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pmls 2 > PMLS2_LEC7 > Flashcards

PMLS2_LEC7 Flashcards

1
Q

e is the method of
choice for collecting blood from infants and children younger than 2 years for the following reasons

A

Dermal/ Capillary/ Skin Puncture

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2
Q

REASONS for dermal puncture in infants and children younger than 2 years

A

● Locating superficial veins that are large enough to accept even a small-gauge needle is difficult
● Use of deep veins can be dangerous and may
cause complications, including cardiac arrest,
venous thrombosis, hemorrhage, damage to
surrounding tissue and organs, infection, and
reflex arteriospasm (which can result in
gangrene)
● Drawing excessive amounts of blood from
premature and small infants can rapidly cause
iatrogenic anemia (i.e, a 2-pound infant may
have a total blood volume of only 150 ml)

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3
Q

for pediatric patients, blood collection should be limited to (what percentage) of the total blood volume within a 24-hour period and to (what percentage) of the total blood volume over an 8-week period

A

1-5%;10%

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4
Q

how do you estimate an infant’s blood volume

A

You can estimate an infant’s blood volume by dividing the child’s weight in pounds by 2 to obtain the kilograms and then multiplying the kilograms by 100, this gives you the approximate total blood volume

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5
Q

It may not be possible to obtain a satisfactory specimen by dermal puncture from patients who are severely
dehydrated and who have poor peripheral circulation or swollen fingers.
You may not be able to use dermal puncture for certain tests because of the larger amount of blood sample required

A

Dermal puncture may be required in many adult
patients, including those who are:
● Burned or scarred
● Receiving chemotherapy and require frequent
tests and whose veins must be reserved for
therapy
● Likely to be thrombotic
● Geriatric or have very fragile veins
● Likely to have inaccessible veins
● Obese
● Apprehensive
● Receiving home glucose monitoring and POCT

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6
Q

what causes hemolysis in dermal puncture

A

Excessive squeezing of puncture site (milking)

Increased number of red blood cells (RBCs) and
increased RBC fragility in newborns

Residual alcohol at the site

Vigorous shaking of the micro-collection tubes after collection.

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7
Q

● Blood collected by dermal puncture comes from ___,___,___
● May contain small amounts of____
(tissue fluid from the spaces between the cells) and ____ (fluid within the cells)

A

capillaries, arterioles, and venules; interstitial fluid, intracellular fluid

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8
Q

Warming the site before specimen collection
increases blood flow as much as ____,
thereby producing a specimen that is very close to the composition of arterial blood.

A

sevenfold

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9
Q

The concentration of
____ is higher in capillary blood than in venous blood, and the concentration of ___, ___, ___ are lower.

A

glucose; potassium, glycoprotein and calcium

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10
Q

Dermal puncture supplies

A

● Automatic retractable safety skin puncture
devices
● Micro-collection containers
● 70% isopropyl alcohol pads
● Gauze pads
● Bandages
● Approved sharp’s container
● Glass slides
● Heel warmer

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11
Q

The Clinical and Laboratory Standards
Institute (CLSI) recommends that the incision depth should not exceed ___ in a device used to perform heel punctures

A

2mm

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12
Q

● To produce adequate blood flow, the depth of
the puncture is actually much less important
than the width of the incision.
● This is because the major vascular area of the skin is located at the dermal-subcutaneous
junction, which in a newborn is only ___ below the skin but can range to 3mm in a
large adult.

A

0.35 to 1.6 mm; 3mm

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13
Q

Incision widths vary from needle stabs to___. Sufficient blood flow should be obtained
from incision widths no larger than___.

A

2.5 mm

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14
Q

● Available in a full range of blades for collecting
specimens, using microhematocrit tubes, as well as microtainer blood collection tubes and needles to collect blood for single drop glucose testing

is designed to activate only when the blade
or needle is positioned and pressed against
the skin.

A

BD Microtainer Contact-Activated Lancet

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15
Q

Color coded heel puncture lancets made
specifically for premature infants, newborns, and
babies

A

BD QUICKHEEL LANCETS

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16
Q

● Provides a range of color-coded, fully
automated, single-use, retractable, disposable
devices of varying depths
● ____ and ____ devices are designed for heel and finger punctures,
respectively

A

INTERNATIONAL TECHNIDYNE CORPORATION; Tenderfoot, Tenderlett

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17
Q

● Tenderfoot devices are available for a range of
patients, from micro-preemies (___), to
preemies (___), to newborns (___) and toddlers (___)

A

blue; white; pink/blue; pink

18
Q

Available in five versions with varying needle gauges and penetration depths

A

UNISTICK 3 SAFETY LANCETS

19
Q

what unistick lancet should be used?
– pediatric patients
– for delicate skin
- for normal skin/
general use
– for tougher skin/larger specimens
– for low-flow heel stick and high flow finger stick

A

● Unistik 3 Gentle (30 gauge)
● Unistik 3 Comfort (28 gauge)
● Unistik 3 Normal (23 gauge)
● Unistik 3 Extra (21 gauge)
● Unistik 3 Dual (18 gauge)

20
Q

device is available for
heel punctures on newborns

A

The Unistik Tiny Touch

21
Q

are color coded, retractable lancets with
an ergonomically rounded design for a
comfortable grip, a rounded base for pinpoint precision, and simple activation by applying pressure on the puncture site.

