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MT 12 lec > PHLEBOTOMY > Flashcards

PHLEBOTOMY Flashcards

1
Q

are the components of the
circulatory system that transport blood throughout the human body

A

blood vessels

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2
Q

Five types of Blood Vessels:

A
  1. Arteries
  2. Arterioles
  3. Capillaries
  4. Venules
  5. Veins
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3
Q

carry the oxygenated blood away
from the heart;

A

Arteries

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4
Q

small branches of an artery leading into capillaries

A

arterioles

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5
Q

exchange of water and chemicals between the blood and the tissues occurs

A

Capillaries

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6
Q

small branches of veins that lead to the
capillaries

A

venules

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7
Q

carry deoxygenated blood from the
capillaries back towards the heart

A

Veins

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8
Q

thicker due to the pressure from the heart
pushing away the blood.

A

Artery

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9
Q

Carry oxygen-rich blood away from the
heart to all of the body’s tissues.

A

Arteries

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10
Q

Small, thin blood vessels that connect
the arteries and the veins.

A

Capillaries

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11
Q

Their thin walls allow oxygen, nutrients, carbon dioxide, and other waste products to pass to and from cells

A

Capillaries

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12
Q

Blood carried by these contains less
oxygen and rich in waste products

A

Veins (towards the heart)

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13
Q

What is the diameter of the capillary that is same with the RBC?

A

8 micrometer in diameter

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14
Q

MAIN TYPES OF BLOOD VESSELS

A
  1. Artery
  2. Capillary
  3. Veins
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15
Q

THE THREE MAJOR LAYERS of the Vein and Capillary

A

Tunica externa
Tunica media
Tunica intima

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16
Q

Outer layer and the thickest layer in veins.

A

Tunica externa

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17
Q

Entirely made of connective tissue.

A

Tunica Externa

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18
Q

Contains nerves that supply the vessel as well as nutrient capillaries (vasa vasorum) in the larger
blood vessels

A

Tunica externa

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19
Q

What is the nutrient capillaries?

A

Vasa Vasorum

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20
Q

Thickest layer in the arteries

A

Tunica Media

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21
Q

Consists of circularly arranged elastic fiber,
connective tissue, polysaccharide substances, the
second and third layer are separated by another
thick elastic band

A

Tunica Media

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22
Q

The second and the third layer of tunica Media is separated by another thick elastic bond called

A

External elastic lamina

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23
Q

Innermost and thinnest layer

A

Tunica intima

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24
Q

Composed of simple squamous epithelial cells (for gas, waste, and nutrients exchange) interlaced with several circularly arranged elastic bands

A

Tunica intima

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25
Q

The tunica intima interlaced with
several circularly arranged elastic bands called the

A

internal elastic lamina

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26
Q

what is the vessel size? ranges from?

A

25 millimeters for aorta to 8 micrometers for capillaries

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27
Q

narrowing of blood vessels
(becoming smaller in cross-sectional area) by
contracting the vascular smooth muscle in the
vessel walls.

A

Vasoconstriction

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28
Q

similar process mediated by
antagonistically acting mediators

A

Vasodilation

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29
Q

What is the most prominent vasodilator?

A

Nitric oxide

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30
Q

TRUE OR FALSE

Increased vessel diameter mean decreased
blood pressure

A

TRUE

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31
Q

What are the potent vasoconstrictors?

A

ATP or ADP
cold water

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32
Q

what are the potent vasodilators?

A

vasopressin
epinephrine

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33
Q

MAJOR ARM & LEG VEINS FOR VENIPUNCTURE

A
  1. Anticubital Fossa
  2. H- Shaped Anticubutal Vein
  3. M -Shaped Anticubital Vein
  4. Other arm and hand Veins
  5. Leg, ankle, and foot Veins
  6. Arteries
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34
Q

Also known as the elbow pit

A

Antecubital Fossa

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35
Q

It is where the triangular area on the Anterior of the elbow, which is a site for major veins

A

Antecubital Fossa

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36
Q

It is the first choice for routine venipuncture since there are several major Veins called antecubutal Veins

