Pre-Analytical Consideration Part B Flashcards

1
Q

avoid these areas since it’s difficult to palpate or penetrate in burned
and scarred areas.
o painful
o susceptible to infection
→ healed sites with extensive scarring may have impaired circulation that
could lead to erroneous (invalid or false) test results

A

Burns, Scars and Tattoos

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2
Q

may feel hard and cordlike and lack of resiliency since they are partially or completely occluded (obstructed)

A

Damaged Veins

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3
Q

Veins may be:

A
  • Sclerosed (hardened)
  • Thrombosed (clotted)
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4
Q

Effects of inflammation, disease, or chemotherapy drugs

A

Thrombosed (clotted)

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4
Q
A
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5
Q

Swelling caused by abdominal accumulation of fluid in tissue

A

Edema

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6
Q

What is the common problem after mastectomy

A

Edema

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7
Q

yield inaccurate test results owing to contamination by swelling
▪ harder to locate
▪ fragile
▪ easily injured by tourniquet & antiseptic
▪ healing may be prolonged

A

Edema

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8
Q

Swelling or mass of blood (often clotted)

A

Hematoma

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9
Q

o can be caused by blood leaking from a blood vessel
o large bruise spread around the area
o Hemolyzed blood will occur when puncturing to hematoma
site
▪ painful
▪ can coagulation and lead to inaccurate test

A

Hematoma

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10
Q

Surgical Breast Removal

A

Mastectomy

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11
Q
  • never drawn blood from an arm on the same side
    o Lymph node removal
    ▪ part of the procedure
A

Mastectomy

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12
Q

May case Lymphocytosis

A

Mastectomy

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13
Q

o Obstruction or stoppage of normal lymph flow
o could change blood composition
o lead to inaccurate test results

A

Lymphocytosis

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14
Q

it’s an impaired lymph flow makes the arm susceptible to
swelling

A

Lymphedema

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15
Q
  • Extremely Overweight
A

Obesity

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16
Q

18 inch long

A

Strap Tourniquet

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17
Q

Designed for obese

A

Bariatric Tourniquets

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18
Q

used and just below the patient’s diastolic pressure

A

Bariatric or XL size blood pressure cuff

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19
Q

What are the steps to locate obese vain

A

–> 1st check antecubital area
→ next palpable is median cubital vein
→ then ask the patient where or what sites have been successful for past blood draws
→ next option: cephalic vein
o to locate: rotate the patient’s arm medially

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20
Q
  • Loss of muscle function
  • Can be temporary or permanent
  • Can be localized in one area or widespread
A

Paralysis

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21
Q

What is the meaning of ALS

A

Amyotrophic lateral sclerosis

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22
Q

What is the meaning of VADS

A

Vascular Access Devices and Sites

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23
Q

→ tubing devices that are designed to allow entry to veins or arteries
→ for patients who require frequent venous or arterial access
→ commonly used for administration of meds, fluids, blood products & sometimes blood collection
→ General Rule: do not performed in extremity with VAD

A

Vascular Access Devices and Sites (VADS)

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24
Q

What is the meaning of IV?

A

Intravenous Line

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25
Q

→ “Pertaining to or within the vein”
→ quick way to deliver fluids, meds, blood transfusion products and other substances

A

Intravenous Line (IV)

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26
Q

o catheter inserted in peripheral vein
▪ its typically connected to a line that is used to administer fluid
o line is attached to a bag containing the substance being
administered

A

Intravenous Line (IV)

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27
Q

Line is usually having a special drip chamber that prevents air from entering the tubing allows the flow rate to be estimated and controlled

A

IV Drip

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28
Q

If the patient has an IV in both arms, draw ____ the IV

A

distal (below)

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29
Q

If both are not free ____ must be taken

A

Capillary puncture

30
Q

needle connection device in the form of a stopcock or a cap that is
connected to a hub of catheter or cannula by short length of IV tubing
o cap or stopcock has a diaphragm
▪ thin, rubberlike cover
▪ for administering meds or drawing blood
o lock, often places in vein in the lower arm above the back of
the wrist and can be left in place for 48 hours

A

IV Catheter Lock

31
Q

Device filled with saline known as SAline Lock

A

Lock

32
Q

One filled with Heparin known as ___ or Heplock

A

Heparin Lock

33
Q
  • A-line or Art-line
  • Catheter placed in an artery
  • located in radial artery of the wrist
A

Arterial Line

34
Q

Permanent surgical connection of an artery and vein

A

Arteriovenous AV shunt

35
Q

bypasses the capillaries and forces
arterial blood directly into a vein

A

AV shunt

36
Q

to move or force

A

shunt

37
Q

dialysis shunt created by direct permanent fusion of the
artery and vein

A

AV fistula

38
Q

Most common type of shunt for dialysis

A

AV Fistula

39
Q

piece of vein or tubing form a loop from the artery to vein that can be seen under the skin

A

AV Graft

40
Q

Distinctive buzzing sensation of shunt

A

Thrill

41
Q

Needle closed blood sampling sometime connected to an arterial or central venous catheter

