Topic 4 BLOOD COLLECTION Flashcards
1
Q
dedicated area of medical laboratory or clinic equipped for performing phlebotomy procedures
A
BLOOD- DRAWING STATION
2
Q
should be comfortable. Have adjustable armrest to achieve proper
position of either arm
A
PHLEBOTOMY CHAIRS
2
Q
make blood collection equipment portable
A
EQUIPMENT CARRIERS
3
Q
This equipment is especially important in hospital setting
A
EQUIPMENT CARRIERS
4
Q
variety of styles and sizes designed to be easily carried
A
Handheld Carriers
5
Q
convenient for “STAT” or emergency situations or for patients who need blood work
A
Handheld Carriers
6
Q
typically made of stainless steel or strong synthetic material
* have swivel wheels, which glide the carts smoothly and quietly
A
Phlebotomy Carts
7
Q
have several shelves to carry adequate supplies for
blood collection
A
Phlebotomy Carts
8
Q
commonly used for early morning hospital phlebotomy rounds
A
Phlebotomy Carts
9
Q
bulky and a potential source of nosocomial infection; thus it is parked outside patient’s room
A
Phlebotomy Carts
9
Q
acronym of OSHA
A
Occupational Safety and Health Administration
10
Q
require the wearing of gloves when performing phlebotomy
* new pair must be used for each patient and removed when the procedure is completed
A
(CDC/HICPAC)
(OSHA)
11
Q
regulates glove quality
A
U.S. FOOD AND DRUG ADMINISTRATION (FDA)
12
Q
acronym HICPAC
A
HEALTHCARE INFECTION CONTROL
PRACTICES ADVISORY COMMITTEE
13
Q
GREEK anti,
A
against
14
Q
GREEK septikos,
A
putrefactive
15
Q
are substances used to prevent sepsis, which is the presence of microorganisms or their toxic products within the bloodstream
A
ANTISEPTICS
16
Q
MOST COMMONLY USED ANTISEPTIC FOR ROUTINE BLOOD COLLECTION
A
70% isopropyl alcohol
17
Q
used needles, lancets, and other
sharps objects must be disposed of
immediately in special containers
referred to as
A
sharps containers.
18
Q
Most are red, for easy identification, but some are clear or opaque to make it easier to tell when they are full
A
sharps containers.
19
Q
All must be clearly marked with a biohazard symbol and be rigid, puncture resistant, leakproof, and disposable and have locking lids to seal the contents when filled to the appropriate volume, after which they must be properly disposed of as biohazardous waste
A
sharps containers.
20
Q
leakproof plastic bags that are
commonly used to transport blood and other specimens from the collection site to the laboratory
A
BIOHAZARD BAGS
21
Q
used to make blood films for hematology determinations.
A
SLIDES
22
Q
available either plain or with
a frosted area at one end where the patient’s name or other information can be written in penciL
A
SLIDES
23
A phlebotomist should always carry a pen with ___, ___ to label tubes and recordother patient informatio
permanent, nonsmear ink
24
portable devices on the market that use transillumination to make it easier to locate veins that are difficult to see or feel.
VEIN-LOCATING DEVICES
24
preferably with a sweep second hand or
timer, is needed to accurately determine specimen
collection times and time certain tests.
WATCH
25
These devices typically shine highintensity LED or infrared red light through the patient’s skin to highlight veins.
VEIN-LOCATING DEVICES
26
device that is applied or tied around a patient’s arm prior to venipuncture to
compress the veins and restrict blood flow.
TOURNIQUET
27
Restriction of venous flow distends or inflates the veins, making them larger and easier to find and stretches the vein walls so they are thinner and easier to pierce with a needle.
TOURNIQUET
28
reusable tourniquets have the
potential to transmit pathogens such as
methicillin-resistant Staphylococcus aureus
29
Needles include:
multisample needles,
hypodermic needles, and winged
infusion (butterfly), and non-winged
blood collection needle sets used with
both the evacuated tube system (ETS)
and the syringe system
30
sterile, disposable, and designed for a
single use only.
