Lesson 9 - Blood Collection in Special Populations

Question 1

What is the abbreviation for ER or ED?

Answer 1

Emergency room/department

Question 2

ICU

Answer 2

Intensive Care Unit

Question 3

LTC

Answer 3

Long-Term Care

Question 4

AV

Answer 4

Arteriovenous

Question 5

CVC

Answer 5

Central Venous Catheter

Question 6

IV

Answer 6

Intravenous

Question 7

PICC

Answer 7

Peripherally Inserted Central Catheter

Question 8

VAD

Answer 8

Vascular Access Device

Question 9

PKU

Answer 9

Phenylketonuria

Question 10

STAT

Answer 10

Immediately or very short turnaround time

Question 11

TLC

Answer 11

Tender loving care

Question 12

What is the total blood volume of the average person?

Answer 12

5L of blood

Question 13

What can cause latrogenic anemia in infants?

Answer 13

Repeated blood draws

Question 14

Fill in the blank.
Children and infants should never have more than ___ percent of their total blood volume in 24 hours, but can have up to ____ percent.

Answer 14

No more than 5% but up to 3%

Question 15

How can you determine the TBV (total blood volume) of an infant?

Answer 15

Calculate:
1. convert wg from lbs to kg,
2. use kg wg and multiply by 100
3. you have your total blood volume

Question 16

With pediatric patients, you must always speak in a warm/calming tone and prep your equipment outside of the room to lessen the anxiety of the child. True or false?

Answer 16

True, always make the child as comfortable as possible. Ex: create distractions and ask what bandage they like.)

Question 17

What must you never say to a patient before a blood draw?

Answer 17

“It won’t hurt”.

Always say “you might feel a small pinch.”

Question 18

Define neonatal bilirubin

Answer 18

A buildup of bilirubin caused by build up in an infant caused by the liver not being able to filter bilirubin out of the blood. Can cause jaundice and brain damage

Question 19

Define neonatal screening

Answer 19

A series of tests used to detect any inherited metabolic disorders

Question 20

True or false?
During a neonatal screening you must:
1. have the infant lying in the prone position
2. use the capillary method to puncture
3. only saturate the outsides of the circles on the testing sheet
4. let dry for 3-4 hours on a flat surface

Answer 20

False,
During a neonatal screening you must:
1. have the infant lying in the SUPINE position
2. use the HEEL STICK method to puncture
3. fully saturate the INSIDES of the circles on the testing sheet w/o touching the circles
4. let dry for 3-4 hours on a flat surface

Question 21

What vein & equipment are used during a infant venous draw?
Hint: there are 4 items NO TOURNIQUET

Answer 21

A 23G needle, syringe, blood transfer device, and the dorsal hand veins

Question 22

Is it okay to use bandages on small children? Why or why not?

Answer 22

No, the bandage can become a choking hazard in small. children. Instead use gauze to stop the bleeding.

Question 23

Teeth rotting, skin , bruising, longer healing time, and loose skin changes can cause difficulty for the phlebotomist while drawing.
True or false?

Answer 23

False, everything except teeth rotting can cause difficulty drawing on geriatric patients.

Question 24

What is a geriatric patient?

Answer 24

An elderly or older patient. Typically between 55 and up

Question 25

Hoe much more assistance do you think a geriatric patient may need during an appointment?

Answer 25

Hearing impairments. We may need to speak louder and clearer.

Question 26

For whom are these guidelines typically used for? Apply pressure longer, give more tension when anchoring the vein for puncture, use the smallest needle or a butterfly, and look for other places to draw from than the antecubital space.

Answer 26

For geriatric patients

Question 27

What is a VAD?

Answer 27

Vascular Access Device

Question 28

What are these? -Central Venous Catheter (CVC) -Peripherally Inserted Central Catheter (PICC) -IV (intravenous)

Answer 28

Other types of VADs (vascular access devices)

Question 29

Where is the CVC located when used?

Answer 29

The chest area

Question 30

Where is the PICC located when used?

Answer 30

The antecubital space

Question 31

These steps are for a phlebotomist drawing on what type of patient? -use other arm if possible -if not possible, ask a nurse to remove the IV 15 minutes prior to draw -use a different vein that the IV was in -discard first sample from heparin use -note that IV arm was drawn form -ask nurse to restart IV

Answer 31

A patient that has an IV in their arm prior to a blood draw

Question 32

For an infant that weighs 3 kg, which represents the preferred total blood that can be drawn in a 24-hour period? Hint: find the TBV (x100), then multiply by the maximum % of blood to be drawn from an infant in a 24 hour period (3%) = __mL

Answer 32

3kg x 100 = 300 300 x 0.03 = 9mL Therefore, no more than 9mL of blood can be drawn in a 24 hour time period from an infant weighing about 3kg

Question 33

If a phlebotomist is required to complete a heel stick to collect a specimen for bilirubin testing on an infant who is under the Bili-light, which of the following is required? a. Shielding the blood sample from the light Correct b. Using filter paper to collect the specimen c. A scalp vein is used for venipuncture d. All of the above

Answer 33

a. Shielding the blood sample from the light

Question 34

How should you use a filter paper when performing a neonatal screening? A. Touch the paper to the skin B. touch the blood to paper C. do not touch thew paper at all

Answer 34

B. touch the blood to paper

Question 35

How should you convert 23lbs to kg?

Answer 35

2.3*2.2= 50.6 lbs