A

Antecubital Fossa

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37
Q

BLOOD FLOW

A
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38
Q

It is the preferred venipuncture site, easy to access, and least painful for the patient

A

Median Cubital Vein

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39
Q

It is the second choice
It is harder to palpate, but
It is usually better when drawing blood from an obese patients

A

Cephalic Vein

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40
Q

It is the last choice vein
Not well anchored
Punctures are more painful
(kay it is near the antebrachial artery)

A

Basilic Vein

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41
Q

It is the intermediate antebrachial veins, which include the median, median cephalic, median basilic

A

M-shaped antecubital vein

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42
Q

Intermediate antebrachial Vein
First choice vein
Safest and less painful

A

Median vein

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43
Q

Intermediate cephalic Vein
2nd choice for venipuncture
less likely to roll

A

Median Cephalic Vein

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44
Q

Intermediate basilic Vein
Last choice because it is more painful

A

Median Basilic Vein

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45
Q

It is used only when anticubital veins are not accessible

A

Other arm and hand veins

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46
Q

Veins at the ____ of the hand can be used but are smaller and more painful

A

Veins at the BACK of the hand

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47
Q

______ of the wrist is never used as a venipuncture site

A

UNDERSIDE of the wrist

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48
Q

These are the veins that must not be used for venipuncture without the permission of the physician due to complications such as THROMBOSIS

A

Leg, ankle, foot Veins

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49
Q

These are not used for routine blood collection and are limited to the collection of arterial blood gas.

A

Arteries

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50
Q

This requires special training, and procedures are too risky for the patient.

A

Arteries

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51
Q

What are the Posterior Veins for venipuncture
(Dorsal)

A

A - accessory cephalic veins
B - basilic Veins
C - cephalic Veins
D - dorsal metatarsal veins; dorsal venous veins
I - intercapitular Veins

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52
Q

What are the basilic veins for venipuncture
(Palmar)

A

Cephalic Vein
Accessory Cephalic Vein
Intermediate Cephalic Vein
Cephalic Vein
Intermediate antebrachial Vein
Basilic Vein
Intermediate Basilic Vein
Perforating Veins

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53
Q

It comes from the greek word phlebo and tomy

A

Phlebotomy

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54
Q

Phlebo means ___ and tomy means ___

A

Phlebo - Vein
Tomy - to make an incision

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55
Q

It is an act of drawing f or removing blood from the circulatory system through a cut or puncture to obtain a sample for analysis and diagnosis

A

Phlebotomy

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56
Q

Also done as part of patient’s treatment for certain blood disorders

A

Phlebotomy

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57
Q

They are the first to perform bleeding by scarification document in Ebers Papyrus

A

Egyptians

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58
Q

He was a prominent Greek physician discovered that arteries as well as Veins had blood. Previously it was thought that arteries were filled with air

A

Galen of Pergamon

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59
Q

He developed quite a complex system for the quantity of blood which should be removed and from what specific areas of the body

A

Galen of Pergamon

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60
Q

Often credited as bringing phlebotomy to the United States in the 18th Century

A

The pilgrims

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61
Q

It was common at this time of use lancets that were fired into Veins at multiple locations, withdrawing up to FOUR PINTS of blood

A

The pilgrims

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62
Q

It was a popular service for almost one hundred years, although it went out of fashion as many harmful incidents came to life

A

Bloodletting

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63
Q

In the 18th century,it was a standard treatment

A

Bleeding

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64
Q

Bleeding was a treatment for in the 18th century?

A

Treatment doe fever such as putrid fevers (typhus and typhoid fever)
Treatment for hypertension, cases of coma, and drowsy headaches
Recommend for inflammation of lungs according to the amount of pain, the pounding of the pulse and the difficulty breathing.

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65
Q

During the 18th century, how many ounces were bled over a 6-day period?

A

210 ounces

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66
Q

On December 13, 1799, he was taken l with a cold and mild hoarseness. Who was he?

