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PMLS 2 > (M) Lesson 3: Capillary Puncture > Flashcards

(M) Lesson 3: Capillary Puncture Flashcards

1
Q

→ aka skin puncture, dermal puncture, or microsampling
→ sample is addressed as capillary, skin puncture, or dermal specimen

A

Capillary Puncture

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2
Q

T or F: Capillary blood is a mixture of arterial, venous, and capillary blood with interstitial, and intracellular fluid

A

True

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3
Q

T or F: Capillary blood has a higher proportion of venous blood than arterial blood

A

False

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4
Q

T or F: Reference values for capillary blood are different from venous blood

A

True

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5
Q

T or F: Glucose is commonly lower while total protein, calcium, and potassium are commonly higher in capillary blood than in venous blood

A

False (glucose is higher while the rest are lower)

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6
Q

Which puncture site is most common for infants?

A

Plantar heel surface

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7
Q

What fingers are preferred in capillary puncture for adults?

A

3rd and 4th

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8
Q

What finger has a pulse hence why is it not a preferred site?

A

Thumb

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9
Q

Which finger is commonly calloused hence why is it not a preferred site?

A

Index

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10
Q

Which finger is in close proximity to a bone hence why is it not a preferred site?

A

Pinky

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11
Q

T or F: Capillary puncture can be used for blood cultures

A

False (needs a large volume of blood)

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12
Q

T or F: Capillary puncture can be used for coagulation studies

A

False (requires the usage of a sodium citrate tube)

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13
Q

T or F: Lancets are sterile and disposable

A

True

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14
Q

This equipment punctures and makes incisions in the skin

A

Lancets/Incision Devices

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15
Q

What is the standard lancet length?

A

1.75mm

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16
Q

What is the incision depth for infants and children?

A

Less than 2mm

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17
Q

What is the incision depth for adults?

A

Less then 2.5mm

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18
Q

What is the standard skin to bone/cartilage distance?

A

1.5mm - 2.4mm

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19
Q

→ an alternative incision device
→ it vaporizes water and makes a small hole in the capillary bed without cauterizing delicate capillaries

A

Laser lancet

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20
Q

T or F: Laser lancets are commonly used for the fingers of adults and children greater than 5 years old

A

True

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21
Q

T or F: Laser lancets can be used on children less than 5 years old

A

True (but you need physician discretion first)

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22
Q

T or F: Laser lancet inserts can be reused

A

False

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23
Q

→ aka microtubes—called as “bullets” because of their size and shape
→ used to collect tiny amounts of blood
→ has color coded bodies or stoppers

A

Microcollection containers

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24
Q

What is the fill range for microcollection containers?

A

250-500 microliters

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25
Q

T or F: Venipuncture-obtained blood can be put in microcollection tubes incase of a short-draw

A

True

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26
Q

T or F: Serum specimen comes first in the order of draw

A

False (hematology specimen first to avoid quick clotting because the skin releases tissue thromboplastin—activates coagulation in blood drops)

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27
Q

→ disposable and narrow-bore or plastic-clad glass tubes
→ aka capillary tubes or “capillet”
→ used for manual hematocrit testing/packed cell volume

A

Microhematocrit tubes

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28
Q

What is the fill range of microhematocrit tubes?

A

50-75 microliters

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29
Q

A red/green microhematocrit tube is coated with what?

A

Ammonium Heparin

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30
Q

Red microhematocrit tubes can collect samples where?

A

Directly from the puncture site

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31
Q

Blue microhematocrit tubes are coated with what?

A

Nothing (plain)

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32
Q

Blue microhematocrit tubes collect samples from where?

A

EDTA tubes

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33
Q

T or F: 1/2 of the microhematocrit tube should be filled

A

False (3/4)

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34
Q

→ plastic or clay
→ seals one end of the microhematocrit tube

A

Sealant

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35
Q

→ long-thin narrow bore tubes
→ 100mm in length; 100uL in capacity
→ has color coded bands (usually green—heparin)

A

Capillary Blood Gas Equipment

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36
Q

A small metal bar aka “flea” that aids in mixing the anticoagulant for CBG collection

A

Stirrer

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37
Q

This mixes the specimen with the metal stirrer (back and forth along the tube length)

A

Magnet

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38
Q

This seals CBG tubes and maintains its anaerobic condition

A

Plastic Caps

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39
Q

→ for blood films for hematology determination
→ may or may not come with a frosted end where patient into is written

A

Microscopic slides

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40
Q

How many times does a warming device increase blood flow to the puncture site?

A

7 times

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41
Q

What is the maximum temperature for warming devices?

A

42 degrees Celsius

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42
Q

T or F: Infants should lie facing down when performing capillary puncture

A

False (supine; lying face up)

43
Q

T or F: Pain fibers decrease in abundance below the capillary bed

A

False (increase)

44
Q

T or F: Non-dominant hands have less callouses than the dominant hand

A

True

45
Q

T or F: Capillary puncture should be performed on the 2nd and 3rd finger of the non-dominant hand

A

False (3rd and 4th)

46
Q

T or F: Puncture site should be parallel to the grooves of the fingerprints

A

False (perpendicular because blood can travel down the finger if done parallel)

47
Q

What does osteomyelitis mean?

A

Bone imflammation

48
Q

What does osteochondritis mean?

A

Bone cartilage inflammation

49
Q

T or F: Heel punctures should be done less than 2mm

A

True

50
Q

Warm specimen is also called as what?

A

Arterialized capillary blood

51
Q

How long is the application for a warming device?

