Phlebotomy Essentials 4Th Edition, Chap 10

Front 1

drops of blood obtained by?

Back 1

puncturing/ incision with lancet or other sharp devise

Front 2

collection sites for blood droplets?

Back 2

fingers(adults) and heels (infants)

Front 3

lancet?

Back 3

sterile disposable sharp pointed or bladed instrument

Front 4

selection of a lancet?

Back 4

age of PT
collection site
volume required
puncture depth needed to collect adequate specimen without injury to bone

Front 5

lasette

Back 5

peforates the skin with a laser instead of a sharp instrument
disposable insert prevents cross contamination

Front 6

microcollection devices

Back 6

microtubes often refered to as bullets
small plastic tubes used to collect tiny amounts of blood obtained from capillary punctures

Front 7

microcollection devices color coding?

Back 7

correspond to ETS blood collection tubes..measured in microliters

Front 8

microhematocrit tubes
description

Back 8

disposable, narrow bore plastic or plastic clad glass tubes that fill by capillary action
hold 50 to 75 µl of blood

Front 9

microhematocrit tubes used for

Back 9

manual hematocrit(Hct)
also called packed cell volume(PVC)

Front 10

microhematocrit tubes color bands

Back 10

heparin tubes-red band
nonadditive- blue band

Front 11

microhematocrit tubes ofeten used for age?

Back 11

infant and child anemia

Front 12

microhematocrit tubes seal with?

Back 12

clay or plastic sealants

Front 13

CBG (capillary blood gas)
tube description

Back 13

long thin narrow-bore capillary tubes..normally plastic

Front 14

CBG (capillary blood gas)
common length
normal band color?
what addative?

Back 14

100µl
green
heparin

Front 15

CBG (capillary blood gas)
stirrers?

Back 15

small metal filings
magnents

Front 16

CBG (capillary blood gas)
end caps?

Back 16

plastic to maintain anaerobic conditions

Front 17

microscope slides

Back 17

blood films for hematology

Front 18

terestital fluid

Back 18

fluid in tissue spaces between cells

Front 19

intracelluar fluid

Back 19

fluid within cells

Front 20

capillary specimens are a mixture of?

Back 20

arterial,venous,capillary blood

Front 21

capillary specimens contain a higher proportion of what type blood?

Back 21

arterial

Front 22

what is falsly elevated if there is tissue fluid contamination or hemolysis

Back 22

potassium values

Front 23

what are the reasons to choose capillary puncture on adults ot older children?

Back 23

no accessible veins
fragile veins
veins saved for other procedures
thrombotic or clot forming tendencies
obtain blood gor POCt(glucose monitoring)

Front 24

why is capillary method preferred for infants/very young children

Back 24

small blood volume
(Lg quan removed rapid can cause cardic arrest)
difficult
other may damage veins
injury by restraint
preferred specimen for newborn screening

Front 25

what test cannot be performed by skin puncture?

Back 25

erythrocyte ded rates
coagulation studies
blood cultures
any test that requre large vol of blood

Front 26

order of draw for capillary puncture

Back 26

1. EDTA
2. other additive
3. Serum

Front 27

capillary puncture steps

Back 27

same as others
1. review and accession test required
2. approach, identify, prepare PT
3. verify diet restrictions and latex sensitivity
4. sanitize hands and put on gloves

Front 28

cyanotic

Back 28

bluish in color from lack of oxygen

Front 29

selection of puncture site for capillary incision

Back 29

warm
pink or normal color
free of scars, cuts, bruises, rashes
NO: cyantotic, edematous, infected

Front 30

recommened site capillary puncture adults and children 1 yr+

Back 30

palmar surface of distal or end segment of middle finger or ring finger of nondominat hand

Front 31

puncture site capillary puncture adults and children 1 yr+

Back 31

central
fleshy portion of finger
slightly to side of center
perpendicular to grooves in the whorls of fingerprints

Front 32

DO NOT collect capillary puncture from fingers of

Back 32

same side as mastectomy
infants and children under 1 yrs
side or very tip of finger
index finger
fifth(little finger)
thumb
parallel to groves of fingerprint

Front 33

infant capillary puncture recommened site in infants less than 1 yr

Back 33

plabntar surface of heel
medial or lateral
medial millde great toe to heel
lateral-between fouth and fith toe to heel

Front 34

osteomyelitis

Back 34

inflammation of bone marrow and adjacent bone

Front 35

osteochondtitis

Back 35

inflammation of bone and cartilage

Front 36

calcaneus

Back 36

heel bone
(small or premature infants 2.0 mm below skin surface)

Front 37

posterior curvature infant heel?

