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HEMATOLOGY > [LAB] Principles of Sample Collection > Flashcards

[LAB] Principles of Sample Collection Flashcards

1
Q

COLLECTION SITES FOR CAPILLARY PUNTURES

A

MIDDLE FINGER
RING FINGER
HEEL (in patients under 6 months)
— Lateral Surface
— Medial Surface
— Plantar Surface

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2
Q

[CAPILLARY PUNCTURE]

TRUE OR FALSE
THE FIRST DROP OF BLOOD SHOULD BE WIPED AWAY

A

TRUE

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3
Q

WHEN PUNCTURING, THE LANCET MUST BE
A. PARALLEL TO THE FINGERPRINT LINES
B. PERPENDICULAR TO THE FINGERPRINT LINES

A

B. PERPENDICULAR TO THE FINGERPRINT LINES

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4
Q

WHAT SOLUTION IS USED TO WIPE THE PUNCTURE SITE CLEAN?

A

70% ETHANOL

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5
Q

ANTICOAGULANT IN CAPILLARY TUBES

A

HEPARIN

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6
Q

IN WHAT SITUATIONS/ UNDER WHAT CONDITIONS ARE YOU TO PERFORM CAPILLARY PUNCTURES

A
  1. When available veins are FRAGILE or must be SAVED for other procedures
  2. Many failed venipunctures
  3. Patient has THROMBOTIC or CLOT-FORMING tendencies
  4. Apprehensive patients or fears needles
  5. No accessible veins
  6. POCT
  7. Burned or scarred patients
  8. Obese patients
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7
Q

WHAT CLINICAL CONDITION MAY RESULT WHEN LARGE AMOUNTS OF BLOOD ARE DRAWN FROM INFANTS?

A

ANEMIA
CARDIAC ARREST

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8
Q

OBTAINING BLOOD FROM INFANTS AND CHILDREN MAY DAMAGE WHAT?

A

VEINS
SURROUNDING TISSUES

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9
Q

PUNCTURING DEEP VEINS MAY RESULTS IN WHAT?

A
  1. Hemmorhage
  2. Venous thrombosis
  3. Infection
  4. Gangrene
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10
Q

WHAT CONDITION IS THE DEATH OF BODY TISSUE DUE TO A LACK OF BLOOD FLOW?

A

GANGRENE

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11
Q

PREFERRED SAMPLE FOR NSTs AND CBGs

A

CAPILLARY BLOOD

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12
Q

IN WHAT TESTS IS CAPILLARY BLOOD USED IN?

A

NEWBORN SCREENING TESTS
CAPILLARY BLOOD GASSES

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13
Q

AT WHAT AGE IS IT APPROPRIATE FOR A HEEL STICK CAPILLARY PUNCTURE TO BE PERFORMED?

A

UNDER 6 MONTHS

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14
Q

AT WHAT AGE IS IT APPROPRIATE FOR A FINGER STICK CAPILLARY PUNCTURE TO BE PERFORMED?

A

ABOVE 6 MONTHS

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15
Q

TRUE OR FALSE
IT IS ACCEPTABLE TO PERFORM CAPILLARY PUNCTURES ON PATIENTS WITH POOR PERIPHERAL CIRCULATION.

A

FALSE

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16
Q

TRUE OR FALSE
CAPILLARY PUNCTURE SHOULDN’T BE PERFORMED ON DEHYDRATED PATIENTS

A

TRUE

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17
Q

UNDER WHAT CONDITION IS IT UNACCEPTABLE FOR CAPILLARY PUNCTURE TO BE PERFORMED

A
  1. Patient is above 6 months old
  2. Dehydration
  3. Poor peripheral circulation
  4. Cold, swollen, scarred, rash-filled fingertips or heels
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18
Q

IS “MILKING” ALLOWED IN CAPILLARY PUNCTURE?

A

NO.
It increases the fluid concentration to blood cells.
Blood specimen is considered to be inaccurate.

