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[Immunohematology] Lec > [21] CHAPTER IX LESSON 3 > Flashcards

[21] CHAPTER IX LESSON 3 Flashcards

1
Q

In medicine, venipuncture or venepuncture is the process of obtaining intravenous access for the purpose of venous blood sampling (also called phlebotomy) or[?].

A

intravenous therapy

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2
Q

The process for collecting blood from donors is similar to that used for [?]; however, a few additional measures are required for collection of donated blood.

A

blood sampling

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3
Q

These measures are primarily to ensure patient safety, but also to minimize [?] of a donated blood unit or its derived components, particularly contamination from the skin flora of the donor’s arm.

A

exogenous contamination

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4
Q

Because of the volume or blood collected and the [?], pathogens can multiply during storage.

A

length of storage

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5
Q

ensures that the blood products are safe for therapeutic use throughout their shelf life.

A

Safe collection

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6
Q

Step1. Identify donor and label blood collection bag and test tubes

A

Disinfect the skin

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7
Q

Step 2.

A

Select the vein

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8
Q

Step 3.

A

Disinfect the skin

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9
Q

Step 4.

A

Perform the venipuncture

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10
Q

Step 5.

A

Monitor the donor and the donated unit

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11
Q

Step 6.

A

Remove the needle and collect samples

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12
Q

Ask the donor to state their full name.

A

Step1

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13
Q

the blood collection bag is of the correct type

A

Step1

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14
Q

the labels on the blood collection bag and all its satellite bags, sample tubes and donor records have the correct patient name and number

A

Step1

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15
Q

the information on the labels matches with the donor’s information

A

Step1

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16
Q

Select a large, firm vein, preferably in the antecubital fossa, from an area free from skin lesions or scars.

A

Step 2

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17
Q

Apply a tourniquet or blood pressure cuff inflated to 40-60 mm Hg, to make the vein more prominent

A

Step 2

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18
Q

Ask the donor to open and close the hand a few times

A

Step 2

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19
Q

Once the vein is selected, release the pressure device or tourniquet before the skin site is prepared.

A

Step 2

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20
Q

If the site selected for venipuncture is visibly dirty, wash the area with soap and water, and then wipe it dry with single-use towels.

A

Step 3

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21
Q

(recommended – takes about one minute)

A

One-step procedure

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22
Q

use a product combining 2% chlorhexidine gluconate in 70% isopropyl alcohol

A

One-step procedure

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23
Q

cover the whole area and ensure that the skin area is in contact with the disinfectant for at least 30 seconds

A

One-step procedure

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24
Q

allow the area to dry completely, or for a minimum of 30 seconds by the clock.

A

One-step procedure

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25
Q

(if chlorhexidine gluconate in 70% isopropyl alcohol is not available, use the following procedure – takes about two minutes)

A

Two-step procedure

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26
Q

– use 70% isopropyl alcohol

A

Two-step procedure step 1

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27
Q

cover the whole area and ensure that the skin area is in contact with the disinfectant for at least 30 seconds

A

Two-step procedure step 1

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28
Q

allow the area to dry completely (about 30 seconds)

A

Two-step procedure step 1

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29
Q

– use tincture of iodine (more effective than povidone iodine) or chlorhexidine (2%)

A

Two-step procedure step 2

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30
Q

cover the whole area and ensure that the skin area is in contact with the disinfectant for at least 30 seconds

A

Two-step procedure Step 2

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31
Q

allow the area to dry completely (about 30 seconds)

A

Two-step procedure 2

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32
Q

Whichever procedure is used, DO NOT touch the venipuncture site once the skin has been disinfected.

A

Step 3

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33
Q

Perform venipuncture using a smooth, clean entry with the needle.

A

Step 4

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34
Q

In general, use a 16-gauge needle, which is usually attached to the blood collection bag.

A

Step 4

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35
Q

Use of a retractable needle or safety needle with a needle cover is preferred if available, but all should be cut off at the end of the procedure rather than recapped.

A

Step 4

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36
Q

Ask the donor to open and close the first slowly every 10–12 seconds during collection.

A

Step 4

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37
Q

Remove the tourniquet when the blood flow is established or after 2 minutes, whichever comes first.

