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Clinical Chemistry (CC 1) > (P) Lec 2: Specimen Collection (Part 1) > Flashcards

(P) Lec 2: Specimen Collection (Part 1) Flashcards

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1
Q

Identifying Patients

What do you verbally ask for in conscious/hospitalized patients?

A

Full name (do not ask yes or no questions)

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2
Q

Identifying Patients

What do you use to confirm a patient’s full name?

A

ID Bracelet

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3
Q

Identifying Patients

If a patient is unconscious, an infant, or mentally incompetent, who can you ask for the patient’s name?

A

Relative, nurse, or physician (record the name of who stated the patient’s name on their behalf)

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4
Q

Identifying Patients

Who verifies the ID when dealing with oupatient/ambulatory patients?

A

Receptionist

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5
Q

Identifying Patients

For outpatient/ambulatory patients, what identifiers must be stated and spelt? (3 answers)

A

State: Full name and DOB
Spell: Last name

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6
Q

What is the first step in sample collection?

A

Proper patient identification

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7
Q

Identifying Patients

For unidentified emergency patients, how many items for identification must be used?

A

2-3 (name, DOB, and address)

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8
Q

Blood Collection

The human body contains approximately how many quarts/liters of whole blood?

A

5 quartz/ 4.73L

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9
Q

Blood Collection

How many liters of whole blood for adult males?

A

5-6L

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10
Q

Blood Collection

How many liters of whole blood for adult females?

A

4-5L

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11
Q

Blood Collection

Whole blood is composed of approximately how many percent of plasma and cells?

A

60% plasma (important for CC) and 40% cells (important for hematology)

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12
Q

Blood Collection

Plasma is how many percent of the total blood volume?

A

55%

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13
Q

Blood Collection

Plasma is how many percent water?

A

91%

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14
Q

Blood Collection

Plasma is how many percent blood proteins (fibrinogen, albumin, and globulin)?

A

7%

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15
Q

Blood Collection

Plasma is how many percent nutrients, hormones, and electrolytes?

A

2%

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16
Q

Blood Collection

How many percent of the total blood volume are the cellular components?

A

45%

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17
Q

Blood Collection

The buffy coat is made up of what 2 components?

A

WBCs and Platelets

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18
Q

Blood Collection

How many WBCs are usually present per cubic millimeter of blood?

A

7,000-9,000

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19
Q

Blood Collection

How many platelets are usually present per cubic millimeter of blood?

A

250,000

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20
Q

Blood Collection

How many RBCs are usually present per cubic millimeter of blood?

A

5,000,000

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21
Q

Blood Collection

Clotted blood specimen is called?

A

Serum

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22
Q

Blood Collection

Unclotted blood specimen is called?

A

Plasma

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23
Q

Blood Collection

What 2 blood specimens are used for clinical chemistry?

A

Serum and Plasma

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24
Q

Blood Collection

What blood specimen is used for hematology?

A

Whole Blood

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25
Q

Serum or Plasma?

  1. Clear
  2. Pale yellow in color
  3. Uses a plain tube
  4. Does not have any fibrinogen
A

Serum

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26
Q

Serum or Plasma?

  1. Clear to slightly hazy
  2. Pale yellow in color
  3. Uses an anticoagulated tube
  4. Contains fibrinogen
A

Plasma

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27
Q

What is the more common and best blood specimen to be used in CC?

A

Serum

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28
Q

What is the specimen best used for STAT procedures?

A

Plasma (because clotting takes time if you use serums)

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29
Q

Lipemic serum indicates an excess/high concentration of what?

A

Triglycerides

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30
Q

Ictericia (jaundice) indicates a problem with what blood component?

A

Bilirubin

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31
Q

Fibrinogen is converted into what during the clotting process of serum?

A

Fibrin

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32
Q

TOF: There is fibrin in plasma because of the anticoagulants

A

False (fibrin can only be found in clotted blood, not in serum or plasma)

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33
Q

What are the 3 methods of blood collection?

A
  1. Arterial Puncture
  2. Skin Puncture
  3. Venipuncture
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34
Q

Type of Blood Collection

  1. Blood is obtained/withdrawn from a patient’s artery
  2. Sample is collected w/o a tourniquet
  3. Specimen is used in BGA and pH analysis
  4. Specimen is oxygenated blood with a bright red color
A

Arterial Puncture

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35
Q

Arterial Puncture

What is the most common and safest site for arterial puncture?

A

Radial Arteries

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36
Q

Who are allowed to perform arterial punctures?

