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87 Cards in this Set

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disinfectants definition of?
chemical substances or solutions used to remove or kill microbes on surfaces and instruments
corrosive
not safe human skin
hand sanitizers reccommended?
CDC
alcohol based hand sanitizer
if no wash fal avil to remove organic materials use detergent containing wipes followed by alcohol based sanitizer
bandages types used?
paper
cloth
knitted tape over folded gauze squareself adhesive gauze placed over gauze pad used more now(PTs allergic to adhesive bandages)(also is used to form a pressure bandage following arterial puncture in pt's with bleeding problems)
latex free avil for PTs with latex allergies
adhesive bandages not used on <2y/o because danger aspiration and suffocation
needles/lancets/sharp objects disposed of where?
Sharps container
variety size and style
most are RED
Biohazard symbol
rigid/puncture resistant/leak proof/disposable/locking lids
in venipuncture tourniquet is used for
apply or tie around PTs arm prior to venipuncture to restrict blood flow(distends or inflates veins making them larger and easier to find; stretches vein walls so they are thinner and easier to pierce with needle)
proper application of a tourniquet
tight enough to restrict venous flow but not so tight to restrict arterial flow
why no longer than 1 min with tourniquet on?
can change blood componets must release during collection
do what before opening a needle package
check packaging for broken seal
discard if no longer sterile
what does the needle part "bevel" refer to?
end that pierces the vein
(because cut on a slant)
allows needle to easily slip into vein without coring(removal of portion of skin or vein)
what does the needle part "shaft" refer to?
long cylindrical portion
what does the needle part "hub" refer to?
end that attaches to blood collection device
what does the needle part "lumen" refer to?
internal space of needle
why inspect needle before use?
what to look for?
-mass produced, damaged could cause pain or venipuncture failure
-blocked/blunt/bent tips
rough bevels or shaft
what does needle gauge refer to?
diameter of the lumen
what does inverse(opposite) gauge mean?
larger the number the smaller the actual lumen is
what is needle type for gauge 18 ?
typical use?
-syringe
-transfer needle..saftey issues reduced use
what is needle type for gauge 20?
typical use?
-multisample syringe
-sometimes used when large volume tubes collected or large volume syringes used on PTs with normal size veins
what is needle type for gauge 21?
typical use?
-multisample syringe
-standard for routine venipuncture with PTs normal veins
what is needle type for gauge 22?
typical use?
-multisample syringe
-used on older children, adult with small veins or difficult draws
what is needle type for gauge 23?
typical use?
-butterfly
-infants, children and difficult or hand veins of adults
how do you select needle gauge?
size and condition of vein, type of procedure, type of equipment
what guage needle is considered standard for most routine situations
21 gauge
why important to choose correct guage?
too large gauge may damage vein needlessly
too small may hemolyse the specimen
what makes identification of gauges easier?
color coding
traditional colors
yellow 20
green 21
black 22
colors may vary by manufacturer
needle lengths
multisample?
syringe?
butterfly?
multisample 1" or 1.5"
syringe many lengths
butterfly 0.5 to .75 (1/2 to 3/4 in)
what is an evacuated (ETS)tube?
fill with blood automatically because of Vacuum(neg pressure)
how is evacuated tube selected
age of PT
condition of vein
amount of blood needed for test
why will a evacuated tube fail to fill properly?
designed to reach stated volume..if lost all or part of vaccume will fail to properly fill
what can cause a "short draw" (partial draw)?
-premature loss of vacuum
(improper storage, opening tube, dropping tube)
-advancing tube too far onto needle
-pulling needle bevel partially out of skin during procedure
-removing tube before vacuum is exhausted
-stoppage of blood flow during the procedure
What is the purpose of a "short draw tube"
designed to partially fill without compromising test results
when do you use a "short draw tube"
in situations when difficult or inadvisable to draw larger quantities
what are non additive tubes used for?
discard or "clear" tubes
these tubes will clot, only yeild serum samples
what does the color of the stopper identify?
type of additive in tube
or special property of the tube
(generally universal)
why is expiration date and proper handliing of tube important
-guaranteed reliability until expired(provided handled and stored proper
-can affect additive integrity and tube vacuum(can lead to compromised test results or improper filling)
stopper color
light blue
additive?
department?
Sodium Nitrate
Coagulation
stopper color
Red(glass)
additive?
department?
none
chemistry
blood bank
serology/immumology
stopper color
Red(plastic)
additive?
department?
clot activator
chemistry
stopper color
red/light gray (plastic)
additive?
department?
nonadditive
NA (discard tube only)
stopper color
red/black (tiger)
Gold
Red/Gold
additive?
department?
clot activator and gel seperator
chemistry
stopper color
green/gray
light green
additive?
department?
lithium heparin and gel separator
chemistry
stopper color
green
additive?
department?
lithium heparin,sodium heparin
chemistry
stopper color
lavender
pink
additive?
department?
EDTA
hematology, blood bank
stopper color
gray
additive?
department?
sodium floride & potassium oxalate, sodium floride and EDTA, sodium floride
chemistry
stopper color
orange
gray/yellow
additive?
department?
thrombin
chemistry
stopper color
royal blue
additive?
department?
None(red label), EDTA (lavender label), Sodium Heparin (green label)
chemistry
stopper color
Tan (glass tube)
Tan(plastic)
additive?
department?
Sodium heparin, EDTA
chemistry
stopper color
yellow
additive?
department?
Sodium Polyanethol sulfonate(SPS)
microbiology
stopper color
Yellow
additive?
department?