A

George Washington

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67
Q

A total of ___ mL of blood was taken over 12 hours

A

2365 mL

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68
Q

He was an Edinburgh trained physician who offered no explanation about George Washington

A

James Craik

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69
Q

What happened to Washington’ s blood that it reflected with dehydration and hypovolemia?

A

Became viscous and flowed slowly

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70
Q

When was the American civil war?

A

1861 - 1865

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71
Q

During this time, military doctors were unable to cope up with the widespread disease and infection, bled Union soldiers, and civilians like

A

American Civil War

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72
Q

Early instruments in the American civil war included anything sharps such as?

A

Hoarded stones
Quills
Thorns or animal teeth

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73
Q

Thumb lancet was introduced in the ______ century

A

15th

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74
Q

It was a double‐edged instrument, often with ornate handles made out of turtle shells.

A

Thumb lancet

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75
Q

They proved conclusively that inflammation
resulted from infection and thus was not susceptible to bloodletting.

A

Louis Pasteur (1822–1895) and Robert Koch
(1843–1910)

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76
Q

They offered a scientifically legitimate way of
thinking about the cause and treatment of the
patient’s illness.

A

Louis Pasteur (1822–1895) and Robert Koch
(1843–1910)

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77
Q

This theory states that diseases are produced due to unhealthy or polluted vapors rising from the ground.

A

Miasma Theory

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78
Q

were reported to be
using leeches, primarily to bleed patients as
treatment

A

Three Kashmiri Hospitals (April 2008)

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79
Q

Three Kashmiri hospitals were reported to be
using leeches, primarily to bleed patients as
treatment for

A

Heart problems, arthritis, gout, chronic headaches, and Sinusitis

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80
Q

These are for single use to avoid transmission of disease!

A

Leeches

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81
Q

● It is used every day to diagnose health problems
and introduce medication intravenously.

A

Phlebotomy today

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82
Q

● It is also used in lifesaving procedures like blood transfusions.

A

Phlebotomy today

83
Q

● Today, trained professionals called phlebotomists withdraw blood in clinics and hospitals all over the world

A

Phlebotomy today

84
Q

What year was army lancet

A

1953

85
Q

Critical areas in quality of phlebotomy:
APCC

A

Appropriateness of Test request
Patient and Sample Identification
Criteria for accepting or rejecting of specimens
Communicating and interpreting of results

86
Q

It is the first step in most laboratory analysis

A

Specimen Collection

87
Q

Quality depends on how a specimen was ____, ____, and ____

A

collected, transported, and processed

88
Q

Quality assessment in phlebotomy includes _____, _____, and ____

PCP

A

preparation of a patient for any specimens to be collected, collection of valid samples, proper specimen transport

89
Q

They are the only laboratory staff member that a patient sees

A

Phlebotomists

90
Q

they are expected to deliver unexcelled customer satisfaction

A

Phlebotomists

91
Q

TRUE OR FALSE

It is important to understand and know the patient’s expectation, manage unrealistic expectations through patient education, and be diplomatic with customer complaints

A

TRUE

92
Q

What are the 5 kinds of patients

A

Conscious in-patients
Sleeping patients
Unconscious or mentally incompetent patients
Infants and Children
Outpatient patient

93
Q

How to identify conscious in-patients?

A

Verbally ask for their full name and verify it using the identification bracelet

94
Q

What is in the identification bracelet?

A

Patient’s first and last name, hospital or unit number, bed/room and physician’s name

95
Q

How to identify sleeping patients?

A

They must be awakened before blood collection
Identify the same as conscious patients

96
Q

How to identify unconscious or mentally incompetent patients?

A

Identified by asking the attending nurse or relative; id bracelet

97
Q

How to identify infants or children?

A

The nurse or relative may identify the patient or by ID bracelet

98
Q

How to identify outpatient patient?

A

Verbally ask for their full name , DOB, and countercheck it with driver’s license or ID with photo. If the patient has ID Card or bracelet, same manner as hospitalised patients

99
Q

When dealing with them, you need to be gentle and treat them with compassion, empathy, and kindness.

