 decks)

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