Pre-Analytical Consideration in Phlebotomy

Question 1

events or actions that take place before laboratory testing

Answer 1

Pre-Analytical Testing Phase

Question 2

doctor’s order/test request is given

Answer 2

Starts

Question 3

when actual laboratory testing starts

Answer 3

ends

Question 4

identify factors that affect the process and address them as needed

Answer 4

Phlebotomist’s role

Question 5

Variable:
Blood Composition Affected: RBC, WBC, and Creatinine clearance could be
affected as we grow old; increase in concentration

Answer 5

Age

Question 6

Variable:
Blood Composition Affected: people living in higher ______ areas have
increase amount in RBC so that they can compensate the oxygen

Answer 6

Altitude

Question 7

Variable:
Blood Composition Affected: glucose, lipids, and electrolytes are increase
when a person is intaking higher glucose, lipids, or
electrolyte diet; person that just ate could have an
increase in the following as well, regardless of their
lifestyle

Answer 7

Diet

Question 8

Variable:
Blood Composition Affected: Hemoconcentration, RBC, Enzymes, Iron (Fe), Calcium (Ca), Sodium (Na)

Answer 8

Dehydration

Question 9

Variable:
Blood Composition Affected: Thyroid Stimulating Hormone (TSH), Cortisol, Iron (Fe)

Answer 9

Diurnal Variation

Question 10

Variable:
Blood Composition Affected: Enzymes, Hormones

Answer 10

Drug Therapy

Question 11

Variable:
Blood Composition Affected: pH, PCO2, Creatine Kinase (CK), Lactic Acid Dehydrogenase (LDH), and Glucose

Answer 11

Exercise, IM
Injection

Question 12

Variable:
Blood Composition Affected: Hormones, Cortisol

Answer 12

Fever

Question 13

Variable:
Blood Composition Affected: RBC, Hemoglobin, Hematocrit

Answer 13

Gender

Question 14

Variable:
Blood Composition Affected: occurs when the liver is not functioning; cause a yellow coloring to the patient: epidermis, sclera of the eyes, and will cause the serum and plasma of the patient hysteric [increase; bright yellow than usual]; any colorimetric tests can be altered

Answer 14

Jaundice

Question 15

Variable:
Blood Composition Affected:
[standing to sitting] can alter
the following mentioned in the table; important to
be in a basal state [not moved for at least 15
minutes]

Answer 15

Changes in position

Question 16

Variable:
Blood Composition Affected: can cause
hemoconcentration wherein blood will have an
increase concentration in tissue fluid and analytes
that will cause intercell

Answer 16

Temperature and humidity

Question 17

Variable:
Blood Composition Affected: Yellow color interfaces due to increased bilirubin

Answer 17

Jaundice

Question 18

Variable:
Blood Composition Affected: Creatine Kinase (CK), Skeletal Muscle Fraction of LDH

Answer 18

Intramuscular
Injection

Question 19

Variable:
Blood Composition Affected: Protein, Potassium (K)

Answer 19

Position

Question 20

Variable:
Blood Composition Affected: RBC

Answer 20

Pregnancy

Question 21

Variable:
Blood Composition Affected: Cholesterol, Cortisol, Glucose, Growth Hormone (GH), Triglyceride,
WBC

Answer 21

Smoking

Question 22

Variable:
Blood Composition Affected: WBC, Iron (Fe), Adrenocorticotropic Hormone, Catecholamine, Cortisol

Answer 22

Stress

Question 23

Variable:
Blood Composition Affected: Hemoconcentration

Answer 23

Temperature and
Humidity

Question 24

PROBLEM AREAS

• Too painful []; circulation is
  impaired [], areas with tattoos
  prone to infection and colorimetric analysis due
  to dyes
• Henna tattoos are not included

Answer 24

Burns, Scars, and Tattoos

Question 25

PROBLEM AREAS Sclerosed, hardened, or clotted

Answer 25

Damaged Vein

Question 26

PROBLEM AREAS - Abnormal swelling due to accumulated interstitial fluid. Locating veins becomes harder [pagmamanas]; IV insertion, heart problems, etc. are the causes of edema. - The blood that will be collected in this area will be contaminated with interstitial fluid

Answer 26

Edema

Question 27

PROBLEM AREAS Removal of breast during surgery. May cause swelling and infection due to obstruction of lymph nodes

Answer 27

Mastectomy

Question 28

PROBLEM AREAS - Veins become deep and difficult to palpate

Answer 28

Obesity

Question 29

PROBLEM AREAS - Swelling or mass of blood in tissues due to leakage. Caused by venipuncture. Painful for patient If selected as a site - Last resort [above the hematoma], but best to avoid

Answer 29

hematoma

Question 30

ALLERGIES Use non-latex alternative to gloves, tourniquet and bandage

Answer 30

Latex Allergy

Question 31

ALLERGIES Use different antiseptic

Answer 31

Antiseptic Allergy

Question 32

ALLERGIES - Gauze pad should be applied over site; removal at 15 mins - Apply pressure for 5 mins

Answer 32

Adhesive Allergy

Question 33

• Due to medications (Aspirin/Anticoagulants) = excessive bleeding • Remedy: apply pressure for an extended time

Answer 33

EXCESSIVE BLEEDING

Question 34

• Patient’s prone to fainting must be aske to lie down prior to procedure

Answer 34

FAINTING

Question 35

• Discontinue the procedure until patient feels better • Emesis bowl must be prepared in case • Cold damp cloth must be ready as well

Answer 35

NAUSEA AND VOMITTING

Question 36

• When patient complains of extreme pain/numbness = stop procedure • Numbness = nerve injury

Answer 36

PAIN

Question 37

• Small red/purple spits appearing as rashes; appears upon tourniquet application

Answer 37

PETECHIAE

Question 38

• Discontinue the blood draw immediately

Answer 38

SEIZURES OR CONVULSIONS