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HEMATOLOGY > [LAB] Principles of Sample Collection > Flashcards

[LAB] Principles of Sample Collection Flashcards

1
Q

COLLECTION SITES FOR CAPILLARY PUNTURES

A

MIDDLE FINGER
RING FINGER
HEEL (in patients under 6 months)
— Lateral Surface
— Medial Surface
— Plantar Surface

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2
Q

[CAPILLARY PUNCTURE]

TRUE OR FALSE
THE FIRST DROP OF BLOOD SHOULD BE WIPED AWAY

A

TRUE

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3
Q

WHEN PUNCTURING, THE LANCET MUST BE
A. PARALLEL TO THE FINGERPRINT LINES
B. PERPENDICULAR TO THE FINGERPRINT LINES

A

B. PERPENDICULAR TO THE FINGERPRINT LINES

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4
Q

WHAT SOLUTION IS USED TO WIPE THE PUNCTURE SITE CLEAN?

A

70% ETHANOL

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5
Q

ANTICOAGULANT IN CAPILLARY TUBES

A

HEPARIN

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6
Q

IN WHAT SITUATIONS/ UNDER WHAT CONDITIONS ARE YOU TO PERFORM CAPILLARY PUNCTURES

A
  1. When available veins are FRAGILE or must be SAVED for other procedures
  2. Many failed venipunctures
  3. Patient has THROMBOTIC or CLOT-FORMING tendencies
  4. Apprehensive patients or fears needles
  5. No accessible veins
  6. POCT
  7. Burned or scarred patients
  8. Obese patients
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7
Q

WHAT CLINICAL CONDITION MAY RESULT WHEN LARGE AMOUNTS OF BLOOD ARE DRAWN FROM INFANTS?

A

ANEMIA
CARDIAC ARREST

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8
Q

OBTAINING BLOOD FROM INFANTS AND CHILDREN MAY DAMAGE WHAT?

A

VEINS
SURROUNDING TISSUES

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9
Q

PUNCTURING DEEP VEINS MAY RESULTS IN WHAT?

A
  1. Hemmorhage
  2. Venous thrombosis
  3. Infection
  4. Gangrene
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10
Q

WHAT CONDITION IS THE DEATH OF BODY TISSUE DUE TO A LACK OF BLOOD FLOW?

A

GANGRENE

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11
Q

PREFERRED SAMPLE FOR NSTs AND CBGs

A

CAPILLARY BLOOD

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12
Q

IN WHAT TESTS IS CAPILLARY BLOOD USED IN?

A

NEWBORN SCREENING TESTS
CAPILLARY BLOOD GASSES

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13
Q

AT WHAT AGE IS IT APPROPRIATE FOR A HEEL STICK CAPILLARY PUNCTURE TO BE PERFORMED?

A

UNDER 6 MONTHS

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14
Q

AT WHAT AGE IS IT APPROPRIATE FOR A FINGER STICK CAPILLARY PUNCTURE TO BE PERFORMED?

A

ABOVE 6 MONTHS

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15
Q

TRUE OR FALSE
IT IS ACCEPTABLE TO PERFORM CAPILLARY PUNCTURES ON PATIENTS WITH POOR PERIPHERAL CIRCULATION.

A

FALSE

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16
Q

TRUE OR FALSE
CAPILLARY PUNCTURE SHOULDN’T BE PERFORMED ON DEHYDRATED PATIENTS

A

TRUE

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17
Q

UNDER WHAT CONDITION IS IT UNACCEPTABLE FOR CAPILLARY PUNCTURE TO BE PERFORMED

A
  1. Patient is above 6 months old
  2. Dehydration
  3. Poor peripheral circulation
  4. Cold, swollen, scarred, rash-filled fingertips or heels
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18
Q

IS “MILKING” ALLOWED IN CAPILLARY PUNCTURE?

A

NO.
It increases the fluid concentration to blood cells.
Blood specimen is considered to be inaccurate.

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19
Q

WHAT HAPPENS TO THE BLOOD SAMPLE WHEN “MILKING” IS DONE IN CAPILLARY PUNCTURES

A

THE SPECIMEN BECOMES INACCURATE DUE TO THE INCREASE OF TISSUE FLUID CONCENTRATION TO THE BLOOD CELLS

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20
Q

ORDER OF DRAW FOR CAPILLARY PUNCTURE

A
  1. CBG (Yellow)
  2. Slides
  3. EDTA (Purple)
  4. Heparin (Light or Dark Green with Gel Separator)
  5. Sodium Fluoride/ Potassium Oxalate (Gray)
  6. Serum (Red with additive)
  7. Plain Tube ( Red without Additive)

CBG > SLIDES > EDTA > HEPA > SF/PO > SERUM > PLAIN

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21
Q

WHAT IS THE DISTANCE BETWEEN THE TOURNIQUET AND PUNCTURE SITE?

