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Hematology Exam 1 > Venipuncture Equipment > Flashcards

Venipuncture Equipment Flashcards

0
Q

What are the components of an ETS?

A

Double-pointed needle
Holder
Color-coded collection tubes

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1
Q

What is an Evacuated Tube System (ETS)?

A

Most frequently used collection system, collected directly into the evacuated tube
Minimizes biohazard exposure

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2
Q

What are the characteristics of the ETS needles?

A

Multisample
Hypodermic
Winged blood collection sets
Various lengths & gauges

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3
Q

What is the length of ETS needles for routine venipuncture?

A

1 inch & 1.5 inch

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4
Q

What are the gauges/diameters for ETS needles?

A

Large - 26 gauge

Small - 23 gauge

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5
Q

What are the uses for the different gauges of needles?

A

Large - collection of units of blood

Small - small veins

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6
Q

What are color-codes for on ETS needles?

A

They are used for gauge

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7
Q

What is the structure of ETS needles from bottom to top?

A 
Hub
Shaft
Lumen
Bevel
Point
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8
Q

What is an example of a multisample needle?

A

Double-pointed ends

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9
Q

What are the different ends for on a double-pointed ends needle?

A

One end for venipuncture

One end to puncture the rubber stopper of the evacuated tube that is covered by a rubber sheath

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10
Q

What are some needle engineering controls?

A

Safety shields

Blunting devices

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11
Q

What are characteristics of needle holders?

A

Tube-advancing line
Flared ends
Disposable - discarded with the used needle
Safety shields

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12
Q

What are characteristics of needle disposal systems?

A

Rigid & puncture resistant sharps container

Labeled with “biohazard”
Sealable & lockable

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13
Q

What is the premeasured vacuum of evacuated collection tubes?

A

1.8 to 15 mL

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14
Q

What are the volume selections for evacuated collection tubes?

A

Amount of blood needed
Age of the patient
Size & quality of the patients veins
Needle gauge used

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15
Q

What are the characteristics of evacuated tubes?

A

Sterile
Silicone coated
Label information
Rubber stoppper

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16
Q

What is on the label information on evacuated tubes?

A

Additives or anticoagulants
Draw volume
Expiration date

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17
Q

What are color-coded tubes indicating?

A

Type of specimen - additives & anticoagulants
Anticoagulated blood - yields whole blood or plasma
Nonadditive tubes or clot activator tubes - yields serum
Dictated by specific laboratory tests

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18
Q

What do anticoagulated blood tubes yield?

A

Whole blood or plasma

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19
Q

What do nonadditive tubes or clot activator tubes yield?

A

Serum

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20
Q

What is plasma?

A

The liquid portion of whole blood containing water, electrolytes, glucose, proteins, etc.
Contains all the clotting factors necessary for coagulation in inactive form

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21
Q

What is serum?

A

The fluid that remains after the plasma has clotted

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22
Q

What should you do with evacuated tubes?

A

Tap to loosen dried anticoagulant
Must be filled to the designated volume
Important to thoroughly but gently mix by inversion
Blood from different tube types can not be mixed

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23
Q

What is in the lavender stopper?

A

EDTA - ethylenediaminetetraacetic acid

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24
Q

Why can’t lavender stopper tubes be used for coagulation studies?

A

Because EDTA interferes with Factor V & thrombin-fibrinogen reaction

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25
Q

What does EDTA do?

A

It is an anticoagulant that binds calcium

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26
Q

How is EDTA used in hematology testing?

A

Maintains cellular integrity
Inhibits platelet clumping
Staining interference is avoided

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27
Q

Is the additive in the lavender stopper an anticoagulant?

A

Yes

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28
Q

What does the lavender stopper yield?

A

Blood or plasma

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29
Q

What is the additive in the light blue stopper?

A

Sodium citrate

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30
Q

Is sodium citrate an anticoagulant?

A

Yes

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31
Q

What does sodium citrate do?

A

Binds calcium

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32
Q

What is the ratio of blood to anticoagulant in the light blue stopper?

A

9:1 & it must be completely filled

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33
Q

What are light blue stoppers used for?

A

Coagulation studies

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34
Q

What do light blue stoppers yield?

A

Blood or plasma

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35
Q

What are CTAD tubes specialized for?

