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Phlebotomy > Module 5: Special Collections > Flashcards

Module 5: Special Collections Flashcards

1
Q

blood smear

A
  • thin film of blood spread into a microscopic glass slide
  • used to microscopically examine blood
  • venous blood or capillary blood
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2
Q

when must peripheral blood smear be prepared when collected in an EDTA tube

A

within 1 hr of collection

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3
Q

wedge method of preparing blood smears

A
  • touching two slides at an angle of 30 to 35 degrees
  • place edge of spreader slide in front of the drop of blood
  • pull back the slide until it touches the blood
  • let blood spread almost to the edges of the spreader slide
  • push spreader slide toward clear end of the slide in one smooth motion
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4
Q

ways to collect blood for blood smear

A
  • dermal puncture
  • venipuncture using tube of uncoagulated blood, usually containing EDTA
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5
Q

how to get blood on slide if collecting with dermal puncture

A
  • perform finger stick
  • wipe away first drop of blood
  • apply pressure to finger to obtain a free-flowing drop of blood
  • allow blood to fall onto glass slide toward one end
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6
Q

how to get blood on slide if collecting with venipuncture

A
  • use a safety device to access the blood or carefully uncap the tube behind a safety shield
  • use disposable pipette or plastic dropper to remove the blood
  • use applicator sticks or a capillary tube to place the drop on the slide
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7
Q

where should you place the drop of blood on a microscope slide

A
  • 1/2 to 1 inch from the end of the slide
  • do not place directly on the frosted end
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8
Q

should the frosted side of the microscope slide be facing up or down when using slides that have a frosted end

A
  • up
  • it is used to write pt information or to affix aliquot label
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9
Q

how should blood be distributed on a slide

A
  • thicker at the drop point
  • thinner on the opposite end
  • tail with a feathered end that is slightly rounded
  • should not touch the edges of the microscopic glass slide
  • smooth without irregularities or holes
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10
Q

how to dry blood smear

A
  • let it air dry before staining
  • do not blow on it
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11
Q

blood cultures

A
  • lab tests used to check for microbes in a blood sample
  • assist in diagnosing conditions in a pt who has a fever of unknown origin (FUO)
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12
Q

how do you know how much blood to collect for blood cultures

A
  • review the medical requisition form
  • mark the bottle with the level of blood required
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13
Q

how to uncap and clean the blood culture bottle

A
  • remove the protective cap, not the entire cap
  • cleanse the top of the bottles with an antiseptic (alcohol)
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14
Q

how to cleanse the skin prior to venipuncture for a blood culture

A
  • clean for 60 seconds using alcohol or chlorhexidine gluconate
  • light friction using outward spiral technique
  • clean around site to a diameter of 2 to 2.5 inches
  • allow area to dry
  • clean the area again using the same technique but with povidone-iodine for 30 to 60 seconds
  • allow area to dry
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15
Q

which blood culture bottle should you collect first when using a butterfly needle

A
  • aerobic
  • anaerobic for other collection methods
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16
Q

when should the pt clench and unclench their fist

A
  • clench: after the tourniquet is applied, before needle insertion
  • unclench: as blood enters the tube or bottle
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17
Q

how long should you observe the venipuncture site for bleeding after releasing pressure

A

10 seconds

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18
Q

inborn errors of metabolism

A
  • newborns screened for various metabolic and genetic disorders by analyzing blood on special filter paper
  • assist in early detection
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19
Q

when is blood testing for newborn screenings performed

A
  • before newborn is 72 hours old
  • if it is obtained before the newborn is 24 hr old, a second specimen should be screened by 2 weeks of age
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20
Q

what conditions does newborn screening help detect

A
  • cystic fibrosis
  • hypothyroidism
  • phenylketonuria (PKU)
  • galactosemia
  • other genetic disorders (biotinidase deficiency, sickle cell disease)
  • infectious diseases (HIV, toxoplasmosis)
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21
Q

cystic fibrosis

A

mucous secretions that accumulate in various organs

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22
Q

hypothyroidism

A

decreased thyroid function

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23
Q

phenylketonuria (PKU)