Back 37

back of heel
puncture may cause bone damage

Front 38

infant capillary puncture precautions

Back 38

DO not puncute:
earlobes
deeper than 2.0 mm
previous puncture sites
area between imaginary boundaries
posterior curvature of heel
area of arch and other areas of foot
severly bruised areas(painful, impaired circulation0

Front 39

Warming area for capillary puncture
Why?

Back 39

increases blood flow up to sevenfold(does not significantly alter results)

Front 40

specimen from warm site is describes as/

Back 40

arterialized (essential when collecting capillary pH or Blood Gases)

Front 41

residual alcohol in addition to causing stinging causes?
interfers with?

Back 41

causes rapid hemolysis
interferes with glucose testing

Front 42

finger puncture
how to puncture the site?

Back 42

flat against skin, in central, fleshy pad, slightly to the side of center and perpendicular to the fingerprint whorls

Front 43

heel puncture
how to puncture the site?

Back 43

encircle heel, wrap index finger around arch and thumb around bottom, other fingers top of foot

Front 44

why wipe away first drop of blood on a capillary collection?

Back 44

normally contaminated with excess tissue fluid and may contain alcohol residue (keeps from forming well rounded drop and hemolyze)

Front 45

where on the site do you apply pressure to form blood drop for collection?

Back 45

gentle intermittent pressure
-tissue surrounding heel
-proximal to a finger puncture
Do not "milk" site

Front 46

why apply gentle pressure and not "milk" site..

Back 46

hemolysis and tissue fluid contamination can result

Front 47

CLSI order of draw for capillary specimens

Back 47

slides, platelet counts, other hemotology(to aviod the effects of platelet aggregation{clumping} and clotting
next , other anticoagulant containers
last serum specimens

Front 48

microhematocrit

Back 48

narrow-bore capillary tube

Front 49

microhematocrit fill procedures

Back 49

hold vertical above drop or horizonal beside drop(will auto fill, may have to have to lower opposite endand bring back into position,while maintain contact with drop)
DO NOT remove from drop or cintinually hold or tip below the site(rusult in air spaces)
plug opposite or dry end with clay or sealant when full

Front 50

blood film procedures

Back 50

thouch appropiate area of slide to drop

Front 51

microcollection or microtube procedures

Back 51

hold upright below drop, touch tip of scoop to drop, allow blood to run down inside wall of tube(should only touch blood and not skin..activates platelets/clump/hemolyse)

Front 52

microhematocrit can be placed in?? for labeling

Back 52

non additive tube or appropate size aliquot tube

Front 53

special handling?
ammonia

Back 53

crushed ice

Front 54

special handling?
cold aggulatinin

Back 54

body temp

Front 55

special handling?
bilirubin

Back 55

light protection

Front 56

bleeding persists longer than ??min?

Back 56

5 min
notify nurse or phys
(notify Pt that bandage kept in place 15 min

Front 57

CBG's

Back 57

capillary blood gas specimens
(rarely on adults mostly small children and infants)

Front 58

over production of bilirubin occurs from

Back 58

HDN-
accelerated red blood cell hemolysis associated with hemolytic disease of the newborn

Front 59

high levels of bilirubin result in

Back 59

jaundice(yellow skin color)

Front 60

-impaired bilirubin excretion often results from temporary

Back 60

abnormal liver function

Front 61

bilirubin can cross the blood-brian barrier in infants causing

Back 61

accumulation to toxic levels
brain damage
death

Front 62

microhematocrit can be placed in?? for labeling

Back 62

non additive tube or appropate size aliquot tube

Front 63

special handling?
ammonia

Back 63

crushed ice

Front 64

special handling?
cold aggulatinin

Back 64

body temp

Front 65

special handling?
bilirubin

Back 65

light protection

Front 66

bleeding persists longer than ??min?

