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CH2

Collection Techniques

QuestionAnswer
Primary Blood Collection Equipment Gloves, ISOPROPYL alcohol, Gauze pads, Tape or bandage, Tourniquet, Needle, Needle holder or Hub, Evacuated tubes or pediatric collection tubes, Winged Infusion Set.
Angle to insert needle 15-30º Angle
Common reasons for a Capillary Collection Point of Care tests (POC) glucose, cholesterol & Hematocrit. Determinants: Patient age, ordered tests, Health status.
Never perform a finger stick if: The finger is cold, Cyanotic (blue), Scarred, Swollen or has a Rash. If it's calloused, choose another finger.
Never use a lancet that goes deeper than___ on a heel stick. 2 mm
The best site for heel stick Lateral (pinky) or Medial (toe) side
Complication: Nerve Damage What to do? Stop the draw
Complication: Hematoma Reduce the risk, how? Perform venipuncture smoothly and accurately, and apply right amount of pressure for the right amount of time after venipuncture.
Phlebitis inflammation of a blood vessel, usually when the same vein has been accessed repeatedly.
Thrombus a blood clot that can occur when insufficient pressure is applied to the vein puncture site.
Petechiae small red dots that may occur where a tourniquet is tied too tightly or left on too long. Increased chances on patients with platelet abnormalities.
Hemoconcentration Stagnated blood flow due to tourniquet on too long. Causes alteration in: ammonia, calcium, coagulation tests, potassium and protein tests.
Collection/processing errors Misidentification of patient, improper site selection and preparation, using wrong tube, failure to invert tubes, failure in timing specimen, mislabeling a specimen.
What is Syncope? Sudden lack of blood supply to the brain/fainting
Syncope, what to do? Before venipuncture: ask if he has ever fainted during venipuncture and proceed with patient lying down. During: Stop the draw, keep patient from falling, call for help. Do not leave until fully recovered.
What if the patient has a Seizure? Stop the draw, avoid to prevent injury. Do not leave alone.
Symptoms of shock Cold, clammy, pale skin, rapid pulse, increased shallow breathing, staring eyes in an expressionless face. Call for help. Ensure open airway. If lying down, lower head below body.. Keep warm until help arrives.
What to do if the patient has Nausea? Stop the draw and provide a container to vomit. Cold compress in the back of the neck. Don't tell patient to vomit or to hold it in. Inform nurse.
Diaphoresis excessive sweating. May be symptom of nausea, vomiting, syncope or panic attack. Observe signs and inform nurse.
Order of Draw Venipuncture Blood Culture (yellow), Coagulation (light blue), Serum (red, gold speckles of red/gray), Heparin-Green, EDTA-Lavender/Pink/Pearl, Gray.
Order of Draw Capillary Blood Gas: EDTA Purple, Lavender, Pink, Pearl Green Other additives Serum: Red, gold
Additive found in LIGHT BLUE tubes, best for coagulating factors: Sodium Citrate
Additive in LAVENDER or PINK and used in hematology to preserve cell shape and reduces platelet clumping. EDTA
Found in GRAY tubes, used for glucose testing because it preserves the glucose, along with sodium fluoride Potassium Oxalate
Inversions LIGHT YELLOW SPS top tubes 8-10
Inversions LIGHT BLUE tops tubes 3-4
SST-Serum Separator Tubes RED tops and Serum tubes RED without separating gel 5
GREEN top tubes 8-10
GRAY to tubes 8-10
QC Check for the following in every blood draw Needles: expiration date, missing labels/seal, bevel burrs/flaws, safety device, adapter-defects, cracks, breaks, discard if they are single-use
Peripheral Blood Smear -Prepared from drop of blood or EDTA tube -Used to examine blood microscopically -should have a feathered edge -should not have blood on the frosted edge
Peripheral blood smear angle 30-35º Angle
Blood Culture Is used to check for bacteria/patients with have a FUO (fever)
Blood Culture Preparation Clean 60 seconds with alcohol or Chlorhexadine gluconate. Apply light friction outward spiral moving outward to diameter of 2-2.5 inches. Repeat process with Povidone-Iodine.
Blood Culture If using a WIS Needle (butterfly) collect_________First Aerobic = because there is Air in the butterfly tubing
Blood Culture If using a Syringe collect __________First 1st the Anaerobic = because there is no air in Syringe 2nd the Aerobic =because 2nd most likely to be exposed to air.
Newborn are tested for: -Cystic Fibrosis, Phenylketonuria (PKU), Galactosemia, Hypothyroidism. -Biotinidase Deficiency, Sickle Cell Disease (other states) -HIV, Toxoplasma Before the baby is 24 hours old.
Newborn test important to remember: -Collected on special forms including specimen on filter paper -Apply on one side of form and allow blood to soak completely --Allow to dry 3 hours (avoiding sunlight and heat).
Reasons for rejection of newborn specimens -Over saturated circle -Not completely filled circles -Expired form -Form not received within 14 days -Specimen is contaminated -Specimen was not allowed to dry thoroughly.
Blood Bank is a screening and release point for donor units and other blood products.
Therapeutic Phlebotomy intentional removal of blood to lower RBC.
Polycythemia vera very high RBC count
Hemochromatosis very high Iron levels
Apheresis the removal of one or more blood products
Plasmapheresis removal of blood plasma from whole blood
Autologous Blood for self
Autologous before a surgery must comply with the following: Must have written order from provider Hgb 11 g/dL Surgery must be 72 hrs. after the donation Blood must be labeled strictly for the donor's use
Iatrogenic Anemia definition, at risk patients, symptoms anemia caused by blood loss due to repeated venipuncture, Geriatric, Pediatric and Underweight patients at most risk. Symptoms: Shortness of breath, fatigue and need for transfusion.
Blood volume to be drawn in a short period of time INFANT 10% of blood volume.
Infant Blood Volume Calculation: Pounds/2.2 = kg Example: 6.2/2.2=2.82 kg Kg x 100 =mL 2.82 x 100 = 282 mL Then convert blood volume in mL to Liters 282 mL/1000 =0.28 L
Age to be a blood donor at least 17 yrs old (16 in some states)
Minimum weight to be a donor 110 pounds
How long before another donation of blood? 8 weeks
What is involved in Donor Screening? Registration (ID info--> Name, Address, DoB) and Written Consent. Interview (medical history, drug use, conditions, etc) Physical exam (weight, temperature, blood pressure, pulse, Hgb or Hct.)
How long is the Donor's information kept on file? 5 years
A unit of blood = 400-500mL
Needle size for Blood donation 16-18 Gauge
What is used to clean skin before donation of blood soap and water, then iodine
A patient can donate every ___________hours/days/weeks 72 hours
Minimum hemoglobin to donate 11 g/dL
A blood culture checks for bacteria
Created by: glamorousglenys