A

2-3 or 4 INCHES
(guys pa check)

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22
Q

WHAT ARE THE THREE COLLECTION SITES FOR VENIPUNCTURE? (IN ORDER OF MOST TO LEAST IDEAL SITE)

A
  1. MEDIAN CUBITAL
  2. CEPHALIC
  3. BASILIC
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23
Q

ANGLE OF NEEDLE INSERTION

A

15 TO 30 DEGREES

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24
Q

WHAT KIND OF VEINS DO PEDIATRIC AND GERIATRIC PATIENTS USUALLY HAVE?

A

FRAGILE
THIN
“ROLLY”

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25
OTHER VENIPUNCTURE SITES
SURFACE VEINS OF THE FEET OR BACK OF THE HANDS
26
TOO LARGE A VACUUM CAUSES THE VEIN TO _____
COLLAPSE
27
SYRINGE VOLUME THAT IS NOT RECOMMENDED
LARGER THAN 10-15 ML
28
WHAT IS THE RELATIONSHIP BETWEEN THE SYRINGE SIZE AND ITS VACUUM?
DIRECTLY PROPORTIONAL
29
WHAT IS THE RELATIONSHIP BETWEEN NEEDLE BORE SIZE AND THE GAUGE NUMBER?
INDIRECTLY PROPORTIONAL
30
ORDER OF DRAW IN VENIPUNCTURE
1. Blood culture tube (Yellow) 2. Coagulation tube (Blue) 3. Serum or Plain (Red) 4. Heparin (Green) 5. EDTA (Lavender or Pink) 6. Sodium Fluoride or Oxalate (Gray) BLOOD CULTURE > COAG > SERUM/PLAIN > HEPA > EDTA > SF/OXALATE
31
USE OF EVACUATED TUBE SYSTEM
FOR LARGE VOLUME COLLECTION FOR MULTIPLE DRAWS
32
IS IT OKAY TO USE THE ETS ON SMALL AND FRAGILE VEINS
NO
33
IDEAL LEVEL OF FILLIN THE CAPILLARY TUBE
UP TO 3/4 OF THE TUBE
34
MEANING OF OSHA
OCCUPATIONAL SAFETY AND HEALTH ACT/ADMINISTRATION
35
[PPT] SELECT SITE OF PUNCTURE IN ADULTS
FINGERS — END OR SIDE OF THE DISTAL PHALANX LOBE OF EAR
36
[PPT] SELECT SITE OF PUNCTURE IN INFANTS
GREAT TOE HEEL SKIN OF THE FOREARM
37
SWITCHING FROM A SUPINE TO A STANDING POSITION CAUSES WHAT
A SHIFT OF BODY WATER INCREASED CONCENTRATION OF MOLECULES IN THE BLOOD
38
THE DIURNAL RYTHM INCREASES WHAT SUBSTANCES IN THE MORNING?
CORTISOL THYROID-STIMULATING HORMNE IRON
39
WHEN ARE CORTISOL, TSH, AND IRON LEVELS INCREASED AND DECREASED?
INCREASED IN THE MORNING DECREASED IN THE AFTERNOON
40
AT WHAT TIME DOES EOSINOPHIL COUNT INCREASE AND DECREASE?
INCREASE IN THE AFTERNOON DECREASE IN THE MORNING
41
TRUE OR FALSE BODY WATER SHIFTS FROM THE INTERSTITIAL SPACES TO THE BLOOD VESSELS
FALSE
42
WHAT BLOOD CONSTITUENTS INCREASE DUE TO EXERCISE
CREATININE TOTAL PROTEIN CK MYOGLOBIN WBC COUNT AST HDL-CHOLESTEROL
43
EXCESSIVE CRYING IN CHILDREN CAN CAUSE WHAT?
TEMPORARY INCREASE IN WBC COUNT
44
DURATION OF FASTING
8-12 HOURS BEFORE BLOOD DRAW
45
WHAT SUBSTANCE IS ALLOWED DURING FASTING PERIODS
WATER
46
EFFECT OF INCREASED LIPIDS IN A SAMPLE
TURBIDITY DUE TO LIPEMIA
47
WHAT MEASUREMENT OR ASSAY DOES TURBIDITY INTERFERE WITH
PHOTOMETRIC MEASUREMENT
48
WHAT DOES SMOKING INCREASE IN BLOOD
WBC COUNTS CORTISOL LEVELS
49
WHAT ARE THE EFFECTS OF LONG TERM EFFECTS OF SMOKING
