Phlebotomy

Description:	Phlebotomy 115 Week 5
Category:	Phlebotomy
Created by:	Adwa on 2008-01-30

Question	Answer
Preferred Puncture Sites	Fleshy surface of the distal degment of the third (middle) or fourth (ring) finger
Not recommended Puncture Sites	Sides or extreme tip of the finger
Preferred Puncture Site	Lateral or medial plantar surface of the heel (pediatric phlebotomies)
Blood volume of a human	4-5 L
Not recommended Puncture Site	Earlobe
Not Recommended Puncture Site	Central arch area of an infants heel and posterior curve of the heel
Not recommended Puncture Site	Fingers of a newborn or infant
Not recommended Puncture Site	The fifth (pinky) finger
Not recommended Puncture Site	The thumb, because it has a pulse
Not Recommended Puncture Site	The index (pointer) finger
Not Recommended Puncture Sites	Fingers on the side of a mastectomy
Not Recommended Puncture Sites	Swollen or previously punctured sites
Complications from heelsticks	Cellulitis
Complications from heelsticks	Osteomyelitis of the calcaneus
Complications from heelsticks	Abscess formation
Complications from heelsticks	Tissue loss
Complications from heelsticks	Scarring of the heel
Complications from heelsticks	Calcified nodules (most common in neonates)
Professional Organizations for Phlebotomists	NPA - National Phlebotomy Association
Organizations for Phlebotomists	ASCP - The American Society for Clinical Pathology
Organizations for Phlebotomy	ASCLS - The American Society for Clinical Laboratory Science
Organizations for Phlebotomy	AMT - American Medical Technologists
Organizations for Phlebotomy	ASPT - American Society of Phlebotomy Technicians
Organizations for Phlebotomy	NAACLS - National Accredediting Agency for Clinical Laboratory Sciences
Organizations for Phlebotomy	NHA - National Healthcareer Association
Order of the Draw	Yellow, Light Blue, Red or Gold, Green, Lavender or Pink, Gray
Order of the Draw	EDTA specimens, other tubes with additives, non-additive tubes
EMLA	A topical anesthetic, needs to sit approx. 1 hr before working
Certification Agencies for Phlebotomists	NPA - National Phlebotomy Association
Certification Agencies for Phlebotomists	ASCP - The American Society for Clinical Pathology
Certification Agencies for Phlebotomists	AMT - American Medical Technologists
Certification Agencies for Phlebotomists	ASPT - American Society of Phlebotomy Technicians
Certification Agencies for Phlebotomists	NHA - National Healthcareer Association
Specimen of choice of Chemistry Department	Green or Gold
Indications for Capillary Blood Collection	Burn Victims
Indications for Capillary Blood Collection	Obesity
Indications for Capillary Blood Collection	Thrombic tendencies - people who tend to have blood clots
Indications for Capillary Blood Collection	Fagile, shallow veins
Indications for Capillary Blood Collection	Saving veins for chemotherapy or other treatment
Indication for Capillary Blood Collection	Point of care testing - only requires a ver small amount of blood, such as hematocrits, hemoglobin, or blood glucoses
Capillary Collection	Step 1 - Chose a finger that is not cold, cyanotic or swollen-preferably the 3rd or 4th finger on the non-dominate hand or the heel on infants less than 1yr of age
Capillary Collection	Cleanse site with 70% alcohol
Capillary Collection	Step 3 - Allow to air dry
Capillary Collection	Step 4 - Secure finger or heel firmly
Capillary Collection	Step 5 - Use a retractable safety device for capillary puncture
Capillary Collection	Step 6 - Position devive perpendicular to the fingerprints and activate device by pressing on the release mechanism
Newborn Screening Tests	PKU - Phenylketonuria
Newborn Screening Tests	Toxoplasmosis
Newborn Screening Tests	Sickle cell disease
Newborn Screening Tests	HIV
Newborn Screening Tests	Galactosemia
Newborn Screening Tests	Maple syrup disease
Venipuncture in pediatrics	Use the standard antecubital space if possible
Venipuncture in pediatrics	Use a 23 guage needle
Venipuncture in pediatrics	Stabilize the childs arm
Venipuncture in pediatrics	Make sure the alcohol is dry
Venipuncture in pediatrics	Select the median cubital vein
Venipuncture in pediatrics	Stretch the skin tight
Interventions to Alleviate Pain	EMLA
Interventions to Alleviate Pain	Oral sucrose - 24% solution
Albumin	Serum protein formed from amino acids, values can provide information on hydration, nutrition and liver function
Globulin	Serum protein formed from amino acids, valus can provide information on hydration, nutrition and liver function
Alkaline Phosphates	An enzyme that plays a role in the crystalization of calcium salts
Bilirubin	A waste product removed by the liver and excreted in the bile
BUN	Blood Urea Nitrogen, excess amino acids are converted to urea, high BUN levels indicate poor kidney function
Creatinine	A metabolic prodict of creatine, a substance stored in the muscle and used for energy, creatinine is excreted by the kidneys
Creatine kinase (CK)	An enzyme in the blood that may indicate that an infarction has occured
Electrolytes	Includes K+, Na+, CO2, and Cl-
Electrolytes	Vital to acid/base balance, pH, heart and muscle function
Gout	A metabolic disorder caused by the formation of crystals of uric acid within the synovial fluid of joints
Lactate dehydrogenase (LDH)	An enzyme in the blood that may indicate that an infarction has occured
Liver enzymes	ALP, ALT, AST, GGT, and LDH
Triglygerides	The main form of lipid storage in adults, the serum or plasma may be milky in appearance when hyperlipidema is present
Glucose	The main analyte measured when evaluating carbohydrate metabolism
Glucose	Normal values 70-110mg/dl
Fasting blood glucose	A blood specimen is collected when a patient has been fasting for a specified period of time, usually 8-12 hrs
Fasting blood glucose	A value above 126 mg/dl is indicative of hyperglycemia in the fasting patient
2 hour post-parandial	A blood specimen is collected when a patient is fasting, and the patient is then instructed to eat a meal rich in carbohydrates or to drink a standardized bottle of glucola (50-100g of glucose)
2 hour post-parandial	Blood is drawn 2 hours post meal
2 hour post-parandial	Blood glucose level should return to normal or below 110mg/dl after 2 hours
Lipids	Organic compounds containing carbons, hydrogens, and oxygens, includes fats, oils and waxes, synthesized from dietary fats in the body
Uric acid	A metabolic waste product formed by the breakdown of nucleic acids and excreted by the kidney, cause of gout when it precicipitates into crystals
GTT	Glucose Tolerance Test
GTT	Test for diabetes & hypoglycemia
GTT	Critical values - blood glucose below 40 mg/do or above 400 mg/dl