A
  • metabolic genetic disorder
  • deficiency in hepatic enzyme phenylalanine hydroxylase
  • causes permanent intellectual disability, seizures, delayed development, behavioral/psychiatric problems, mousy body odor, lightening of hair/skin, eczema
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24
Q

galactosemia

A
  • lack of enzyme that breaks down galactose (a milk sugar)
  • infant can slowly starve if left untreated
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25
Q

biotinidase deficiency

A

deficiency of enzyme that breaks down biotin

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26
Q

sickle cell disease

A

abnormal hemoglobin structure

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27
Q

what should you check newborn screening forms for

A
  • expiration dates: substances within absorbent areas of filter paper can expire
  • guardians phone number: in case any tests yield positive results
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28
Q

how do you collect blood for newborn screenings

A
  • capillary puncture on infants heel
  • allow large blood droplet to form
  • touch the filter paper to the drop of blood to soak through completely in each circle
  • circles must be totally saturated
29
Q

how long should filter paper dry for newborn screenings

A
  • air dry
  • 3 hr
  • room temperature
  • away from direct sunlight and heat
30
Q

how not to get blood on filter paper for newborn screenings

A
  • avoid touching the skin with the card
  • avid blotting or attempting to color in the circle with several blood drops: causes serum rings
  • do not use capillary tubes: make filter paper rough and cause overabsorption
31
Q

why might specimens for newborn screenings be rejected

A
  • a circle is oversaturated
  • all circles are not completely filled
  • expired form is used
  • form not received within 14 days of collection
  • specimen is contaminated with foreign substance
  • specimen not allowed to dry thoroughly
  • circles have serum rings
32
Q

autologous transfusion

A

pt donates their own blood for use for a transfusion or upcoming surgery

33
Q

blood banks

A
  • handle blood used in blood donations
  • responsible for collection, processing, storing
  • usually part of the lab
  • work closely with regional blood centers that provide blood and blood products to hospitals
34
Q

therapeutic phlebotomy

A
  • intentional removal of blood to lower RBC or iron levels
  • polycythemia vera: high RBC count
  • hemochromatosis: high iron count
  • performed by blood banks
35
Q

how to hang bags during blood donation collection

A
  • lower than pts arm
  • gravity helps fill the bag
36
Q

what to do and what not to do if blood donation bag only fills partially

A
  • do: restart blood collection
  • don’t: combine two bags
37
Q

apheresis

A
  • removal of blood plasma from pts body without withdrawing the blood itself
  • separates blood into plasma and cells
  • returns cells to pt body
  • aka power red
38
Q

plasmapheresis

A

removal of blood plasma from whole blood

39
Q

requirements for blood donation

A
  • at least 17 y/o (16 with parent permission in some states)
  • weigh at least 110 pounds
  • pulse: 50-100 bpm
  • diastolic pressure: less than 100 mmHg
  • temperature: less than 99.5 F
  • hematocrit: over 38%
  • donations at least 56 days apart (8 wks)
40
Q

apheresis requirements for males

A
  • age 17+ y/o
  • weight 130+ lbs
  • height 61+ in
41
Q

apheresis requirements for females

A
  • age 17+ y/o
  • weight 150+ lbs
  • height 65+ in
42
Q

what is done before someone can donate blood

A
  • get complete medical history
  • mini-physical exam: temp, pulse, BP
  • hemoglobin or hematocrit levels measured
  • blood tested for HIV, AIDS, and hepatitis
43
Q

what is done before someone can donate blood

A
  • get complete medical history
  • mini-physical exam: temp, pulse, BP
  • hemoglobin or hematocrit levels measured
  • blood tested for HIV, AIDS, and hepatitis
44
Q

what questions are included in the medical history for pts wishing to donate blood

A
  • sexual activity
  • recent out-of-country travel
  • use of medications
45
Q

what must a pts hemoglobin be before they can do an autologous blood donation

A

at least 11 g/dL

46
Q

when must a pts surgical procedure be scheduled for a pt to do an autologous blood donation