DECREASED PULMONARY FUNCTION INCREASED HEMOGLOBIN LEVELS
50
WHAT IS THE FUNCTION OF A TOURNIQUET
BARRIER AGAINST VENOUS BLOOD FLOW HELP LOCATE THE VEIN
51
HOW LONG CAN A TOURNIQUET BE LEFT ON A PATIENT FOR
NOT MORE THAN 1 MINUTE
52
EFFECT OF LEAVING A TOURNIQUET ON FOR TOO LONG
HEMOCONCENTRATION
53
WHAT ARE MOST GLASS TUBES COATED WITH
SILICONE
54
FUNCTION OF SILICONE IN GLASS TUBES
HELP DECREASE POSSIBILITY OF HEMOLYSIS PREVENT BLOOD FROM ADHERING TO THE TUBES’ SIDES
55
LENGTH OF SPECIMEN CLOTTING
30 TO 60 MINUTES
56
FUNCTION OF GLASS SILICA
COAGULATION ACTIVATED FACTOR XII IN THE COAGULATION PATHWAY
57
FUNCTION OF THROMBIN
COAGULATION CONVERTS FIBRINOGEN TO FIBRIN
58
FUNCTION OF SODIUM FLUORIDE
ANTIGLYCOLYTIC AGENT INHIBIT GLUCOSE METABOLISM
59
INERT MATERIAL THAT UNDERGOES A TEMPORARY CHANGE IN VISCOSITY DURING CENTRIFUGATION
SEPARATOR GELS
60
SERVES AS A BARRIER BETWEEN SERUM/PLASMA AND CELLS
SEPARATOR GEL
61
MOST COMMON GAUGE USED
21 GAUGE
62
CONSISTS OF A SHORT NEEDLE WITH PLASTIC WINGS CONNECTED TO THIN TUBING
BUTTERFLY/WINGED COLLECTION SET
63
FUNCTION OF THE RUBBER SLEEVE IN ETS NEEDLES
PREVENT BLOOD FROM DRIPPING INTO THE HOLDER
64
GRADUATIONS IN BARRELS ARE IN WHAT UNIT OF VOLUME
mL
65
TRUE OR FALSE AFTER CLEANING THE SITE, THE ALCOHOL MUST BE BLOW DRIED
FALSE SITE MUST AIR DRY
66
SOLUTIONS USED FOR PUNCTURE SITE STERILIZATION
1% TO 10% POVIDONE-IODINE PADS TINCTURE OF IODINE CHLORHEXIDINE COMPOUNDS
67
MOST COMMON SITE OF VEINS FOR VENIPUNCTURE
ANTECUBITAL FOSSA
68
WHAT KIND OF PATTERN DO THE VEINS IN THE ANTECUBITAL FOSSA HAVE
“M” PATTERN
69
WHAT VEIN IS THE LAST CHOICE AND WHY
BASILIC VEIN INCREASED RISK OF INJURY AD PUNCTURE OF BRACHIAL ARTERY
70
WHAT VEIN IS THE FIRST CHOICE AND WHY
MEDIAN CUBITAL VEIN VEINS MORE SECURE LESS PRONE TO ANY ARTERIAL OR NERVE DAMAGE
71
IS FIST PUMPING DURING VENIPUNCTURE ALLOWED? WHY?
NO MUSCLE ACTIVITY INCREASES THE CONCENTRATION OF SOLUTES IN THE BLOOD
72
VENIPUNCTURE SITES TO AVOID
VEINS IN THE FEET (UNLESS ALLOWED BY THE PHYSICIAN) VEINS IN THE INNER WRIST
73
FACTORS TO CONSIDER BEFORE DRAWING BLOOD
DIETARY RESTRICTIONS
74
FIRST STEP OF ANY LABORATORY PROCEDURE
PATIENT IDENTIFICATION
75
COMPONENT IN TOURNIQUETS THAT MAY CAUSE ALLERGIC REACTIONS
LATEX
76
NEEDLE GAUGLE USED IN CHILDREN
22-23 GAUGE
77
METHOD USED TO CLEAN PUNCTURE SITES
CIRCULAR MOTION IN TO OUT guys pa check
78
DISPOSAL CONTAINER FOR NEEDLES AND LANCETS
SHARPS CONTAINER
79
BLOOD TO ANTICOAGULANT RATIO IN TUBES FOR COAGULATION TESTING
9:1
80
LEAKAGE OF A SMALL AMOUNT OF BLOOD IN TISSUE AROUND THE PUNCTURE SITE
ECCHYMOSIS BRUISE
81
TROUBLESHOOT ECCHYMOSIS
APPLY DIRECT PRESSURE TO THE PUNCTURE SITE WITH A GAUZE PAD DO NOT BEND THE PATIENT’S ARM
82
LEAKAGE OF A LARGE AMOUNT OF BLOOD AROUND THE PUNCTURE SITE CAUSES THE AREA TO SWELL
