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Chapter24

Blood collection technique

QuestionAnswer
Aliquot Portion of specimen that is used for testing
Constrict Narrowing of the blood vessel
Lipemia Abnormal amount of fat in the blood causing the serum or plasma To appear cloudy or milky
Hematoma Swelling or accumulation of blood due to leakage from a blood Vessel during or after venipuncture
Lancet Sterile disposable sharp pointed blade used to pucture the skin To collect a blood sample
Gauge Diameter of the lumen of the needle
Phlebotomy Piercing the vein with a needle to obtain a blood specimen
Serum Liquid portion of the blood that remains after the blood has clotted
Tourniquet Device used to distend veins to assist with venipuncture
Primary container Original container in which the specimen is collected
Veinupucture Puncture of a vein to collect a blood sample
Plasma Liquid portion of whole blood which comes from a sample Which contains no anticoagulant
Butterfly Small winged needle used for venipuncture / needle attached to tubing and an adapter to be used with a syrine or vacuum tube system
Integrity Guarantees the purity or quality of the specimen
Evacuated tube Collection tube which contains a vacuum that facilitates the collection of blood during venipuncture
Additive Substance such as a clotting activator Separation gel Anticoagulant Cell preservation ( helps to Maintain the integrity or function of specimen)
Thixotropic gel Additive used to separate cells from plasma
Antecubital space Space in the elbow (Ventral/ anitomical)
Hemolysis Destruction of RBC during veinupucture to much blood volume
Hemoconcentration Increase of the portion of formed elements in the blood
Palpate To feel /touch/ bounce /to find vein depth and direction
Capillary puncture Skin pucture/ methods used to obtain small amounts of blood for testing Done on fingertips / great finger/baby's heal
QNS Quantity not sufficient
An additive /anticoagulant in the vacuum tube Can help preserve the integrity of the specimen
An anticoagulant added To a collection tube prevents the blood from clotting
Winged infusion or butterfly set Is used to collect blood from small or difficult veins Usually in the hand
EDTA Ethylenediaminetetraacetic acid Used as an anticoagulant for preserving blood specimens A chelating agent that binds calcium
ERS Erythrocyte sedimentation rate
aPPT Activated partial thromboplastin time
INR International normalized ratio
SPS Sodium Polyanethole sulfate
SST Serum separator tube
MCV Mean corpuscular volume
POCT Point of care testing
OSHA Occupational safety and health administration
BMP Basic metabolic panel
21g - 23g The range of syringe volumes most commonly used for blood collection
Semi-fowler's position For Pt's with history of fainting( syncope )
When palpating for a vein ( Tendons )located near the surface will feel hard and cord-like They are not a vein
Color coding for needles is Not universal they vary by manufacturers
Hematoma Common complication Resulting from a venipuncture A swelling or bruising resulting from an accumulation of blood at the puncture site
Capillary puncture Also known as skin or dermal puncture
Vacuum tube method supplies Needle holder Capped needle Tube
Explain the correct order of drawer To prevent cross contamination of additives Can lessen discomfort and complications for PT Lessens procedure time and prevent errors in diagnosis Caused by crossed contamination of additives between blood collection tubes
CLSI order of drawer for capillaries punctures Lavender topped Lavender topped (EDTA) tubes for hematology studies
CLSI order of drawer for capillaries puctures Green topped Green topped / heparin tubes
CLSI order of drawer for capillaries Red topped Red topped non- additive tubes contains no anticoagulant / gels / or clotting activators
Lavender top (Plasma) EDTA anticoagulant Binds calcium to prevent clotting 8-10 inversions Hematology testing: complete blood count (CBC), differential, and erythrocyte sedimentation rate (ESR)
Dark green top (Plasma) Sodium/ heparin Anticoagulant Inhibits formation of thrombin and prevents clotting Chemistry plasma studies electrolytes, arterial blood gases, and so on. Same testing as PST tube. 8-10 inversions
Light ( mint) green top (Plasma) Lithium/ heparin/ thixopic gel anticoagulant // Stat chemistry
Gray top (Plasma) Sodium fluoride / potassium oxalate Glucose/chemistry FBS /any glucose test and alcohol levels
Light blue top (Plasma) Sodium citrates anticoagulant Test coagulation/ clotting factors PT PTT PT INR FIBRINOGEN
Marble red/black top (Serum) Thixopic gel and clot activator
Insufficient mixing Causes micro-clot formation which will produce erroneous test results
Explain the importance of mixing the blood sample in tube with an additive They should be inverted immediately to mix the additive with specimen Each additive requires a specific number of in versions
Vigorous invertions Will result in hemolysis
Prevention of hematoma tips 1 Use smaller needles for small or fragile veins 2 Avoid going through the vein partially penetrating a vein or excessive movement in the vein 3 the bevel should be facing up and completely in the vein 4 avoid excessive probing
Rejection of specimen Improper labeling Using incorrect tubes Improperly filled tubes Incorrect collection time / handling Sending a hemolyzed or Lipemia specimen
Transportation of tubes Kept In upright position
Leaving a tourniquet on for more then 1 minute Can result in Hemoconcentration
Placement of tourniquet 3/4 inches above the elbow
OSHA requirement regarding blood tray Should be red in color or have the biohazard symbol displayed
Wiping away the first drop Lancet finger puncture/ is diluted with tissue fluid
DARK GREEN test for CHEMISTRY/ PLASMA WHOLE BLOOD SAMPLE/ Arterial blood gases / chemistry ADDITIVES SODIUM HEPARIN 8/10 inverts
RED PLAIN Tests for CHEMISTRY / SEROLOGY / TESTOSTERONE / TOXICOLOGY NO ADDITIVES Plastic : 5 inverts Glass : none
BLOOD CULTURE (STERILE) tests for MICROBIOLOGY/ BACTERIA ADDITIVES ANAEROBIC AND AEROBICS BROTH or SPS / Sodium Polyanethole / Sulfonate (pale yellow) 8-10 inverts
Orange top Liver panel / organs
MARBLE LIGHT GREEN / GRAY tests for - CHEMISTRY/ OR STAT CHEMISTRY PLASMA WHOLE BLOOD SAMPLE electrolytes/ KFT / LFT / Cardiac enzymes / Metabolic panels ADDITIVES USED / Lithium Heparin with Thixotropic Gel 8/10 inverts
MINT / LIGHT GREEN (PLASMA) Tests for - CHEMISTRY OR STAT CHEMISTRY PLASMA/ WHOLE BLOOD SAMPLE electrolytes, KFT / LFT / Cardiac enzymes / Metabolic Panels ADDITIVES Lithium Heparin with Thixotropic Gel 8/10 inverts
GRAY TUBE (PLASMA) tests for GLUCOSE / CHEMISTRY - FBS / glucose tolerance testing/ Glucose challenge testing / Random glucose / Alcohol levels ADDITIVE USED POTASSIUM OXALATE and SODIUM FLUORIDE 8-10 inversions
LIGHT BLUE (PLASMA) tests for Coagulation/clotting factors PT /. PTT PT. / INR Fibrinogen additive Sodium Citrate 3/4 inverts
LAVENDER (PLASMA) tests for HEMATOLOGY / CBC / RBC count / WBC count / with or w/o DifferentIal / PLATELETS / Hgb / HCT/ ESR Additive ETHYLENEDIAMINETETRAACETIC -acid 8/10 inverts
GOLD (SST) Tests for - Chemistry, serology, immunology Serum sample/clotted blood Titers hormones lipids CMP Electrolytes amino acids ect... Additive Thixopic gel Clot activator 5/6 inverts Let stand for 30/45 mins
Created by: Tbella