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19
Q

WHAT HAPPENS TO THE BLOOD SAMPLE WHEN “MILKING” IS DONE IN CAPILLARY PUNCTURES

A

THE SPECIMEN BECOMES INACCURATE DUE TO THE INCREASE OF TISSUE FLUID CONCENTRATION TO THE BLOOD CELLS

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20
Q

ORDER OF DRAW FOR CAPILLARY PUNCTURE

A
  1. CBG (Yellow)
  2. Slides
  3. EDTA (Purple)
  4. Heparin (Light or Dark Green with Gel Separator)
  5. Sodium Fluoride/ Potassium Oxalate (Gray)
  6. Serum (Red with additive)
  7. Plain Tube ( Red without Additive)

CBG > SLIDES > EDTA > HEPA > SF/PO > SERUM > PLAIN

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21
Q

WHAT IS THE DISTANCE BETWEEN THE TOURNIQUET AND PUNCTURE SITE?

A

2-3 or 4 INCHES
(guys pa check)

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22
Q

WHAT ARE THE THREE COLLECTION SITES FOR VENIPUNCTURE? (IN ORDER OF MOST TO LEAST IDEAL SITE)

A
  1. MEDIAN CUBITAL
  2. CEPHALIC
  3. BASILIC
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23
Q

ANGLE OF NEEDLE INSERTION

A

15 TO 30 DEGREES

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24
Q

WHAT KIND OF VEINS DO PEDIATRIC AND GERIATRIC PATIENTS USUALLY HAVE?

A

FRAGILE
THIN
“ROLLY”

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25
Q

OTHER VENIPUNCTURE SITES

A

SURFACE VEINS OF THE FEET OR BACK OF THE HANDS

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26
Q

TOO LARGE A VACUUM CAUSES THE VEIN TO _____

A

COLLAPSE

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27
Q

SYRINGE VOLUME THAT IS NOT RECOMMENDED

A

LARGER THAN 10-15 ML

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28
Q

WHAT IS THE RELATIONSHIP BETWEEN THE SYRINGE SIZE AND ITS VACUUM?

A

DIRECTLY PROPORTIONAL

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29
Q

WHAT IS THE RELATIONSHIP BETWEEN NEEDLE BORE SIZE AND THE GAUGE NUMBER?

A

INDIRECTLY PROPORTIONAL

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30
Q

ORDER OF DRAW IN VENIPUNCTURE

A
  1. Blood culture tube (Yellow)
  2. Coagulation tube (Blue)
  3. Serum or Plain (Red)
  4. Heparin (Green)
  5. EDTA (Lavender or Pink)
  6. Sodium Fluoride or Oxalate (Gray)

BLOOD CULTURE > COAG > SERUM/PLAIN > HEPA > EDTA > SF/OXALATE

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31
Q

USE OF EVACUATED TUBE SYSTEM

A

FOR LARGE VOLUME COLLECTION
FOR MULTIPLE DRAWS

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32
Q

IS IT OKAY TO USE THE ETS ON SMALL AND FRAGILE VEINS

A

NO

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33
Q

IDEAL LEVEL OF FILLIN THE CAPILLARY TUBE

A

UP TO 3/4 OF THE TUBE

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34
Q

MEANING OF OSHA

A

OCCUPATIONAL SAFETY AND HEALTH ACT/ADMINISTRATION

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35
Q

[PPT] SELECT SITE OF PUNCTURE IN ADULTS

A

FINGERS — END OR SIDE OF THE DISTAL PHALANX
LOBE OF EAR

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36
Q

[PPT] SELECT SITE OF PUNCTURE IN INFANTS

A

GREAT TOE
HEEL
SKIN OF THE FOREARM

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37
Q

SWITCHING FROM A SUPINE TO A STANDING POSITION CAUSES WHAT

A

A SHIFT OF BODY WATER
INCREASED CONCENTRATION OF MOLECULES IN THE BLOOD

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38
Q

THE DIURNAL RYTHM INCREASES WHAT SUBSTANCES IN THE MORNING?

A

CORTISOL
THYROID-STIMULATING HORMNE
IRON

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39
Q

WHEN ARE CORTISOL, TSH, AND IRON LEVELS INCREASED AND DECREASED?

