Phlebotomy Essentials 5Th Edition

Front 1

Your lab report must indicate the fact that a specimen has been collected by capillary puncture because?

Back 1

test results can vary depending on the method of collection

Front 2

Microcollection Containers

Back 2

Small plastic tubes used to collect tiny amounts of blood from capillary punctures
Some come with narrow capillary tubes attached
Have color-coded bodies or stoppers & markings for min/max fill levels that correspond to color-coding of ETS blood collection tubes

Front 3

Microhematocrit Tubes and Sealants

Back 3

Disposable, narrow-bore plastic or plastic-clad glass tubes
Fill by capillary action & hold 50 to 75 ml
Used primarily for hematocrit determinations
One end of tube is sealed w/ plastic or clay sealants
They are used primarily for manual hematocrit (Hct), not manual potassium.

Front 4

Capillary Blood Gas Equipment (CBG)

Back 4

CBG collection Tubes: narrow-bore plastic capillary tubes
Stirrers: metal filings or bars inserted into tube to mix Referred to as fleas
Magnet: used for mixing, in conjunction w/ stirrer
Plastic caps: used to seal tubes

Front 5

Microscope Slides

Back 5

used for blood films for hematology determinations

Front 6

Warming Devices

Back 6

Warming the site increases blood flow as much as 7 times

Front 7

Capillary blood gases are less desirable than arterial blood gases because?

Back 7

Skin puncture blood contains tissue fluid, it is only partly arterial, and the blood is exposed to air during collection

Front 8

Composition of Capillary Specimens are?

Back 8

mixture of arterial, venous, & capillary blood
interstitial & intracellular fluid
more closely resembles arterial blood than venous

Front 9

Capillary reference values may differ from venous values because?

Back 9

Glucose concentrations are higher in capillary blood.
Total protein (TP), calcium (Ca2+), and potassium (K+) concentrations are lower in capillary blood.
Interstitial fluid (fluid in the tissue spaces between the cells) and intracellular (fluid within the cells) from the surrounding tissues.

Front 10

Indications for Capillary Puncture in Adults & Older Children are?

Back 10

Available veins are fragile or must be saved for other procedures.
Several unsuccessful venipunctures have been performed.
Patient has clot-forming tendencies.
Patient is apprehensive or has an intense fear of needles.
There are no accessible veins (IVs in both arms, scars, burns).
For POCT procedures such as glucose monitoring.

Front 11

Reasons for Capillary Puncture in Infants & very Young Children are?

Back 11

Small blood volume & risk of anemia.
Risk of cardiac arrest when large quantities of blood are removed.
Venipuncture is difficult & may damage veins & surrounding tissues.
Puncturing deep veins can cause hemorrhage, venous thrombosis, infection, & gangrene.
Risk of injury due to restraint needed for venipuncture.
Capillary blood is preferred specimen for some tests.

Front 12

Tests That Cannot Be Collected by Capillary Puncture are?

Back 12

Most erythrocyte sedimentation rate methods.
Coagulation studies that require plasma specimens (Light blue tube).
Blood cultures.
Tests that require large volumes of serum or plasma.

Front 13

Capillary Puncture Order of Draw

Back 13

Blood gas specimens (CBGs) White or yellow
EDTA specimens Lavender
Other additive specimens
Serum specimens Red

Front 14

The order of draw for collecting multiple specimens by capillary puncture is not the same as for venipuncture because?

Back 14

Puncturing the skin releases tissue thrombosplastin, which activates the coagulation process in the blood drops.
Specimens must be collected quickly to minimize the effects of platelet clumping. And microclot formation and to ensure that an adequate
Amount of specimen is collected before the site stops bleeding.
Hematology specimens are collected first because they are
Most affected by the clotting process. Serum specimens are
Collected last because they are supposed to clot.

Front 15

an example of platelet clumping would be what kind of specimen?

Back 15

EDTA

Front 16

Selecting a Puncture/Incision Site

Back 16

GENERAL CRITERIA
skin is warm, pink normal color.
no scars, cuts, bruises, rashes, cyanoti, edema, or infection.
ADULTS & OLDER CHILDREN
palmar surface of distal or end segment of middle or ring finger of nondominat hand.
Central, fleshy portion of the finger (never the pinky, little or 5th.
INFANTS
plantar surface of heel, on medial or lateral edge to avoid bone damage (< 2.0 mm deep)

Front 17

The term Cyanotic is?

Back 17

bluish in color, from lack of oxygen.

Front 18

The calcaneus is another name for?

Back 18

heel bone

Front 19

An infant heel puncture should be done on the?

Back 19

lateral planter surface no more than 2.0mm below the skin surface. Punctures deeper than this may cause bone damage.
It is necessary to control depth of lancet insertion during capillary puncture
To avoid injuring the heel bone. Never puncture toes even big fleshy toes.
Box 10-2 Refer to heel puncture precautions.

Front 20

On an adult finger puncture, the puncture should be in the?

Back 20

central, fleshy
Portion of the finger, slightly to the side of center and perpendicular to
Grooves in the whorls of the fingerprint.

Front 21

Capillary punctures should not be performed on the Fingers or?

Back 21

earlobes of newborns or other infants under 1 year of age.

Front 22

The rational for wiping away the first drop of blood is to eliminate?

Back 22

Tissue fluid contamination

Front 23

Fill and Mix tubes/containers in order of draw

Back 23

Collect slides, platelet counts, & other hematology specimens first to avoid clumping & clotting.
Collect other anticoagulant containers next & serum specimens last.
Touch collection tube or device to drop of blood.

Front 24

Capillary bilirubin specimens should be protected from?

Back 24

light

Front 25

Phenylketonuria (PKU)

Back 25

is a hereditary inability to metabolize phenylalanine

Front 26

Routine blood Film/smear preparation is required to?

Back 26

perform a manual differential (Diff) a test in which the number
Type and characteristics of blood cells are determined by examining a
Stained blood smear under a microscope.

Front 27

Blood smears prepared from EDTA specimens should be made within?

Back 27

1 Hour of collection to eliminate cell distortion caused by the anticoagulant.

Front 28

A good blood smear should exhibit?

Back 28

a feathered edge.

Front 29

Thick blood smear preparation

Back 29

Used to test for malaria.
Diagnosed by presence of organism in peripheral blood smear.
A very large drop of blood is placed in center of glass slide.
Drop is spread with corner of another slide or cover slip until it is the size of a dime.
Allow to dry for a minimum of 2 hours before staining.