A

more than 72 hrs after the donation

47
Q

iatrogenic anemia

A
  • blood loss due to repeated venipunctures in a short period of time
  • older pts, pediatric pts, pts who are underweight
48
Q

why are older pts at risk of iatrogenic anemia

A
  • medications may suppress bone marrow production
  • decreases in nutritional intake
  • significant amount of blood collected from different doctors
49
Q

max amount of blood that can be taken from infants

A
  • 1-5% of blood volume within 24 hrs
  • 10% of blood volume over 8 wk period
50
Q

max amount of blood that can be taken from adults

A
  • 100 mL
  • over that can cause decreased hemoglobin or hematocrit
51
Q

how to calculate infant blood volume

A
  • convert weight in lbs to kg: divide by 2.2
  • convert kg to mL: multiply by 100
  • convert mL to L: divide by 1000
52
Q

what can iatrogenic anemia lead to

A
  • shortness of breath
  • fatigue
  • need for blood transfusions
53
Q

random urine collection

A
  • most commonly performed urine test
  • no preparations or time restrictions
  • use a sterile specimen container
54
Q

glucose tolerance test

A
  • confirm pt is fasting, usually for 12 hr
  • blood and urine tests should be performed at the same time
  • collections every 1 to 2 hrs after finishing glucose solution
  • drink glucose solution within five minutes
  • document time specimen was collected
  • if not collected on time, document reason and actual time it was collected
55
Q

postprandial test

A
  • void and then eat a meal
  • specimen collection 2 hr after pt eats prescribed amount of carbs or glucose
  • monitors effects of insulin dosage for those with diabetes
  • screening tool
56
Q

24-hour urine collection

A
  • container that holds 3-4 L
  • discard first-morning specimen and collection and specimens after that for 24 hrs
57
Q

urine drug testing

A
  • accuracy and privacy
  • chain of custody form: everyone who handles the specimen must sign and date the form
58
Q

clean-catch midstream urine collection

A
  • use antiseptic that won’t damage genitals
  • void small amount into toilet
  • begin collection
  • stop collection before urine flow stops completely
  • finish voiding into the toilet
  • used for culture and sensitivity testing
59
Q

reagent strip for urine

A
  • chemical analysis
  • strip dipped into urine and analyzed
  • use analysis chart to determine level of substance in the urine
  • dispose of used strip in biohazard bag
60
Q

saliva specimens

A

test for hormone, alcohol, and drug levels

61
Q

sputum specimens

A
  • collected from lungs, trachea, and bronchi
  • pt takes deep breath and expectorates by coughing deeply into specimen container
  • best to collect before or several hours after eating to prevent vomiting
  • larger volume is available in the morning
62
Q

fecal specimens

A
  • determines bacterial infections, parasites, and occult blood
  • dietary restrictions may be required
  • keep sample at 98.6 F
63
Q

semen specimens

A
  • sperm count to assess fertility, DNA to prove identity in rape cases
  • pt may need to refrain from ejaculation prior to specimen collection
  • collect in sterile container, condoms contain spermicides
  • keep specimen warm, protect from light
  • return in 2 hr, 1 hr preferred
64
Q

throat swab

A
  • culture specimen, tests for strep throat
  • wipe both tonsils, the throat, and all areas that look inflamed or infected
  • wear a mask to protect yourself from airborne contanimation
65
Q

buccal swab

A
  • collected from inside of the cheek in the mouth
  • collects pt DNA
  • gently rub swab against inside of pts cheek
66
Q

what should you verify on the requisition form when receiving a forensic specimen

A
  • type of specimen
  • case number
  • name, age, and sex of person it was taken from
67
Q

what color tube is used to test testosterone levels

A

red

68
Q

where to collect two sets of blood cultures from

A
  • if both must be taken from the same site: wait 1 hr
  • draw from two separate sites to get most accurate results: two sites on pt left arm

Phlebotomy (9 decks)

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