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Specimen collection Flashcards

Patient prep, Veni, arterial, skin puncture, order of draw (70 cards)

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1
Q

Repeated venipuncture of large amounts of blood in premature infants can cause

A

Iatrogenic anemia

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2
Q

Order of draw in Microcollection tubes

A 
Blood gas
Slide
EDTA
Other additives
Serum
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3
Q

Skin puncture is useful in:

A

Extreme obesity
Severe burns
Thrombotic tendencies

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4
Q

Specimen used for blood gas analysis in newborn/infants for measuring pH,pCO2, but not pO2

A

Arterialized capillary blood

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5
Q

Preferred site for arterialized capillary blood collection

A

Earlobe

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6
Q

Most commonly used site for Arterialized capillary blood

A

Lateral plantar heel surface

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7
Q

Warming the site of skin puncture

A

Must be 39-42’C for 3-5 mins

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8
Q

Capillary arterialization should NOT be done if

A

BP is below 95 mmHg or if area is poor in blood supply

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9
Q

Minute metal filling inserted in capillary tube to help on mixing the specimen

A

Flea

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10
Q

Best method for blood gas collection

A

Indwelling umbilical artery catheter

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11
Q

Length of lancet for Skin puncture

A

1.75 mm

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12
Q

Depth of incision in Skin puncture

A

< 2mm in infants and child

< 2.5 mm for adults

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13
Q

Distance of skin surface from bone or cartilage

A

1.5-2.4 mm

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14
Q

The cut in skin puncture must be

A

Oriented across the fingerprints/ perpendicular

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15
Q

Preferrable sites of skin puncture

A

Lateral plantar surface of heel-newborn
Palmar surface of fingers(3rd & 4th)
Plantar surface of the big toe
Earlobes- least site

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16
Q

Sites to avoid in venipuncture

A 
IV lines in both arms
Burned or scarred areas
Hematoma
Thrombosed veins
Edematous arms
Partial/Radical Mastectomy
AV shunt
Casts on arms
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17
Q

Complications in Veni

A

Immediate Local Complication
Late Local complication
Late General complication

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18
Q

Late general complication/s

A

Serum Hepa

AIDS

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19
Q

Late local complication/s

A

Thrombosis

Thrombophlebitis

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20
Q

Immediate local complication/s

A

Hemoconcentration
Failure to enter the syringe/Vacu tube
Syncope/fainting

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21
Q

Traumatic draw can increase:

A

CK
Myoglobin
Potassium

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22
Q

Renin blood level is collected after

A

3-day diet,

In the peripheral vein

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23
Q

Disinfectant for Ethanol testing

A

Benzalkonium Chloride (Zephiran Chloride 1:750)

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24
Q

Disinfectant for blood culture

A

70% alcohol followed by iodophor

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25
CLSI recommended disinfectant for blood culture of infants 2 months and older and Px with iodine sensitivity
Chlorhexidine Gluconate
26
Standard needle gauge
21 g
27
Gauge for children
23g | 23-25g for butterfly
28
Gauge for collecting blood from scalp or tiny veins
25g
29
Standard needle length and gauge
1 in or 1.5 in 21-23g | 1/2 or 3/4 in butterfly
30
Tube component that cause the blood to clot within 15-30mins
Silica particles
31
Gel separator clotting time
30mins
32
Clot activator(thrombin) clotting time
5 mins
33
Plain red stopped/no additives clotting time
60mins
34
Tubes not used in blood bank procedures
Containing gels
35
Tubes not used for TDM
SST | Gel separator
36
Use of gel sep and SST in TDM will cause
Falsely low result
37
Additive for Lactate sample
Fluoride oxalate
38
Additive for ethanol specimens
Sodium fluoride
39
Angle in veni
15-30 degrees
40
10% contam of 5% dextrose will result in
Increase glucose by 500 mg/dL or more
41
BP cuff as tourniquet
60 mmHg
42
Tourniquets is reapplied after ____
2 mins
43
Sites for veni
Antecubital fossa Veins on wrist and dorsal aspect of hands Veins on ankle
44
Best site for veni
Median cubital vein
45
Minute amount of blood escaped into skin epithelium
Petechiae
46
Order of draw for Veni
Yellow(blood culture) Light blue (Trisodium citrate) Serum (w/ or w/o clot activator or gel sep) Green (heparin) Lavender/purple(EDTA) Gray (NaF and K oxalate/iodoacetate and heparin)
47
Apply tourniquet ____ above site
3-4 inches
48
Arterial puncture sites
Radial, brachial,femoral,scalp and umbilical arteries
49
Arterial puncture is for testing
Blood gas analysis | pH measurement
50
A test performed before collecting arterial blood
Modifed Allen test
51
Modified allen test
To determine wether Ulnar artery can provide collateral circulation
52
Largest and easy to puncture site for arterial puncture
Femoral artery
53
Major complications in arterial puncture
Thrombosis Hemorrhage Possible infection
54
Angle in brachial artery
18-20 degrees
55
Angle in femoral artery
90 degrees
56
Radial artery gauge
23-25g
57
Place the arterial sample in
1-5'C ice water
58
Compress arterial puncture site for ____
3-5 mins
59
First step in sample collection
Patient identification
60
3-Way ID
Patient verbal ID statement Check ID card Visual comparison of labeled specimen with ID
61
Average human whole blood
5 q(4.73L) M: 5-6L F: 4-5L
62
Whole blood component
60% plasma | 40% cells
63
Advantage of Central Venous Cava (CVA) Collection
Eliminates multiple phlebotomies in critical and surgical situations
64
All measurements should be performed within
45 mins to 1 hr
65
Centrifugation requirement
3000 RCF for 10 mins
66
Glycolysis occurs faster in
``` Newborns(increased metabolism) Leukemic patients (high metabolic activity of WBCs) ```
67
To prevent glycolysis
Use 2mg NaF/mL of blood to prevent it within 48-72 hrs
68
Least stable substances in serum
Potassium Phosphorous Glucose
69
Unstable for 6 hrs if not removed from clot
``` Albumin Bicarbonate Chloride C-peptide HDl-chole LDL-Chole Total protein ```
70
Most common interfering conditions in measuring analytes
Hemolysis Icterus Lipemia

ClinChem (2 decks)

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