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Phlebotomy
Phlebotomy 115 Week 5
| 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 |
| Triglycerides | 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 |
Created by:
Adwa
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