A

Step 4

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38
Q

Closely monitor the donor and the injection site throughout the donation process

A

Step 5

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39
Q

sweating, pallor or complaints of feeling faint that may precede fainting

A

Step 5

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40
Q

development of a hematoma at the injection site

A

Step 5

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41
Q

changes in blood flow that may indicate the needle has moved in the vein, and needs to be repositioned

A

Step 5

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42
Q

About every 30 seconds during the donation, mix the collected blood gently with the anticoagulant, either manually or by continuous mechanical mixing.

A

Step 5

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43
Q

Cut off the needle using a sterile pair of scissors

A

Step 6

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44
Q

Collect blood samples for laboratory testing.

A

Step 6

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45
Q

ask the donor to remain in the chair and relax for a few minutes

A

After a blood donation: Donor care

46
Q

inspect the venipuncture site; if it is not bleeding, apply a bandage to the site; if it is bleeding, apply further pressure

A

After a blood donation: Donor care

47
Q

ask the donor to sit up slowly and ask how the person is feeling

A

After a blood donation: Donor care

48
Q

before the donor leaves the donation room, ensure that the person can stand up without dizziness and without a drop in blood pressure

A

After a blood donation: Donor care

49
Q

offer the donor some refreshments.

A

After a blood donation: Donor care

50
Q

Blood collected in an anticoagulant can be stored and transfused to a patient in an unmodified state. This is known as [?].

A

‘whole blood’ transfusion

51
Q

However, blood can be used more effectively if it is processed into components, such as red cell [?]. In this way, it can meet the needs of more than one patient

A

concentrates, platelet concentrates, plasma and cryoprecipitate

52
Q

Most whole blood donations are spun in centrifuges to separate it into transfusable components:

A

red cells, platelets, and plasma.

53
Q

Plasma may be processed into components such as[?], which helps control the risk of bleeding by helping blood to clot.

A

cryoprecipitate

54
Q

Red cells and platelets are [?], which means your white cells are removed in order to reduce the possibility of the recipient having a reaction to the transfusion.

A

leuko-reduced

55
Q

Each component is packaged as a “[?],” a standardized amount that doctors will use when transfusing a patient.

A

unit

56
Q

When test results are received, units suitable for transfusion are [?].

A

labeled and stored

57
Q

Red cells are stored in refrigerators at [?] depending on the anticoagulant used.

A

6ºC for up to 42 days

58
Q

Platelets are stored at room temperature in agitators for up to [?].

A

five days

59
Q

Plasma and cryoprecipitate are frozen and stored in freezers for up to [?].

A

one year

60
Q

Advantages of Component Therapy
1. the recipient can be treated with only those blood components that are lacking, reducing the occurrence of [?];
2. [?] can be treated with blood components derived from one donation;
3. therapeutic support for patients with special transfusion requirements can be provided, for example, plasma that often is not directly needed for transfusion can be used manufacturing of [?] for Hemophilia A patients;
4. [?] of each component when varied storage conditions and shelf lives were applied.

A

adverse transfusion reactions

more than one patient

Factor VIII concentrate

improved quality and functional capacity

61
Q

Once dispensed, any [?] shall be immediately transported directly to the RN or LIP requesting the component for transfusion.

A

PRBCs

62
Q

PRBCs are stored in a Blood Bank refrigerator at a temp of [?] until issue.

A

1-6ºC

63
Q

The shelf life is [?] from the date of collection

A

42 days

64
Q

The expiration date is located on the

A

unit(s).

65
Q

If the transfusion cannot be initiated within a time frame that would allow for completion within [?] of time issued, return the component to the Blood Bank.

A

4 hours

66
Q

Blood can be stored in a Blood Bank validated cooler for up to [?].

A

6 hours

67
Q

The cooler must be returned to the Blood Bank prior to the [?] cooler expiration time.

A

6-hour

68
Q

The cooler will then be [?] if the blood products are still needed.

A

repacked and reissued

69
Q

The cooler expiration time is noted on the [?] of the cooler.

A

outside

70
Q

[?] must be thawed prior to issue. This process takes approximately [?].

A

Frozen Plasma

45 minutes

71
Q

Once dispensed, any plasma shall be immediately transported directly to the [?] requesting the component for transfusion.

A

RN or LIP

72
Q

Frozen Plasma is maintained in the Blood Bank freezer at a temp [?] until it is thawed.

A

≤-18ºC

73
Q

Once thawed, it is stored in a Blood Bank refrigerator at a temp of [?] until issue.

