UNIT 7- CAPILLARY PUNCTURE

Question 1

Making an incision in dermal layer of the skin
- uses a lancet to make a small incision into the capillary
bed of the skin to obtain a small volume of blood
specimen.

Answer 1

CAPILLARY PUNCTURE

Question 2

sterile, sharp instruments
that are intended for
one-time use only. They are designed for use in making
cuts in the skin for finger or
heel puncture.

Answer 2

Lancet/Incision Device

Question 3

produces a small hole in the skin by vaporizing water in the skin. This eliminates the
risk of sharp injury because
cauterizing the skin is not necessary.

Answer 3

Laser Lancets

Question 4

There are 2 types
that are used in
capillary puncture:

Answer 4

finger puncture
lancet and heel
puncture lancet.

Question 5

known as microtube, a
small plastic tube used to
hold blood specimens
collected in the capillary
puncture. It has markings on
the side that show the
minimum and maximum fill
levels and, occasionally,
comes with a narrow
capillary tube.

Answer 5

Microcollection Tubes

Question 6

narrow bore
tubes that are
made of either
plastic or glass,
typically used for
hematocrit
determinations.
They can hold 50
to 75 pL and are
filled by capillary
action. One end is
sealed with
sealants made of
clay or plastic.

Answer 6

Microhematocrit tubes
and sealants

Question 7

used for blood films for
hematology determinations.

Answer 7

Microscope slides

Question 8

used to increase the blood flow seven-fold by warming the puncture site.

Answer 8

Warming Devices

Question 9

special equipment used
for collecting capillary blood gas (CBG) specimens,
which contains CBG
collection tubes, stirrers,
magnets, and plastic caps.

Answer 9

Capillary Blood Gas Tubes

Question 10

Special Equipment for capillary blood gas
equipment

Answer 10

Capillary Blood Gas Tubes, Stirrers, Plastic Cups, Magnets

Question 11

is the bright red blood
found in the pulmonary
vein, left chamber of the
heart, and the arteries.
● It is the oxygenated blood
in the circulatory system.

Answer 11

ARTERIAL BLOOD

Question 12

is the blood that travels
from the peripheral veins
passing through the venous
system then through the
right chamber of the heart.
● This is dark red in color
because it is
deoxygenated.

Answer 12

VENOUS BLOOD

Question 13

is the preferred specimen
for infants, young children,
elderly patients, and
Patients with severe burns.
● It is extracted from the
venules and arterioles
found in the capillary bed.

Answer 13

CAPILLARY BLOOD

Question 14

fills the spaces around the
cells, filtered from the blood
capillaries, and drained
away as lymph.

Answer 14

INTERSTITIAL FLUID

Question 15

is found inside the cells. It facilitates the movement of fluid in the membrane and
blocks the entrance of
unwanted materials.

Answer 15

INTERCELLULAR FLUID

Question 16

Alternative to venipuncture if properly collected
When small amount of blood is needed
Small amount of blood is needed in the test

Answer 16

INDICATIONS FOR CAPILLARY PUNCTURE

Question 17

Available vein is fragile, must be saved for other
procedures such as chemotherapy, and not accessible
because of scars and burns
After several unsuccessful venipuncture and specimen for
the test can be collected by capillary puncture
Thrombotic or clot-forming tendencies
Apprehensive patient or has intense fear of needles
No accessible vein
Blood needed is for POCT (glucose monitoring)

Answer 17

TRUE

Question 18

Why is capillary puncture preferred for blood collection for infants?

Answer 18

● Low blood volume amount collected may lead to anemia
(4mg of iron is lost for every 10 mL of blood removes)
● Large quantity remove can cause cardiac arrest (life
threatening if >10% of blood is removed)
● Venipuncture may be difficult in infants and may damage
veins and surrounding tissues
● Puncturing deep veins can cause hemorrhage, venous
thrombosis, infection,and gangrene
● Infants can be injured by the restraining method used
during venipuncture
● Preferred specimen for some tests such newborn
screening

Question 19

Tests that cannot be collected by capillary puncture

Answer 19

ESR, Coagulations studies requiring plasma specimens, Blood culture, Tests that require large volume of serum or plasma

Question 20

ORDER OF DRAW

Answer 20

1. Blood gas specimens (CBGs)
2. EDTA specimens
3. Other additive specimens
4. Serum specimens

Question 21

READ CAPILLARY PUNCTURE STEPS

Answer 21

READ CAPILLARY PUNCTURE STEPS

Question 22

Supported on firm surface
Hands extended, palm up

Answer 22

Finger Puncture

Question 23

Baby in supine position
Foot lower than torso

Answer 23

Infant Heel Puncture

Question 24

If the patient is a young child, he/she
should be placed on the lap of his/her
guardian.

Answer 24

TRUE

Question 25

Measuring of oxygen, carbon dioxide and blood pH ○ Warm site for 5-10 minutes prior to collection ○ Proper collection technique ■ Minimize exposure to air ■ Immediately cap both ends ■ Mix specimen ■ Place tube in ice ○ There should be NO AIR SPACE. It should be filled entirely with blood

Answer 25

CBG

Question 26

Need of serum samples and larger amount of blood ○ Done in newborns ○ Heel puncture ○ Proper collection is crucial to accuracy of the results ○ Quick collection to minimize light exposure ○ Collected on amber-colored microtainer; if not available, just cover the tube to cover the light ○ Avoid hemolysis – we have to be very careful

Answer 26

Neonatal bilirubin collection

Question 27

screening on all babies born ○ Performed on infants between 24 and 72 hours postnatal ○ Mandated testing of newborns ■ Important to detect the presence of genetic, metabolic, hormonal, and functional disorders ■ Detection and early treatment ■ Inborn disorders that could be detected: Phenylketonuria, Hypothyroidism, Galactosemia, Cystic fibrosis

Answer 27

Newborn/Neonatal Screening

Question 28

is a blood test that is used to check abnormalities in the blood cells. A small drop of blood is placed near the frosted end of the glass side. Another slide is used to spread the blood in a thin film over the slide. It is then air-dried and stained.

Answer 28

Routine blood film/smear preparation

Question 29

Thick blood smear preparation is used to determine if the patient has malaria, which is diagnosed by its presence in the peripheral blood smear.

Answer 29

TRUE

Question 30

is recommended for infants and small children. The blood samples are collected on the same site as routine capillary puncture specimens. Preferred: 2 Serum gel microtainers ■ Acceptable: 2 Red-top microtainers ■ Submission Container/Tube: Amber vial (T192) ■ Specimen Volume: 0.5 mL5 ■ Collection Instructions: 1. Serum gel microtainers should be centrifuged within 2 hours of collection. 2. Red-top microtainers should be centrifuged and aliquoted within 2 hours of collection

Answer 30

Capillary blood gas specimen by heel puncture

Question 31

collection is used to help determine any liver disorder in infants. This is collected with a heel stick.

Answer 31

Neonatal bilirubin test

Question 32

done 24 to 48 hours after the baby is born, in which a few drops of blood are collected through heel stick to determine disorders that are not apparent at birth and could lead to disability or even death.

Answer 32

Newborn screening blood spot collection