A

Pediatric patients

100
Q

When dealing with them, you need to attempt to interact with these patients

A

Pediatric patients

101
Q

Acknowledge the parent and the child

A

Pediatric patients

102
Q

When dealing with these patients, u need to be friendly, courteous, and responsive

A

Pediatric patients

103
Q

You need to allow enough time for the procedure also when dealing with these patients

A

Pediatric patients

104
Q

When obtaining a blood specimen from these patients, you need to be RELAXED and be PERCEPTIVE about any anxiety the he/she may have

A

Adolescent Patients

105
Q

General interaction techniques include:

A

Allowing enough time for the procedure
Establishing eye contact
Allowing the patient to maintain a sense of control

106
Q

You need to treat these patients with DIGNITY and RESPECT
> do nor demean the patient
> address the patient with a more formal title
> they love to talk, so keep a flexible agenda for more enough time
> speak slowly and allow enough time for questions
>they have the right to informed consent

A

Geriatric Patients

107
Q

What are the categories of additives used for blood collection?

A
  1. Antiglycolytic agent
  2. Anticoagulant agent
  3. Clot activator
  4. Thixotropic gel separator
  5. Trace element-free tubes
108
Q

This additive inhibits the use of glucose by blood cells

A

Antiglycolytic Agent

109
Q

Examples of Antiglycolytic agents are?

A

Sodium fluoride and lithium iodoacetate

110
Q

Generated liquid after centrifugation of antiglycolytic agent is

A

Plasma

111
Q

This additive prevents blood from clotting?

A

Anticoagulant Agent

112
Q

The mechanism by which clotting is prevented varies with the _____ ?

A

anticoagulant

113
Q

EDTA, citrate, and oxalate removes ____ by forming insoluble salts

A

removes calcium

114
Q

Heparin prevents conversion of ___ to ___?

A

prothrombin to thrombin

115
Q

If you remove the calcium or thrombin is not formed, ____ does not occur

A

coagulation

116
Q

What is the general liquid form after centrifugation of the anticoagulant agent?

A

plasma

117
Q

It helps to enhance or initiate the clotting mechanism

A

Clot Activator

118
Q

These clot activator particles provide increased surface area for platelet activation and clotting factors such as thrombin

A

glass and silica particles

119
Q

The generated liquid after centrifugation of clot activator is ?

A

Serum

120
Q

an inert material that undergoes a TEMPORARY CHANGE IN VISCOSITY during the centrifugation process, which serves as a SEPARATION BARRIER between the liquid and the cells (serum and plasma)

A

Thixotropic gel separator

121
Q

The generated liquid after centrifugation for thixotropic gel separator?

A

serum

122
Q

Made up of materials that are free trace element contamination

A

Trace element-free tubes

123
Q

It has royal blue stoppers, and it is used for trace element tests, toxicology studies, and nutrient determination

A

trace element-free tubes

124
Q

Red

A

No additive

125
Q

Orange

A

Coagulant (coagulate in 5 mins)

126
Q

Yellow

A

Coagulant and Separation Gel

127
Q

Green

A

Sodium Heparin

128
Q

Light Green

A

Lithium Heparin

129
Q

Purple

A

EDTA

130
Q

Light Blue

A

Sodium Citrate 1:9 (anticoagulant blood) 3.2%

131
Q

Black

A

Sodium Citrate 1:4 (anticoagulant blood) 3.8%

132
Q

Grey

A

Potassium Oxide Monohydrate and Sodium Flouride

133
Q

What are the 5 anticoagulants?
(COFEH)

A

Citrate
Oxalate
Fluoride
Ethylenediaminetetraacitic acid (EDTA)
Heparin

134
Q

anticoagulant that combines with calcium to form insoluble salt

A

Oxalate

135
Q

Combines with calcium in a NON-IONIZED FORM

A

Citrate

136
Q

Forms weakly dissociated calcium

A

Fluoride

137
Q

Combined with calcium in a process called chelation

A

EDTA (ethylenediaminetetraacitic acid)