Acid citrate destrose(ACD)
blood bank/immunohematology
What type patient is a syringe system used for
PTs with small or difficult veins
Winged infusion blood collection set (butterfly)
what PTs used for
small difficult veins (hands
elderly
pediatric
why should you not use a needle that is too small?
may hemolyze specimen
Butterfly
1st tube
Why
Air in tubing(use clear/discard tube to clear draw few mL and discard)
why should you never transfer blood collected in an additive tube to another additive tube?
will create excess additive in specimen and interfeer with testing
most common anticoagulants?
ethylenediaminetetraacetic acid (EDTA)
citrates
heparin
oxalates (*IMPT* use correct Anitcoagulant for type test collected)
Anitcoagulant
ECHO
most common Anitcoagulants
E(EDTA) C(citrate) H(heparin) O(oxalate)
EDTA prevents coagulation by?
binding or chelating calcium
Why should an EDTA tube never be underfilled
causes the RBCs to shrink and changes the CBC results
citrates prevent coagulation by?
binding or chelating calcium
citrates inversions?
reason for not vigorously mixing
3-4 gentle inversions
vigorous or excessive number can activate platelets and shorten clotting times
Heparin prevents clotting by?
inhibiting thrombin formation
Thrombin is a?
enzyme needed to convert fibrinogen into the fibrin necessary for clot formation
what color are heparin tubes?
green stoppers and royal blue top tubes with green on the label
oxalates prevent coagulation by?
precipitating calcium
Potassium oxalate is commonly added to what tubes?
those containg glucose preservatives to provide plasma for glucose testing
oxalate inversions?
8 eight
mix immediately to prevent clot formation and fibrin generation
Acid Citrate Dextrose (ACD)
Solution aviliable in how many formulas?
Name them
what tests used for?
two(2) formulations
Solution A
Solution B
for hematology tests
(DNA testing, human leukocyte antigen(HLA), phenotyping used in paternity evaluation and determine transplant compatibility
Acid Citrate Dextrose (ACD)
how does each part work?
acid citrate prevents coagulation bu binding calcium(little effect on cells and platelets)
Dextrose acts as a RBC nutrient and preservative (by maintaining red cell viability)
ACD tubes
color of top?
inversions?
Yellow top
eight (8) immed after collection to prevent clotting
citrate-phosphate-dextrose (CPD)
used for what tests?
how does each part work?
- collecting units of blood for transfusion
-citrate-chelating calcium
-phosphate-stabilizes pH
-dextrose- provide cells with energy and helps keep them alive
sodium polyanethol sulfonate (SPS)
how does it work?
used for What tests?
prevents coagulation by binding calcium
reduces the action of a protien called Complement that destroys bacteria
slow down phagocytosis
reduces activity of certain antibiotics
used for blood culture collection
SPS
color tube stoppers?
inversions?
Yellow
eight (8) to prevent clotting
Antiglycolytic agent
definition?
substance that prevents glycolysis(the breakdown or metabolism of glucose (blood sugar) by blood cells)
sodium floride
what does it do?
preserves glucose for up to 3 days
also inhibits the growth of bacteria
sodium floride tubes
stopper color
inversions
gray stoppers
8 eight for proper mixing
what is Thixotropic gel seperator
used for?
density of gel is between cells and serum or plasma, forms a physical barrier between them
stopper color normally indicates a type of additive
what doesroyal blue indicate?
trace-element-free tubes
Label color indicates the additive
what is order of draw?
a special sequence of tube collection that is intended to minimize contamination of the specimen by additive carryover, tissue thromboplastin or microbes
blood cultures require?
collected when in order of draw?
why?
special site-cleaning measures prior to draw?
-first(not often because typically drawn separately)
-to prevent microbial contamination of the needle from unsterile tops of tubes used to collect other tests
order of draw (memory Jogger)
Stop Light Red. Stay Put. Green Light Go.
Stop (yellow) Sterile
Light (light blue)
Red (red)
Stay (yellow) PST
Green (green)
Light (lavender)
Go (gray(places the red top before SST and PST before green top for convenience in memorization
Blood cultures (sterile collections)
-tube stopper color?
-rationale for collection order?
yellow SPS
sterile media bottles
-minimizes chance of microbial contamination
Coagulation tubes
-tube stopper color?
-rationale for collection order?
light blue
-first additive tube in the order because all other additive tubes affect coagulation
glass nonadditive
-tube stopper color?
-rationale for collection order?
red
-prevents contamination by additives in other tubes
plastic clot activator tubes
Serum sparator tubes (SSTs)
-tube stopper color?
-rationale for collection order?
red
r-ed&gray rubber
gold plastic
-filled after coagulation tests because silica particles activate clotting and affect coagulation tests(carry over of silica into subsequent tubes can be overridden by anticoagulant in them
plasma separator tubes PSTs
heparin
-tube stopper color?
-rationale for collection order?
Green & gray rubber
light green plastic
green
-heparin aggects coagulation tests and interferes in collection of serum specimens; causes the least interference in tests other than coagulation tests
EDTA tubes
plasma preparation tubes PPTs
-tube stopper color?
-rationale for collection order?
Lavender
pink
-pearl top
-responsible for more carrover problems than any other additive: elevates Na and K+ levels...chelates and decreases calcium and iron levels, elevates PT and PTT results
oxalate/flouride tubes
-tube stopper color?
-rationale for collection order?
gray
-sodium floride and potassium oxalate affect sodium and potassium levels, respectively. After hematology tubes, because oxalate damages cell membranes and causes abnormal RBC morphology. Oxalate interfers in enzyme reactions
Alternate syringe order of draw (memory jogger)
Silly ladies Love Green & Gray Roses
Silly (yellow) sterile
Ladies (lt blue)
Love (lavender)
Green (green/PST)
Gray (gray)
Roses (red/sst)