NEEDLES
31
Needle type and typical use of gauge 15-17
Special needle attached to collection bag
Collection of donor units
Autologous blood donation
therapeutic phlebotomy
32
Needle type and typical use of gauge 20
Multisample and Hypodermic
Larger-volume tubes are collected
Large volume syringe used on normal size of vein
33
Needle type and typical use of gauge 21
Multisample and Hypodermic
standard venipuncture needle for routine venipuncture
patients with normal vein
syringe blood culture collection
34
Needle type and typical use of gauge 22
Multisample and Hypodermic
used on older children and adult with small veins/difficult veins
35
Needle type and typical use of gauge 23
Blood collection set
veins of infants and children
difficult or hand veins of adult
36
Needle type and typical use of gauge 25
Blood collection set (thin-wall needle)
veins of infants and children
difficult and hand veins of adults
36
a clear, plastic, disposable
cylinder with a small threaded opening at one end (often also called a hub) where the needle is screwed into it and a large opening at the other end where the collection tube is placed
TUBE HOLDER
37
are typically available in several sizes
to accommodate different-sized tubes, including special sizes for large-diameter blood culture bottles, some of which have adapter inserts to narrow the diameter of the holder and allow for the collection of evacuated tubes after the blood culture specimens
TUBE HOLDER
38
used with both
the ETS and the syringe method of
obtaining blood specimens.
Evacuated Tubes
39
volumes of evacuated tube ranges from
1.8 ti 15 mL
40
based on the age
of the patient, the amount of blood
needed for the test, and the size and
condition of the patient’s vein
Tube selection
41
light blue stopper color Additive and department
Sodium citrate
Coagulation
42
Red (plastic) stopper color Additive and department
Clot activator
Chemistry
42
Red (glass) stopper color Additive and department
None
Chemistry, Blood bank, Serology/Immunology
43
Red/light gray clear stopper color Additive and department
None
NA (discard tube only)
44
Green/gray and light green stopper color Additive and department
Lithium heparin and gel seperator
Chemistry
45
Red/Black (tiger) gold stopper color Additive and department
Clot activator and gel seperator
Chemistry
46
green stopper color Additive and department
Lithium heparin and sodium heparin
Chemistry
47
Lavender (purple) stopper color Additive and department
EDTA
Hematology
48
pink stopper color Additive and department
EDTA
Blood Bank
49
gray stopper color Additive and department
Sodium flouride and pottasium oxalate
Sodium flouride and EDTA
Sodium flouride
Chemistry
50
Orange, gray/yellow stopper color Additive and department
Thrombin
Chemistry
51
stopper color Additive and department royal blue
None
EDTA
Sodium heparin
Chemistry
52
Tan stopper color Additive and department
EDTA
Chemistry
53
Yellow stopper color Additive and department
Sodium polyanethol sulfonate (SPS)
Microbiology
Acid citrate dextrose (ACD)
Blood Bank/Immunohematology
54
sometimes used for
patients with small or difficult veins
syringe system
55
preferred method of blood collection
Evacuated Tube System
56
This system consists of a sterile syringe needle
called a hypodermic needle and a sterile plastic
syringe with a Luer-lock tip
SYRINGE SYSTE
57
a special tip that allows
the needle to attach more securely than a slip tip
Luer-lock tip
58
allows the safe transfer of blood into the tubes without using the syringe needle or removing the tube stopper. The device is similar to an ETS tube holder but has a permanently attached needle inside
syringe transfer device
59
an indispensable tool for collecting blood from small or difficult veins such as hand veins and veins of
elderly and pediatric patients as it allows much more flexibility and precision than a needle and syringe
winged infusion blood collection set
60
used by specially
trained personnel to collect blood from scalp or other
tiny veins of premature infants and other neonates.