A

MDs and Respiratory Technicians (+ other HCWs with training)

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37
Q

Arterial Puncture

What is the least preferred site for arterial puncture?

A

Femoral Artery

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38
Q

Arterial Puncture

The brachial artery is not an ideal site for puncture due to the abundance of what?

A

Nerves

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39
Q

Arterial Puncture

This is a test to know if collateral circulation is present before performing arterial puncture

A

Allen’s Test

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40
Q

Arterial Puncture

When handling the syringe like a dart, what is the ideal angular range for needle entry?

A

45-90 degrees

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41
Q

Arterial Puncture

What are the 5 sites for puncture (in newborns)?

A

1.Radial
2.Brachial
3.Femoral
4.Scalp
5.Umbilical

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42
Q

Arterial Puncture

What are the 3 sites for puncture (in adults)?

A
  1. Radial
  2. Brachial
  3. Femoral
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43
Q

Arterial Puncture

What is the best puncture site choice for newborns?

A

Umbilical Cord

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44
Q

Skin Puncture

Skin puncture is aka? (2 answers)

A
  1. Capillary Puncture
  2. Microsampling
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45
Q

Skin Puncture

Length of lancet?

A

1.75mm

46
Q

Skin Puncture

Incision depth for infants and children?

A

Less than 2mm

47
Q

Skin Puncture

Incision depth for adults?

A

Less than 2.5mm

48
Q

Skin Puncture

What is the distance from the skin surface to bone/cartilage?

A

1.5 - 2.4mm

49
Q

Skin Puncture

Punctures should not be made more than how many mm deep for infants and adults?

A

Infants: Not more than 2.5mm
Adults: Not more than 2-3mm

50
Q

Skin Puncture

What is the most common and best skin puncture site for newborns/infants less than 1 year old?

A

Lateral plantar heel

51
Q

Skin Puncture

What is the most common puncture site for adults?

A

Palmar surfaces of fingers (3rd and 4th fingers; 4th being more common)

52
Q

Skin Puncture

What fingers are avoided when doing skin punctures?

A
  1. Thumb - has a pulse
  2. Index
  3. Pinky - skin is thin and sensitive
53
Q

Skin Puncture

What is the least preferred skin puncture site?

A

Earlobes

54
Q

Skin Puncture

If a patient has underwent a mastectomy, what arm should you choose to perform skin puncture on?

A

Opposite of the mastectomy side

55
Q

Skin Puncture

It is important to not milk the puncture site to prevent what event and the excess of what component?

A

Hemolysis and excess tissue fluid

56
Q

Skin Puncture

One should prevent the introduction of what into the sample?

A

Air bubbles

57
Q

Skin Puncture

This is a mixture of arterial and venous blood; content is most comparable with arterial blood

A

Capillary Blood

58
Q

Skin Puncture

Capillary blood content is most comparable with?

A

Arterial blood

59
Q

Arterialized Capillary Blood

It is not able to identify what analyte concentration?

A

Partial Pressure of O2

60
Q

Arterialized Capillary Blood

What is the preferred and common site for newborns? (2 different answers)

A

Preferred: Earlobe
Common: Lateral plantar heel surface

61
Q

Arterialized Capillary Blood

This should not be done if arterial BP is less than?

A

95mmHg (there would be poor blood supply)

62
Q

Arterialized Capillary Blood

Warm the earlobe or heel surface with a paper towel saturated with warm water reaching temperatures of?

A

39 - 45ºC

63
Q

Arterialized Capillary Blood

How many heparinized tubes are used?

A

2

64
Q

Arterialized Capillary Blood

The area is cleansed with how many percent alcohol?

A

70%

65
Q

Arterialized Capillary Blood

What is the preferred site for newborns?

A

Indwelling umbilical artery

66
Q

Skin Puncture

What is the order of filing a microsampling tube?

A

EDTA > other additive tubes > serum tubes

67
Q

Skin Puncture

What should be immediately done upon puncturing the site?

A

Wipe away the first drop

68
Q

Type of Blood Collection

  1. Blood is obtained from a vein
  2. Specimen is deoxygenated with a dark red color
A

Venipuncture

69
Q

Venipuncture

What are the 3 veins in the antecubital fossa region?

A

Basilic, Cephalic, and Median Cubital

70
Q

Venipuncture

If the patient is diabetic, one should ask their physician first before using the vein on what body part?

A

Ankle

71
Q

Venipuncture

What is the best site in terms of anchorage and size (largest)?