HEMATOMA
83
CAUSE OF HEMATOMA
NEEDLE GOES STRAIGHT THROUGH THE VEIN NEEDLE IS PARTIALLY IN THE VEIN
84
PREVENTION OF HEMATOMA
APPLY PRESSURE TO THE PUNCTURE SITE
85
OTHER TERM FOR FAINTING
SYNCOPE
86
WHAT SUBSTANCE IS NOT RECOMMENDED BY THE CLSI TO REVIVE PATIENTS
AMMONIA
87
INCREASED CONCENTRATION OF CELLS, LARGER MOLECULES, AND ANALYTES IN THE BLOOD DUE TO A SHIFT IN WATER BALANCE
HEMOCONCENTRATION
88
RUPTURE OF BLOOD CELLS WITH THE CONSEQUENT ESCAPE OF HEMOGLOBIN
HEMOLYSIS
89
APPEARANCE OF SERUM IN HEMOLYZED SAMPLE
PINK OR RED
90
CAUSES OF HEMOLYZED SAMPLES
DRAWING BLOOD THROUGH EXISTING HEMATOMA PULLING THE PLUNGER TOO QUICKLY SPECIMEN CONTAMINATED WITH ALCOHOL OR WATER AT THE VENIPUNCTURE SITE
91
TEST RESULTS ALTERED BY HEMOLYZED SAMPLES
POTASSIUM LACTATE DEHYDROGENASE ASPARTATE AMINOTRANSFERASE
92
SHARP PAIN, SHOOTING, TINGLING, OR NUMBNESS IN THE ARM
NERVE DAMAGE
93
SWELLING DUE TO ABNORMAL ACCUMULATION OF FLUID
EDEMA
94
VEINS ARE NEITHER PALPABLE OR PROMINENT IN THIS KIND OF PATIENT
OBESE
95
LIMITS OF USING A BP CUFF
SHOULD NOT BE INFLATED HIGHER THAN 40 MMHG SHOULD NOT BE LEFT FOR LONGER THAN 1 MINUTE
96
SITES THAT SHOULD BE AVOIDED BECAUSE THEY DO NOT ALLOW BLOOD TO FLOW FREELY
VEINS THAT WERE: BURNED DAMAGED SCARRED OCCLUDED
97
WHAT TO DO WHEN DRAWING FROM A PATIENT UNDERGOING INTRAVENOUS THERAPY
AVOID ARM WITH THE IV INSERTION — IF NOT POSSIBLE, DRAW BELOW THE IV SITE DRAW ON OPPOSITE ARM ASK NURSE/HCW TO STOP THE INFUSION FOR 2 MINUTES BEFORE DRAWING BLOOD NOTE ON REQUISITION FORM
98
HOW LONG SHOULD THE IV INFUSION BE STOPPED BEFORE DRAWING BLOOD
2 MINUTES
99
[TROUBLESHOOTING] NEEDLE INSERTED THROUGH THE VEIN
WITHDRAW THE NEEDLE
100
[TROUBLESHOOTING] PARTIAL NEEDLE INSERTION
INSERT THE NEEDLE FURTHER
101
[TROUBLESHOOTING] BEVEL RESTING ON VEIN WALL
ADJUST ANGLE OF NEEDLE INSERTION
102
INFANT HEEL PUNCTURE DEPTH
NOT MORE THAN 2 MM DEEP
103
WHY SHOULDN’T A HEEL PUNCTURE BE DEEPER THAN 2 MM
RISK OF BONE INJURY AND INFECTION (OSTEOMYELITIS)
104
SHAKING THE SAMPLE CAN RESULT IN
HEMOLYSIS
105
EXPOSURE OF BLOOD SPECIMEN TO LIGHT CAN CAUSE
FALSELY DECREASED VALUES OF: BILIRUBIN BETA-CAROTENE VITAMIN A PORPHYRINS
106
IS SPECIMEN CHILLING ALLOWED
NO
107
TESTS THAT CHILL SPECIMENS
AMMONIA LACTIC ACID PARATHYROID HORMONE GASTRIN
108
[REJECT OR ACCEPT] HEMOLYZED SPECIMEN
REJECT
109
[REJECT OR ACCEPT] SPECIMEN COLLECTED AT THE WRONG TIME
REJECT
110
[REJECT OR ACCEPT] CLOTTED SPECIMEN FOR TESTS REQUIRING WHOLE BLOOD OR PLASMA
REJECT
111
[REJECT OR ACCEPT] COMPLETELY LABELED SPECIMEN
ACCEPT
112
[REJECT OR ACCEPT] LIPEMIC SPECIMEN
REJECT** Cannot be used for certain tests
113
[REJECT OR ACCEPT] SPECIMEN CONTAMINATED WITH IV FLUID
REJECT

HEMATOLOGY (13 decks)

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