25-gauge buttefly needle
61
Order of Draw
1. Sodium polyanethol sulfonate (SPS)
2. Light Blue (coagulation tubes)
3. Red - glass non additive tube
Red - Plastic clot activator tube
4. Red and gray rubber gold plastic -Serum seperator tubes (SST)
5. Green and gray rubber/light-green plastic - Heparin tubes with gel/Plasma-seperator tubes (PST)
6. Green - Heparin tubes
7. Lavender,pink,purple - EDTA tubes
8. Pearl/white top - EDTA tubes with gel/Plasma-preparation tube (PPT)
9. Gray - Oxalate/flouride tubes
62
Venipuncture procedure
1. TEST REQUISITION
2. APPROACH, IDENTIFY AND
PREPARE PATIENT
3. VERIFY DIET RESTRICTIONS AND
LATEX SENSITIVITY
4. SANITIZE HANDS AND PUT ON
GLOVES
5. POSITION PATIENT, APPLY
TOURNIQUET, AND ASK PATIENT TO
MAKE A FIST
6. SELECT VEIN, RELEASE TOURNIQUET,
AND ASK PATIENT TO OPEN FIST
7. CLEAN AND AIR-DRY THE SITE
8. PREPARE EQUIPMENT
9. REAPPLY TOURNIQUET, UNCAP
AND INSPECT NEEDLE
10. ASK PATIENT TO MAKE A FIST,
ANCHOR VEIN, AND INSERT
NEEDLE
11.ESTABLISH BLOOD FLOW,
RELEASE TOURNIQUET, AND
ASK PATIENT TO OPEN FIST
12. FILL, REMOVE, AND MIX TUBES
IN ORDER OF DRAW,
OR FILL SYRINGE
13.PLACE GAUZE, REMOVE NEEDLE,
ACTIVATE SAFETY FEATURE, AND
APPLY PRESSURE
14.DISCARD COLLECTION UNIT,
SYRINGE NEEDLE, OR TRANSFER
DEVICE
15.LABEL TUBES
16.OBSERVE SPECIAL HANDLING
INSTRUCTIONS
17.CHECK PATIENT’S ARM AND
APPLY BANDAGE
18.DISPOSE OF
CONTAMINATED
MATERIALS
19.THANK PATIENT,
REMOVE GLOVES, AND
SANITIZE HANDS
20.TRANSPORT SPECIMEN
TO THE LAB
63
Common Test status designations
Stat - First
Med Emerg - Same as stat
Timed - Second
ASAP - 2nd or 3rd depending on test
Preop and Postop - same as ASAP
Fasting - 4th
NPO - N/A
Routine - N/A
64
Test samples for Stat
glucose
H & H
Electrolytes
Cardiac enzymes
65
Test samples for med emerg
glucose
H & H
Electrolytes
Cardiac enzymes
66
Test samples for timed
2 hour PP
GGT
Cortisol
Cardiac Enzyme
TDM
Blood cultures
67
Test samples for Fasting
Glucose
Cholesterol
Triglycerides
67
Test samples for ASAP
Electrolytes
Glucose
H & H
68
Test samples for NPO
None
69
Test samples for Preop
CBC
PTT
Platelet function studies
70
Test samples for Postop
H & H
71
Test samples for routine
CBC
Chem profile
72
phase of the testing process begins for the laboratory when a test is ordered and ends when testing begins
preanalytical or pre-examination
73
Most tests are performed to confirm health or to screen for, diagnose, or monitordisease. To be properly evaluated, test results typically need to be compared withresults expected of healthy individuals.
REFERENCE RANGES/INTERVALS
74
refers to the resting metabolic state of the body early in the morning after fasting for
approximately 12 hours
BASAL STATE
75
ideal for establishing reference
ranges on inpatients because the effects of diet, exercise, and other controllable
factors on test results are minimized or eliminated
BASAL STATE
76
Values for some blood components vary considerably depending upon the ____ of the
patien
Age
77
Test results for some blood analytes show significant variation at higher elevations compared with results at sea level.
ALTITUDE
78
which occurs, for example, with persistent vomiting or diarrhea, causes HEMOCONCENTRATION, a condition in which blood components
that cannot easily leave the blood- stream become concentrated in the smaller plasma volume.
