unit 4 chapter 14 part 2

Question 1

blood cultures (BC)
Bacteremia

Answer 1

-specifically, to the presence of bacteria in the blood
-enter the bloodstream (gut, mouth)

Question 2

blood cultures (BC)
septicemia

Answer 2

-life threatening infection
-rapid multiplication of pathogens in the bloodstream
-microorganisms in the blood triggers a systemic inflammatory response

Question 3

blood cultures (BC)
sepsis

Answer 3

-systemic inflammatory response
-life threatening and go untreated lead to death

Question 4

blood cultures (BC)
fever of unknown orgin (FUO)

Answer 4

-chills and fever
-may require a BC

Question 5

why are blood cultures order?

Answer 5

to detect the presence of microorganisms in the blood, a potentially life-threatening situation

-such microorganism include bacteria, fungi, protozoa
-STAT or timed specimens

Question 6

collection containers

Answer 6

1. long-necked bottles: BD Vacutainer needle and tube holder
2. shorter bottles: wing infusion device BD bactec, special adapter
3. a standard evacuated tube with SPS
   -ARD (antibiotic removal device)
   -resin that absorbs antibiotics from the pts. blood
   -inhibits the growth of bacteria in the culture container

Question 7

recommended blood culture volumes

Answer 7

adult - 8-10ml
pediatric- 2.5-10ml
infant- 0.5-1.0ml

Question 8

site preparation with antiseptics

Answer 8

-reduce the contamination of skin flora
- alcoholic preparations of iodine or proidone-iodine
-CHG (chlorohexidine gluconate) is recommended by CLS over 2 months of age
-place alcohol pads on bottles to prevent contamination

Question 9

timing

Answer 9

-number of organisms in the bloodstream in the highest before spike in temperature
- best time to collect 30 minutes before spike

Question 10

multiple sites

Answer 10

-two different sites should be used (1 set from each arm) to collect 2 pairs
-dr, will write the site down

Question 11

sample collections

Answer 11

-ratio of blood to culture media is crucial to the culture
-aerobic bacteria: need oxygen to survive
-aerobic bottle: 1st bottle used (butterfly)
-anaerobic bacteria: cannot tolerate oxygen
-anaerobic bottle: 2nd bottle used (butterfly)
-sps tubes (yellow sterile) only 1 tube is used per site

Question 12

steps to bc collection

Answer 12

1. prepare site: scrub with chlora prep swabs 60secs in circle, 2.5 inches beyond puncture site, allow to dry 1min, avoid touching site
2. prepare collection equipment: remove cap on bottles, clean top with alcohol pad and leave one on top of bottle, dont touch bottle tops
3. collect sample: place tournkit and do venipuncture, collect 2 sample 1 in each arm fill containers min/max line, anaerobic (butterfly)=4 bottles
4. attend to the pt. : once collection and needle removed, check site

Question 13

age and weight for donors

Answer 13

at least 17yrs old, min weight of 110 and cannot have donated blood in the past 8 weeks

(SCREENING )
registration
interview and medical history
physical examination

hemogoblin is usally measured w a drop of whole blood from dermal puncture.

Question 14

donor collection

Answer 14

-collected by unit (400 to 500 ml)
-collected into directly into sterile collection bag
-16- or 18 gauge needle (faster flow and prevents hemolysis)
-large vein in antecubital fossa

Question 15

steps in collection

Answer 15

Site is cleaned with soap and water then with iodine
* Prepare needle and insert into site
* Secure needle to arm to prevent motion during collection
* Patient pump fist
* Phlebotomist looks out for complications, signs of distress, anxiety, pale looking skin
* Once blood is drawn, needle is taken out and apply pressure and bandage.

Question 16

autologous donation

Answer 16

• Is blood donated by a patient for his/her own healthcare
• Needs written order by DR
• Donor may donate 3 to 7 days
• Patient’s H&H must be monitored
• Hemoglobin must be 11 g/dl
• Hematocrit must be 33%
• 72 hours prior to surgery