Lesson 7: Capillary Puncture Equipment and Procedure Flashcards
1
Q
method that uses a lancet to make a small incision into the capillary bed of the skin to obtain a small volume of blood specimen
A
capillary puncture or skin puncture
2
Q
- sterile, sharp instruments
- one-time use only
- designed for making cuts in the skin for finger or heel puncture
A
lancet or incision device
3
Q
- type of lancet that produces a small hole in the skin by vaporizing water in the skin
- eliminates the risk of sharp injury
A
laser lancet
4
Q
two types of laser lancet that are used in capillary puncture
A
- finger puncture lancet
- heel puncture lancet
5
Q
other name for microtube
A
microcollection container
6
Q
- small plastic tube
- used to hold blood specimen collected in capillary puncture
- has marks on the side that shows the minimum and maximum fill levels
A
microcollection container
7
Q
- narrow bore tubes
- made of either plastic or glass
- used for hematocrit determinations
- can hold 50 to 75 uL
- filled by capillary action
- one end is sealed with sealants or plastic
A
microhematocrit tubes and sealants
8
Q
blood films for hematology determinations
A
microscope slides
9
Q
to increase blood flow seven-fold by warming the puncture site
A
warming devices
10
Q
- special equipment
- used for Capillary blood gas (CBG) specimen
- CBG collection tubes
- stirrers
- magnet
- plastic caps
A
Capillary blood gas equipment
11
Q
Capillary blood specimen is a mixture of different blood and fluid which includes? [AVCII]
A
- arterial blood
- venous blood
- capillary blood
- interstitial fluid
- intracellular fluid
12
Q
- bright red blood
- found in the pulmonary vein, left chamber of the heart, and arteries
- flowing towards the organ system
- oxygenated blood
A
Arterial blood
13
Q
- dark red blood
- travels from the peripheral veins passing through the venous system then through the right chamber of the heart
- flowing towards the heart
- deoxygenated blood
A
Venous blood
14
Q
- extracted from the venules and arterioles found in the capillary bed
A
Capillary blood
15
Q
Capillary blood is preferred specimen for? [IYES]
A
- infants
- young children
- elderly patients
- patients with severe burns
16
Q
- fills the spaces around the cells
- filtered from the blood capillaries
- drained away as lymph
- found inside the cells
- facilitate movement of fluid in the membrane
- blocks the entrance of unwanted materials
A
Interstitial fluid
17
Q
As compared to venous blood reference values, what blood tests has higher capillary reference value ?
A
glucose
18
Q
As compared to venous blood reference values, what blood tests has lower capillary reference value ? [TCP]
A
- total protein
- calcium conc.
- potassium conc.
19
Q
indications of performing capillary puncture on Adults and Children
A
- fragile veins
- not accessible veins because of scars and burns
- veins are reserved for another procedure such as chemotherapy
- clotting tendencies
- extreme fear of needles
- veins will be used for glucose monitoring or oral glucose tolerance test (OGTT)
20
Q
six (6) reasons why capillary puncture is the preferred method for infants
A
- health risks such as anemia and cardiac arrest
- requires only a small volume of blood
- venipuncture could damage veins and tissues surrounding the site
- puncturing could result in hemorrhage, thrombosis, gangrene, and infection
- risk of injury because of the restraint needed in venipuncture
- capillary blood is the preferred specimen
21
Q
When NOT to perform a capillary puncture?
A
- erythrocyte sedimentation rate methods
- blood cultures
- studies that need plasma specimen
- studies that need large volume specimen requirement
22
Q
Order of Draw for collecting Capillary specimen
A
(1) Blood gas- CBG Tube
(2) EDTA- Lavender, pink
(3) Lithium Heparin- Green
(4) Lithium Heparin with Gel Separator - White
(5) Sodium Fluoride/ Potassium Oxalate- Grey
(6) Serum- Clot Activator- Orange, yellow
(7) Serum- No Additive
(8) Newborn Blood Spot Card
23
Q
What is the position of an Adult of Children patient during capillary finger puncture?
A
- patient’s arm should b placed on a firm surface
- arms should be extended
- palms facing up
24
Q
What is the position of a young child/ infant patient during capillary heel puncture?
A
- baby in a supine position
- foot not lower than his/her torso
25
What is the general criterion for selecting the puncture or incision site? [PNW] [SCBRCEI]
- pink
- normal in color
- warm
Should be free from:
- scars
- cuts
- bruises
- rashes
- cyanosis
- edema
- infection
26
What is the criterion for selecting the puncture or incision site for an adult or an older child?
- palmar surface of the distal, end segment of the middle finger or ring finger
- non-dominant hand
- center of fleshy portion of the finger
27
What is the criterion for selecting the puncture or incision site for infants?
- site should be less than 2.0 mm deep
- to avoid bone damage, site should be on the plantar surface of the heel or on the median or lateral side
28
What is the purpose of warming the incision site?
- increase blood circulation up to seven times
- if the specimen is for pH or blood gas
29
When preparing for the equipments where should be the packages be opened?
in front of the patient
30
What is the procedure for finger puncture?
- hold the finger between the thumb and index finger of the non-dominant hand
- place the lancet flat against the central fleshy part of the incision site
31
What is the procedure for heel puncture?
- hold the foot gently but firmly
- encircle the heel using the index finger near the arch
- thumb should be placed at the bottom, and the rest of the fingers around the top portion of the foot
- lancet is positioned in the medial or lateral plantar of the heel
32
Why does the first drop of blood in capillary puncture should be wiped away?
because it may be contaminated with excess tissue fluid
33
What should a phlebotomist prioritize upon the collection of blood samples in capillary puncture?
- slides
- platelet counts
- other hematology specimens to avoid clumping and clotting
- anticoagulant containers
- serum specimens
34
What is the use of routine blood film/ smear preparation?
blood test that is used to check abnormalities in the blood cells
35
What is the procedure for preparing thin blood film?
- small drop of blood is placed near the frosted end of the glass slide
- another slide is used to spread the blood in a thin film over the slide
- air-dried
- stained
36
What is the use of thick blood smear?
to determine if the patient has malaria
37
What is the procedure for thick blood smear preparation?
- large drop of blood in the center of the slide
- blood is spread until it is about the size of a dime, using a cover slip or another slide
- air-dried for at least two hours
- stain
38
What is the recommended procedure for capillary blood gas specimen collection in infants?
- heel puncture
- same site as routine capillary puncture specimens
39
- used to determine any liver disorder in infants
- collected with a heelstick
neonatal bilirubin collection
40
What is the collection container/tube for neonatal bilirubin collection?
Preferred: 2 serum gel microtainers
Acceptable: 2 Red-top microtainers
41
What is the submission container/tube for neonatal bilirubin collection?
Amber vial (T192)
42
What is the collection instruction for the preferred container/tube for neonatal bilirubin collection?
-serum gel microtainers
- should be centrifuged within 2 hours of collection
43
What is the collection instruction for the acceptable container/tube for neonatal bilirubin collection?
- red-top microtainers
- centrifuged and aliquoted within two hours of collection
44
newborn/ neonatal screening
- part of routine check for infants
- to determine inborn disorders
45
Give at least 4
- inborn disorders
[PHGC]
- phenylketonuria
- hypothyroidism
- galactosemia
- cystic fibrosis
46
When does a newborn screening blood spot is done?
24 to 48 hours after the baby is born
47
Newborn screening blood spot
- few drops of blood are collected through heel stick
- determine disorders that are not apparent at birth and could lead to disability or even death
