(P) Lec 2: Specimen Collection (Part 1) Flashcards
1
Q
Identifying Patients
What do you verbally ask for in conscious/hospitalized patients?
A
Full name (do not ask yes or no questions)
2
Q
Identifying Patients
What do you use to confirm a patient’s full name?
A
ID Bracelet
3
Q
Identifying Patients
If a patient is unconscious, an infant, or mentally incompetent, who can you ask for the patient’s name?
A
Relative, nurse, or physician (record the name of who stated the patient’s name on their behalf)
4
Q
Identifying Patients
Who verifies the ID when dealing with oupatient/ambulatory patients?
A
Receptionist
5
Q
Identifying Patients
For outpatient/ambulatory patients, what identifiers must be stated and spelt? (3 answers)
A
State: Full name and DOB
Spell: Last name
6
Q
What is the first step in sample collection?
A
Proper patient identification
7
Q
Identifying Patients
For unidentified emergency patients, how many items for identification must be used?
A
2-3 (name, DOB, and address)
8
Q
Blood Collection
The human body contains approximately how many quarts/liters of whole blood?
A
5 quartz/ 4.73L
9
Q
Blood Collection
How many liters of whole blood for adult males?
A
5-6L
10
Q
Blood Collection
How many liters of whole blood for adult females?
A
4-5L
11
Q
Blood Collection
Whole blood is composed of approximately how many percent of plasma and cells?
A
60% plasma (important for CC) and 40% cells (important for hematology)
12
Q
Blood Collection
Plasma is how many percent of the total blood volume?
A
55%
13
Q
Blood Collection
Plasma is how many percent water?
A
91%
14
Q
Blood Collection
Plasma is how many percent blood proteins (fibrinogen, albumin, and globulin)?
A
7%
15
Q
Blood Collection
Plasma is how many percent nutrients, hormones, and electrolytes?
A
2%
16
Q
Blood Collection
How many percent of the total blood volume are the cellular components?
A
45%
17
Q
Blood Collection
The buffy coat is made up of what 2 components?
A
WBCs and Platelets
18
Q
Blood Collection
How many WBCs are usually present per cubic millimeter of blood?
A
7,000-9,000
19
Q
Blood Collection
How many platelets are usually present per cubic millimeter of blood?
A
250,000
20
Q
Blood Collection
How many RBCs are usually present per cubic millimeter of blood?
A
5,000,000
21
Q
Blood Collection
Clotted blood specimen is called?
A
Serum
22
Q
Blood Collection
Unclotted blood specimen is called?
A
Plasma
23
Q
Blood Collection
What 2 blood specimens are used for clinical chemistry?
A
Serum and Plasma
24
Q
Blood Collection
What blood specimen is used for hematology?
A
Whole Blood
25
# Serum or Plasma?
1. Clear
2. Pale yellow in color
3. Uses a plain tube
4. Does not have any fibrinogen
Serum
26
# Serum or Plasma?
1. Clear to slightly hazy
2. Pale yellow in color
3. Uses an anticoagulated tube
4. Contains fibrinogen
Plasma
27
What is the more common and best blood specimen to be used in CC?
Serum
28
What is the specimen best used for STAT procedures?
Plasma (because clotting takes time if you use serums)
29
Lipemic serum indicates an excess/high concentration of what?
Triglycerides
30
Ictericia (jaundice) indicates a problem with what blood component?
Bilirubin
31
Fibrinogen is converted into what during the clotting process of serum?
Fibrin
32
TOF: There is fibrin in plasma because of the anticoagulants
False (fibrin can only be found in clotted blood, not in serum or plasma)
33
What are the 3 methods of blood collection?
1. Arterial Puncture
2. Skin Puncture
3. Venipuncture
34
# Type of Blood Collection
1. Blood is obtained/withdrawn from a patient’s artery
2. Sample is collected w/o a tourniquet
3. Specimen is used in BGA and pH analysis
4. Specimen is oxygenated blood with a bright red color
Arterial Puncture
35
# Arterial Puncture
What is the most common and safest site for arterial puncture?
Radial Arteries
36
Who are allowed to perform arterial punctures?