138
Q

prevents the form of thrombin

A

Heparin

139
Q

Glass or Plastic

a.) Red-Top Tube
- no additive
- Glass surface activates clotting sequence
- Do not mix
- SERUM : used for TDM (Therapeutic Drug Monitoring)

A

Glass Red-Top Tube

140
Q

Glass or Plastic

a.) Red-Top Tube

  • contains additive to activate clotting sequence
  • do Invert (5x) to mix additive and initiate clotting sequence
  • SERUM
  • let the sample rest for 30 MINUTES before centrifugation to GENERATE SERUM
A

Plastic red-top tube

141
Q

Blood Clotting Time for Red-Top Tube (how many mins)

A

60 mins

142
Q

Also known as plain tube

A

Red-Top Tube

143
Q

Its laboratory use are:

1) serum determination in chemistry
2) Routine blood donor screening
3) Diagnostic Testing for infectious disease

A

Red-Top Tube

144
Q
  • Also known as the Serum Separator Tube
  • contains CLOT ACTIVATOR and GEL (SST)
  • Invert to mix and initiate clotting sequence
  • SERUM
A

Gold or Mottled-Red-Gray Test tube

145
Q

What is the blood clotting time for gold or mottled-red-gray tube?

A

30 mins

146
Q

Its laboratory use are:

1) serum determination in chemistry
2) blood donor screening
3) serum testing for infectious disease

A

Gold or mottled-red-gray top tube

147
Q

Anticoagulant = 3.2% sodium Citrate
Specimen - Plasma
Binds with calcium
Blood: anticoagulant ratio critical (9:1)

A

Light Blue Top Tube

148
Q

The inversion needed for light blue-top tube is?

A

3-4 full gentle inversion

149
Q

Harsh inversions may generate

A

microclots

150
Q

Laboratory use:

1) clot based studies/
2) coagulation studies

A

Light Blue top tube

151
Q
  • Anticoagulant- heparin
  • Three formulations:
    1. Lithium Heparin
    2. Ammonium Heparin
    3. Sodium Heparin
  • Inhibits Thrombolin
  • must be full and on ice to prevent consumption of oxygen, if needed for pH, ionised Ca analysis
A

Green-Top Tube

152
Q

Laboratory use: plasma determinations in Chemistry

A

Green-Top Tube

153
Q

How many inversions does the green-top tube need?

A

8 full inversions

154
Q
  • Anticoagulant = glass - liquid K2EDTA
    plastic - spray-dried K3EDTA
  • sample = can be either plasma or whole blood
  • binds with calcium
  • requires 8 full inversion (10 if the sample rested for long time)
A

Purple-Top Tube

155
Q

Laboratory use: hematology determination (CBC), routine immunohematology testing (blood typing), blood donor screening (both red and purple top are used for crossmatching)

A

Purple-Top Tube

156
Q

Anticoagulant = Potassium Oxalate
> binds with calcium
> plasma, whole blood
Antiglycolytic = sodium fluoride
> monitors plasma glucose levels

A

Gray-Top Tube

157
Q

Laboratory Use: Glucose determination and Lactic acid level determination

A

Gray-Top Tube

158
Q

ACD = Acid Citrate Dextrose
• Blood Bank Studies
• HLA Penotyping
• Paternity Testing
• DNA

A

Yellow Top Tube

159
Q

SPS = Sodium Polyanethol Sulfonate
• special blood culture studies
• inhibited certain antibiotics
> Both bind calcium ACD and SPS
> PLASMA, Whole blood

A

Yellow Top Tube

160
Q

Additive (1) : thrombin-based clot activator with gel for serum separation
Inversion: 5-6 times
Laboratory use: stat serum determination, Inversion ensures mixing or clot activator with blood
Blood Clotting Time: 5 mins

Additive (2): Thrombin-based clot activator
Inversions : 8 times
Laboratory use: stat serum determination, Inversion ensures mixing of clot activator with blood
Clotting Time: 5 mins

A

Orange-Top Tube

161
Q

Additive: Clot activator (plastic serum) or K2EDTA (plastic)
Inversions: 8 times
Laboratory Use: trace element, toxicology, and nutritional-chemistry determination

A

Royal Blue Top Tube

162
Q

It provides low levels of trace elements

A

Special stopper formulation

163
Q

Ensure mixing of either clot activator or anticoagulant (EDTA) with blood

A

Inversions

164
Q

Additive: K2EDTA (plastic)
Inversions: 8 times
Laboratory Use: lead determination. This tube is certified to contain less than 0.1 ųg/ml (ppm) lead. Tube inversions prevent clotting.