A

INCREASED IN THE MORNING
DECREASED IN THE AFTERNOON

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40
Q

AT WHAT TIME DOES EOSINOPHIL COUNT INCREASE AND DECREASE?

A

INCREASE IN THE AFTERNOON
DECREASE IN THE MORNING

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41
Q

TRUE OR FALSE
BODY WATER SHIFTS FROM THE INTERSTITIAL SPACES TO THE BLOOD VESSELS

A

FALSE

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42
Q

WHAT BLOOD CONSTITUENTS INCREASE DUE TO EXERCISE

A

CREATININE
TOTAL PROTEIN
CK
MYOGLOBIN
WBC COUNT
AST
HDL-CHOLESTEROL

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43
Q

EXCESSIVE CRYING IN CHILDREN CAN CAUSE WHAT?

A

TEMPORARY INCREASE IN WBC COUNT

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44
Q

DURATION OF FASTING

A

8-12 HOURS BEFORE BLOOD DRAW

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45
Q

WHAT SUBSTANCE IS ALLOWED DURING FASTING PERIODS

A

WATER

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46
Q

EFFECT OF INCREASED LIPIDS IN A SAMPLE

A

TURBIDITY DUE TO LIPEMIA

47
Q

WHAT MEASUREMENT OR ASSAY DOES TURBIDITY INTERFERE WITH

A

PHOTOMETRIC MEASUREMENT

48
Q

WHAT DOES SMOKING INCREASE IN BLOOD

A

WBC COUNTS
CORTISOL LEVELS

49
Q

WHAT ARE THE EFFECTS OF LONG TERM EFFECTS OF SMOKING

A

DECREASED PULMONARY FUNCTION
INCREASED HEMOGLOBIN LEVELS

50
Q

WHAT IS THE FUNCTION OF A TOURNIQUET

A

BARRIER AGAINST VENOUS BLOOD FLOW
HELP LOCATE THE VEIN

51
Q

HOW LONG CAN A TOURNIQUET BE LEFT ON A PATIENT FOR

A

NOT MORE THAN 1 MINUTE

52
Q

EFFECT OF LEAVING A TOURNIQUET ON FOR TOO LONG

A

HEMOCONCENTRATION

53
Q

WHAT ARE MOST GLASS TUBES COATED WITH

A

SILICONE

54
Q

FUNCTION OF SILICONE IN GLASS TUBES

A

HELP DECREASE POSSIBILITY OF HEMOLYSIS
PREVENT BLOOD FROM ADHERING TO THE TUBES’ SIDES

55
Q

LENGTH OF SPECIMEN CLOTTING

A

30 TO 60 MINUTES

56
Q

FUNCTION OF GLASS SILICA

A

COAGULATION
ACTIVATED FACTOR XII IN THE COAGULATION PATHWAY

57
Q

FUNCTION OF THROMBIN

A

COAGULATION
CONVERTS FIBRINOGEN TO FIBRIN

58
Q

FUNCTION OF SODIUM FLUORIDE

A

ANTIGLYCOLYTIC AGENT
INHIBIT GLUCOSE METABOLISM

59
Q

INERT MATERIAL THAT UNDERGOES A TEMPORARY CHANGE IN VISCOSITY DURING CENTRIFUGATION

A

SEPARATOR GELS

60
Q

SERVES AS A BARRIER BETWEEN SERUM/PLASMA AND CELLS

A

SEPARATOR GEL

61
Q

MOST COMMON GAUGE USED

A

21 GAUGE

62
Q

CONSISTS OF A SHORT NEEDLE WITH PLASTIC WINGS CONNECTED TO THIN TUBING

A

BUTTERFLY/WINGED COLLECTION SET

63
Q

FUNCTION OF THE RUBBER SLEEVE IN ETS NEEDLES

A

PREVENT BLOOD FROM DRIPPING INTO THE HOLDER

