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ClinChem > Specimen collection > Flashcards

Specimen collection Flashcards

Patient prep, Veni, arterial, skin puncture, order of draw

1
Q

Repeated venipuncture of large amounts of blood in premature infants can cause

A

Iatrogenic anemia

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2
Q

Order of draw in Microcollection tubes

A 
Blood gas
Slide
EDTA
Other additives
Serum
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3
Q

Skin puncture is useful in:

A

Extreme obesity
Severe burns
Thrombotic tendencies

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4
Q

Specimen used for blood gas analysis in newborn/infants for measuring pH,pCO2, but not pO2

A

Arterialized capillary blood

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5
Q

Preferred site for arterialized capillary blood collection

A

Earlobe

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6
Q

Most commonly used site for Arterialized capillary blood

A

Lateral plantar heel surface

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7
Q

Warming the site of skin puncture

A

Must be 39-42’C for 3-5 mins

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8
Q

Capillary arterialization should NOT be done if

A

BP is below 95 mmHg or if area is poor in blood supply

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9
Q

Minute metal filling inserted in capillary tube to help on mixing the specimen

A

Flea

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10
Q

Best method for blood gas collection

A

Indwelling umbilical artery catheter

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11
Q

Length of lancet for Skin puncture

A

1.75 mm

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12
Q

Depth of incision in Skin puncture

A

< 2mm in infants and child

< 2.5 mm for adults

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13
Q

Distance of skin surface from bone or cartilage

A

1.5-2.4 mm

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14
Q

The cut in skin puncture must be

A

Oriented across the fingerprints/ perpendicular

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15
Q

Preferrable sites of skin puncture

A

Lateral plantar surface of heel-newborn
Palmar surface of fingers(3rd & 4th)
Plantar surface of the big toe
Earlobes- least site

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16
Q

Sites to avoid in venipuncture

A 
IV lines in both arms
Burned or scarred areas
Hematoma
Thrombosed veins
Edematous arms
Partial/Radical Mastectomy
AV shunt
Casts on arms
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17
Q

Complications in Veni

A

Immediate Local Complication
Late Local complication
Late General complication

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18
Q

Late general complication/s

A

Serum Hepa

AIDS

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19
Q

Late local complication/s

A

Thrombosis

Thrombophlebitis

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20
Q

Immediate local complication/s

A

Hemoconcentration
Failure to enter the syringe/Vacu tube
Syncope/fainting

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21
Q

Traumatic draw can increase:

A

CK
Myoglobin
Potassium

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22
Q

Renin blood level is collected after

A

3-day diet,

In the peripheral vein

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23
Q

Disinfectant for Ethanol testing

A

Benzalkonium Chloride (Zephiran Chloride 1:750)

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24
Q

Disinfectant for blood culture

A

70% alcohol followed by iodophor

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25
Q

CLSI recommended disinfectant for blood culture of infants 2 months and older and Px with iodine sensitivity

A

Chlorhexidine Gluconate

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26
Q

Standard needle gauge

A

21 g

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27
Q

Gauge for children

A

23g

23-25g for butterfly

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28
Q

Gauge for collecting blood from scalp or tiny veins

A

25g

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29
Q

Standard needle length and gauge

A

1 in or 1.5 in 21-23g

1/2 or 3/4 in butterfly

30
Q

Tube component that cause the blood to clot within 15-30mins

A

Silica particles

31
Q

Gel separator clotting time

A

30mins

32
Q

Clot activator(thrombin) clotting time

A

5 mins

33
Q

Plain red stopped/no additives clotting time

A

60mins

34
Q

Tubes not used in blood bank procedures

A

Containing gels

35
Q

Tubes not used for TDM

A

SST

Gel separator

36
Q

Use of gel sep and SST in TDM will cause

A

Falsely low result

37
Q

Additive for Lactate sample

A

Fluoride oxalate

38
Q

Additive for ethanol specimens

A

Sodium fluoride

39
Q

Angle in veni

A

15-30 degrees

40
Q

10% contam of 5% dextrose will result in

A

Increase glucose by 500 mg/dL or more

41
Q

BP cuff as tourniquet

A

60 mmHg

42
Q

Tourniquets is reapplied after ____

A

2 mins

43
Q

Sites for veni

A

Antecubital fossa
Veins on wrist and dorsal aspect of hands
Veins on ankle

44
Q

Best site for veni

A

Median cubital vein

45
Q

Minute amount of blood escaped into skin epithelium

A

Petechiae

46
Q

Order of draw for Veni

A

Yellow(blood culture)
Light blue (Trisodium citrate)
Serum (w/ or w/o clot activator or gel sep)
Green (heparin)
Lavender/purple(EDTA)
Gray (NaF and K oxalate/iodoacetate and heparin)

47
Q

Apply tourniquet ____ above site

A

3-4 inches

48
Q

Arterial puncture sites

A

Radial, brachial,femoral,scalp and umbilical arteries

49
Q

Arterial puncture is for testing

A

Blood gas analysis

pH measurement

50
Q

A test performed before collecting arterial blood

A

Modifed Allen test

51
Q

Modified allen test

A

To determine wether Ulnar artery can provide collateral circulation

52
Q

Largest and easy to puncture site for arterial puncture

A

Femoral artery

53
Q

Major complications in arterial puncture

A

Thrombosis
Hemorrhage
Possible infection

54
Q

Angle in brachial artery

A

18-20 degrees

55
Q

Angle in femoral artery

A

90 degrees

56
Q

Radial artery gauge

A

23-25g

57
Q

Place the arterial sample in

A

1-5’C ice water

58
Q

Compress arterial puncture site for ____

A

3-5 mins

59
Q

First step in sample collection

A

Patient identification

60
Q

3-Way ID

A

Patient verbal ID statement
Check ID card
Visual comparison of labeled specimen with ID

61
Q

Average human whole blood

A

5 q(4.73L)
M: 5-6L
F: 4-5L

62
Q

Whole blood component

A

60% plasma

40% cells

63
Q

Advantage of Central Venous Cava (CVA) Collection

A

Eliminates multiple phlebotomies in critical and surgical situations

64
Q

All measurements should be performed within

A

45 mins to 1 hr

65
Q

Centrifugation requirement

A

3000 RCF for 10 mins

66
Q

Glycolysis occurs faster in

A 
Newborns(increased metabolism)
Leukemic patients (high metabolic activity of WBCs)
67
Q

To prevent glycolysis

A

Use 2mg NaF/mL of blood to prevent it within 48-72 hrs

68
Q

Least stable substances in serum

A

Potassium
Phosphorous
Glucose

69
Q

Unstable for 6 hrs if not removed from clot

A 
Albumin
Bicarbonate
Chloride
C-peptide
HDl-chole
LDL-Chole
Total protein
70
Q

Most common interfering conditions in measuring analytes

A

Hemolysis
Icterus
Lipemia

ClinChem (2 decks)

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