A

Blood Sampling Device

42
Q

Also known as indwelling line

A

Central Vascular Access Devices (CVAD)

43
Q

o consists of tubing inserted into main vein or artery
o primarily used for administering fluids and meds
o monitoring pressures and drawing blood

A

Central vascular Acess devices

43
Q

Mostly; povidone-iodine

A

Antiseptic Allergy

43
Q

→ place a clean, folded gauze square over the
site & wrap it with self-adherent elastic bandage
→ instruct to remove after 15 mins
→ hold press the site for 5 mins

A

Adhesive Allergy

44
Q
  • Involves irritation or rashes
  • can be; life-threatening reaction
A

Latex Allergy

45
Q

→ aspirin or anticoagulant therapy (may take longer to stop bleeding)
→ if continuous in 5mins, notify personnel’s

A

Excessive Bleeding

46
Q

→ loss of consciousness and postural tone
→ contributing factors: anemia,
dehydration, emotional problems, fatigue, hypoglycemia, hyperventilation, medications, nausea, needle phobia and poor or compromised breathing

A

Fainting [Syncope]

47
Q

→ not usual to experience
→ do not attempt until it subsides
→ give an emesis basin or wastebasket to hold as precaution
→ ask to breath slowly & deeply
→ apply cold, damp washcloth or cold compress to forehead

A

Nausea and Vomiting

48
Q

→ usually in routine venipuncture & capillary puncture

A

Pain

49
Q

→ Tiny, non-raised red, purple or brownish spots when tourniquet is applied
→ spots are mins drops of blood that escape capillaries and come to surface
→ Thrombocytopenia – low platelet count

A

Petechiae

50
Q

→ discontinue the draw
→ call for help to ease patient

A

Seizures / Convulsions

51
Q

→ common complication
→ if hematoma forms while blood drawing; discontinue
→ hold for 3 to 5 mins
→ the arm should be elevated and put cold compress

A

Hematoma Formation and Bruising

52
Q

adjective used to describe an adverse condition brought
the effect of treatment

A

Iatrogenic

53
Q

Blood loss though blood removed for testing

A

Iatrogenic blood loss

54
Q

o blood loss to a point at which life cannot be sustained
o life may be threatened if more than 10% (infant) 14% (adult) volume is removed

A

Exsanguination

55
Q

→ rare when proper venipuncture is followed
→ most often associated with deep or blind probing
o especially in basilic vein close to brachial artery

A

Inadvertent Arterial Puncture

56
Q

–> rare occurrence but does happen
o don’t open adhesive tape or bandages ahead of time or
temporarily tape them to lab-coat cuffs or other contaminated objects
o don’t pre-load (attach) needles onto tube holders to have a
supply for many draws ahead of time. sterility of needle is
breached once seal is broken
o allow alcohol to dry prior to needle insertion
o before/during don’t touch the site with finger, glove, gauze
or any nonsterile after it has been cleaned
o try to minimize the time between removing the needle cap
o remind patient to keep bandage atleast 15 mins

A

Infection

57
Q

→ flow back
→ to avoid reflux; place patient’s arm downward position
→ will cause buildup of scar tissue and increase difficulty to performing subsequent venipunctures
→ Blind probing and improper technique can damage veins and impair vein patency

A

Reflux of Additive

58
Q

→ localized venous stasis or stagnation of normal venous blood flow

A

Hemoconcentration

59
Q

Ways to prevent Hemoconcentration

A

o ask to release fist upon blood flow
o choose appropriate patent vein
o don’t allow to pump the fist
o don’t excessively massage the area in locating vein
o don’t probe or redirect the needle multiple times in search of
a vein
o release tourniquet within 1 min

60
Q

→ results when RBC are damaged or destroyed

A

Hemolysis

61
Q

Slightly hemolysis

A

Pink

62
Q

Moderate hemolysis

A

Dark Pink to light Red

63
Q

Gross hemolysis

A

Dark red

64
Q

→ Hemolyzed specimen can result in conditions such as

A

o hemolytic anemia
o liver disease
o transfusion reaction

65
Q

→ Must fill ETS tubes until normal amount of vacuum is exhausted

A

Partially Filled Tubes

66
Q

→ Short Draws
o failure to partially filled tubes
o acceptable only in: Red tops & SSTs

A

Partially Filled Tubes

67
Q

→ improper technique or carelessness

A

Specimen Contamination

68
Q

→ Affect test results and jeopardized patient safety

A

Wrong or Expired Collection Tube

69
Q

→ not inserted far enough
→ bevel partially out of the skin
→ bevel partially into the skin
→ bevel partially through the vein
→ bevel completely through the vein
→ bevel against vein wall
→ bevel in valve
→ needle beside the vein
→ undetermined needle position

A

Needle Positions

70
Q

What are some needle positions

A

→ not inserted far enough
→ bevel partially out of the skin
→ bevel partially into the skin
→ bevel partially through the vein
→ bevel completely through the vein
→ bevel against vein wall
→ bevel in valve
→ needle beside the vein
→ undetermined needle position