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43 Cards in this Set

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  • Back
What does preanalytical mean?
before analysis
-phase of testing process that begins when a test is ordered and ends when the testing begins
Basal state
definition?
what used for?
the resting metabolic state of the body earl in the morning after fasting for a min of 12 hours
-ideal for establishing reference ranges
what is a reference range?
normal lab test values for healthy individuals
( not outpatient)
what is hemoconcentration
a condition in which blood componets that cannot easily leave the bloodstream become concentrated in the smaller plasma volume
what is lipemic?
specimen is cloudy
(remember fat lip or fat white cloud = fats in blood)
what is icteric?
dark yellow specimen
from jaundice
what is a diurnal variation?
factors that affect it?
happening daily
posture, activity, eating, daylight darkness, awake or asleep
what is a circadian variation?
having a 24 hour cycle
jaundice
another name?
characterized by?
-icterus(icteric means relating to or marked by Jaundice)

-bilirubin(product of breakdown of RBCs) -deposits of yellow bile in pigment in skin, mucous membranes and sclera
Why should you avoid burns, scars and tattoos
veins difficult to palpate or penetrate in these areas
may have impaired circulation
painful suscepitble to infection
dye can interfere with testing
Why should you avoid damaged veins
dificult to puncture impaired blood flow
( hard, cord like, lack resiliency because occluded or obstructed)
what is sclerosed
hardened
what is thrombosed
clotted
Why should you avoid an Edema
inaccurate results due to contamination with tissue fluid
or altered blood compisition due to swelling
what is an edema
swelling caused by to abnormal accumulatio of fluid in tissues
(alert appropriate personnel if caused by IV)
what is a hematoma?
swelling or mass of blood (often clotted) caused by blood leaking from a blood vessel during or following venipuncture
Why should you avoid a hematoma
-contamination with hemolyzed blood from outside the vein
-also painful
-obstruction of flow and effects of the coagulation process lead to inaccurate results
( never collect through a hematoma; no alternative perform distal to ensure free flowing blood)
Why should you avoid same side as mastectomy?
lymph node removal causes lymphostasis. (obstruction or stoppage of normal lymph flow)makes arm susceptible to swelling and infection
should you do venipuncture on an arm with art line??
NEVER!
special trained personnel only can access arterial line
arteriovenous (AV) shunt/fistula/graft
definition?
common location?
venipuncture?
permanent, surgical fusion of artery and a vein(provide access for dialysis)
-back of arm above wrist
-never do BP/tourniquet/ venipuncture on arm with a shunt
Heparin or saline lock
what are they?
venipuncture?
why?
catheter or cannula connected to a stopcock or cap with a diaphragm, provides access for admin of meds or blood draw
-specially trained personnel only
-flushed with saline or heparin(adheres to surfaces)
-
Intravenous(IV)
definition?
IV line?
venipuncture?
-pertaing to or within a vein
-a catheter in a vein to admin fluids
- use other arm..if not possible use capillary..or have nurse turn off for 5 min then draw below IV
CVADs (central Vascular Access Devices)
also called?
definition?
used for?
venipuncture?
-indwelling line
-tubing inserted into a main vein or artery
-admin fluids/meds/monitoring pressures/blood draw
-specially trained only
what are some phlebotomy concerned allergies?
adhesive
antiseptic
latex
excessive bleeding
if not stopped after 5 min
contact appropriate personnel
fainting
another name?
definition?
syncope (sin'ko-pea)
-loss of consciousness and postural tone that results from insufficent blood flow to brain
signs to watch for in PT when drawing blood
pallor
perspitation
hyperventilation
indication fron PT of vertigo
dizziness
light headedness
nausea
what is probing?
should you do it?
excessive, deep, blind,or lateral redirection on needle
-NO
what are the indications of nerve involvement?
what to do?
marked or extreme pain
numbness of arm
burning or electrick shock sensation
radiating pain
(if pain persists after needle removal notify appropiate personell)
remove needle immediatley and apply Ice pack
what are Petechiae?
indication of?
tiny, nonraised red spots on PTs skin when tourniquet is applied
-may bleed excessively
Hematoma formation
identification
results?
most common complication of venipuncture
-rapid swelling at or near venipuncture site
-bruising
compression injuries to nerves
lawsuit
Hematoma formation
situations that can trigger??
-vein fraginle or too smalll for needle
-needle penetrates all the way through vein
-needle only partially inserted into vein
-excessive or blind probing used to locate vein
-needle removed when tourniquet is still on
-pressure not adequate following venipuncture
Iatrogenic
what is it?
iatrogenic blood loss?
iatrogenic anemia?
-adjective used to describe an adverse condition brought on by the effects of treatment
-blood loss as a result of blood removed for testing
-rmeoving blood on a regular basis or in large quanitys (especially infants)
what is exsanguination
blood loss to the point where life cannot be supported
arterial puncture
how to reconize?
what to do
bright red blood or spurts/pulses into tube
-withdraw and hold pressure for full 5 min
what is reflux?
how to prevent?
why prevent?
-backflow
-PT arm in downward position
-adverse reaction to tube additives
what is venous stasis or venostasis?
result?
stagnation of normal venous blood flow (trapping of blood in an extremity by compression of veins)
-hemoconcentration (decrease in fluid content of blood with a subsequent oncrease of nonfilterable large molecule or protien based componets)
what can fist pumping cause in test results
increase in blood potassium levels
how to prevent hemoconcentration
- ask PT to release fist upon blood flow
-choose appropriate vein
-do not allow to pump fist
-do not excessive massage area
-do note probe
-release tourniquet within 1(one min
what is hemolysis?
when RBCs are damaged or destroyed and he Hgb escapes into fluid portion of specimen
- serum appears pink to lt red
what causes hemolysis
- blood draw from vein with hematoma
-failure to wipe 1st drop (may contain alcohol) during capillary puncture
-forcing blood from syringe into evac tube
-frothing(caused by improper fit of needle on syringe
-mixing too vigorously
-partial fill a normal sodium floride tube
-pulling plunger too quick on syringe
-rough handling or hroizonal transport
-squeezing site during capillary collection
-needle too small
-too large tube with small diameter butterfly needle
what does a short hissing sound with a sputrt of blood before flow stops indicate?
needle bevel not completely under the skin or bevel backs out of skin sllightly
troubleshooting failed venipuncture?
-Tube position-proper seat..reseat
-tube vacuum- bevel under skin(hissing sound), tube dropped or cracked or pushed too far onto needle
-needle position- against vein wall..pull needle back slightly or rotate/ too deep..angle too steep or tube holder not held steady/ nor deep enough.. partly through vein wall..very slow fill, hematoma/ beside vein..roll if not anchored..withdraw slightly, anchor and redirect into vein/ undetermined needle position..pull back slightly feel with finger above point of insertion (not too close) relocate, pull taunt, reinsert. (if lateral movement needed withdraw and coose another site)
-collapsed vein..vacuume of tube or syringe too great will tem collapse vein or if tourniquet too tight/ also can collapse if tourniquet removed during blood draw..remove tube wait few seconds for blood to reestablish flow or retighten tourniquet(if not poss apply pressure with finger) if does not reestablish, withdraw and coose another site