MDs and Respiratory Technicians (+ other HCWs with training)
37
# Arterial Puncture
What is the least preferred site for arterial puncture?
Femoral Artery
38
# Arterial Puncture
The brachial artery is not an ideal site for puncture due to the abundance of what?
Nerves
39
# Arterial Puncture
This is a test to know if collateral circulation is present before performing arterial puncture
Allen's Test
40
# Arterial Puncture
When handling the syringe like a dart, what is the ideal angular range for needle entry?
45-90 degrees
41
# Arterial Puncture
What are the 5 sites for puncture (in newborns)?
1.Radial
2.Brachial
3.Femoral
4.Scalp
5.Umbilical
42
# Arterial Puncture
What are the 3 sites for puncture (in adults)?
1. Radial
2. Brachial
3. Femoral
43
# Arterial Puncture
What is the best puncture site choice for newborns?
Umbilical Cord
44
# Skin Puncture
Skin puncture is aka? (2 answers)
1. Capillary Puncture
2. Microsampling
45
# Skin Puncture
Length of lancet?
1.75mm
46
# Skin Puncture
Incision depth for infants and children?
Less than 2mm
47
# Skin Puncture
Incision depth for adults?
Less than 2.5mm
48
# Skin Puncture
What is the distance from the skin surface to bone/cartilage?
1.5 - 2.4mm
49
# Skin Puncture
Punctures should not be made more than how many mm deep for infants and adults?
Infants: Not more than 2.5mm
Adults: Not more than 2-3mm
50
# Skin Puncture
What is the most common and best skin puncture site for newborns/infants less than 1 year old?
Lateral plantar heel
51
# Skin Puncture
What is the most common puncture site for adults?
Palmar surfaces of fingers (3rd and 4th fingers; 4th being more common)
52
# Skin Puncture
What fingers are avoided when doing skin punctures?
1. Thumb - has a pulse
2. Index
2. Pinky - skin is thin and sensitive
53
# Skin Puncture
What is the least preferred skin puncture site?
Earlobes
54
# Skin Puncture
If a patient has underwent a mastectomy, what arm should you choose to perform skin puncture on?
Opposite of the mastectomy side
55
# Skin Puncture
It is important to not milk the puncture site to prevent what event and the excess of what component?
Hemolysis and excess tissue fluid
56
# Skin Puncture
One should prevent the introduction of what into the sample?
Air bubbles
57
# Skin Puncture
This is a mixture of arterial and venous blood; content is most comparable with arterial blood
Capillary Blood
58
# Skin Puncture
Capillary blood content is most comparable with?
Arterial blood
59
# Arterialized Capillary Blood
It is not able to identify what analyte concentration?
Partial Pressure of O2
60
# Arterialized Capillary Blood
What is the preferred and common site for newborns? (2 different answers)
Preferred: Earlobe
Common: Lateral plantar heel surface
61
# Arterialized Capillary Blood
This should not be done if arterial BP is less than?
95mmHg (there would be poor blood supply)
62
# Arterialized Capillary Blood
Warm the earlobe or heel surface with a paper towel saturated with warm water reaching temperatures of?
39 - 45ºC
63
# Arterialized Capillary Blood
How many heparinized tubes are used?
2
64
# Arterialized Capillary Blood
The area is cleansed with how many percent alcohol?
70%
65
# Arterialized Capillary Blood
What is the preferred site for newborns?
Indwelling umbilical artery
66
# Skin Puncture
What is the order of filing a microsampling tube?
EDTA > other additive tubes > serum tubes
67
# Skin Puncture
What should be immediately done upon puncturing the site?
Wipe away the first drop
68
# Type of Blood Collection
1. Blood is obtained from a vein
2. Specimen is deoxygenated with a dark red color
Venipuncture
69
# Venipuncture
What are the 3 veins in the antecubital fossa region?
Basilic, Cephalic, and Median Cubital
70
# Venipuncture
If the patient is diabetic, one should ask their physician first before using the vein on what body part?
Ankle
71
# Venipuncture
What is the best site in terms of anchorage and size (largest)?