64
Q

GRADUATIONS IN BARRELS ARE IN WHAT UNIT OF VOLUME

A

mL

65
Q

TRUE OR FALSE
AFTER CLEANING THE SITE, THE ALCOHOL MUST BE BLOW DRIED

A

FALSE
SITE MUST AIR DRY

66
Q

SOLUTIONS USED FOR PUNCTURE SITE STERILIZATION

A

1% TO 10% POVIDONE-IODINE PADS
TINCTURE OF IODINE
CHLORHEXIDINE COMPOUNDS

67
Q

MOST COMMON SITE OF VEINS FOR VENIPUNCTURE

A

ANTECUBITAL FOSSA

68
Q

WHAT KIND OF PATTERN DO THE VEINS IN THE ANTECUBITAL FOSSA HAVE

A

“M” PATTERN

69
Q

WHAT VEIN IS THE LAST CHOICE AND WHY

A

BASILIC VEIN
INCREASED RISK OF INJURY AD PUNCTURE OF BRACHIAL ARTERY

70
Q

WHAT VEIN IS THE FIRST CHOICE AND WHY

A

MEDIAN CUBITAL VEIN
VEINS MORE SECURE
LESS PRONE TO ANY ARTERIAL OR NERVE DAMAGE

71
Q

IS FIST PUMPING DURING VENIPUNCTURE ALLOWED? WHY?

A

NO
MUSCLE ACTIVITY INCREASES THE CONCENTRATION OF SOLUTES IN THE BLOOD

72
Q

VENIPUNCTURE SITES TO AVOID

A

VEINS IN THE FEET (UNLESS ALLOWED BY THE PHYSICIAN)
VEINS IN THE INNER WRIST

73
Q

FACTORS TO CONSIDER BEFORE DRAWING BLOOD

A

DIETARY RESTRICTIONS

74
Q

FIRST STEP OF ANY LABORATORY PROCEDURE

A

PATIENT IDENTIFICATION

75
Q

COMPONENT IN TOURNIQUETS THAT MAY CAUSE ALLERGIC REACTIONS

A

LATEX

76
Q

NEEDLE GAUGLE USED IN CHILDREN

A

22-23 GAUGE

77
Q

METHOD USED TO CLEAN PUNCTURE SITES

A

CIRCULAR MOTION
IN TO OUT
guys pa check

78
Q

DISPOSAL CONTAINER FOR NEEDLES AND LANCETS

A

SHARPS CONTAINER

79
Q

BLOOD TO ANTICOAGULANT RATIO IN TUBES FOR COAGULATION TESTING

A

9:1

80
Q

LEAKAGE OF A SMALL AMOUNT OF BLOOD IN TISSUE AROUND THE PUNCTURE SITE

A

ECCHYMOSIS
BRUISE

81
Q

TROUBLESHOOT
ECCHYMOSIS

A

APPLY DIRECT PRESSURE TO THE PUNCTURE SITE WITH A GAUZE PAD
DO NOT BEND THE PATIENT’S ARM

82
Q

LEAKAGE OF A LARGE AMOUNT OF BLOOD AROUND THE PUNCTURE SITE
CAUSES THE AREA TO SWELL

A

HEMATOMA

83
Q

CAUSE OF HEMATOMA

A

NEEDLE GOES STRAIGHT THROUGH THE VEIN
NEEDLE IS PARTIALLY IN THE VEIN

84
Q

PREVENTION OF HEMATOMA

A

APPLY PRESSURE TO THE PUNCTURE SITE

85
Q

OTHER TERM FOR FAINTING

A

SYNCOPE

86
Q

WHAT SUBSTANCE IS NOT RECOMMENDED BY THE CLSI TO REVIVE PATIENTS

A

AMMONIA

87
Q

INCREASED CONCENTRATION OF CELLS, LARGER MOLECULES, AND ANALYTES IN THE BLOOD
DUE TO A SHIFT IN WATER BALANCE

A

HEMOCONCENTRATION

88
Q

RUPTURE OF BLOOD CELLS WITH THE CONSEQUENT ESCAPE OF HEMOGLOBIN

A

HEMOLYSIS

89
Q

APPEARANCE OF SERUM IN HEMOLYZED SAMPLE

A

PINK OR RED

90
Q

CAUSES OF HEMOLYZED SAMPLES

A

DRAWING BLOOD THROUGH EXISTING HEMATOMA
PULLING THE PLUNGER TOO QUICKLY
SPECIMEN CONTAMINATED WITH ALCOHOL OR WATER AT THE VENIPUNCTURE SITE