A

Tan Test Tube

165
Q

Additive: K2EDTA and gel for plasma separation
○ Inversions: 8 times
○ Laboratory use: For use in molecular diagnostic
test methods (such as, but not limited to,
polymerase chain reaction [PCR] and/or
branched DNA [bDNA] amplification techniques).
Tube inversions ensure the mixing of
anticoagulant (EDTA) with blood to prevent
clotting.

A

White Test Tube

166
Q

Additive: Spray-coated K2EDTA (plastic)
○ Inversions: 8 times
○ Laboratory use: For whole blood hematology
determinations. May be used for routine
immunohematology testing and blood donor
screening. Designed with a special cross-match
label for patient information required by the
AABB. Tube inversions prevent clotting.

A

Pink Top Tube

167
Q

ORDER OF DRAW (EVACUATED TUBE)

A

● Blood Culture or sterile tubes (yellow stopper)
● Coagulation tube (light blue stopper)
● Serum tube with or without clot activator or gel (red,
gold, or red gray marbled)
● Heparin tube (green or light green stopper)
● EDTA tube (lavender stopper)
● Oxalate/fluoride tube (gray stopper)

168
Q

memory jagger for order of draw

A

Stop
Light
Red
Stay
Put
Green
Light
Go

169
Q

Give the inversions of the following tubes:

Blood Gases
Slides and Smears
Lithium heparin
Lithium heparin with gel
separator
Sodium fluoride/
Potassium oxalate
Serum- clot activator
Serum- no additive
Newborn Blood Spot
Card

A

Blood Gases - rotate between palm to mix
Slides and Smears - 10
Lithium heparin - 10
Lithium heparin with gel separator - 10
Sodium fluoride/Potassium oxalate - 10
Serum- clot activator - 5
Serum- no additive - 0
Newborn Blood Spot Card - recommended to be collected separately

170
Q

> Rarely collected in adults
Usually performed on INFANTS and YOUNG CHILDREN
CBG specimens are collected from the same sites as routine capillary puncture specimens
warming the site for 5-10 mins is necessary

A

Capillary Blood Gases

171
Q

● Done to newborns to detect and monitor
increased bilirubin levels caused by
overproduction or impaired excretion of bilirubin.
● Bilirubin can cross the blood-brain barrier (BBB) of
infants accumulating to toxic levels that can cause
permanent brain damage or even death
● Bilirubin breaks down in the presence of light
● Collection is done quickly by heel puncture,
protected from light during transportation and
handling. Sample is collected in amber-colored
microcollection tubes (alternative is to wrap the tube
with carbon paper/foil).

A

Neonatal Bilirubin Collection

172
Q

● Testing of newborns for the presence of certain
genetic, metabolic, hormonal, and functional
disorders that can cause severe mental handicaps
or other serious abnormalities
● Sample collected through blood spot collection
○ Sample is obtained through heel puncture (lateral
side)
○ Blood drops are collected by absorption onto
circles printed on a special type of filter pape

A

NEWBORN/NEONATAL SCREENING

173
Q

● failure to mix or inadequate mixing of samples
collected into an additive tube.
● The red cells clump together, making the sample unsuitable for testing

A

Clotted

174
Q

This is usually caused by a procedural error such
as using too small of a needle or pulling back too
hard on the plunger of a syringe used for collecting the sample

A

Hemolysis

175
Q

● The red cells rupture, resulting in hemoglobin being released into the serum/plasma, making the sample unsuitable for many laboratory tests.
● The serum/plasma will appear red instead of straw color

A

Hemolysis

176
Q

● certain additive tubes must be filled completely.
● Incorrect blood-to-additive ratio will adversely affect
the laboratory test results

A

insufficient sample

177
Q

Always refer to procedure manual when uncertain.