Median cubital vein
72
# Venipuncture
Found at the center of the antecubital fossa (first choice for venipuncture)
Median Cubital
73
# Venipuncture
Found laterally on the antecubital fossa (second choice for venipuncture)
Cephalic
74
# Venipuncture
This vein is often hard to palpate but is prominent in obese patients
Cephalic
75
# Venipuncture
Found medially on the antecubital fossa (third choice for venipuncture)
Basilic
76
# Venipuncture
This vein is not well-anchored (rolls easily) and is in close proximity with the brachial artery and median cutaneous nerve branch
Basilic
77
# Venipuncture
What are the 3 methods?
Syringe, Butterfly Infusion Set, and Vacutainer (ETS)
78
# Venipuncture
Povidone iodine is used for what test?
Bacterial culture
79
# Venipuncture
A larger needle gauge number means?
Smaller bore and length
80
# Venipuncture
What are the 3 common needle gauges for adults?
21, 22, and 23
81
# Venipuncture (color of the gauge)
20 gauge
Yellow
82
# Venipuncture (color of the gauge)
21 gauge
Green
83
# Venipuncture (color of the gauge)
22 gauge
Black
84
# Venipuncture (color of the gauge)
23 gauge
Blue
85
# Venipuncture (color of the gauge)
25 gauge
Orange
86
# Venipuncture (color of the gauge)
26 gauge
Brown
87
# Venipuncture
What is the ideal needle gauge for the elderly and children?
25
88
# Venipuncture
What are the ideal needle gauges for blood donation?
16-18
89
# Venipuncture
How long is the standard needle for the syringe method?
1 or 1.5 inches
90
# Venipuncture
How long is the standard needle for the butterfly method?
1/2 to 3/4 inches
91
# Type of Blood Collection Method
1. A short needle with a thin tube attached to plastic wings is used (+ Luer adapter)
2. Used for infants, children, and patients with fragile veins
3. Could be connected to a syringe or evacuated tube
Butterfly method
92
# Type of Blood Collection Method
Uses a multisample needle, tube holder, and evacuated tubes
Evacuated Tube System/ Vacutainer
93
# Evacuated Tube System
What is the standard length of needle?
1 to 1.5 inches
94
# Evacuated Tube System
An underfilled evacuated tube makes the sample what?
Diluted with anticoagulant
95
# Evacuated Tube System
What anticoagulant is best used in chemistry as it is less prone to interferences?
Heparin
96
# Evacuated Tube System
This inhibits coagulation
Anticoagulant
97
# Evacuated Tube System
These prevent glycolysis and are best for blood glucose (sodium fluoride)
Antiglycolytics and anticoagulants
98
# Evacuated Tube System
This preserves a specific blood constituent and aids in the separation of serum from cell
Tube Additives
99
# Evacuated Tube System
How many inversions for EDTA and Heparin?
8-10 times
100
# Evacuated Tube System
How many inversions for Sodium Citrate?
3-4 times
101
# Evacuated Tube System
What 2 anticoagulants are used in blood banking?
1. Acid citrate dextrose
2. Citrate phosphate sulfonate
102
# Evacuated Tube System
What anticoagulant is used in blood cultures?
Sodium Polyanethol Sulfonate (SPS)
103
# Evacuated Tube System
Identify the additive: Red (glass)
None
104
# Evacuated Tube System
Identify the additive: Red (plastic)
Clot activator
105
# Evacuated Tube System
Identify the additive: Pink
EDTA (for blood bank)
106
# Evacuated Tube System
Identify the additive: Lavender
EDTA (for hematology)
107
# Evacuated Tube System
How long does it take for clot activators to work?
1-2 hours
108
# Evacuated Tube System
For thixotropic gel separators, what is the specimen sample considering it has a faster clotting time?
Serum
109
# Evacuated Tube System
What is the order of draw?
1. Yellow (sterile)
2. Light Blue
3. Red
4. Yellow (SST)
5. Light Green (PST)
4. Green
5. Lavender
6. Gray
110
# Evacuated Tube System
What does EDTA mean?
Ethylenediaminetetraacetic acid