DEHYDRATION
79
Blood analyte composition can be altered by the ingestion of food and drink. As a result, blood specimens collected soon after a meal or snack are unsuitable for many laboratory test
Diet
80
Factors that play a role in
______ include posture, activ- ity, eating, daylight and darkness, and being awake or asleep
DIURNAL/CIRCADIAN VARIATIONS
81
Some drugs alter physiological functions, causing changes in the concentrations of
certain blood analytes. The effect may be desired or an unwanted side effect or
sensitivit
Drug Theraphy
81
affects the levels of a number of hormones. also increases cortisol and may disrupt its normal diurnal variation
FEVER
82
Arterial pH and PaCO2 levels are reduced.
Glucose, creatinine, insulin, lactic acid, and total protein can be elevated by moderate muscular activity.
K is released from the cells during ____
Exercise
83
increases
insulin levels, followed by a rise in glucagon levels.
Fever- induced hypoglycemia
84
affects the concentration of a number of blood components. Most
differences are apparent only after sexual maturity and are reflected in separate normal values for males and females.
Sex
85
increase levels of creatine kinase (CK) and the skeletal muscle fraction at least 1 hour after injection. Muscular trauma from injuries or surgery can
also increase CK levels
INTRAMUSCULAR INJECTION
86
Jaundice is also called
icterus
87
also called icterus, is a condition character- ized by increased bilirubin (a product of the breakdown of RBCs) in the blood, leading to deposits of yellow bile pigment in the skin, mucous membranes, and sclerae (whites of the eyes), giving the patient a yellow appearance
Jaundice
88
can influence specimen composition Going from supine (lying down on the back) to an upright sitting or standing position causes blood fluids to filter into the tissues, decreasing plasma volume in an adult up to 10%
Position
89
Increases in body fluid that are normal during ____, have a diluting effect on the RBCs,
leading to lower RBC counts
pregnancy
90
Increased cholesterol, cortisol, glucose, growth hormone, and triglyceride levels as well as
WBC counts. often leads to decreased pulmonary function and increased
RBC counts and hemoglobin level
Smoking
91
anxiety, fear, or trauma can cause transient (short-lived) elevations
in WBCs
Stress
92
Other term for Harderned Veins
Sclerosed
93
Other term for Clotted Veins
Thrombosed
94
swelling caused by the abnormal accumulation of fluid in the tissues. It sometimes results when fluid from an IV infiltrates the surrounding tissues
Edema
95
swelling or mass of blood
(often clotted) that can be caused by blood
leaking from a blood vessel during or
following venipuncture
HEMATOMA
96
Blood should never be drawn from an arm on the same side. may cause
lymphostasis (obstruction or stoppage of normal lymph flow).
MASTECTOMY
97
Lymphostasis
Obstruction or stoppage of normal lymph flow
98
patients often present a challenge to the phlebotomist. patients veins may be deep and difficult to find.
OBESITY
99
Drawing blood from a ____ should be avoided if possible
paralyzed arm
100
the loss of
muscle function
paralysis
101
can be temporary or permanent; localized in one area of the body,
or widespread
paralysis
102
Intravenous Line
1. Ask patients nurse to turn off IV for at least 2 minutes prior to collection
2. Apply torniquet distal to the IV
3. Select a venipuncture site distal to the IV and the torniquet
4. Perform the venipuncture in a different vein than the one with the IV if possible
5. Ask the nurse to restart the IV after the specimen has been collected
6. Document that the specimen was collected below an IV, indicate the type of fluid in the IV, and identify which arm was used.
103
PATIENT COMPLICATIONS AND CONDITIONS
* ADHESIVE ALLERGY
* ANTISEPTIC ALLERGY
* LATEX ALLERGY
* EXCESSIVE BLEEDING
* FAINTING
* NAUSEA AND VOMITING
* PAIN
* PETECHIAE
* SEIZURES/CONVULSIONS
104
SPECIMEN QUALITY CONCERNS
* HEMOCONCENTRATION
* HEMOLYSIS
* PARTIALLY FILLED TUBES
* SPECIMEN CONTAMINATION
* WRONG OR EXPIRED COLLECTION TUBE