Safety Lancet needle depths range from ___

A

GREINER BIO-ONE LANCELINO SAFETY LANCETS; 1.2 to
2.4mm

22
Q

● The latest device designed to make blood
collection fast and painless is _____
● The device, which is about the size of a stethoscope
head, is secured on the skin of the patient’s upper
arm by an adhesive hydrogel.

A

Seventh Sense
Biosystem’s Touch Activated Phlebotomy

23
Q

have largely replaced the large bore glass micropipettes.

A

Micro collection tubes or microtubes

24
Q

____which are frequently referred to as ____, are small tubes used to collect approximately 50 to 75 µL of blood for the primary purpose of performing a microhematocrit test.

A

Capillary tubes; microhematocrit tubes

25
Q

● microhematocrit tubes are available plain or coated with ammonium heparin; they are also color coded, with a ___ band for heparinized tubes and a ___ band for plain tubes.

A

red; blue

26
Q

● Heparinized tubes should be used for hematocrit tests collected by dermal puncture, and plain
tubes are used when the hematocrit test is being
performed on blood from a lavender stopper
EDTA tube.

A
27
Q

● The___ with ____
closures are designed to reduce the risk of blood splatter and blood leakage. The Microgard closure is removed by twisting and lifting.

A

BD microtainer tubes; BD Microgard

28
Q

have a wide diameter, textured interior and integrated blood collection scoop to
enhance blood flow into the tube and eliminate
the need to assemble the equipment

has a pierceable cap that is compatible with most
automated hematology instruments.

A

BD MICROTAINER TUBES

29
Q

Microtainer tubes have markings to indicate
minimum and maximum collection amounts
in ____ to prevent underfilling or
overfilling which can cause erroneous results.

A

microliters

30
Q

are available for microtainers to facilitate labeling and handling.

A

Tube extenders

31
Q

Other capillary blood collection devices have
plastic capillary tubes inserted into the collection container

After you have collected the blood, you remove
the capillary tube and use the appropriate
color-coded cap to close the tube.

A

SAFE-T-FILL CAPILLARY BLOOD COLLECTION DEVICES

32
Q

study procedures from pg. 7 onwards

A
33
Q

is a very light sensitive chemical and is
destroyed rapidly when exposed to light.

A

Bilirubin

34
Q

Infants who appear jaundiced frequently are
placed under an ultraviolet light to lower the level of circulating bilirubin. ____ must be turned off during specimen collection.

A

UV light

35
Q

____colored microcollection tubes are available for collecting bilirubin; if you are using microcollection tubes of another color, then you should shield the filled tubes from light.

In the lab, you do this by wrapping sample tubes
with_____

A

Amber; carbon paper

36
Q

is the testing of newborn babies for genetic, metabolic, hormonal and
functional disorders that can cause physical
disabilities, mental retardation or even death if not detected and treated early.
● Screening of newborns for___inherited
metabolic disorders currently can be performed from blood collected by heel puncture and placed on specially designed filter paper

A

Newborn screening; 50

37
Q

in newborn screening, blood collected between ____ hours after birth before the baby is released from the
hospital

A

24 and 48 hours

38
Q

study pg. 13 procedure of newborn screening

A
39
Q

When collecting CBGs, it is essential to ____
the collection site to arteralize the specimen
using a commercial heel warmer or warm moist
washcloth
● Collect the specimens in _____ the correspond to the volume and
sampling requirements of the blood gas analyzer being used
● Place the tube horizontally in an___to slow the metabolism of white blood cells as well
as changes in the pH and concentrations of
blood gases when the specimen will not be
tested within 15 minutes.

A

warm; heparinized capillary tubes; ice slurry

40
Q

are needed for microscopic examination of blood cells for a differential blood cell count for special staining procedures and for non automated respiratory counts

A

Blood smears

You should collect blood for the blood smear
before other specimens to avoid platelet
clumping.

41
Q

CHARACTERISTICS OF PROPERLY PREPARED
BLOOD SMEAR (WEDGE METHOD)

A

● Gradual transition from thick to thin area
● ⅔ to ¾ the length of the film side
● Finger shaped
● Visible lateral edge
● Without irregularities, holes or streaks
● Feather edge has rainbow appearance
● Whole drop of blood is picked up and spread

42
Q

● Measures time required for platelets to form a plug to stop bleeding from an incision
● Screening test to detect platelet disorders
● Performed by making an incision on the volar
surface of the forearm and inflating a blood
pressure cuff to ____ to control blood flow to the area.

A

BLEEDING TIME; 40 mmHg

pmls 2 (6 decks)

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