Lecture 12b - Specimen Collection Part 2

Question 1

In vivo

Answer 1

Inside of the body (blood in liquid form)

Question 2

In vitro

Answer 2

Outside of the body (solid form)

Question 3

What are the three layers present within a centrifuged SST tube?

Answer 3

Serum, gel separator, and clotted RBCs.

Question 4

What are the three layers present within a centrifuged plasma tube?

Answer 4

Plasma, buffy coat, and erythrocytes (RBCs)

Question 5

What kind of education/training is needed to become a phlebotomist?

Answer 5

Typically on the job trained, but certificate programs are available.

Question 6

What are three types of venipuncture techniques?

Answer 6

1. Vacutainer
2. Syringe Method
3. Butterfly

Question 7

Where are the two common locations on the body where capillary blood is drawn?

Answer 7

1. Finger

2. Heel

Question 8

How does the gauge size relate the the size of the needle?

Answer 8

The larger the gauge size, the smaller the inner diameter.

Question 9

What type of safety control is a vacutainer hub?

Answer 9

An engineering control - protects user from accidental needle sticks.

Question 10

What is a advantage and disadvantage of using the butterfly method for venipuncture?

Answer 10

Smaller gauge needle may take longer, but needs to be saved for elderly patients/patients with small veins.

Question 11

For venipuncture, what implied consent is used?

Answer 11

Arm out

Question 12

How many verbal patient identifiers must be given prior to collecting lab samples?

Answer 12

Two; first and last name and DOB.

Question 13

Can an armband be used to confirm patient identity?

Answer 13

Yes, but you still need two verbal identifiers.

Question 14

(T/F) A patient can never refuse a blood draw.

Answer 14

False, a patient can always refuse.

Question 15

Hematoma

Answer 15

Collection of blood under the skin which can be caused by needle bevel is half in the vein and half in the tissue, or premature needle removal.

Question 16

Where should you label patient specimens?

Answer 16

Always label in the presence of the patient.

Question 17

At what stage of the venipuncture process should you invert anticoagulant tubes?

Answer 17

While you are applying the bandage and cleaning up supplies.

Question 18

Where do you draw blood if the antecubital veins have an H pattern orientation?

Answer 18

Median Cubital Vein

Question 19

Where do you draw blood if the antecubital veins have an M pattern orientation?

Answer 19

Median Vein

Question 20

What are some special considerations and areas to avoid when selecting a vein?

Answer 20

1. Arteries
2. IV Lines
3. Edema
4. Scarring or Burn Patients
5. Dialysis Patients
6. Mastectomy Patients
7. Tendons

Question 21

What are some special considerations for Mastectomy patients?

Answer 21

If lymph nodes were removed, you should draw on the opposite side.

Question 22

In what order should evacuated tubes be collected?

Answer 22

Light yellow (SPS); Light Blue Top; Red Top; SST (gold); PST (mint); Dark Green; Lavender; Gray

Stop Light Red Stay Put Green Light Go

Question 23

If a wrong tube was collected, what adverse effect on test results could occur?

Answer 23

1. Assay interference
2. Constituent removal
3. Effect on enzymes
4. Alteration of cellular structures
5. Incorrect amount of anticoagulant

Question 24

In what circumstances should a capillary stick be used?

Answer 24

1. Neonatal testing
2. Blood glucose testing
3. Hard sticks

Question 25

What are some advantages of capillary sticks?

Answer 25

1. Small sample size –> Common for POC testing

2. Hard draws

Question 26

What are some disadvantages of capillary sticks?

Answer 26

1. Specimen acceptability

2. Small sample size

Question 27

(T/F) When doing a capillary stick procedure, the position of the lancet blade should be parallel to the whirls on the finger?

Answer 27

False, you should always be perpendicular.

Question 28

Hemolysis

Answer 28

Rupture of the RBC membrane, releasing hemoglobin into the plasma/serum.

Question 29

What are the common causes of hemolysis?

Answer 29

1. Pulling back too fast on a syringe
2. Forcing blood into an evacuated tube
3. Excessive trauma during venipuncture

Question 30

What test(s) can hemolysis cause a false increase?

Answer 30

Potassium and certain enzymes

Question 31

What is a lipemic specimen?

Answer 31

Serum/plasma with the presence of excess fats or lipids. Has a milky white color.

Commonly caused by blood draw too close to a meal, or very high lipid levels.

Test affected: triglycerides, cholesterol, etc.

Question 32

What is an icteric specimen?

Answer 32

Serum/plasma with the presence of excess bilirubin. Has a brownish-yellow color.

Caused by excessive intravascular hemolysis, obstruction of the bile duct, or impairment of the liver.

Test affected: Photometric assays

Question 33

How does temperature affect specimen stability?

Answer 33

Lower the temperature, the greater the specimen stability.

Question 34

What specimen storage is most common?

Answer 34

Refrigeration

Question 35

What happens to RBCs if they are frozen?

Answer 35

They get lysed

Question 36

How should bilirubin samples be stored?

Answer 36

Protected from light

Question 37

(T/F) Serum/plasma must be removed from RBCs prior to storage?

Answer 37

True