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Phlebotomy laboratory finals > MODULE 5 Capillary > Flashcards

MODULE 5 Capillary Flashcards

1
Q

Why do we not must puncture any deeper than 2mm?

A

Deeper punctures risk injuring the bone, even in the safest puncture areas

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2
Q

Why do we NOT puncture areas between the imaginary boundaries?

A

The calcaneus may be as little as 2.4mm deep in this area

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3
Q

Why do we not puncture bruised areas?

A

Because it can be painful, and impaired circulation or byproducts of the healing process can negatively affect the specimen

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4
Q

Why do we not puncture in the arch and any other areas of the foot other than the heel?

A

Arteries, nerves, tendons, and cartilage in these areas can be injured

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5
Q

Why do we not puncture sites that are swollen

A

Excess tissue fluid in the area could contaminate the specimen

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6
Q

Why do we not puncture the posterior curvature of the heel?

A

The bone can be as little as 1mm deep in this area

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7
Q

Why do we not puncture through previous puncture sites?

A

This can be painful and can spread undetected infection

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8
Q

What are the safest areas to puncture?

Enumerate based on the safest to least

A

Medial
Lateral
Plantar
Heel

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9
Q

Why do we warm the site of puncture?

A

Warming increases blood flow up to sevenfold

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10
Q

Inflammation of the bone marrow and adjacent bone

A

osteomyelitis

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11
Q

Inflammation of the bone and cartilage due to infection

A

Osteochondritis

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12
Q

Why do we not puncture fingers of infants and children under 1 year of age

A

The amount of tissue and skin surface is too small that could lead to gone injury easily.

Also can leas to gangrene and infection

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13
Q

Why do we not puncture fingers on the same side of mastectomy without permission from the patient’s physician

A

The arm is susceptible to infection, and effects of lymphostasis can lead to erroneous results.

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14
Q

Why do we not puncture parallel to the grooves or lines of the fingerprint?

A

It makes blood collection difficult and the blood will run down the finger rather than form a rounded drop that is easier to collect

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15
Q

Why must not puncture the fifth/little/pinky finger?

A

The tissue between the skin surface is the thinnest and can lead to bone injury easily

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16
Q

Why must not puncture the index finger?

A

It is Usually more calloused and harder to puncture, more sensitive so the puncture can be more painful. It is usually used more and the patient may notice pain longer

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17
Q

Why do we not puncture the side or very tip of the finger?

A

Because it is in the central fleshy portion of the finger

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18
Q

Why do we not puncture the thumb?

A

Because it has pulse, indicating an artery in the puncture area, and the skin is generally thicker and more calloused, making it difficult to obtain a good specimen

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19
Q

What is/are the common tests performed using microhematocrit tubes?

A

Manual Hct or packed cell volume (PCV)

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20
Q

What is coated to the tube for collecting Hct tube directly from a capillary puncture?

A

Ammonium heparin

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21
Q

What is coated to the tube when Hct tube is filled with blood from a lavender-top tube?

A

Plain or none

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22
Q

What color do the non-additive tubes have?

A

Blue

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23
Q

How man uL can microhematocrit tubes fill?

A

50uL to 75uL

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24
Q

What type of patients does capillary specimen collection is especially useful?

A

Pediatric

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25
Q

Why is capillary specimen collection useful for pediatric patients

A

Removing large quantities of blood can have serious consequences

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26
Q

Often referred as “bullets”

A

Microtubes or microcollection tubes

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27
Q

What are the types of sealants are used?

A

Plastic
Clay
Wax-type

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28
Q

Ability of a liquid to flow into a narrow space or thin tube without the use of external force such as gravity

A

Capillary action

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29
Q

What is the common capacity of CBG?

A

100uL

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30
Q

What additive is found in CBG?

A

Heparin

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31
Q

Warming device must not exceed to what temperature?

A

42C or 108F

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32
Q

What are the composition of capillary specimens?

A

Interstitial fluid
Intracellular fluid
Arterial blood
Venous blood
Capillary blood

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33
Q

Why is capillary blood contains a higher portion of arterial blood than venous blood?

A

Because arterial blood enters the capillaries under great pressure than the venous pressure at the exit of capillaries

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34
Q

Warming the site can increase what type pf composition of blood of capillaries will increase its flow?

A

Arterial

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35
Q

Tissue fluid from spaces between the cells?

A

Interstitial fluid

36
Q

Fluid within the cells

A

Intracellular fluid

37
Q

concentration of what is higher in capillary blood specimen?

A

Glucose

38
Q

What analyte concentrations are lower in capillary blood

A

Bilirubin
Calcium
Chloride
Sodium
Potassium
Total protein

39
Q

What are the following circumstances capillary puncture is appropriate choice for older children and adults?

A

Available veins are fragile, difficult to access, or must be saved for other procedures such as chemotherapy.

• Several unsuccessful venipunctures have been performed and the requested test can be collected by capillary puncture.

• The patient has thrombotic or clot-forming tendencies.

• The patient is apprehensive or has an intense fear of needles, and capillary collection is acceptable.

• The patient is extremely overweight, and veins are difficult to find.

• There are no accessible veins (e.g., the patient has intravenous [IV] lines in both arms or the only acceptable sites are in scarred or burned areas).

• To obtain blood for point-of-care testing (POCT) procedures such as glucose monitoring

40
Q

For every 10mL of blood, ____ of iron is removed

A

4mg

41
Q

Life may be threatened if more than ____ of blood volume is removed at once

A

10%

42
Q

Aside for manual Hct, capillary blood is the preferred specimen for some tests, such as?

