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PMLS2 LEC > VENIPUNCTURE PROCEDURE > Flashcards

VENIPUNCTURE PROCEDURE Flashcards

1
Q

First step in Venipuncture Procedure

A

Prepare Request form of the Patient

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2
Q

Second step in Venipuncture Procedure

A

Greet and Identify the Patient

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3
Q

Out Patient (Conscious)

A

Ask patient to give their full name and spell their last name, Compare information on identification bracelet and request form

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4
Q

Sleeping Patient

A

Awaken a sleeping patient before venipuncture

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5
Q

Unidentified Emergency Patient

A

Use ID number on all tests; cross-reference if patient is already identified with the temporary number

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6
Q

Third step in Venipuncture procedure

A

Verify diet restriction, latex sensitivity, and other allergies

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7
Q

Sites to be avoided

A
  • Burns, Scars, or tattoos
  • Damaged veins
  • Edema (high tissue fluid)
  • Hematoma
  • Mastectomy (lymph node removal)
  • IV line, cannula, fistula
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8
Q

Order of Draw

A
  • Blood Culture Bottles
  • Coagulation Tubes
  • Serum Tubes with or w/o clot activator/ gel serum separator
  • Heparin Tubes with or w/o gel plasma separator
  • EDTA Tubes
  • Oxalate/fluoride, glycolytic inhibitor tubes
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9
Q

PROBLEMS ENCOUNTERED

A
  • Pain
  • Nerve Damage
  • Nausea
  • Syncope
  • Diabetic Shock
  • Convulsions
  • Cardiac Arrest
  • Continuous Bleeding
  • Skin Allergies
  • Hematoma
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10
Q

UNUSUAL BLOOD SPECIMENS

A
  • Icteric
  • Lipemic
  • Hemolyzed
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11
Q

ICTERIC

A

px w/ jaundice; large amounts of bilirubin

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12
Q

LIPEMIC

A

px not fasting; large amounts of lipids/fats

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13
Q

HEMOLYZED

A

Contaminated w/ RBC Contents

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14
Q

Causes of Hemolysis

A
  • drawing from a hematoma
  • Rupturing of RBCs
  • Alcohol on the site
  • Pulling the plunger too forcibly
  • Fast drip/expelling blood vigorously
  • Redirecting
  • Mixing tubes vigorously
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15
Q

POSSIBLE CAUSES FOR FAILED VENIPUNCTURE

A
  1. Vacuum at tube is not working
  2. Bevel against the vein wall
  3. Bevel inserted too far
  4. Needle partially inserted
  5. Needle slipped beside the vein
  6. Collapsed the vein
  7. Undetermined needle position
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16
Q

TECHNIQUES TO ENHANCE VEIN AND RECOVER A FAILED VENIPUNCTURE

A
  • Retie the tourniquet
  • Use a blood pressure cuff in place of a tourniquet
  • Massage arm/ warm location
  • Lower arm
  • Reseat tube holder
  • Use a different tube
  • Place finger below site and stretch the vein slightly
  • Pull back/ advance needle slightly
  • Rotate the needle one quarter to one half turn
  • 2 tries only
17
Q

MOST COMMON ERRORS IN SPECIMEN COLLECTION

A
  • Misidentification of px
  • Mislabeling
  • Short draws/wrong AC/blood ratio
  • Mixing problems/clots
  • Hemolysis/lipemia
  • Hemoconcentration from prolonged tourniquet time
  • Exposure to light/extreme temperatures
  • Improperly timed specimen/ delayed delivery to lab
  • Processing errors: incomplete centrifugation, improper storage
18
Q

SPECIMEN CONSIDERATIONS

A
  • Fasting
  • Random
  • Post-Prandial
  • Basal state
19
Q

FACTORS CONTRIBUTING TO THE VARIATION OF RESULTS

A
  • Exercise
  • Fasting
  • Diet
  • Position/Posture
  • Tourniquet
  • Smoking
  • Alcohol ingestion
  • Stress/anxiety
  • Drugs
20
Q

Exercise can increase

A

Blood glucose, lactic acid, serum proteins, muscle enzymes

21
Q

Px did not undergo fasting:

A

Elevated blood glucose, potassium, lipids

22
Q

Prolonged fasting:

A

Elevated serum bilirubin, TAG, glycerol, free FA, and decreased plasma glucose

23
Q

High protein diet:

A

increased urea, ammonia, urates

24
Q

Long time vegetarian

A

decreased LDL, VLDL, total lipid, phospholipid, cholesterol, TAG

25
Q

Hyperchylomicronemia

A

increases turbidity or latescence (TAG level exceeds 4.6 mmol/L (4.0g/L)

26
Q

Smoking affects hematological tests such as

A

HGB, HCT. BLOOD COUNTS

27
Q

Alcohol ingestion increases:

A
  • plasma concentration of lactate, urate, acetate & acetaldehyde, GGT Concentration
  • May affect blood sugar and fat levels
28
Q

Stress affects

A

hormone secretion and results to hyperventilation leading to a disturbance in acid-base balance in the blood

29
Q

DRUGS

A

may affect liver function tests

30
Q

Vasovagal Syncope

A

fainting due to abrupt pain or trauma

31
Q

LABELLING

A

a. patient’s first and last name
b. identification number
c. date and time of collection
d. initials of phlebotomist

32
Q

Damaged veins

A

sclerosed = hardened, thrombosed = clotted

PMLS2 LEC (2 decks)

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