Pre-Analytical Consideration in Phlebotomy Flashcards
events or actions that take place before laboratory testing
Pre-Analytical Testing Phase
doctor’s order/test request is given
Starts
when actual laboratory testing starts
ends
identify factors that affect the process and address them as needed
Phlebotomist’s role
Variable:
Blood Composition Affected: RBC, WBC, and Creatinine clearance could be
affected as we grow old; increase in concentration
Age
Variable:
Blood Composition Affected: people living in higher ______ areas have
increase amount in RBC so that they can compensate the oxygen
Altitude
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
Diet
Variable:
Blood Composition Affected: Hemoconcentration, RBC, Enzymes, Iron (Fe), Calcium (Ca), Sodium (Na)
Dehydration
Variable:
Blood Composition Affected: Thyroid Stimulating Hormone (TSH), Cortisol, Iron (Fe)
Diurnal Variation
Variable:
Blood Composition Affected: Enzymes, Hormones
Drug Therapy
Variable:
Blood Composition Affected: pH, PCO2, Creatine Kinase (CK), Lactic Acid Dehydrogenase (LDH), and Glucose
Exercise, IM
Injection
Variable:
Blood Composition Affected: Hormones, Cortisol
Fever
Variable:
Blood Composition Affected: RBC, Hemoglobin, Hematocrit
Gender
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
Jaundice
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]
Changes in position
Variable:
Blood Composition Affected: can cause
hemoconcentration wherein blood will have an
increase concentration in tissue fluid and analytes
that will cause intercell
Temperature and humidity
Variable:
Blood Composition Affected: Yellow color interfaces due to increased bilirubin
Jaundice
Variable:
Blood Composition Affected: Creatine Kinase (CK), Skeletal Muscle Fraction of LDH
Intramuscular
Injection
Variable:
Blood Composition Affected: Protein, Potassium (K)
Position
Variable:
Blood Composition Affected: RBC
Pregnancy
Variable:
Blood Composition Affected: Cholesterol, Cortisol, Glucose, Growth Hormone (GH), Triglyceride,
WBC
Smoking
Variable:
Blood Composition Affected: WBC, Iron (Fe), Adrenocorticotropic Hormone, Catecholamine, Cortisol
Stress
Variable:
Blood Composition Affected: Hemoconcentration
Temperature and
Humidity
PROBLEM AREAS
- Too painful []; circulation is
impaired [], areas with tattoos
prone to infection and colorimetric analysis due
to dyes - Henna tattoos are not included
Burns, Scars, and Tattoos
PROBLEM AREAS
Sclerosed, hardened, or clotted
Damaged Vein
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
Edema
PROBLEM AREAS
Removal of breast during surgery. May cause
swelling and infection due to obstruction of
lymph nodes
Mastectomy
PROBLEM AREAS
- Veins become deep and difficult to palpate
Obesity
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
hematoma
ALLERGIES
Use non-latex alternative to gloves, tourniquet
and bandage
Latex Allergy
ALLERGIES
Use different antiseptic
Antiseptic Allergy
ALLERGIES
- Gauze pad should be applied over site; removal
at 15 mins
- Apply pressure for 5 mins
Adhesive Allergy
• Due to medications (Aspirin/Anticoagulants) =
excessive bleeding
• Remedy: apply pressure for an extended time
EXCESSIVE BLEEDING
• Patient’s prone to fainting must be aske to lie down
prior to procedure
FAINTING
• Discontinue the procedure until patient feels better
• Emesis bowl must be prepared in case
• Cold damp cloth must be ready as well
NAUSEA AND VOMITTING
• When patient complains of extreme pain/numbness
= stop procedure
• Numbness = nerve injury
PAIN
• Small red/purple spits appearing as rashes; appears
upon tourniquet application
PETECHIAE
• Discontinue the blood draw immediately
SEIZURES OR CONVULSIONS
