ROUTINE CAPILLARY PUNCTURE

Question 1

When should capillary puncture be used?

Answer 1

Ideal for small children when only a small volume of blood is needed.

Advantageous in certain adult populations whose veins are inaccessible:
Severely burned.
Cancer patients
Obese
Geriatric patients
Point of care testing (POCT)
Patients performing tests on themselves.
Special procedures that require capillary blood

Question 2

The capillary puncture should not be used on patients who ____

Answer 2

Should NOT be used on patients who are extremely dehydrated or cold

Question 3

INDICATIONS FOR PERFORMING CAPILLARY PUNCTURE: Adults

Answer 3

No accessible veins
To save veins for chemotherapy
Clotting tendencies
POCT procedures such as glucose monitoring

Question 4

INDICATIONS FOR PERFORMING CAPILLARY PUNCTURE: Children and Infant

Answer 4

To prevent anemia
To prevent cardiac arrest from removal of large quantities of blood
Venipuncture too difficult
To prevent injury

Question 5

CAPILLARY EQUIPMENT

Answer 5

Lancet
Micro-Collection Containers
Hematocrit Tubes
Plastic/ Clay Sealant
Microscope Slides
Warming Devices

Question 6

Lancets should be

Answer 6

Sterile and disposable
Retractable blade
Either finger or heel

Question 7

Collects tiny amounts of blood.

Answer 7

MICRO-COLLECTION CONTAINERS

Question 8

Manual Hct

Answer 8

HEMATOCRIT TUBES

Question 9

Used to seal the tip of capillary tubes

Answer 9

PLASTIC/CLAY SEALANT

Question 10

Smearing

Answer 10

MICROSCOPE SLIDES

Question 11

SITE SELECTION

Answer 11

Ring or great finger
Infant’s heel
Earlobe

Question 12

Why should the non-dominant hand be used when performing capillary puncture?

Answer 12

less calloused

Question 13

What should be the direction of the puncture?

Answer 13

opposite direction of the fingerprint

Question 14

Capillary SPecimen is a mixture of

Answer 14

arterial, venous and capillary
blood

Question 15

• fluid outside of the body’s cells (extracellular)

Answer 15

Interstitial fluid

Question 16

fluid in the tissue spaces between cells

Answer 16

Interstitial fluid

Question 17

fluid within cells from surrounded tissues

Answer 17

Intracellular fluid

Question 18

contains water and dissolved solutes (electrolytes) and proteins

Answer 18

Intracellular fluid

Question 19

Puncture blood
Higher result in

Answer 19

Glucose

Question 20

Puncture blood:
Lower result in

Answer 20

Total Protein, Calcium and Potassium

Question 21

Choose a finger that is not ___ or __________ for the puncture site

Answer 21

cold or edematous

Question 22

Clean the puncture site with ______________________ and let it dry.

Answer 22

70% Isopropyl alcohol

Question 23

Massage the _________ of the finger to stimulate blood flow.

Answer 23

lower portion

Question 24

Puncture the skin while pressing the area ______ the puncture site. Dispose puncture device.

Answer 24

below

Question 25

Wipe away the first drop of blood with a___________.

Answer 25

sterile dry gauze

Question 26

Collect the sample in the chosen container in a ______________ and a gentle pressure is applied to the finger

Answer 26

downward angle

Question 27

In cleaning the site, do not use

Answer 27

Povidone-lodine (Betadine)

Question 28

What would happen if betadine is used to clean the site?

Answer 28

this will result to an increase in Potassium

Question 29

As you hold the patient's hand, position the hand so that the puncture site permits the _________________ of blood.

Answer 29

downward flow

Question 30

T or F | Do not scrape the blood from the surface of the skin.

Answer 30

T

Question 31

If blood lodges in the tip of the device, a ____ on the hard surface should facilitate blood flow.

Answer 31

tap

Question 32

T or F | Rotate the tube after every drop

Answer 32

T

Question 33

OBTAINING BLOOD SAMPLES FROM BABIES: SITES TO AVOID

Answer 33

Medial or big toe side. Lateral or little toe side. Central arch area of the foot.

Question 34

DEPTH OF PUNCTURE: Premature

Answer 34

0.85mm

Question 35

DEPTH OF PUNCTURE: Full-Term

Answer 35

2mm

Question 36

Puncture of the fingers of infants __________________ should be done only after other options are considered.

Answer 36

<1 year old

Question 37

Distant to the _________________________ of the infant’s fingers is 1.2-2.2mm.

Answer 37

bones and main nerves

Question 38

Distant to the bones and main nerves of 6 months- 8y/o

Answer 38

1.5mm

Question 39

Distant to the bones and main nerves of Child over 8 y/o

Answer 39

2.4mm

Question 40

Distant to the bones and main nerves of Adult

Answer 40

2.4mm

Question 41

PRECAUTIONS: When collecting blood from babies

Answer 41

Excessive crying Hemolysis Newborn with elevated bilirubin Concentration of chemical constituents in capillary blood. Collecting sequential sample

Question 42

CAUSES OF HEMOLYSIS

Answer 42

Alcohol used to clean the skin was not allowed to dry. Finger or heel was squeezed too vigorously in an attempt to produce greater blood flow. Newborn infants have increased red cell fragility and high RBC volume. Blood was scraped off, instead of allowing it to flow into the micro-collection container.

Question 43

DIFFERENCES IN LABORATORY VALUES IN CAPILLARY BLOOD IN RELATION TO VENOUS BLOOD: Glucose

Answer 43

Higher in capillary blood

Question 44

DIFFERENCES IN LABORATORY VALUES IN CAPILLARY BLOOD IN RELATION TO VENOUS BLOOD: Total Protein

Answer 44

Lower in capillary blood

Question 45

DIFFERENCES IN LABORATORY VALUES IN CAPILLARY BLOOD IN RELATION TO VENOUS BLOOD: Calcium

Answer 45

Lower in capillary blood

Question 46

DIFFERENCES IN LABORATORY VALUES IN CAPILLARY BLOOD IN RELATION TO VENOUS BLOOD: Potassium

Answer 46

Lower in capillary blood

Question 47

ORDER OF DRAW FOR A CAPILLARY PUNCTURE

Answer 47

1. Gas tubes 2. Slides 3. EDTA (purple top tube) 4. Heparin- light or dark green top tube 5. Other additive micro-collection cont. 6. Serum - red top or amber tube with red top.