SPECIMEN QUALITY CONCERNS Flashcards
HEMOCONCENTRATION
Decrease in fluid content or plasma volume
● Caused by stagnation of the normal venous blood flow because of
torniquet application
● Increased concentration of RBCs and other non filterable large
molecules
● Increases albumin, ammonia, calcium, cholesterol, coagulation factors,
enzymes, iron, potassium,and total protein
● Decrease in fluid content or plasma volume
HEMOCONCENTRATION
HEMOCONCENTRATION
● Decrease in ___
fluid content or plasma volume
Caused by stagnation of the normal venous blood flow because of
torniquet application
HEMOCONCENTRATION
Increased concentration of RBCs and other non filterable large
molecules
HEMOCONCENTRATION
Increases albumin, ammonia, calcium, cholesterol, coagulation factors,
enzymes, iron, potassium,and total protein
HEMOCONCENTRATION
HEMOCONCENTRATION
Increases ____
albumin, ammonia, calcium, cholesterol, coagulation factors,
enzymes, iron, potassium,and total protein
HEMOCONCENTRATION
Increased ____
concentration of RBCs and other non filterable large
molecules
Ways To Help Prevent Hemoconcentration During Venipuncture
● Release the tourniquet within ___
1 minute.
Ways To Help Prevent Hemoconcentration During Venipuncture
● Ask the patient to release the fist upon blood flow.
● Do not allow the patient to pump the fist.
● Do not excessively massage the area in locating a vein.
● Do not probe or redirect the needle multiple times in search
of a vein.
● Release the tourniquet within 1 minute
“hemolyzed” specimen
HEMOLYSIS
RBCs are damaged or destroyed and the hemoglobin escapes into the
fluid portion of the specimen
HEMOLYSIS
serum or plasma appears pink (slight hemolysis)
○ dark pink to light red (moderate hemolysis)
○ dark red (gross hemolysis)
HEMOLYSIS
slight hemolysis
serum or plasma is pink
moderate hemolysis
dark pink to light red
gross hemolysis
dark red
● Failure to wipe away the first drop of capillary blood (alcohol residue)
CAUSES OF SPECIMEN HEMOLYSIS
Drawing blood through a hematoma or from a vein with a
hematoma
CAUSES OF SPECIMEN HEMOLYSIS
● Forceful aspiration of blood during a syringe draw
CAUSES OF SPECIMEN HEMOLYSIS
● Horizontal transport of tubes
CAUSES OF SPECIMEN HEMOLYSIS
● Forcing the blood from a syringe into an evacuated tube
CAUSES OF SPECIMEN HEMOLYSIS
● Frothing of blood caused by improper fit of the needle on a syringe
CAUSES OF SPECIMEN HEMOLYSIS
● Mixing additive tubes vigorously
CAUSES OF SPECIMEN HEMOLYSIS
● Drawing blood through a hematoma or from a vein with a
hematoma
● Failure to wipe away the first drop of capillary blood (alcohol residue)
● Forceful aspiration of blood during a syringe draw
● Forcing the blood from a syringe into an evacuated tube
● Frothing of blood caused by improper fit of the needle on a syringe
● Horizontal transport of tubes
● Mixing additive tubes vigorously
● Partially filling a sodium fluoride tube
● Pulling back the plunger too quickly
● Rough handling during transport
● Squeezing the site (capillary blood collection)
● Syringe transfer delay in which partially clotted blood is forced into a
tube
● Using a large-volume tube with a small-diameter butterfly needle
● Using a needle with a diameter that is too small
CAUSES OF SPECIMEN HEMOLYSIS
CAUSES OF SPECIMEN HEMOLYSIS
● Partially filling a ___
sodium fluoride tube
CAUSES OF SPECIMEN HEMOLYSIS
Using a needle with a diameter that is ______________
too small
CAUSES OF SPECIMEN HEMOLYSIS
● Using a ______ with a _____
large-volume tube with a small-diameter butterfly needle
Never pour two partially filled additive tubes together to fill
one tube (affects the blood-to-additive ratio)
PARTIALLY FILLED TUBES or SHORT DRAW
CAUSES OF SPECIMEN HEMOLYSIS
● Under-filled anticoagulant tubes:
blood-to-additive ratio
Under-filled anticoagulant tubes: blood-to-additive ratio
PARTIALLY FILLED TUBES or SHORT DRAW
Short-draw serum tubes generally acceptable
PARTIALLY FILLED TUBES or SHORT DRAW
● Alcohol, glove powder, baby powder, or urine from wet diapers
SPECIMEN CONTAMINATION
● Glove powder on blood films (slides)
SPECIMEN CONTAMINATION
● Dripping perspiration into capillary specimens
SPECIMEN CONTAMINATION
● Wrong antiseptic
SPECIMEN CONTAMINATION
● Not following proper antiseptic procedure
SPECIMEN CONTAMINATION
WRONG OR EXPIRED COLLECTION TUBE
- Expiration dates of tubes must be checked ____ and expired
tubes discarded.
routinely
WRONG OR EXPIRED COLLECTION TUBE
- Formation of ____
microclots
WRONG OR EXPIRED COLLECTION TUBE
- __- and ____
serum and plasma
WRONG OR EXPIRED COLLECTION TUBE
- Additives in ___ may not work properly
expired tubes
SPECIMEN QUALITY CONCERNS (5)
Hemoconcentration
Hemolysis
Partially filled tubes or short draws
Specimen contamination
Wring or expired collection tube
