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CLINICAL CHEMISTRY (Topnotcher QT) > SPECIMEN COLLECTION AND CONSIDERATIONS > Flashcards

SPECIMEN COLLECTION AND CONSIDERATIONS Flashcards

1
Q

the act of obtaining a blood sample from a vein using a needle to a syringe or a stoppered evacuated tube; it is the most common way to collect blood specimens

A

Venipuncture

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2
Q

The major veins for venipuncture are in the:

A

antecubital fossa, the area of the arm in front of the elbow

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3
Q

Located near the center of the antecubital fossa; preferred vein because it is typically large, closer to the surface and the most stationary; most likely to bruise

A

Median cubital vein

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4
Q

Second-choice vein; often harder to palpate than median cubital vein; fairly well-anchored; often the only vein felt in obese patients

A

Cephalic vein

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5
Q

Last choice/least preferred; not well-anchored and rolls easily; increased risk of puncturing a median cutaneous nerve branch or the brachial artery; not recommended unless no other vein in either arm is more prominent

A

Basilic vein

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6
Q

Types of blood specimemns:

A
  1. serum
  2. plasma
  3. whole blood
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7
Q

Normally a clear, pale yellow fluid; separated from clotted blood by centrifugation (approx. 10 minutes at an RCF of 1,000 to 2,000g)

A

Serum

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8
Q

Normally a clear to slightly hazy, pale yellow fluid; separates from the cells when blood in an anticoagulant tube is centrifuged; contains fibrinogen

A

Plasma

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9
Q

Contains both cells and plasma; must be collected in an anticoagulant tube to keep it from clotting; used for most hematology tests and many point-of-care tests (POCTs), especially in acute care and stat situations

A

Whole blood

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10
Q

Methods of venipuncture:

A
  1. Evacuated tube system (ETS)
  2. Needle and syringe
  3. Butterfly set
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11
Q

preferred method because blood is collected directly from the vein into a tube, minimizing the risk of specimen contamination and exposure to the blood

A

Evacuated tube system (ETS)

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12
Q

Discouraged by CLSI due to safety and specimen quality issues; sometimes used on small, fragile, or damaged veins

A

Needle and syringe

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13
Q

Can be used with the ETS or a syringe; often used to draw blood from infants and children, hand veins, and in other difficult-draw situations

A

Butterfly set

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14
Q

Venipuncture equipment that restricts venous flow but not arterial flow:

A

Tourniquet

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15
Q

Tourniquet rule:

A

Must not be left on longer than 1 minute

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16
Q

Tourniquet dimensions:

A

1 inch wide x 15 inch long

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17
Q

considered standard needle gauge (adult) for routine venipuncture:

A

21 gauge

18
Q

Three basic components of ETS:

A
  1. Multisample needle
  2. Tube holder
  3. Evacuated tubes
19
Q

usual needle gauge for butterfly system

A

23 gauge - most commonly used for phlebotomy; used among children

20
Q

A handheld medical device that helps medical staff visualize veins before phlebotomy. The device emits infrared light and is held about 7 inches over the potential phlebotomy site

A

AccuVein

21
Q

Order of Draw:

A
  1. Sterile tube (blood culture)
  2. Coagulation tube (blue top)
  3. Serum tube with or without clot activator, with or without gel (Red top)
  4. Heparin tube with or without get separator (green top)
  5. EDTA tube with or without get separator (lavender top, pearl top)
  6. Glycolytic inhibitor tube (gray top)

Mnemonic:
Stop - Sterile
Light - Light blue
Red - Red
Stay - SST (serum separator tube)
Put - PST (plasma separator tube)
Green - Green
Light - Lavender
Go! - Gray

22
Q

Lengths of lancet should be:

A

less than 2.0 mm to avoid penetrating the bone

23
Q

Sites for capillary puncture:

A
  1. Palmar surface of 3rd and 4th fingers
  2. Lateral plantar heel surface (newborns)
  3. Earlobes
24
Q

Capillary order of draw (CLSI)

A
  • EDTA specimens
  • Other additive specimens
  • Serum specimens
25
Q

What equipment is used for drawing blood for blood gas analysis:

A

Syringe

syringe are used instead of evacuated tubes because of the pressure in an arterial blood vessel

26
Q

Preferred anticoagulant for blood gas analysis:

A

Heparin/ 0.05 heparin/mL of blood

27
Q

Primary arterial sites:

A

Radial artery
Brachial artery
Femoral artery

28
Q

It is done before collecting arterial blood from radial artery; to determine whether the ulnar artery can provide collateral circulation to the hand after the radial artery puncture.

A

Modified Allen test

29
Q

Diurnal variations

Increase in AM:
Increase in PM:

A

Diurnal variations

Increase in AM: ACTH, Cortisol, Fe, Aldosterone
Increase in PM: ACP, Growth hormone, PTH, TSH

30
Q

Recent food ingestion

increase:
decrease:

A

Recent food ingestion

increase: Glucose, insulin, triglycerides, gastrin, ionized calcium
decrease: Chloride, phosphorus, potassium, amylase, ALP

31
Q

Stress

increase:

A

increase: ACTH, cortisol, catecholamines, prolactin

32
Q

First hormone to increase during stress:

A

Catecholamines

33
Q

Parameters that require fasting:

A

FBS
GTT
Triglycerides
Lipid panel
Gastrin
Insulin
Aldosterone/Renin

34
Q

Parameters that increases in Hemolysis:

A

Potassium
PO4
Fe
Magnesium
ALT
AST
LD
ALP
Catecholamines
CK (marked hemolysis)

35
Q

Anaerobic and require ICE slurry (immediate cooling)

A

Lactic acid
Ammonia
Blood gas (if not cooled = decrease pH and pO2)

“LAB”

36
Q

Routine specimens ideally delivered to the laboratory wihthin:

A

45 minutes of collection

37
Q

Routine specimens are centrifuged within:

A

1 hour of arrival if serum or plasma is needed

38
Q

Maximum time limit for serum or plasma separation is:

A

2 hours after collection (CLSI standard)

39
Q

a medical term meaning “immediately”; collected and analyzed immediately; given the highest priority and are usually ordered from the emergency department and critical care

A

Stat collections

40
Q

Analytical patient-testing activities provided within the institution, but performed outside the physical facilities of the clinical laboratories; Laboratory testing that is performed outside the central or core laboratory and generally at the site of clinical care or close to the patient

A

Point-of-Care testing (POCT)

41
Q

The highest-volume POC test in most health care institutions

A

POC glucose

42
Q

Most common POCT specimen:

A

Capillary blood

CLINICAL CHEMISTRY (Topnotcher QT) (3 decks)

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