A

Median cubital vein

72
Q

Venipuncture

Found at the center of the antecubital fossa (first choice for venipuncture)

A

Median Cubital

73
Q

Venipuncture

Found laterally on the antecubital fossa (second choice for venipuncture)

A

Cephalic

74
Q

Venipuncture

This vein is often hard to palpate but is prominent in obese patients

A

Cephalic

75
Q

Venipuncture

Found medially on the antecubital fossa (third choice for venipuncture)

A

Basilic

76
Q

Venipuncture

This vein is not well-anchored (rolls easily) and is in close proximity with the brachial artery and median cutaneous nerve branch

A

Basilic

77
Q

Venipuncture

What are the 3 methods?

A

Syringe, Butterfly Infusion Set, and Vacutainer (ETS)

78
Q

Venipuncture

Povidone iodine is used for what test?

A

Bacterial culture

79
Q

Venipuncture

A larger needle gauge number means?

A

Smaller bore and length

80
Q

Venipuncture

What are the 3 common needle gauges for adults?

A

21, 22, and 23

81
Q

Venipuncture (color of the gauge)

20 gauge

A

Yellow

82
Q

Venipuncture (color of the gauge)

21 gauge

A

Green

83
Q

Venipuncture (color of the gauge)

22 gauge

A

Black

84
Q

Venipuncture (color of the gauge)

23 gauge

A

Blue

85
Q

Venipuncture (color of the gauge)

25 gauge

A

Orange

86
Q

Venipuncture (color of the gauge)

26 gauge

A

Brown

87
Q

Venipuncture

What is the ideal needle gauge for the elderly and children?

A

25

88
Q

Venipuncture

What are the ideal needle gauges for blood donation?

A

16-18

89
Q

Venipuncture

How long is the standard needle for the syringe method?

A

1 or 1.5 inches

90
Q

Venipuncture

How long is the standard needle for the butterfly method?

A

1/2 to 3/4 inches

91
Q

Type of Blood Collection Method

  1. A short needle with a thin tube attached to plastic wings is used (+ Luer adapter)
  2. Used for infants, children, and patients with fragile veins
  3. Could be connected to a syringe or evacuated tube
A

Butterfly method

92
Q

Type of Blood Collection Method

Uses a multisample needle, tube holder, and evacuated tubes

A

Evacuated Tube System/ Vacutainer

93
Q

Evacuated Tube System

What is the standard length of needle?

A

1 to 1.5 inches

94
Q

Evacuated Tube System

An underfilled evacuated tube makes the sample what?

A

Diluted with anticoagulant

95
Q

Evacuated Tube System

What anticoagulant is best used in chemistry as it is less prone to interferences?

A

Heparin

96
Q

Evacuated Tube System

This inhibits coagulation

A

Anticoagulant

97
Q

Evacuated Tube System

These prevent glycolysis and are best for blood glucose (sodium fluoride)

A

Antiglycolytics and anticoagulants

98
Q

Evacuated Tube System

This preserves a specific blood constituent and aids in the separation of serum from cell

A

Tube Additives

99
Q

Evacuated Tube System

How many inversions for EDTA and Heparin?

A

8-10 times

100
Q

Evacuated Tube System

How many inversions for Sodium Citrate?

A

3-4 times

101
Q

Evacuated Tube System

What 2 anticoagulants are used in blood banking?

A
  1. Acid citrate dextrose
  2. Citrate phosphate sulfonate
102
Q

Evacuated Tube System

What anticoagulant is used in blood cultures?

A

Sodium Polyanethol Sulfonate (SPS)

103
Q

Evacuated Tube System

Identify the additive: Red (glass)

A

None

104
Q

Evacuated Tube System

Identify the additive: Red (plastic)

A

Clot activator

105
Q

Evacuated Tube System

Identify the additive: Pink

A

EDTA (for blood bank)

106
Q

Evacuated Tube System

Identify the additive: Lavender

A

EDTA (for hematology)

107
Q

Evacuated Tube System

How long does it take for clot activators to work?

A

1-2 hours

108
Q

Evacuated Tube System

For thixotropic gel separators, what is the specimen sample considering it has a faster clotting time?

A

Serum

109
Q

Evacuated Tube System

What is the order of draw?

A
  1. Yellow (sterile)
  2. Light Blue
  3. Red
  4. Yellow (SST)
  5. Light Green (PST)
  6. Green
  7. Lavender
  8. Gray
110
Q

Evacuated Tube System

What does EDTA mean?

A

Ethylenediaminetetraacetic acid

Clinical Chemistry (CC 1) (22 decks)

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