A

1-6ºC

74
Q

Frozen Plasma - The shelf life is [?] from the date of collection.

A

1 year

75
Q

Thawed Plasma - The shelf life of thawed plasma is either [?], depending on the plasma product.

The expiration date is located on the unit(s). Returns- Same as pRBCs.

A

24 hours or 5 days

76
Q
  • Therapeutic dose collected from 1 via an automated apheresis procedure
A

Apheresis Platelets or Single Donor Platelets

77
Q

is equivalent to 6 whole blood derived

A

Apheresis Platelets or Single Donor Platelets

78
Q
  • Therapeutic dose from up to 6 whole blood donors pooled together
A

Pooled Platelets

79
Q

is equivalent a single apheresis platelet unit.

A

Pooled Platelets

80
Q

Once dispensed, platelets shall be immediately transported directly to the [?] requesting the component for transfusion.

A

RN or LIP

81
Q

Platelets must remain at

A

room temperature.

82
Q

Platelets are never place inside a [?] for any reason.

A

Blood Bank blood cooler

83
Q

All platelets are stored at [?] with gentle agitation until issue. o

A

room temperature (20-24ºC)

84
Q

The shelf life of plt is [?] from the date of collection.

A

5 days

85
Q

Pooled Platelets expire [?] from the time of preparation (pooling if required) pooling.

A

4 hours

86
Q

The expiration date of plt is located on the [?].

A

unit(s)

87
Q

Return plt as soon as possible if the component is not able to be [?].

A

transfused

88
Q

A therapeutic dose of cryoprecipitate is generally a pool of 5 units

A

Cryoprecipitate

89
Q

this is typically issued as a single bag containing all of the individual units pooled together

A

Cryoprecipitate

90
Q

The pool size and the number of units required for a therapeutic dose are determined by the blood supplier and available inventory may vary.

A

Cryoprecipitate

91
Q

Cryoprecipitate will need to be thawed prior to issue. This process takes approximately [?].

A

45 minutes

92
Q

Pooling of individual units, if required, may take additional time.

A

Cryoprecipitate

93
Q

Once dispensed, [?] shall be immediately transported directly to the one requesting the component for transfusion.

A

Cryoprecipitate

94
Q

Must remain at room temperature.

A
95
Q

Never place inside a Blood Bank blood cooler for any reason.

A

Cryoprecipitate

96
Q

Cryoprecipitate is stored in the Blood Bank freezer at a temp of [?] until thawing.

A

≤18°C

97
Q

After thawing, Cryoprecipitate should be maintained at room temperature [?].

A

(20 - 24°C)

98
Q

It should never be refrigerated or placed in a blood cooler.

A

Cryoprecipitate

99
Q

Frozen Cryoprecipitate - The shelf life is [?] from the date of collection. Single units expire [?] from time of thawing.

A

1 year

6 hours

100
Q

The expiration date is located on the unit(s).

A
101
Q

Return as soon as possible if the component is not able to be transfused.

A

Cryoprecipitate

102
Q

The recommended transport conditions must be maintained when blood is moved from one location to another, including:
o from a [?] to the laboratory
o from the blood bank to a [?] (to a hospital or clinic or another blood bank)
o from the blood bank to [?] (WHO, 2005)

A

mobile or satellite collection site

different facility

hospital wards or operating rooms

103
Q

Thus, each blood transport box must have [?] as coolants in order to ensure an acceptable cold life. (WHO, 2002).

A

frozen ice packs

104
Q

The transport method in the policy must specify transport conditions for the different [?] as recommended below: (WHO, 2005)

A

individual blood products

105
Q

-Ice should not be allowed to come into direct contact with the blood as the red cells nearest to the ice may freeze and hemolyze.

A
  1. Red cell components
106
Q

Appropriate materials and packing arrangements are therefore necessary.

A
  1. Red cell components
107
Q

Transport temperature range: 2-10 degrees Celsius

A
  1. Red cell components
108
Q

-There should be at least as much wet ice in the cold box as there is plasma.

A
  1. Plasma
109
Q

If possible, they should have been placed in cardboard boxes before freezing to protect the bags from developing small cracks.

A
  1. Plasma
110
Q

Transport temperature range: At or below –25 degrees Celsius

A
  1. Plasma

[Immunohematology] Lec (35 decks)

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