A

wrong tube collection for test ordered

178
Q

certain tests must be collected and placed in ice,
protected from light, or be kept warm after collection

A

improper storage

179
Q

● most commonly encountered complication in
obtaining a blood specimen.
● It is caused by leakage of a small amount of fluid around the tissue.

A

Ecchymosis (bruise)

180
Q

● second most common complication.
● Before drawing blood, the collector should ask if he/she had prior episodes of fainting

A

syncope (fainting)

181
Q

when leakage of a large amount of fluid around
the puncture site causes the area to swell.
● Most commonly occurs when the needle goes
through the vein, bevel is partially inserted in the
vein and if the collector fails to apply enough
pressure after venipuncture

A

hematoma

182
Q

due to improper needle positioning

A

failure to draw blood

183
Q

small red spots indicating that small amounts of
blood have escaped into the skin epithelium.

A

petechiae

184
Q

swelling caused by an abnormal accumulation of
fluid in the intracellular spaces.

A

edema

185
Q

veins may be neither readily visible nor easy to
palpate

A

obesity

186
Q

is an increased concentration of larger
molecules and analytes (potassium) in the blood
as a result of a shift in water balance.

A

hemoconcentration

187
Q

Primary effect is hemoconcentration. The
hydrostatic pressure causes some water and
elements to leave the extracellular space.

A

prolonged tourniquet application

188
Q

Burned, damaged, scarred and occluded veins,
seizure and tremors, vomiting and choking, allergies
and mastectomy patients.

A

Other complications

189
Q

rupture of red blood cells with the consequent
escape of hemoglobin.
● Can cause the plasma or serum to appear pink or red.

A

Hemolysis

190
Q

fluid may dilute the specimen, so collect from
the opposite arm if possible.

A

IV Therapy

191
Q

changing from a supine (lying) to a sitting or
standing position results in a shift of body water
from inside the blood vessels to the interstitial
spaces.

A

Posture

192
Q

levels of certain hormones such as cortisol and
adrenocorticotropic hormone decreases in the
afternoon. Other test values, such as iron and
eosinophil levels increase in the afternoon.

A

Diurnal rhythm

193
Q

anxiety can cause a temporary increase in white
blood cel

A

Stress

194
Q

Muscle activity elevates creatine, protein, creatine
kinase, AST (Aspartate Aminotransferase) and LDH
(Lactate Dehydrogenase). Exercise activates
coagulation and fibrinolysis and increases platelet
and white blood cells.

A

Exercise

195
Q

if a patient has eaten recently (less than 2 hours
earlier), there will be a temporary increase in
glucose and lipid content in the blood. Serum may
appear cloudy or turbid (take into consideration
the fasting requirements or dietary restrictions)

A

Diet

196
Q

Patients who smoke before blood collection may
have increased white blood cell counts and
cortisol levels. Long term smoking can lead to
decrease pulmonary function and result in increased
hemoglobin levels

A

Smoking

197
Q

Prolonged application of tourniquet (>1 min)
○ Causes hemoconcentration (affects analytes)

A

Venous statis

198
Q

○ Drawing above IV (Dilute sample)
○ Short draw (blood to anticoagulant ratio) (Results
in QNS or dilution)

A

Hemodilution

199
Q

○ Traumatic stick
○ Too vigorous mixing
○ Alcohol still wet (always wipe the first drop of
blood)
○ Using too small of needle
○ Forcing blood into syringe

A

Hemolysis

200
Q

○ Inadequate mixing
○ Traumatic stick

A

Clotted Sample

201
Q

○ Short draw
○ Sodium citrate tube draw volume critical

A

Partially filled tubes

202
Q

○ Using incorrect cleanser
○ Alcohol still wet
○ Powder from gloves
○ Drawing above IV

A

Specimen contamination

203
Q

○ Exposure to light
○ Pre-chilled tube
○ Body temperature

A

Specimen Handling

MT 12 lec (5 decks)

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