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mt 12 > Lesson 3 > Flashcards

Lesson 3 Flashcards

1
Q

The first step in most laboratory analysis.

A

Specimen Collection

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2
Q

Can be measured by the proper specimen collection and handling.

A

Accuracy and Precision

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3
Q

Test results are therefore said to be _____.

A

As good as sample collection and handling

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4
Q

Identification procedure for conscious patients

A
  • verbally ask their full names,
  • verify it using the identification bracelet (which includes first and last name, hospital number/unit number, room/bed and
    physician’s name)
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5
Q

Identification procedure for sleeping patients

A
  • They must be awakened before blood collection
  • Identified same as conscious patients
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6
Q

Identification procedure for unconscious/mentally incompetent patients

A
  • identified by asking the attending nurse or relative;
    -ID bracelet
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7
Q

Identification procedure for infants and children

A
  • Nurse or relative may identify the patient
  • ID bracelet
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8
Q

Identification procedure for outpatient patients

A
  • verbally ask their full name, DOB
  • counter check with driver’s license or ID with photo
  • If the patient has ID card or bracelet, same manner as with hospitalized patients.
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9
Q

Characteristics of Blood

It is in fluid form in ___ due to the ____, but in ___ it coagulates within ____.

A
  • vivo
  • naturally circulating anticoagulants
  • vitro
  • 5-10 minutes
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10
Q

Characteristics of Blood

►Red in color due to ___
►A ph average of ___
►Thick and viscous, ____ times thicker than water.
►For adult males, they have approx. ___ liters of blood
►For adult females, have ___ liters of blood

A
  • hemoglobin
  • 7.4
  • 3.5 – 4.5
  • 5-6
  • 4 to 5
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11
Q

What is the composition of blood?

A
  • Liquid Portion
    ~ Plasma
    ~ Serum
  • Solid Portion
    ~ RBCs
    ~ WBCs
  • Gaseous Portion
    ~ exchange between O2 and CO2
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12
Q

Liquid portion of the unclotted blood with the protein fibrinogen

A

Plasma

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13
Q

Liquid portion of the clotted blood without the fibrinogen.

A

Serum

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14
Q

This is converted to fibrin for clot formation

A

fibrinogen (protein)

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15
Q

WBCs

Increase during bacterial infection

A

Neutrophil

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16
Q

WBCs

Increase during parasite (parasitic infection) and in some allergies

A

Eosinophil

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17
Q

WBCs

Increase during severe allergies

A

Basophil

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18
Q

WBCs

Increase during viral infection

A

Lymphocyte

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19
Q

WBCs

Increase during chronic infection

A

Monocyte

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20
Q

WBCs

Considered as “cleaners”

21
Q

Capillary blood specimen is a mixture of?

A
  1. Arterial blood (Bright Red-Oxygenated)
  2. Venous blood (Dark Red- Deoxygenated)
  3. Capillary blood
  4. Interstitial blood
  5. Intracellular fluid
22
Q

Capillary blood specimen

This is more abundant in capillary blood.
Why?

A

Arterial (Oxygenated) Blood

  • because of the higher arterial pressure in the extremities
23
Q

Skin/Capillary Puncture

A fingerstick to obtain blood for routine laboratory analysis is usually preferred for
____.

24
Q

Length of the lancet

A

1.75mm (needle)

25
The depth of the incision should be ____ for children and ____ for adults. Why?
- <2.0mm - <2.5 mm - the depth of incision matters (in babies, their bone may be hit which can result to osteomyelitis [inflammation of bone? due to bacterial infection])
26
The cut should be oriented _____ the fingerprints to generate a large drop of blood using single deliberate motion.
- across or perpendicular
27
Preferred sites for Skin Puncture
1. Lateral (or medial) plantar heel surface 2. Palmar surface of the non dominant fingers (3rd and 4th fingers) – most common 3. Plantar surface of the big toe 4. Earlobes – least preferred site
28
Sites to avoid for Skin Puncture
►Inflamed and pallor areas ►Cold and cyanotic areas ►Congested and edematous areas ►Scarred and heavily calloused areas
29
Advantages of Skin Puncture
►It is accessible to the operator ► Easy to manipulate ►Ideal for peripheral blood smears. ► It is less painful due to lesser nerve endings. ► There is more free flow of blood due to thinner skin layer. ► Less tissue juice contamination due to lesser tissues and muscle (earlobe).
30
Disadvantages of Skin Puncture
►Less amount of blood can be obtained ►Additional and repeated test cannot be done ►Blood obtained has tendencies to hemolyze easily.
31
Why does edematous needs to be avoided?
- area is filled with tissue fluid that dillutes the sample which causes a false decrease in glucose and electrolytes
32
CLSI recommends using _____ to clean capillary bed of the skin with a lancet or other sharp device.
- 70% isopropyl alcohol
33
Are used to wipe away the first drop of blood to eliminate alcohol residue and excess tissue fluid.
Gauze or cotton balls
34
Are used to cover the site after collection.
Bandages
35
Why should we remove alcohol residue?
It can cause: - lysis of RBCs - contaminate/affect glucose results - prevent a round drop of blood
36
Why is povidone iodine (betadine) not used as disinfectant in skin puncture?
it can: - increase K+ (Potassium) - increase Phosphorus - increase Uric Acid
37
Are sterile, disposable, sharp instruments used for capillary puncture. Their blades or points must permanently retract to prevent sharp injuries
Lancet/s
38
Increases blood flow up to seven times and is especially important when performing heel sticks. Water temperature must not exceed ___ or it could scald the patient.
Warming Devices - 42ºC
39
Special small plastic tubes often referred to as “bullets” Most have color-coded stoppers that correspond to color-coding of ETS tubes
Microtubes/ Microcollection Tubes
40
Narrow-bore capillary tubes primarily used for manual hematocrit determinations Either coated with heparin for collecting directly from a capillary puncture or plain to be used when filling with blood from an EDTA tube
Microhematocrit Tubes
41
Coated with (sodium) heparin
Red
42
Plain
Blue
43
Volume of microhematocrit tube
50-75uL
44
Are claylike substances used to seal one end of microhematocrit tubes
Sealants
45
Height of sealants
4-6mm, just above the band
46
Order of sealants
Clay ----> Paraffin wax
47
Indications for Capillary Puncture
►Can be done if small amount of blood is required. ►There are no accessible veins ►Available veins are fragile or must be saved for other procedures such as chemotherapy ►Blood is to be obtained for POCT procedures such as glucose monitoring ►Capillary blood is the preferred specimen for some tests such as newborn screening
48
Skin punctures are also useful for the ff adult patients:
► 1. Patients with severe burns ► 2. Obese patients ► 3. Patients with thrombotic tendencies ► 4. Oncology patients whose veins are being saved for therapy. ► 5. Geriatric patients ► 6. Those who have fragile veins ► 7. Patients doing home testing (e.g., blood glucose screening)

mt 12 (3 decks)

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