A

3-5 minutes

52
Q

How many fingers should you grasp for pediatric patients when performing capillary puncture?

A

3-4 fingers

53
Q

When performing heel puncture, at what degree should the incision be made to create a gap puncture (opens when pressure is applied)?

A

90-degrees

54
Q

T or F: You can use the first drop of blood as a sample

A

False (contains interstitial fluid and alcohol)

55
Q

In what direction should you wipe the first drop in order to encourage blood flow?

A

Downwards

56
Q

In what direction should you fill the tubes in order to encourage blood flow?

A

Downward

57
Q

T or F: Do not squeeze or “milk” the site as hemolysis and tissue fluid contamination can occur

A

True

58
Q

How many times should you invert the microcollection tubes?

A

8-10 times

59
Q

T or F: You cannot tap microtubes after filling

A

False

60
Q

T or F: A microhematocrit tube will automatically fill by capillary action

A

True

61
Q

T or F: A diagonal position above the blood drop should be maintained when using microhematocrit tubes

A

False ( vertically or horizontally)

62
Q

T or F: Microcollection containers are to be held upright just below the blood drop

A

True

63
Q

T or F: You can use a scooping motion against the surface of the skin as blood flows down the finger

A

False (activates platelet action resulting in clot formation and hemolysis)

64
Q

T or F: Microhematocrit tubes can be directly labeled

A

False (place in a non-additive tube or aliquot tube, then label)

65
Q

How long should the bandage be kept on after the procedure?

A

15 minutes

66
Q

T or F: You can apply bandages even for infants

A

False (it is a choking hazard)

67
Q

This special test is rarely collected in adults and more preferably for infants

A

Capillary Blood Gas

68
Q

T or F: Capillary blood gas specimen is transported via a warm environment

A

False (cold; sometimes even with ice)

69
Q

This test is done as detection and monitoring of increased bilirubin levels due to overproduction or impaired excretion

A

Neonatal bilirubin collection

70
Q

T or F: High levels of bilirubin can be caused by heme production from RBC hemolysis

A

True

71
Q

T or F: High levels of bilirubin = jaundice but low risk for permanent brain damage

A

False (high risk for brain damage)

72
Q

T or F: Jaundiced patients are exposed to UV light to decrease bilirubin levels as they are photosensitive

A

True

73
Q

Neonatal bilirubin collection is done in which site for infants?

A

Plantar heel surface

74
Q

What color are the microcollection containers used in neonatal bilirubin collection?

A

Amber

75
Q

This is the mandated testing of newborns for the presence of certain genetic (inherited), metabolic (chemical changes within living cells), hormonal, infectious, and functional disorders that can cause handicaps and abnormalities if not treated early

A

Newborn screening/Neonatal screening

76
Q

Neonatal screening is ideally performed on babies how many days old?

A

1-2 days

77
Q

T or F: Early collection for infants less than 24 hours can still yield accurate results

A

False

78
Q

T or F: Neonatal screening is collected separately from the microsampling tubes

A

True

79
Q

→ few drops obtained from heel puncture
→ blood drops adsorbed onto circles printed on a special type of filter paper (blood circles)

A

Blood Spot Collection

80
Q

How many diseases can blood spot collection detect?

A

Around 30

81
Q

T or F: For blood spot collection, you can touch the paper to the heel surface

A

False

82
Q

What can multiple drops in the circles lead to?

A

Layering of blood cells

83
Q

T or F: Neonatal screening specimen can be collected after blood transfusion

A

False

84
Q

T or F: Blood spot filter papers can air dry in an elevated, vertical position away from heat or sunlight

A

False (horizontal)

85
Q

What can happen if the blood spot filter paper is hung or stacked together?

A

Blood migration and cross contamination

86
Q

How many smears are always prepared for routine blood films?

A

2

87
Q

T or F: Blood films are only prepared manually

A

False (can be obtained from EDTA tubes)

88
Q

T or F: Blood smears from EDTA specimens should be made after 1 hour of collection

A

False (within; to eliminate cell distortion caused by the anticoagulant)

89
Q

T or F: Routine blood smears are to be performed before the micrsampling tubes

A

True

90
Q

How many mm should the blood drop diameter be in routine blood smears?

A

1-2

91
Q

At what angle must the spreader slide be held?

A

30 degrees

92
Q

T or F: You need to wait for the first smear to dry before proceeding to use it as a spreader slide

A

True

93
Q

T or F: Frosted slides can have the labels written on them

A

True

94
Q

How many minutes should the EDTA tube be mixed before performing blood smears?

A

2 minutes

95
Q

T or F: Smears are considered non-infectious until they are stained or fixed

A

False

96
Q

An acceptable smear covers how much of the slide surface?

A

1/2 to 3/4

97
Q

In which part of the slide is a differential count performed?

A

Along the feathery edge

98
Q

Thick smears indicate what?

A

Stacked cells

99
Q

This smear is used in malaria detection (plasmodium species—vector-borne)

A

Thick smears

100
Q

T or F: Suspected malaria test requests only require a thick smear

A

False (comparison of both thin and thick smear)

101
Q

T or F: Thin smears detect the species of malaria present in the patient while thick smears only confirm if a patient has malaria

A

True

102
Q

T or F: Thick smears cannot be ordered as STAT

A

False (you can; collect before onset of fever and chills)

103
Q

How long should a thick blood drop dry before staining?

A

2 hours

104
Q

What is the stain used for thick smears?

A

Giemsa

PMLS 2 (16 decks)

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