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Skin Puncture
Skin Puncture Equipment and Procedures
| Question | Answer |
|---|---|
| arterialized | increased arterial composition due to warming the collection site |
| blood smear | blood film made from a drop of blood on a glass slide |
| calcaneus | heel bone |
| capillary blood gases | arterialized skin puncture blood gases |
| clay sealant | substance used to plug one end of a microhematocrit |
| cyanotic | pertaining to blue-gray discoloration of skin due to lack of oxygen |
| differential | determination of the number and characteristics of cells on a blood smear by staining and examining it under |
| feather | thinnest area of blood smear where a differential is performed |
| interstitial fluid | fluid found between cells or in spaces within an organ or tissue |
| intracellular fluid | fluid found within cell membranes |
| lancet | sterile, disposable, sharp-pointed instrument used to pierce the skin to obtain droplets of blood for testing |
| microcollection containers | small plastic tubes with color-coded bodies or stoppers corresponding to evacuated tubes that are used to collect drops of skin puncture blood |
| microhematocrit tubes | disposable, narrow-bore, plastic-clad glass or plastic tubes used for manual packed cell volume determination |
| newborn screening | performing tests on neonates to check for genetic or inherited diseases |
| osteochondritis | inflammation of bone and cartilage |
| osteomyelitis | inflammation of bone, especially marrow, caused by bacterial infection |
| PKU | heredity disease caused by inability to metabolize phenylalanine because of a defective enzyme |
| plantar surface | bottom or sole of the foot |
| reference values | normal values for lab tests, usually established using basal state specimans |
| whorls | grooves of the fingerprint |
| characteristics of skin puncture lancets are: | controlled puncture depth, permanently retractable blade, and sterile. (cannot be reused) |
| What equipment is used to perform a manual packed cell volume test? | microhematocrit tube |
| what equipment may be used to collect capillary blood gases? | magnet (both ends of the CBG tube are sealed immediately), metal "flea" (stirrers are small metal filings or bars) and, special capillary tube (long thin narrow-bore tube that is color-coded by a band) |
| mirocollection container that container that contains a fluid for direct dilution of the speciman | Microtainer |
| capillary specimans are a mixture of what composition? | a mixture of venous, arterial, and capillary blood and more closely resembles arterial blood. |
| If venous blood is placed in skin puncture collection devices, it is important to do what? | label it as venous blood |
| why should a laboratory report form indicate the fact that a specimen has been collected by skin puncture? | some test results may vary depending on the source of the specimen |
| skin puncture blood is sometimes called capillary blood because? | it is obtained from the capillary bed |
| skin puncture blood is the perferred specimen for this test? | phenylketonuria |
| reference values for skin puncture blood are higher for? | glucose |
| you need to collect blood cultures, a gray top, and a lavender top on an adult with difficult veins. Which specimens can be collceted by skin puncture? | gray top and lavendar top only (never a light blue top) |
| which skin puncture specimen is typically collected in an amber mirocollection container? | bilirubin |
| when can a skin puncture can be done rather than a venipuncture? | a child is younger than 2 years old, an adult has difficult veins, and veins need to be saved for chemortherapy |
| it is not a good idea to perform skin puncture if the patient is/has? | dehydrated, in shock and, poor circulation |
| what is the proper site for finger puncture on an adult? | distal segment of the middle or ring finger |
| skin puncture is the perferred method to obtain blood from infants and children because? | they can be injured by restraining methods used during venipuncture, they have small blood volumesm and venipuncture may damage veins and surrounding tissue |
| what is normal site of skin puncture? | a site below an IV, the lateral plantar surface of a baby's heel, and the middle finger of a warm, adult hand. (never an edematous extremity) |
| it is necessary to control the depth of lancet insertion during skin puncture to avoid what? | bone injury |
| the maximum depth of heel puncture recommended by the NCCLS is? | 2.0 mm |
| what complication can result from a deep skin puncture of an infant's heel? | ostechondritis |
| what is a safe area for an infant heel puncture? | lateral plantar surface |
| a recommended site for skin puncture on children 2 years of age or older is? | palmar fleshy portion of the middle finger |
| distance between the skin surface and the bonein the end segment of a finger is? | less at the side and tiip than the center |
| major blood vessels of the skin arelocated in/at the? | dermal-subcutaneous junction |
| skin puncture that parallels the whorls of the fingerprint will? | allow the blood to run down the finger |
| skin puncture equipment includes? | lancet, microcolletion tube, and/or microhematocrit |
| which color-coded microcollection container would be used to collect a complete blood count? | lavender (would be collected first) |
| what is the purpose of warming the site before skin puncture? | increasing blood flow up to 7 times |
| this test requires warming of the heel before specimen collection for accurate test results? | blood gases |
| the typical anitseptic used to clean a skin puncture site is? | 70% isopropanol |
| the antiseptic must be completely dried before performing skin puncture to avoid? | hemolysis |
| povidone-iodine contamination of a skin puncture specimen affects? | bilirubin, potassium and uric acid |
| errors in glucose results have been attributed to this? | isoproply alcohol contamination of the specimen |
| the purpose of wiping away the first drop of blood during skin puncture is to? | eliminate tissue fluid contamination |
| contamination of a skin puncture specimen with residual alcohol can erroneously elevate results for this test | hemoglobin and potassium |
| the puncture site of the fingerprint (whorls)should be? | slightly to the side of center and perpendicular to the whorls. (parallel puncture will allow blood to run down the finger) |
| it is inappropriate to apply a bandage to a skin puncture site on an infant younger than 2 years of age because? | an adhesive bandage can irritate an infants tender skin, the bandage can come off and present a chocking hazard, and the bandage can tear the skin when removed |
| proper technique for filling a microcollection tubes include? | touching the scoop of the collection tube to blood drop, tapping the tube gently to encourage blood to settle to the bottom. (never scoop up blood that runs down the finger) |
| which of the following activities can introduce tissue fluid into the skin puncture specimen? | milking and massaging, squeezing, and applying strong repetitive pressure |
| during multisampe skin puncture collections, blood smears, and EDTA specimens are obtained before other specimens to? | minimize the effects of platelet clumping |
| a blood smear is required for this test | manual differential |
| an acceptable blood smear | has a feathered uniform edge |
| a blood smear prepared from an EDTA speciman should be made | within 1 hour of collection |
| if the phlebotomist makes a blood smear that is too short, he or she should try again and? | decrease the angle of the spreader slide |
| holes in a blood smear can be caused by? | dirt on the slide, fingerprints on the slide, or lipids in the blood |
| collection of a thick blood smear may be requested to detect? | malaria |
| iron fillings used in capillary blood gas collection | aid in mixing the anticoagulant |
| capillary blood gases | are less dangerous to perform on infants than arterial blood gases (ABG's), contain both venous and arterial blood, and employ an open collection system |
| an infant may require a blood transfusion if blood levels of this substance exceed 18 mg/dL. | bilirubin |
| phenylketonuria (PKU) is a newborn screen test and is? | hereditary inability to metabolize phenylalanine |
| falsely decreased bilirubin results can be caused by | specimen collection that was too slow, hemolysis of a specimen, or failure to protect the specimen from light |
| contamination of a phenylketonuria (PKU) test can result from | failure to discard the first drop of blood, gloves or hands touching the blood spot circles, or stacking specimen slips together after collection |
| erroneous newborn screening results can be caused by | applying blood drops to both sides of the filter paper, hanging specimen slips to dry, or layering successive drops in the same collection circle |
| neonatal blood screening for this disorder is required by law in the United States | hepatitis B |
| jaundice in a newborn is associated with high levels of | bilirubin |
Created by:
jkc
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