A

Platelet testing

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36
Q

Dark blue tubes are special for what?

A

Fibrin degradation products

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37
Q

What is the additive in dark blue tubes?

A

Soybean trypsin inhibitor

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38
Q

What additives are in the green stopper?

A

Heparin

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39
Q

What ions are in the green stopper that work with heparin?

A

Sodium ion
Lithium ion
Ammonium ion

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40
Q

Is heparin an anticoagulant?

A

Yes

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41
Q

What does the green stopper yield?

A

Blood or plasma

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42
Q

What is the action of heparin?

A

Inhibits thrombin

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43
Q

What are green stoppers primarily used for?

A

Chemistry tests

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44
Q

What are the additives in the red/gray or gold stopper?

A 
Silica
Separation gel (SST)
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45
Q

What is silica used for?

A

A clot activator that reduces clotting time

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46
Q

What does separation gel (SST) do?

A

Gel changes viscosity during centrifugation

47
Q

What is SST not recommended for?

A

Therapeutic drug testing
Blood bank
Certain serology & immunology

48
Q

What does the red/gray or gold stopper yield?

A

Serum

49
Q

What are the additives in the red (plain) stopper in glass tubes?

A

None

50
Q

What is in the red (plain) plastic stopper?

A

Silica

51
Q

What does the red (plain) stopper in plastic tubes yield?

A

Serum

52
Q

How long does it take to clot in the red (plain) stopper glass tubes?

A

60 mins

53
Q

What are red (plain) stopper in plastic tubes used for?

A

Serum chemistry & serology tests

54
Q

Is there a gel separator in the red (plain) stopper in plastic tubes?

A

No

55
Q

What is the use for the order of the draw?

A

Collected in a specific, predetermined order

56
Q

How can an out-of-order draw affect test results?

A

Bacterial contamination
Tissue fluid contamination
Additive/anticoagulant carry-over

57
Q

What happens when anticoagulant transfer between tubes?

A

EDTA & heparin falsely increase coagulation studies
EDTA can affect chemistry tests due to calcium binding
Heparin will affect the properties of serum
Box 8-2

58
Q

What happens when contamination of a sterile specimen occurs?

A

Blood culture specimens are always collected first when ordered

59
Q

What is the additive in a pink stopper?

A

EDTA

60
Q

What are pink stoppers used for?

A

Immunohematology

61
Q

What do pink stoppers yield?

A

Blood or plasma

62
Q

What is the additive in the white stopper?

A

EDTA

63
Q

What are white stoppers used for?

A

Plasma preparation tubes (PPT)

64
Q

What do white stoppers yield?

A

Blood or plasma

65
Q

What is the additive in black stoppers?

A

Buffered sodium citrate

66
Q

What are black stoppers used for?

A

Erythrocyte sedimentation rate

67
Q

What is the ratio of blood to additive in the black stopper?

A

4:1

68
Q

What is the additive in the light green stopper?

A

Heparin with lithium

69
Q

What type of gel is in the light green stopper?

A

Plasma separator tubes (PST) / gel barrier tubes

Inert separation gel

70
Q

What are light green stoppers used for?

A

Potassium determination

71
Q

What do light green stoppers yield?

A

Plasma

72
Q

What additives are in the gray stopper?

A

Sodium fluoride

Potassium oxalate

73
Q

What does sodium fluoride do?

A

Preserves glucose (antiglycolytic); not an anticoagulant

74
Q

What does potassium oxalate do?

A

Anticoagulant

Binds calcium

75
Q

What are gray stoppers used for?

A

Glucose determination & blood alcohol levels

76
Q

What do gray stoppers yield?

A

Blood or plasma

77
Q

What are the additives in the royal blue stopper?

A

Clot activator for serum

78
Q

What anticoagulants can be added to the royal blue stopper?

A

EDTA

Sodium heparin

79
Q

What are royal blue stoppers used for?

A

Toxicology
Trace metal analysis
Nutritional analysis

80
Q

What do royal blue stoppers yield?

A

Serum

81
Q

What is the additive in tan stoppers?

A

EDTA

Less than 0.1 ug/mL of lead

82
Q

What is the tan stopper used for?

A

Lead determination

83
Q

What are the types of yellow stoppers?

