PMLS 2 Lecture P2

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Venipuncture

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106 Terms

1

Venipuncture

most frequently performed phlebotomy procedure

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2

Dermal Puncture

Method of choice for collecting blood from infants and children younger than 2 years

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3

Clinical and Laboratory Standards Institute (CLSI)

the organization that stated incision depth must not exceed 2.0mm

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4

Occupational Safety and Health Administration (OSHA)

recommends the lock and retract safety device to prevent reuse and needlestick injury

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5

0.35 - 1.6mm

Needle depth for newborn

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6

2.5mm

Ideal width for needle

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7

3.0mm

incision depth for adults

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8

capillary tubes

referred to as microhematocrit tubes

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9

50 - 75 ul of blood

volume of blood in microhematocrit tubes

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10

Red

color of band for heparizined tube

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11

Blue

color of band for plain tube

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12

requisition form

cannot proceed to extraction if the patient does not have this

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13

lying down on back with heel downward

position for patient (newborn)

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14

lying down or seated with fingers downward

position for adults

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15

third and fourth finger of non-dominant hand

ideal site for collection in adults

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16

lateral and medial of the plantar heel

ideal site for collection in infants

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17

42 degrees

ideal temperature for warming the site

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18

3-5 mins

ideal minutes for warming the site

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19

bilirubin

light-sensitive chemical and destroyed when exposed to light

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20

UV light

treatment for infants with jaundice

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21

hemolyzed sample

can falsely lower bilirubin results

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22

24 - 72 hours

blood is collected between ____ and ____ hours after birth

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23

newborn screening test

performed when blood is collected between 24 and 72 hours after birth

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24

phenylketonuria

caused by the lack of enzyme needed to metabolize the amino acid phenylalanine

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25

congenital hypothyroidism

thyroid hormone deficiency present at birth

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26

galactosemia

genetic metabolic disorder caused by the lack of liver enzyme needed to convert galactose into glucose

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27

Plasmodium species

parasite that causes malaria

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28

malaria

exhibits periodic episodes of fever and chills

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29

2 hours

smears are allowed to dry for at least ____

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30

bleeding time

performed to measure the time required for platelets to form a plug strong enough to stop bleeding

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31

volar surface of forearm

place where bleeding time is performed

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32

40 mmHg

mm Hg of blood cuff when doing BT

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33

Joint commission

recommends that phlebotomist must be proficient with all age groups

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34

Geriatric population

goal is to perform atraumatic venipuncture without bruising or excessive bleeding

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35

FALSE

TRUE OR FALSE: Patients in comma no longer need to be talked about the procedure

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36

winged blood collection set with 23 gauge needle

Ideal equipment to use when handling geriatric patients

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37

forearm or hand

site to perform venipuncture in oldies

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38

dealing with children

introduce him to the parents and explain the procedure

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39

Toddlers

talk to the child calmly and maintain eye contact

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40

older children

interactive conversation (ie touching the tourniquet)

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41

teenagers

use adult language

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42

Vertical restraint

method of restraint that involves an upright position on the lap

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43

Horizontal restraint

method of restraint that involves lying down and parent leaning over holding the near arm

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44

3%

maximum of child’s blood volume collected at one time

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45

10%

maximum of child’s blood volume collected at one month

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46

Phototherapy

solution for hyperbilirubinemia

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47

Quantity insufficient for testing

Filter paper is removed before blood has completely filled circle

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48

Appears scratched

blood applied with capillary pipette

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49

Not dry before mailing

Sample mailed before drying a minimum of 3 hours

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50

Appears supersaturated

excess blood applied to filter paper using an alternate device. Blood applied to both sides of filter paper

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51

Appears diluted, discolored, contaminated

Filter paper contaminated with powder, alcohol, formula, water, lotion. Blood spots exposed to direct heat

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52

Exhibits serum rings

alcohol not dry before puncture. Milking the puncture site

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53

appears clotted or layered

several drops used. blood applied to both sides

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54

TRUE

True or False: performing deep arterial puncture in newborns and young children is usually not recommended

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55

Blood smear

needed for microscopic examination of blood cells that is performed for differential blood cell count

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56

Blood smear

made within 1 hour of collection to avoid cell distortion caused by EDTA anticoagulant

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57

syncope

other term for fainting

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58

fainting

Spontaneous loss of consciousness

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59

Apprehensive patients

requires nursing assistance to help calm the patient

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60

Cold compress

applied to the forehead and back of the neck will help to revive the patient

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61

15 - 30 minutes

amount of time needed for a prolonged fasting patient to remain in the area

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62

seizure

restraining the patient to prevent further injury

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63

petechiae

small, non-raised red hemorrhagic spots

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64

petechiae

indication of coagulation disorder

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65

allergies

occasionally allergic to alcohol, iodine, latex, or glue in adhesive bandages

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66

Vomiting

forceful ejection of the contents of the stomach and upper digestive system through the mouth

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67

hemoconcentration

application of tourniquet for more than 1 minute causes ____

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68

damaged veins

veins that contain thrombi

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69

hematoma

indicates that blood has been accumulated in the tissue surrounding a vein during venipuncture

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70

edema

areas containing excess tissue fluid

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71

Burns, scars, and tattoo

have decreased circulation and yields inaccurate results

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72

fistula

patients receiving renal dialysis have a permanent surgical fusion of an artery and vein called what

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73

cannula

temporary external connection between the artery and a vein that contains a special T-tube connector with a diaphragm for drawing blood

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74

needle too deep

technical complication that involves the angle being too steep (greater than 30 degrees)

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75

Needle too shallow

technical complication that involves the angle being too steep (less than 15 degrees)

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76

faulty evacuated tube

technical complication if there is no quality check

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77

Nerve injury

may lead to loss of movement and improper venipuncture technique

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78

Iatrogenic anemia

healthcare induced anemia; condition of blood loss caused by treatment

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79

hemolysis

presence of pink or red plasma/serum

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80

Point-of-care testing

referred to as bedside testing

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81

CLIA 88

encompasses all laboratory testing and requires every testing site to be regulated

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82

Food and Drug Administration (FDA)

has the responsibility for categorizing tests and classifying testing device and systems

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83

Waived complexity

simple procedures that are cleared by the FDA

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84

Certificate of Waiver

this is obtained from CMS to perform waived testing

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85

waived complexity test

pregnancy test, glucose monitoring

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86

Moderate complexity

more difficult to perform and require documentation of training in testing principle, instrument calibration, and QC.

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87

Moderate complexity

chemistry and hematology are assigned in this category of complexity

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88

High complexity

require sophisticated instrumentation and a high degree of interpretation by the testing personnel

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89

High complexity

must have formal education with a degree in laboratory science

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90

High complexity

microbiology, immunology, immunohematology, and cytology belong in this category

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91

provider-performed microscopy procedure

includes clinical microscopy procedures only

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92

provider-performed microscopy procedure

contains certain procedure that can be performed in conjunction with any waived test and includes clinical microscopy procedures

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93

2 years

laboratories performing moderate or high complexity test must be inspected every how many years

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94

FALSE

TRUE OF FALSE: waived laboratories are subjected to routine inspection

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95

30 - 40 degrees

angle when making blood smear

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96

bleeding time

test performed to evaluate platelet performance

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97

blood smear, CBC, bilirubin

order of draw between cbc, bilirubin, blood smear

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98

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99
  1. Cholesterol level; 2. 2-5%; 3. 10-15%

_____ increases ______ to ______ percent when tourniquet is left for 2 minutes and ____ after 5 minutes

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100

edema

this causes the sample to be contaminated with tissue fluid and yield inaccurate results

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