1. Correct patient identification. 2. Correct specimen identification. (Proper labeling: Patient's Full Name, Hospital Identification Number, Location, Time and Date and the initials of the phlebotomist) 3. Consistent with universal precautions (Gloves, Gowns must be worn at all times and hands must be washed in between patients) 4. Aseptic Technique (Cleaning of puncture site with 70% alcohol) 5. Sharp objects must be thrown into appropriate containers and must not be unsheathed or bent. 6. Gauze and cotton must be waste in biohazard containers or trash bins.

Quiz 1 Flashcards by eureka juneille

3 TYPES OF BLOOD COLLECTION

Venipuncture
Capillary Puncture
Arterial Puncture

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most critical step in blood collection

Patient Identification

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MT’s mortal sin

Mislabeling

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must in phlebotomy

Correct patient identification.
Correct specimen identification. (Proper
labeling: Patient’s Full Name, Hospital
Identification Number, Location, Time and
Date and the initials of the phlebotomist)
Consistent with universal precautions
(Gloves, Gowns must be worn at all times
and hands must be washed in between
patients)
Aseptic Technique (Cleaning of puncture
site with 70% alcohol)
Sharp objects must be thrown into
appropriate containers and must not be
unsheathed or bent.
Gauze and cotton must be waste in
biohazard containers or trash bins.

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VENIPUNCTURE
- Ideal procedure is to have the pa琀椀ent

lie down or if not possible, the patient should sit in a sturdy, comfortable chair and not on high stools.

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There’s should be _____ inside the patient’s mouth during the procedure.

nothing

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Ideal site for puncture:

Antecubital Fossa

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Type of veins

Median Cubital Vein
Cephalic Vein
Basilic Vein

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2 anatomical patterns

H pattern ans M pattern

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H-Pattern

a. Median Cubital Vein
b. Cephalic Vein
c. Basilic

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M-Pattern

a. Median Vein
b. Accessory Cephalic Vein
c. Basilic

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are the
possible e昀昀ects of prolonged tourniquet applica琀椀on.

Hemoconcentra琀椀on, Hemolysis, Shortened Coagula琀椀on Time (PT/APTT)

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Application of tourniquet must be _____ above puncture site.

3 – 4 inches

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condition in which venous flow is slowed.

statis

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is the most common needle size for adult.

21-gauge (1 inch long) needle

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Phlebotomist must never puncture the patient _____.

twice

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Patient should not _____.

pump the fist

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Tourniquet Application must be less than

1 minute

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Angle between skin and needle

Less than 30 degrees

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Causes of Specimen Hemolysis

Prolonged tourniquet application on
Moisture or contamination of blood collecting tubes
Needly with small bores
Excessive agitation
Frothing of the blood sample

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Apply tourniquet _____ away from the site of the puncture.

2 – 4 inches

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Apply ______ in a _____starting from inside then out.

antiseptics (70% alcohol) , circular manner

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_______ manner can be done

Up and down or forward and backward

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_____ cannot be used in capillary only

Betadine

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Reapply tourniquet. Insert needle with _____.

15 – 30 degrees angle

Withdraw blood by pulling the _____, not too fast, not too slow.

plunger

Transfer blood ample to anticoagulated tube. Remove needle and tube cap and let blood flow on the sides to avoid ____.

hemolysis

ORDER OF DRAWS Evacuated Tube and Syringe

1. Yellow (Blood Culture Tubes) 2. Blue Stopper (Coagulation Sodium Citrate Tube) 3. Serum Tubes with or without clot activator or gel separator 4. Green Stopper (Heparin Tubes w/ or w/o gel) 5. Lavender Stopper (Ethylenediaminetetraacetic Acid Tubes) 6. Gray Stopper (Glycolyctic Inhibitor Tubes)

Blood Culture Tube (Yellow) Number of Inversions

Citrated Tube (Light Blue Top) Number of Inversions

Serum Tube Red Top (Glass, Non additive) Number of Inversions

Serum Tube Red Top (Plastic, Clot Activator) Number of Inversions

Heparinized Tube (Green Top)

EDTA Tube (Lavender, Purple, Pink)

Sodium Fluoride Tube (Gray Top)

refers to the small blood vessels connecting the arterioles to the small veins

Capillary

Due to its ______, it is accessible only if small amount of blood is needed.

diameter

Capillary puncture is done if the patient is:

-Infants less than 1 year old. -Severely burned patients -Patients whose veins are reserved for therapeutic purposes. -Extremely obese patients. -Adult with poor veins.

Avoid applying ___,_____, ____

pressure, squeezing, “milking

Discard

first drop of blood

Discard excess —— and ————

tissue fluid and dead epidermal cells

Discard first drop of blood

Facilitate free flow of blood

Depth of Skin Puncture for Adult, Infants, Premature

o Adult: 2.0 – 2.5 mm o Infants: <2.0 mm o Premature: <0.85 mm

MATERIALS FOR CAPILLARY PUNCTURE

- Blood Lancet - Cotton Balls - 70% Alcohol - Capillary Tubes - Gauze - Sealing Clay

SITES TO BE AVOIDED

- Hematoma - Burned, damaged, occluded veins - Intravenous catheter (IV Line) - Edema - Post Mastectomy Side - Skin with Tatto

COMPLICATIONS DURING VENIPUNCTURE

Ecchymosis (Bruise) Hematoma Fainting (Syncope) Hemoconcentration Intravenous (IV) Therapy Mastectomy Patients Obesity Iatrogenic Anemia Failure to Draw Blood Petechiae Nerve Damage Hemolysis Burned, Damage, Scarred and Occluded Veins Seizures and Tremors

Most common and Leakage of small amount of blood

Ecchymosis (Bruise)

Leakage of large amount of blood

Hematoma

Short lapse in consciousness

Fainting (syncope)

o Prolonged tourniquet applicationon o Wait for 2 minutes before reapplying the tourniquet

Hemoconcentration

Wait for _____ before reapplying the tourniquet

2 minutes

o Draw in the opposite side of the IV o Stop IV for 2 minutes and discard 昀椀rst 5-ml of blood

Intravenous (IV) Therapy

Draw in the _____ side of the IV

opposite

Stop IV for ___ minutes and discard first ____ of blood

2, 5mL

Draw blood from the opposite of mastectomy side

Mastectomy Patients

BP Cuff will help

Obesity

BP cuff will help (Must not be more than ____ and ____)

40 mmHg and 1 minute

is the study of blood cells and its components

Hematology

Red Blood Cells Medical Term

Erythrocytes

White Blood Cells Medical Term

Leukocytes

Platelets medical term

Thrombocytes

Human body is composed of approximately ______.

5 liters of blood

Red Blood Cells Components

▪ Hemoglobin ▪ Hematocrit ▪ Red Blood Cell Indices ▪ Reticulocytes

White Blood Cells Components

▪ Neutrophil ▪ Lymphocytes ▪ Monocytes ▪ Eosinophils ▪ Basophils

What to put in specimen identification

Patient’s first and last name Hospital identification number location time and date initials of the phlebotomist

Gauze and cotton waste must be placed in _____

biohazard containers

universal precautions

Gloves must be worn at all times, and hands must be washed in between patients

more stable ; visible vein

Median Cubital Vein

not stable

Cephalic/ median cephalic vein

Basilic Vein

small ; not anchored well ; tendency to move ; close to brachial artery

light blue additive

3.2 sodium citrate

prevents blood from clotting by binding calcium

3.2 sodium citrate

Quiz 1 Flashcards

(72 cards)