A

Newborn screening tests

43
Q

True or false
Capillary puncture is appropriate for patients who are dehydrated or have poor circulation to the extremities than Venipuncture

A

False. It is not appropriate because it could cause shock since specimens may be hard to obtain and may not be representative of blood elsewhere

44
Q

What are the tests that cannot be collected by capillary puncture?

A

Erythrocyte Sedimentation Rate (ESR)
Rate Methods
Coagulation studies (requiring plasma specimens)
Blood cultures
Tests requiring large volumes of serum or plasma

45
Q

What is the order of draw for capillary puncture?

A

Blood gas specimen
EDTA specimen
Other additive specimen (Heparin)
Serum Specimen

46
Q

Why is EDTA specimen collected first than other additive specimens?

A

Because other additive specimens can affect EDTA specimen by clotting

47
Q

Why is CBG collected first?

A

To minimize exposure pf the blood to air and because clots in the specimen is not acceptable

48
Q

Heelstick is used for?

A

Infants less than a year old

49
Q

What is the position of infant for heel puncture?

A

Should be supine with the foot lower than the torso so the force of gravity can assist blood flow

50
Q

Bluish in color usually from a shortage of oxygen in the blood

A

Cyanotic

51
Q

Swollen with fluid, infected, or a recent previous puncture sites

A

Edematous

52
Q

Puncture site must be free from:

A

Scar
Bruise
Rashes
Cyanotic
Edematous

53
Q

What is the cite to puncture for adults and older children?

A

Palmar surface of the distal segment of the middle finger or ring finger

54
Q

What is the puncture site for burned patients?

A

Earlobes

55
Q

What is the puncture site for infants?

A

Heel

56
Q

Safest area for heel puncture?

A

Most medial and lateral portion of the plantar surface of the heel

57
Q

Warming the site can be accomplished by wrapping the site for how many minutes?

A

3-5 minutes

58
Q

What is the CLSI recommended antiseptic for cleaning a capillary puncture site?

A

70% isopropanol

59
Q

What antiseptic is not recommended to use to clean the site? And why?

A

Povidone iodine. Because it can greatly interferes with some tests- uric acid, phosphorus, and potassium

60
Q

What tests will be affected when using povidone-iodine as antiseptic for cleaning the site?

A

Uric acid
Phosphorus
Potassium

61
Q

What happens when we squeeze or use strong repetitive pressure?

A

Can result to hemolysis and tissue fluid contamination

62
Q

Why do we not apply bandages to infants and children under 2 years of age?

A

They pose to choking hazard

63
Q

What age is not recommended to use bandages?

A

Infants and children under 2 years of age

64
Q

Brain dysfunction caused by toxic levels of bilirubin

A

Kernicterus

65
Q

A treatment used for jaundice infants that can be placed under special lights to lower their bilirubin levels

A

Phototherapy

66
Q

Testing of newborns to detect certain genetic, metabolic, hormonal, and functional disorders or conditions that can cause severe mental handicaps or other serious problems if not detected and treated early

A

Newborn/Neonatal Screening

67
Q

What puncture is preferred for newborn screening?

A

Heel puncture

68
Q

Disorder that is characterized by insufficient levels of thyroid hormones

A

Hypothyroidism

69
Q

Inherited disorder characterized by lack of enzyme needed to convert milk sugar galactose into glucose needed by the body for energy

A

Galactosemia

70
Q

Why must not the paper touch the surface of the heel for newborn screening?

A

It could allow smearing, blotting, and stoppage of blood flow and incomplete penetration of blood through the paper

71
Q

Blood smears prepared from EDTA specimens should be made within ____ of collection to eliminate cell distortion caused by anticoagulants

A

1 hour

72
Q

The drop of blood to the slide should be _____ in diameter?

A

1-2mm

73
Q

What is the angle of spreader slide?

A

30 degrees

74
Q

Probable cause:
Absence of feather

A

Spreader slide lifted before the smear was completed

75
Q

Probable cause:
Holes in the smear

A

Dirty slide
Fat globules in the blood

76
Q

Probable cause:
Ridges or uneven thickness

A

Too much pressure applied to the spreader slide

77
Q

Probable cause:
Smear too thick

A

Blood drop too large
Spreader slide angle too steep
Patient has high red blood cell count

78
Q

Probable cause:
Smear too short

A

Blood drop too small
Spreader slide angle too deep
Spreader slide pushed too quickly

79
Q

Probable cause:
Smear too long

A

Blood drop too large
Spreader slide angle too shallow
Spreader slide pushed too slowly

80
Q

Probable cause:
Smear is too thin

A

Blood drop too small
Spreader slide angle too shallow
Patient has a low hemoglobin

81
Q

Probable cause:
Streaks or tails in feathered edge

A

Blood drop started to dry out
Edge of. spreader slide dirty or chipped
Spreader slide pushed through blood drip
Uneven pressure applied to spreader slide

82
Q

True or false:
Blood smears are considered non biohazardous or infectious until they are stained or fixed

A

False. They are biohazardous or infectious until they are stained or fixed

83
Q

What species caused malaria

A

Plasmodia

84
Q

Thick blood smear is used for

A

Test for malaria

85
Q

Progressive destruction of red blood cells in certain types of malaria causes?

A

Severe anemia

86
Q

Type of specimen preferred for infants, young children, elderly patients, and patients with severe burn

A

Capillary blood

Phlebotomy laboratory finals (3 decks)

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