Ch 13 - Preanalytic Variable and Venipuncture Complication

Question 1

____ _____ occur before analysis of specimen and the phlebotomist is the most responsible

Answer 1

preanalytic variables

Question 2

____ _____ can affect test outcomes

Answer 2

preanalytical variables

Question 3

age
alcohol consumption
altitude 
dehydration
smoking
diurnal variation
stress
exercise
fasting
sex
medications and medical treatment
posture
pregnancy
obesity

What are all of these factors?

Answer 3

preanalytical variables

Question 4

if a patient is ______, still communicate everything as you normally would

Answer 4

unconscious

Question 5

occluded

Answer 5

blocked

Question 6

sclerosed

Answer 6

hardened

Question 7

veins that are occluded or sclerosed feel hard/cordlike and lack _____

Answer 7

resiliency

Question 8

_____/_____ can be caused by inflammation, disease, chemotherapy, prolonged IV therapy, or repeated venipuncture

Answer 8

occluded/sclerosed

Question 9

caused by needle going through the vein, failing to apply enough pressure after withdrawal, or by having the bevel opening only partially in the vein

Answer 9

hematoma

Question 10

arm may appear swollen because of accumulation of tissue fluid with this condition

Answer 10

edematous tissue

Question 11

the removal of lymph tissue on the side of the mastectomy causes ____

Answer 11

lymphostatis

Question 12

lack of lymph fluid movement

Answer 12

lymphostasis

Question 13

massage the arm gently from wrist to elbow
dangle arm downward to promote blood flow
apply heat
rotate wrist to increase prominence of cephalic vein
pump hand/make a fist

What are these useful for?

Answer 13

enhancing vein prominence

Question 14

70% isopropyl alcohol, methanol, ethyl alcohol, or tincture of iodine cannot be used to clean the site for ___ ___ test

Answer 14

blood alcohol

Question 15

povidone-iodine or benzalkonium chloride are used to clean the site in the ____ ____ test

Answer 15

blood alcohol

Question 16

benzalkonium chloride cannot be used in children under the age of __

Answer 16

2

Question 17

medical term for fainting

Answer 17

syncope

Question 18

patient’s skin feels cold, damp, and clammy
beads of sweat may form
may state they aren’t feeling well or stop talking
eyes may start to roll back
head could tilt forward or backward

What are these symptoms of?

Answer 18

syncope

Question 19

medical term for nausea and vomiting

Answer 19

emesis

Question 20

too much pressure on a small/weak vein causes _____ vein

Answer 20

collapsed

Question 21

destruction of Red Blood Cells, which causes the release of hemoglobin and cellular contents into the plasma

Answer 21

hemolysis

Question 22

serum or plasma is ___ in a hemolyzed sample

Answer 22

pink/red

Question 23

• blood frothing caused by needle improperly attached to a syringe
• drawing blood too quickly into a syringe
• excessively shaking blood
• failing to allow the blood to run down the side of the tube when using a syringe to fill the tube
• using too small of needle relative to vein size or vacuum tube size
• mishandling and improper specimen transport
• readjustment of the needle in the vein

What are these causes of?

Answer 23

hemolysis

Question 24

aspartate aminotransferase
potassium
lactate dehydrogenase

These chemistry and hematology tests are ____ affected by hemolysis

Answer 24

seriously

Question 25

alanine aminotransferase CBC serum iron thyroxine These chemistry and hematology tests are ____ affected by hemolysis

Answer 25

moderately

Question 26

``` acid phosphate magnesium albumin phosphorus calcium total protein ``` These chemistry and hematology tests are ____ affected by hemolysis

Answer 26

slightly

Question 27

flow of blood from collection tube back into patient's vein

Answer 27

reflux of anticoagulant

Question 28

``` albumin bilirubin calcium cell counts cholesterol enzymes hemoglobin or hematocrit high-density lipoprotein iron lipids protein triglycerides ``` These are tests affected by:

Answer 28

patient position

Question 29

anemia caused by excessive removal of blood at the physician's request

Answer 29

iatrogenic anemia

Question 30

pressure within the tissue prevents blood from flowing freely in the blood vessels

Answer 30

compartment syndrome

Question 31

iatrogenic anemia compartment syndrome infection nerve damage potential long-term complications associated with ____

Answer 31

venipuncture

Question 32

timed specimens are useful to monitor ___ ___

Answer 32

cardiac enzymes

Question 33

if an IV is in place and there are no accessible sites, where should the blood specimen be collected?

Answer 33

distal to the IV

Question 34

avoid the ____ vein to avoid nerve damage

Answer 34

basilic

Question 35

body's state 8-12 hours of fasting

Answer 35

basal state