Module 5: Specimen Quality Issues

Question 1

Stagnation of venous blood flow cause by tourniquet application

Answer 1

Venous stasis

Question 2

How does Hemoconcentration happen following tourniquet application?

Answer 2

When tourniquet is applied venous stasis happens (for veins to show u better). This now can lead to fluids (water and filterable components of the blood) to pass through capillary wall into tissues. This means that proteins or non filterable large molecules stay in veins causing an increase in number of these large molecules while fluid would decrease.

Question 3

What increases during hemoconcentration?

Answer 3

1. Red Blood cells
2. Albumin
   3.Ammonia
   4.Calcium
   5.Coagulation factors
3. Enzymes
   7.Iron
   8.Potassium
   9.Cholesterol- increase up to 5% after 2 minutes of tourniquet application and up to 15% after 5 min.

Question 4

Other factors of hemoconcentration?

Answer 4

1. Massaging or squeezing site
2. probing
3. long-term IV therapy
4. Draw blood from sclerosed or occluded veins
5. Vigorous hand pumping - increase K to 20%, responsible for third of all elevated potassium and may increase lactate and phosphate levels

Question 5

What happens when RBCs are damaged and destroyed and Hmg escapes into fluid portion

Answer 5

HEMOLYSIS

Question 6

What would be the appearance of plasma or serum after hemolysis

Answer 6

Pink (slight)
Dark Pink or Light Red ( Moderate)
Dark Red (Gross)

Question 7

What can cause Hemolysis inn specimen

Answer 7

1. Drawing blood through hematoma
2. Failure to wipe first blood drop in capillary puncture
   3.forcing blood from syringe into tube
3. Frothing of blood due to improper needle size
4. horizontal transfer
5. mixing vigorously, shaking, inverting quickly
   7.Partially filling sodium fluoride tube (gray)
6. pull plunger too quick
7. rough handling
8. squeezing site during capillary puncture
9. syringe transfer delay
10. using large volume tube with small diameter butterfly needle
11. needle with small diameter for venipuncture

Question 8

What are the physiological indications of hemolyzed specimens if collection is proper?

Answer 8

hemolytic anemia, liver diseases, transfusion reaction

Question 9

What elevates due to hemolysis?

Answer 9

Ammonia, Catecholamines, Phosphates, Creatinine Kinase, Iron, magnesium, Potassium

Question 10

What decreases following hemolysis?

Answer 10

RBC count

Question 11

Partially filling tubes are called

Answer 11

Short draw

Question 12

Short draw serum tubes such as red tops and SST are generally acceptable for testing as long as specimen is not hemolyzed and there is sufficient specimen to perform test.

Answer 12

TRUE

Question 13

undefiled EDTA tube (excess edta) can cause?

Answer 13

1. RBC to shrink, low blood cell counts and hematocrits, negative impact to morphological exam
2. alter staining characteristics

Question 14

Undefiled heparin tube (excess heparin) in plasma

Answer 14

1. interfere with testing of come chem. analytes

Question 15

Excess sodium flouride

Answer 15

-cause hemolysis

Question 16

Undefiled coagulation tube (blue tubes)

Answer 16

• produce erroneous results

Question 17

tubes that are same size as normal but designed to contain smaller volumes are called

Answer 17

short-draw tube