A

Acid citrate dextrose (ACD)

Sodium polyanethol sulfonate (sterile)

84
Q

What is the purpose of the acid citrate dextrose (ACD) yellow stopper?

A

Cellular studies in blood bank & immunology

Binds calcium & preserves red blood cells

85
Q

What is the sodium polyanethol sulfonate (sterile) yellow stopper used for?

A

Culture of microorganisms (blood cultures)

Binds calcium & aids microbial growth

86
Q

What are the additives in the light blue/black stopper?

A

Sodium citrate
Cell preparation tubes (CPT)
Gel

87
Q

What are the light blue/black stoppers used for?

A

Density gradient liquid
Separation of mononuclear cells from plasma/blood
Molecular diagnostics testing

88
Q

What is the additive in the red/green stopper?

A 
Sodium heparain (CPT)
Polyester gel
89
Q

What is the red/green stopper used for?

A

Density gradient liquid

Molecular diagnostics testing

90
Q

What is the additive in the yellow/gray & orange stopper?

A

Clot activator - thrombin

91
Q

What does thrombin do in the yellow/gray & orange stopper?

A

Faster clot formation - within 5 minutes

92
Q

What are yellow/gray & orange stoppers used for?

A

STAT serum chemistry determinations

Used on patients receiving anticoagulation therapy

93
Q

What do yellow/gray & orange stoppers yield?

A

Serum

94
Q

What are anticoagulants or additives in the red/light gray & clear stoppers?

A

None

95
Q

What are red/light gray & clear stoppers used for?

A

Discard tubes

Collect blood to discard - important when using winged blood collection sets to collect coagulation studies

96
Q

What is the CLSI recommended order of draw?

A
  1. blood cultures (SPS or culture bottles)
  2. light blue (sodium citrate)
  3. red/gray or gold, red (glass or plastic)
  4. green or light green (heparin, all types)
  5. lavender (EDTA), pink, or white
  6. gray (sodium fluoride, potassium oxalate)
  7. yellow/gray-orange (thrombin clot activator)
97
Q

What are syringes used for?

A

Smaller veins

98
Q

What are the control of suction pressure in syringes for?

A

Manual withdrawal of syringe plunger

Creates vacuu,

99
Q

What type off barrel is used in a syringe?

A

Graduated barrel

100
Q

What needle is used with a syringe?

A

Hypodermic syringe needle

101
Q

What are the parts of a syringe?

A

Luerlock tip
Barrel
Plunger

102
Q

What must hypodermic syringe needles have?

A

Safety shields

103
Q

What are blood transfer devices used for?

A

To safely transfer blood from syringe to evacuated tube

104
Q

What is the syringe order of the draw?

A

Same order as the ETS system

105
Q

What are winged blood collection sets (butterflies) used for?

A

Venipunctures on very small veins

IV infusion of fluids

106
Q

What are the measurements of winged blood collection sets?

A

21 or 23 gauge
1/2- to 3/4- in length
Attached to flexible tubing (0.5 mL volume)

107
Q

What are tourniquets used for?

A

Impedes venous but not arterial blood flow below application site
Disposable latex or non-latex
Sephygmomanometer inflated to 40 mmHg

108
Q

What are vein locating devices used for?

A

Locating nonvisible veins

High intensity LED light

109
Q

What are the characteristics of gloves?

A 
OSHA mandate
Non-sterile
Proper fit
Powder free
Nonlatex or latex - glove liners
110
Q

What are puncture site protections?

A

Antiseptic - 70% isopropyl alcohol primary for venipuncture & bacteriostatic
Stronger antiseptic used for blood cultures - iodine & chlorhexidine gluconate

111
Q

Bandage characteristics are?

A

2x2 inch gauze pads - for pressure application
Cover with bandage or adhesive tape - latex free
Self-adhering bandage - coban/coflex
Instruct patient on removing bandages

112
Q

What are some additional supplies for venipuncture?

A

Glass slides
Biohazard transport bags
Alcohol-based hand sanitizer
Labeling pen

113
Q

Quality control of equipment includes?

A

Ensuring sterility - packaging intact
Visual inspection of needles for defects
Checking for expiration dates

114
Q

What happens when tubes are used past expiration date?

A

Short draws
Clotted anticoagulated samples
Improperly preserved samples
Insecure gel barriers

Hematology Exam 1 (7 decks)

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