Laboratory Activity 2: BLOOD COLLECTION: Venous & Capillary Puncture

Question 1

is an integral part of medical laboratory practice.

Answer 1

Phlebotomy

Question 2

It is one of the most common invasive procedures in health care.

Answer 2

Phlebotomy

Question 3

It is therefore good to remember that no laboratory procedure will be any better than the quality of the specimen that is being tested.

Answer 3

Phlebotomy

Question 4

Each step in the process of phlebotomy affects the(?) and is thus important for preventing laboratory error and patient injury.

Answer 4

quality of the specimen

Question 5

Regardless of the blood collection method, the goal is to obtain an(?) from the correct patient into the correct collection tube and with minimal trauma.

Answer 5

appropriate blood sample

Question 6

1. Verify (?) and check (?). Ask the patient for his or her (?).

Answer 6

requisition form
patient identification
full name, address and/or date of birth

Question 7

2. If a (?) or a dietary restriction is required, confirm that patient has fasted or eliminated foods from diet as ordered by physician.

Answer 7

fasting specimen

Question 8

3. (?) the patient properly. Assemble equipment and supplies.

Answer 8

Position

Question 9

4. Apply a (?) and ask the patient to make a fist without vigorous hand pumping. Select a suitable vein for puncture.

Answer 9

tourniquet

Question 10

5. Put on(?) with consideration of latex allergy for the patient.

Answer 10

gloves

Question 11

6. Cleanse the venipuncture site with (?). Allow the area to dry.

Answer 11

70% isopropyl alcohol

Question 12

7.(?) the vein firmly.

Answer 12

Anchor

Question 13

8. Enter the skin with the needle at approximately a (?)angle or less to the arm, with the bevel of the needle up:

Answer 13

15 30°

Question 14

a. Follow the (?) of the vein with the needle.
b. Insert the needle (?) to minimize patient discomfort.

Answer 14

geography
smoothly and fairly rapidly

Question 15

• pull back on the barrel with a slow, even tension as blood flows into the syringe. Do not pull back too quickly to avoid hemolysis or collapsing the vein.

Answer 15

c. (Syringe/Open-system)

Question 16

• as soon as the needle is in the vein, ease the tube forward in the holder as far as it will go, firmly securing the needle holder in place. When the tube has filled, remove it by grasping the end of the tube and pulling gently to withdraw, and gently invert tubes containing additives.

Answer 16

d. (Evacuated tube system/ETS)

Question 17

9. Release the tourniquet when blood begins to flow. Never withdraw the needle without removing the (?).

Answer 17

tourniquet

Question 18

10. (?), and then apply pressure to the site. Apply adhesive bandage strip over a cotton ball or gauze to adequately stop bleeding and to avoid a hematoma.

Answer 18

Withdraw the needle

Question 19

11. (?) tubes with anticoagulant; do not shake the tubes. Check (?). (?) in designated containers (sharps container) using Universal Precautions.

Answer 19

Mix and invert
condition of the patient
Dispose of contaminated material

Question 20

12. Label the tubes before leaving patients side with:

Answer 20

a. Patients first and last name
b. Identification number
c. Date of collection
d. Time of collection
e. Identification of person collecting specimen

Question 21

13. (?) of blood for testing to appropriate laboratory section or central receiving and processing area.

Answer 21

Deliver tubes

Question 22

3. Select an appropriate puncture site.
   a. For infants younger than 12 months old, this is most usually the (?).
   b. For infants older than 12 months, children, and adults, the (?) may be used.
   c. The (?) must not be used, and the site of puncture must not be edematous or a previous puncture site because of accumulated tissue fluid.

Answer 22

lateral or medial plantar heel surface
palmar surface of the last digit of the second, third, or fourth finger
thumb and fifth finger

Question 23

4. Warm the puncture site with a warm, moist towel no hotter than(?); this increases the blood flow through arterioles and capillaries and results in arterial-enriched blood.

Answer 23

42°C

Question 24

5. Cleanse the puncture site with (?). Allow the area to dry. Do not touch the swabbed area with any nonsterile object.

Answer 24

70% aqueous isopropanol solution

Question 25

6. Make the puncture with a sterile lancet or other skin-puncturing device, using a (?) to the skin surface. For a heel puncture, hold the heel with the (?) proximal to the puncture site at the ankle. If using a lancet, the blade should not be longer than (?) to avoid injury to the calcaneus (heel bone).

Answer 25

single deliberate motion nearly perpendicular
forefinger at the arch and the thumb
2 mm

Question 26

7. (?) by wiping it away with a sterile pad. Regulate further blood flow by gentle thumb pressure. (?) the site, as this may cause hemolysis and introduce excess tissue fluid.

Answer 26

Discard the first drop of blood
Do not milk

Question 27

8. Collect the specimen in a suitable container by capillary action.
   a. (?) are available for collection of non-anticoagulated blood and with additives for whole blood analysis.
   b. (?) are most often used up to volumes of 200 L. (Both heparinized and non-heparinized micropipettes are available).
   c. Use the appropriate (?) for the test ordered. Mix the specimen as necessary.

Answer 27

Closed systems
Open-ended, narrow-bore disposable glass micropipettes
anticoagulant

Question 28

9. (?) and dispose of the puncture device.

Answer 28

Apply pressure

Question 29

10. (?) of the patient. Dispose of contaminated materials in designated containers (sharps container) using Universal Precautions.

Answer 29

Check condition

Question 30

11. Label the specimen container with (?).

Answer 30

date and time of collection and patient demographics

Question 31

12. Indicate in the (?) that test results are from skin puncture.

Answer 31

report