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Mod 6 Flashcards

1
Q

preferred method of blood collection

A

evacuated tube system (ETS)

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2
Q

sometimes used for patients with small or difficult veins

A

syringe system

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3
Q

system consists of a sterile syringe needle called a hypodermic needle and a sterile plastic syringe with a Luer-lock tip

A

syringe system

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4
Q

Hypodermic Needle

A

SYRINGE NEEDLES

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5
Q

Gauge and length for phlebotomy procedure

A

gauges 21 to 23,
in 1- or 1.5-in. lengths.

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6
Q

allow safely covered and removed so that a transfer device can be attached to the syringe to fill the evacuated tubes.

A

resheathing feature

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7
Q

Routine blood collection volume

A

i. 5ml
ii. 10ml

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8
Q

This device allows the safe transfer of blood into the tubes without using the syringe needle or removing the tube stopper.

A

SYRINGE TRANSFER DEVICE

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9
Q

The device is similar to an evacuated tube system(ETS) holder but has a permanently attached needle inside.

A

SYRINGE TRANSFER DEVICE

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10
Q

used by drawing the plunger backwards which creates a vacuum that draws blood into the syringe barrel when the needle is inserted into a vein.

A

syringe plunger

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11
Q

needle is too large for the vein causes

A

bleeding–hematoma.

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12
Q

needle is too small

A

damage the blood cells during sampling

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13
Q

invented to avoid accidents in the laboratory when it comes to transferring blood samples from the syringe into evacuated tubes.

A

syringe transfer device

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14
Q

Venipuncture procedure

A
  1. Review and accession test request
  2. Approach, identify, and prepare patient
  3. Verify diet restrictions and latex sensitivity
  4. Sanitize hands
  5. Position patient, apply tourniquet, make fist
  6. Select vein, release tourniquet, open fist
  7. Clean and air-dry site
  8. Prepare equipment and put on gloves
  9. Reapply tourniquet, uncap, inspect needle
  10. Ask patient to make a fist, anchor vein, and insert needle
  11. Establish blood flow, release tourniquet, ask patient to open fist
  12. Fill syringe
  13. Place gauze, withdraw needle, activate safety device, apply pressure
  14. Discard needle, fill tubes, discard syringe and transfer device
  15. Label tubes
  16. Observe special handling instructions
  17. Check patient’s arm and apply bandage
  18. Dispose of used and contaminated materials
  19. Thank patient, remove gloves, sanitize hands
  20. Transport specimen to the lab
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15
Q

Purpose of syringe transfer device

A

To safely transfer blood from a syringe into ETS tubes

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16
Q

Syringe transfer device procedure

A
  1. Remove the needle from the syringe The needle must be removed to attach the transfer and discard it in a sharps container.
  2. Attach the syringe hub to the transfer device hub, rotating it to ensure secure attachment.
  3. Hold the syringe vertically with the tip down and the transfer device at the bottom.
  4. Place an ETS tube in the barrel of transfer device and push it all the way to the end.
  5. Follow the order of draw if multiple tubes are to be filled.
  6. Keep the tubes and transfer device vertical
  7. Let tubes fill using the vacuum draw of the tube. Do not push on the syringe plunger.
  8. If you must underfill a tube, hold back the plunger to stop blood flow before removing it
  9. Mix additive tubes as soon as they are removed.
  10. When finished, discard the syringe and transfer device unit in a sharps container.
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17
Q

ORDER OF DRAW

A
  1. Sterile Tube (blood culture)
  2. Blue-top coagulation tube
  3. Serum tube (with or without clot activator, with or
    without gel)
  4. Heparin tube (with or without gel plasma separator)
  5. EDTA tube
  6. Glycolytic inhibitor tube
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18
Q

closed system of sample collection, making it the preferred
method. This closed system enables blood to be directly collected to a tube minimizing the risk of specimen contamination and allowing multiple tubes to be collected.

A

evacuated system

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19
Q

evacuated system three basic components

A

A. Multi-sample needle/Two-way needle
B. Tube holder/Adapter
C. Evacuated tubes

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20
Q

An organized order of draw must be followed when collecting samples using the ETS to prevent the following:

A
  1. CARRYOVER / CROSS-CONTAMINATION
  2. TISSUE THROMBOPLASTIN CONTAMINATION
  3. MICROBIAL CONTAMINATION
  4. INTERFERENCE WITH ASSAY
  5. REMOVAL OF CONSTITUENTS
  6. EFFECT ON ENZYME ACTION
  7. ALTERATION OF CELLULAR CONSTITUENTS
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21
Q

source of more carryover problems than any other additive

A

EDTA

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22
Q

least interference in tests other than coagulation tests because it occurs naturally
in blood

A

Heparin

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23
Q

necessary for coagulation tests other than prothrombin time or partial thromboplastin time

A

Discard tube

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24
Q

collected first in the order of draw to ensure that they are collected when sterility of the site is optimal and to prevent microbial contamination

A

Blood culture tubes or bottles

25
Q

The additive may contain a substance that is the same or reacts in the same way as the substance being measured

A

INTERFERENCE WITH ASSAY

26
Q

The additive may remove the constituent to be measured

A

REMOVAL OF CONSTITUENTS

27
Q

The additive may affect enzyme reactions

A

EFFECT ON ENZYME ACTION

28
Q

An additive may alter cellular constituents

A

ALTERATION OF CELLULAR CONSTITUENTS

29
Q

Tests: Blood culture

A

Additive/s: Sodium polyanethol sulfonate
Number of inversions: 8 – 10 times Specimen: Whole blood