Back 66

5 min
notify nurse or phys
(notify Pt that bandage kept in place 15 min

Front 67

bilirubin breaks down in presence of

Back 67

LIGHT
(collect quickly to minimize exposure)
(amber tubes)
(accurate timing)

Front 68

newborn/neonatal testing is routine and is looking for the presence of?

Back 68

genetic disorders(inheritied)
metabolic disorders(chemical changes within liiving cells)
hormonal disorders
infectious agents (toxoplasma and HIV)
phenylketonuria (PKU)
galactosemia
hypothyroidism
(29 specific disorders including hearing loss)
functional disorders

Front 69

newborn/neonatal testing is ideally performed when?

Back 69

24-72 hrs old

Front 70

PKU requires retest. when?

Back 70

2 weeks old

Front 71

phenylketonuria (PKU)

Back 71

genetic disorder-caracterized by a defect in the enzyme that breaks down the amino acid phenylalanine..converts to amino acid tyrosine

Front 72

galactosemia

Back 72

inherited disorder characterized by lack of enzyme needed to cover milk sugar galactose in to glucose

Front 73

hypothyroidism

Back 73

disorder characterized by insufficent levels of thyroid hormaines
can be inherited or noninherited

Front 74

phenylketonuria (PKU)
treatment?
untreated?

Back 74

No but can be treated..diel low in phenylalanine
untreated can lead to toxic levels..brian damage..mental retardation

Front 75

hypothyroidism
treatment?
untreated?

Back 75

treated bu supplying TSH hormone orally
untreated it hinders growth and brain development

Front 76

galactosemia
treatment?
untreated?

Back 76

remove all milk and dariy products from diet
untreated..within a weekk, fail to thrive (anorexia, diarrrhea,vomiting..may starve to death..fail to grow..mentally handicapped..cataracts

Front 77

blood spot collection

Back 77

absorption onto circles printed on special type of filter paper (blood filled circles are refered to "blood spots")

Front 78

blood spot collection procedure

Back 78

fill from one side only..use one drop to fill circle..allow to air dry in elevated horizonal position..no heat or sunlight..touch with gloves only..do not stack can cross contaminate..place in special envelope when dry

Front 79

blood film or smear

Back 79

drop of blood spread thin on a microscope slide (stained)
usually made from EDTA tube in the lab

Front 80

blood film or smear used for?

Back 80

manual differential(diff)
(number,type,characteristics of blood cells are determined

Front 81

leukocyte alkaline phosphate (LAP) stain ore score

Back 81

blood smear from a fresh frop of blood from a fingertip (nto in contact with EDTA) collect forts to avoid platelt clumping

Front 82

what is a acceptable blood film or smear

Back 82

1/2 to 3/4 of surface of slide
no holes,lines,or jagged edges

Front 83

blood film or smear "feather" refer to?

Back 83

thinnest area of a properly made smear, one cell thick,where the differential preformed

Front 84

thick blood smear used for

Back 84

detect presence of malaria

Front 85

malaria

Back 85

disorder caused by four species of parasitic sporozoan (types of portozoa) organisms called plasmodia

Front 86

malaria transmitted by

Back 86

infected female anopheles mosquitoes

Front 87

malaria symptoms

Back 87

fever, chills at regular intervals
..progressive destructtion of RBCs in certain types causes severe anemia..

Front 88

malaria smears collected?

Back 88

stat or timed intervals
-most commonly just prior to onset of fever and chills

Front 89

thick smear preparation

Back 89

very large drop of blood placed in center of glass slide and spread with corner of another slide or cover slip until size of dime..dry 2hrs then fresh diluted giemsa stained

Front 90

giemsa stain

Back 90

water based stain that lysis the RBCs and makes organism easier to see

Front 91

what test requires arterialized specimen

Back 91

CBGs

Front 92

concentration of this substance is higher in capillary blood than in venous blood

Back 92

glucose

Front 93

heel puncture lancet should not be deeper than

Back 93

2.0mm

Front 94

when making a routime blood smear the pusher slide is normally held at an angle of

Back 94

30degrees