Pediatric Draws and Capillary Blood Collection Ch. 6

How can a parent or caregiver assist with a pediatric draw?

holding the child on their lap and gently securing their arms and legs

What is the APE strategy in peds?

Approach calmly and gently without unguaranteed promises,
Position the patient
Equipment, use a high gauged butterfly needle, pediatric tubes based on child size and age

removing no more than _ of an infant’s total blood volume within a _ period

1-5%, 24 hour

conversion from kg to lb

1 kg = 2.205 lb

What do capillary vessels contain? (A mix of _)

venous blood (deoxygenated), arterial blood (oxygenated), and interstitial fluid

interstitial fluid is the fluid that surrounds _ and _

cells, tissues

Capillary action is the _ of _ through _ _ due to _ and _

movement of liquid through narrow spaces due to cohesion (molecule attraction) and adhesion (surface attraction)

A microcollection tube is a _ used to collect a _ of _

small plastic container, small amount of blood

A microhematocrit tube is a _ or _ that draws _ as it _ on the skin through _

thin glass or plastic tube, blood, beads, capillary action

POCT devices (_) use _ to _ for immediate _, _ or _ the patients location

point of care testing, test strips, test the blood, results, at or near

blood spot collection cards are used to collect _ from _ for _ and _ testing

samples, newborns, screening, laboratory

How much blood can a microcollection tube hold?

0.75 mL

How do you collect blood with a microcollection tube?

place directly against the blood drop

How many times do you invert a microcollection tube?

8-10

What is the order of draw for microcollection tubes? (EHAS)

EDTA, Heparin, any other additive, serum (SST)

When collecting blood with a microhematocrit tube, hold the tube _, place one end against the _. Draw until _ full, then _ one end with a _ or _

horizontally, blood drop, two-thirds, seal, cap, or clay sealant (critoseal)

After collection using a blood spot collection card, the blood should _, before the card is _

dry, sent to the lab

For capilary sticks on infants under _ of age, collect sample from the _ by using a lancet

one to two years, heel

In heel sticks, the area of the heel punctured should only be the _ (toward the _) and _ (away from the _) _ which is the _ of the _.

medial (toward the midline), lateral (away from the middle), plantar surface, underside of the foot

The _ (AAP), and the _ (CLSI) provide guidelines on infant heel punctures to _

American Academy of Pediatrics, Clinical Laboratory Standards Institute, prevent injury

For preterm infants max heel puncture depth is _, for full term infants max heel puncture depth is _.

0.85 mm, 2.0 mm

to prevent complications such as excessive _ or _, which is _-_ inflammation of the _, punctures should not exceed _. Punctures should never be performed on _

bruising, osteomyelitis, infection-induced, bone, 2.0 mm. previous draw sites

_ (NBS) is a series of _ performed on _ (newborns in the first _ days of life), typically within the first _ days after birth, to enable the early _ and _ of certain _

Newborn Screening, tests, neonates, 28, one to three, detection, management, health conditions

what type of disorder is an endocrine disorder?

hormone-related

On blood spot collection cards, the circles must be filled _, the card must not _ the infants skin _, the blood must not be _ or _

completely, touch, directly, smeared, streaked

newborn screening check for conditions such as; elevated _ levels, _ (PKU), congenital _, cystic _, _ cell disease, _ (G6PD) deficiency, and _

elevated bilirubin levels, phenylketonuria, congenital hypothyroidism, cystic fibrosis, sickle cell disease, glucose-6-phosphate dehydrogenase deficiency, galactosemia

_ (PKU) is a genetic disorder that causes _, a building block of protein, to accumulate to _ levels in the body. A PKU test must be collected within _ after birth

Phenylketonuria, phenylalanine, dangerous, 72 hours

Which fingers are optimal for dermal puncture?

middle and ring

Why cant the thumb, index, and pinky be punctured?

the thumb has a pulse, the index is callused, and the pinky is close to the bone

Avoid _ or forcefully _ the finger to encourage blood flow, as this may _ the sample

milking, squeezing, hemolyze

Puncture depth for children is _, and for adults _

1.5-2.4 mm, 2.0-2.4 mm

What are the four stages of the clotting process?

Vasoconstriction, platelet plug, coagulation, clot retraction and fibrinolysis

What are the three phases of the clotting process?

Vascular, platelet, fibrinolysis

Vasoconstriction during hemostasis is the vessel’s _ reaction to _. The vessel _, causing a _

initial, injury, narrows, decrease in blood flow

In Platelet Plug Formation during hemostasis, platelets stick to the damaged _, then gather to form a temporary plug in a process called _

endothelium, aggregation

In coagulation during hemostasis, the platelet plug is reinforced by a stable _ _

fibrin clot

In clot retraction and fibrinolysis in hemostasis, the clot _ to bring the wound edges _. Fibrinolysis then occurs, _ and removing the _ once healing is _

shrinks, closer together, breaking down, blood clot, complete

If a child is 5.2 kg, what is the blood volume and max blood draw?

move decimal 2 places, blood volume 520 mL, 5.2×2 = 10.4 mL max blood draw