MLS LECTURE 5

Question 1

What are the things that can be known from a blood test?

Answer 1

• Glucose rate
• Alcohol
• Drugs
• Genetic testing
• Infections

Question 2

Lab test information provided can include:

Answer 2

• Lab where a test is performed
• Availability
• TAT
• Special instructions
• Specimen type
• Volume of specimen
• Minimum volume needed
• Collection container
• Collection type
• Transport instruction
• Storage instructions
• cause of rejection
  -normal value-reference range
• Critical value
• Test limitation

Question 3

How important are we as lab workers?

Answer 3

we play an important role in the process of collection since we give about 80% of the information needed to diagnose and treat a patient

Question 4

True or False: Accurate patient identification could give you the perfect time to do a test as a lab worker.

Answer 4

True; accurate patient identification = timely results
quality lab sample = quality test results

Question 5

What would happen if you rejected a blood sample (patient safety and experience)?

Answer 5

1- Delay in results
2- Delay in treatments
3- Delay in discharge
4- Dissatisfaction

Question 6

Why would a patient be dissatisfied if the blood samples are rejected?

Answer 6

because there will be additional needle sticks and blood loss, which could be discomforting, affect the patient negatively, and is time-consuming

Question 7

What would happen if you rejected a blood sample (lab and clinical staff)?

Answer 7

1- Extra work
2- additional cost, time, and supplies
3- Delay in processing other tests, which might increase STATS

Question 8

Give the reasons for rejecting blood samples:

Answer 8

1- Hemolyzed samples
2- QNS (Quantity not sufficient)
3- Wrong collection tube
4- Improper paperwork (mainly labelling the samples)

Question 9

What is the meaning of hemolysis?

Answer 9

the breaking open of red blood cells

Question 10

When can hemolysis occur?

Answer 10

• when specimens are mishandled because the membrane is fragile and easily damaged
• when the red cell membrane breaks other cellular components (enzymes, electrolytes are released, etc.)

Question 11

What causes hemolysis?

Answer 11

1- using force to transfer blood through a needle using a syringe into tubes
2- mixing the sample in a not very gentle way after collection
3- puncturing the vein before the alcohol dries which might get the alcohol mixed with the sample
4- Really old specimens

Question 12

QNS means:

Answer 12

quantity not sufficient; not enough blood in tube required for testing

Question 13

True or False: You should never under-fill a tube but it is fine to over-fill it just in case you needed extra samples.

Answer 13

False; you should never over or under-fill a tube

Question 14

What would happen if a tube contains additives and it is underfilled?

Answer 14

It can have a high concentration of additives, giving inaccurate results (erroneous)

Question 15

True or False: different tube = different additive.

Answer 15

True

Question 16

How many blood collection tubes are there?

Answer 16

Over 9

Question 17

What would happen if a shuffle in the order of collection tubes happened?

Answer 17

cross-contamination may occur

Question 18

give the order of draw (tubes)

Answer 18

1- Black (culture)
2- Blue (sodium citrate / no citrate)
3- Gold (serum (SST))
4- Red (serum)
5- Green (Heparin)
6- Tan/Pink/Lav (EDTA)
7- Grey (Na Flouride/glycolytic inhibitor)

Question 19

What is the most important step in specimen collection?

Answer 19

Patient identification

Question 20

How many identifiers are usually used for each patient?

Answer 20

2 unique identifiers

Question 21

True or False: The number of the hospital room can be used as an identifier.

Answer 21

False; this should never be used as an identifier.

Question 22

True or False: The number of the hospital room can be used as an identifier.

Answer 22

False; this should never be used as an identifier.

Question 23

What is the first choice of venipuncture site collection?

Answer 23

Median Cubital vein

Question 24

Why is the median cubital vein picked first?

Answer 24

• least painful
• anchors really well
• large
• least likely to bruise

Question 25

The second choice after the median cubital vein is:

Answer 25

Cephalic vein

Question 26

Reasons for picking the cephalic vein after the median cubital vein

Answer 26

-more painful than the median cubital vein -not as well anchored as the median cubital vein

Question 27

When are the hand or wrist veins picked?

Answer 27

you cant find both the median cubital vein and the cephalic vein

Question 28

the hand or wrist veins are known to have:

Answer 28

narrow diameter and needs small gauge needles and small volume evacuation tubes

Question 29

For safe puncturing:

Answer 29

1- avoid hitting a nerve 2- avoid puncturing the arteries 3- avoid excessive or blind needle probing

Question 30

How do you control the infection?,

Answer 30

Wash your hands with soap and water Or Use a waterless sanitizer Put your gloves on both hands

Question 31

How do you clean the venipuncture site?

Answer 31

- Use an antiseptic to clean the venipuncture site - never forget to start at the center the move outward to prevent re-introducing dirt & bacteria - never apply or use over-pressure - before venipuncturing let the site dry and don't wipe or fan the site

Question 32

Why should you never wipe or fan the site for it to dry faster?

Answer 32

To prevent introducing or reintroducing contaminants

Question 33

What would happen if you used the wrong needle gauge?

Answer 33

You will increase the chances of hemolysis

Question 34

State the steps of the proper insertion of the needle.

Answer 34

Step 1: hold the patient's arm (thumb on top and the rest of the fingers below ) Step 2: pull the skin below the intended venipunctured site with your thumb Step 3: smoothly and quickly insert the needle (the bevel must be up) * if the resistance decreased = you must stop since that indicates entry into the vein

Question 35

How are the samples mixed?

Answer 35

They are inverted (mostly 180 degrees and back) for 5-10 time (mostly around 8)

Question 36

What cat happen if the specimen is not mixed properly?

Answer 36

Blood clot & will need to be redrawn Hemolysis

Question 37

What could happen if you removed the gauze too soon?

Answer 37

You may disturb the clot and bleeding may restart

Question 38

State the common causes of needle stick injuries.

Answer 38

1) safety device is not activated 2) improper disposal 3) hand-off of needle device is often used 4) manipulating needle in the patient 5) patient moving throughout the process

Question 39

How do you avoid possible needle stick injuries?

Answer 39

1) plan the disposal of needle before you start the procedure 2) do one thing at a time 3) always activate safety device 4) work in good lighting 5) explain the procedure to the patient 6) immediately dispose needles after the procedure

Question 40

State 2 other ways to draw blood

Answer 40

1) finger stick 2) heel stick