30
Q

Tests: Coagulation tests

A

Additive/s: Sodium citrate (3.2% or 3.8%)
Number of inversions: 3 - 4 times
Specimen: Whole blood

31
Q

Test: Specialized platelet testing
Glass CTAD tube with a light blue Hemogard closure contains

A

Contains sodium citrate, theophylline, adenosine and dipyridamole

32
Q

Minimizes in vitro platelet activation and the artificial entry of platelet factors into plasma

A

Glass CTAD tube with a light blue Hemogard closure

33
Q

▪ Thrombin and soybean trypsin inhibitor
▪ Providing serum for determinations of certain fibrin degradation products

A

Special blue stopper

34
Q

CLSI recommended for coagulation tests on patients with polycythemia or hematocrit reading

A

3.2% sodium citrate

35
Q

activate platelets and cause erroneous coagulation test results

A

Overmixing

36
Q

Tests: Stat and routine chemistry tests, ammonia, electrolytes, arterial blood gases

A

RED
Additive/s: Silica (clot activator), none in glass
Number of inversions: 5 times for plastic tubes; none for glass tubes
Specimen: Serum after centrifugation

37
Q

Blood collected in red stopper glass tubes clots by the normal coagulation process in about

A

60 minutes

38
Q

Tests: Most chemistry tests; “stat” tests

A

GOLD
Additive/s: Spray-coated silica (to increase platelet activation) and a polymer barrier gel
Number of inversions: 5 times, complete clotting within 30 minutes
Specimen: Serum after centrifugation

39
Q

suitable for use in the blood bank and for certain immunology and serology because the gel may interfere with immunological reactions

A

Serum-separator tubes

40
Q

Red/Light Gray and Clear top Function

A

Discard tube

41
Q

Tests: Chemistry (stat tests), Serology, Blood bank

A

GREEN
Additive/s: Heparin with sodium, lithium or ammonium ion
Number of inversions: 5 – 10 times (depending on the manufacturer) Specimen: Whole blood

42
Q

interferes with lithium testing; least interference in chemistry
testing and most widely used

A

Lithium heparin

43
Q

BUN determination

A

Ammonium heparin

44
Q

sodium in electrolyte panel

A

Sodium heparin

45
Q

interferes with Wright’s stain and causes the stain to have a blue background on blood smear

46
Q

only anticoagulant used for the determination of pH, blood gases, electrolytes and blood gases

47
Q

Tests: Chemistry with use of plasma

A

LIGHT GREEN PST
Additive/s: Lithium heparin and Polymer gel
Number of inversions: 8 times
Specimen: Whole blood

48
Q

Tests: Routine hematology procedures (CBC, sedimentation rate)

A

LAVENDER
Additive/s: Spray-dried K2EDTA or Liquid K3EDTA; Powdered Na2EDTA Number of inversions: 8 times
Specimen: Whole blood

49
Q

Tests: Blood bank (Compatibility testing)

A

PINK
Additive/s: K2EDTA
Number of inversions: 8 times
Specimen:Whole blood

50
Q

Tests: Molecular diagnostics but can be used for MI panels and ammonia levels, depending on the test methodology and instrumentation

A

PEARL/WHITE TOP: PLASMA PREPARATION TUBES

Additive/s: Spray-coated K2EDTA
Number of inversions: 8 times
Specimen: Whole blood

51
Q

Tests: Lactic acid, Glucose tolerance test, Fasting blood sugar, Blood alcohol levels

A

GRAY

Additive/s: Anti-glycolytic agent (Sodium fluoride or Iodoacetate) and Potassium oxalate or Na2EDTA
Number of inversions: 8 times
Specimen: Whole blood

52
Q

Tests: Stat serum chemistry determinations and samples from patients receiving anticoagulant therapy

A

THROMBIN-BASED TUBES
a. Yellow/gray and Orange top

Additive/s: Thrombin – clots within 5 minutes
Number of inversions: 8 times
Specimen: Serum

53
Q

Tests: Stat serum tests

A

THROMBIN-BASED TUBES
b. Orange top: Rapid serum Tests (RSTs)

Additive/s: Thrombin-based medical clotting agent – clots within 5 minutes and separation gel
Number of inversions: 5 times
Specimen: Serum

54
Q

Tests: Lead determination

A

TAN
Additive/s: K2EDTA
Number of inversions: 8 times Specimen: Whole blood

55
Q

Tests: Toxicology, trace metals, nutritional analysis

A

ROYAL BLUE

Additive/s: Spray-coated silicon clot activator or; K2EDTA or Heparin Number of inversions: 8 times
Specimen: Serum or plasma

56
Q

Tests: Cellular studies in blood bank, human leukocyte antigen (HLA) phenotyping and DNA and paternity testing

A

YELLOW

Additive/s: Acid Citrate Dextrose
Number of inversions: 8 times
Specimen: Whole blood

57
Q

Test: Westergren sedimentation rate

A

BLACK
Additive/s: Buffered sodium citrate (4:1 ratio)
Number of inversions: 8 times
Specimen: Whole blood

58
Q

Tests: Whole blood molecular diagnostics testing;

A

LIGHT BLUE/BLACK: CELL PREPARATION TUBES (CPT)

Additive/s: Sodium citrate and Polyester gel and a Density gradient liquid
Number of inversions: 8 times
Specimen: Whole blood

59
Q

Tests: Whole blood molecular diagnostics testing

A

RED/GREEN
Additive/s: Sodium heparin and a Polyester gel and Density gradient liquid Number of inversions: 8 times
Specimen: Whole blood

PMLS 2 (6 decks)

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