91
Q

TEST RESULTS ALTERED BY HEMOLYZED SAMPLES

A

POTASSIUM
LACTATE DEHYDROGENASE
ASPARTATE AMINOTRANSFERASE

92
Q

SHARP PAIN, SHOOTING, TINGLING, OR NUMBNESS IN THE ARM

A

NERVE DAMAGE

93
Q

SWELLING DUE TO ABNORMAL ACCUMULATION OF FLUID

A

EDEMA

94
Q

VEINS ARE NEITHER PALPABLE OR PROMINENT IN THIS KIND OF PATIENT

A

OBESE

95
Q

LIMITS OF USING A BP CUFF

A

SHOULD NOT BE INFLATED HIGHER THAN 40 MMHG
SHOULD NOT BE LEFT FOR LONGER THAN 1 MINUTE

96
Q

SITES THAT SHOULD BE AVOIDED BECAUSE THEY DO NOT ALLOW BLOOD TO FLOW FREELY

A

VEINS THAT WERE:
BURNED
DAMAGED
SCARRED
OCCLUDED

97
Q

WHAT TO DO WHEN DRAWING FROM A PATIENT UNDERGOING INTRAVENOUS THERAPY

A

AVOID ARM WITH THE IV INSERTION — IF NOT POSSIBLE, DRAW BELOW THE IV SITE
DRAW ON OPPOSITE ARM
ASK NURSE/HCW TO STOP THE INFUSION FOR 2 MINUTES BEFORE DRAWING BLOOD
NOTE ON REQUISITION FORM

98
Q

HOW LONG SHOULD THE IV INFUSION BE STOPPED BEFORE DRAWING BLOOD

A

2 MINUTES

99
Q

[TROUBLESHOOTING]
NEEDLE INSERTED THROUGH THE VEIN

A

WITHDRAW THE NEEDLE

100
Q

[TROUBLESHOOTING]
PARTIAL NEEDLE INSERTION

A

INSERT THE NEEDLE FURTHER

101
Q

[TROUBLESHOOTING]
BEVEL RESTING ON VEIN WALL

A

ADJUST ANGLE OF NEEDLE INSERTION

102
Q

INFANT HEEL PUNCTURE DEPTH

A

NOT MORE THAN 2 MM DEEP

103
Q

WHY SHOULDN’T A HEEL PUNCTURE BE DEEPER THAN 2 MM

A

RISK OF BONE INJURY AND INFECTION (OSTEOMYELITIS)

104
Q

SHAKING THE SAMPLE CAN RESULT IN

A

HEMOLYSIS

105
Q

EXPOSURE OF BLOOD SPECIMEN TO LIGHT CAN CAUSE

A

FALSELY DECREASED VALUES OF:
BILIRUBIN
BETA-CAROTENE
VITAMIN A
PORPHYRINS

106
Q

IS SPECIMEN CHILLING ALLOWED

A

NO

107
Q

TESTS THAT CHILL SPECIMENS

A

AMMONIA
LACTIC ACID
PARATHYROID HORMONE
GASTRIN

108
Q

[REJECT OR ACCEPT]
HEMOLYZED SPECIMEN

A

REJECT

109
Q

[REJECT OR ACCEPT]
SPECIMEN COLLECTED AT THE WRONG TIME

A

REJECT

110
Q

[REJECT OR ACCEPT]
CLOTTED SPECIMEN FOR TESTS REQUIRING WHOLE BLOOD OR PLASMA

A

REJECT

111
Q

[REJECT OR ACCEPT]
COMPLETELY LABELED SPECIMEN

A

ACCEPT

112
Q

[REJECT OR ACCEPT]
LIPEMIC SPECIMEN

A

REJECT**
Cannot be used for certain tests

113
Q

[REJECT OR ACCEPT]
SPECIMEN CONTAMINATED WITH IV FLUID

A

REJECT

HEMATOLOGY (13 decks)

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