PRE-ANALYTICAL CONSIDERATIONS IN PHLEBOTOMY Flashcards
events or actions that take place before laboratory
testing
Pre-Analyitcal Testing Phase
identify factors that affect the process and address them as
needed
Phlebotomist’s role
Red Blood Cells (RBC), White Blood Cells (WBC), Creatinine Clearance
Age
Red Blood Cells
Altitude
Hemoconcentration, RBC, Enzymes, Iron (Fe), Calcium (Ca), Sodium (Na)
Dehydration
Glucose, Lipids, Electrolytes
Diet
Thyroid Stimulating Hormone (TSH), Cortisol, Iron (Fe)
Diurnal Variation
Enzymes, Hormones
Drug Therapy
pH, PCO2, Creatine Kinase (CK), Lactic Acid Dehydrogenase (LDH), and Glucose
Exercise, IM Injection
Hormones, Cortisol
Fever
RBC, Hemoglobin, Hematocrit
Gender
Yellow color interfaces due to increased bilirubin
Jaundice
Creatine Kinase (CK), Skeletal Muscle Fraction of LDH
Intramuscular Injection
Protein, Potassium (K)
Position
RBC
Pregnancy
Cholesterol, Cortisol, Glucose, Growth Hormone (GH), Triglyceride, WBC
Smoking
WBC, Iron (Fe), Adrenocorticotropic Hormone, Catecholamine, Cortisol
Stress
Hemoconcentration
Temperature and Humidity
too painful; circulation is impaired, areas with tattoos prone to infection and colorimetric analysis due to dyes
Burns, Scars, and Tattoos
sclerosed, hardened, or clotted
Damaged Vein
Abnormal swelling due to accumulated interstitial fluid. Locating veins becomes harder.
Edema
removal of the breast during surgery. May cause swelling and
infection due to obstruction of lymph nodes.
Mastectomy
veins become deep and difficult to palpate
Obesity
Swelling or mass of blood in tissues due to leakage. Caused by
venipuncture. Painful for patient if selected as a site.
Hematoma
= Gauze pad should be applied over site; removed at 15 mins
= Apply pressure for 5 mins
Adhesive Allergy
Use different antiseptic
Antiseptic Allergy
Use non-latex alternative to gloves, tourniquet and bandage
Latex Allergy
Due to medications (Aspirin / Anticoagulants) = excessive bleeding
Excessive Bleeding
Patient’s prone to fainting must be asked to lie down prior to procedure
Fainting
- Discontinue the procedure until patient feels better
- Emesis bowl must be prepared in case
Nausea and Vomiting
When patient complains of extreme pain / numbness = stop procedure
Pain
Small red/purple spots appearing as rashes; appears upon tourniquet application
Petechiae
Discontinue the blood draw immediately
Discontinue the blood draw immediately
