Chapter 7: Variables & Complications

What is the common complication?

pain and hematomas

What’s the duration of the “pre-analytical” phase?

Begins when a test is ordered to when testing begins.

What is a “basal state”

The condition of a patient at rest after fasting and hasn’t exercised for at least 8-12 hours.

What is a “postprandial state”

The condition of a patient at rest not fasting and/or has exercised for at least 8-12 hours.

What effect does “age” have on collection and testing?

RBC and WBC count varies with age

What effect does “altitude” have on testing?

RBC counts may increase due to lower O₂ levels

What effect does “dehydration” have on testing?

Less plasma in blood and blood cells are concentrated

What effect does “diet” have on testing?

Blood glucose levels and lipemia vary with fasting or recent food intake.

What effect do “diurnal/circadian variations” have on testing?

Physiological changes throughout the day can affect hormone levels, enzymes, and other biomarkers in the blood.

What effect do “drugs” have on testing?

Chemotherapy decreases WBCs

Steroids and Diuretics may increase pancreatic enzymes

Toxic drugs may increase live enzymes

What effect does “exercise” have on collection and testing?

decreases pH and O₂

Increases blood pressure, metabolism, body temperature, glucose, creatinine, insulin, skeletal muscle enzyme, cholesterol, and lactic acid levels

What effect does “fever” have on collection and testing?

Alters hormones, increases cortisol, and disrupts normal diurnal variation

What effect does “gender” have on testing?

RBC, Hgb, and Hematocrit is higher in those AMAB than for AFAB

What effect does “jaundice” have on collection and testing?

Bilirubin is present in plasma, serum, or urine

What effect does “position” have on collection and testing?

Increases potassium within 30 minutes of standungstanding

Decreases plasma volume in adults, and blood pressure

What effect does “pregnancy” have on collection and testing?

Increases body fluids and RBCs

Decreases Hgb

What effect does “smoking” have on testing?

Increases cholesterol, cortisol, triglyceride levels, RBCs, and Hgb

Decreases pulmonary functions

What effect does “stress” have on testing?

Increases adrenal hormones and WBCs

What effect does “temperature and humidity” have on testing?

Sweating tends to cause hemoconcentration

What effect do burns, scars, or tattoos have on collection?

can alter the integrity of the skin and surrounding tissue, potentially leading to contamination or impaired sample quality or cause infection.

What effect do “damaged, occluded, or obstructed” veins have on collection?

can impede blood flow and make venipuncture challenging, resulting in difficulty obtaining a sample or potential injury to the patient.

What effect does edema have on collection?

can cause difficulty in locating veins for collection, potentially leading to inaccurate results or complications during the process.

What effect do hematomas have on collection?

can make it difficult to locate a suitable vein, cause pain or discomfort for the patient, and may lead to inaccurate results due to the alteration of blood flow.

What effect do mastectomies have on collection?

can complicate venous access and may result in swelling or altered lymphatic drainage, choose arm without mastectomy.

If double mastectomy, choose oldest side.

What effect does obesityhave on collection?

can complicate collection processes by making access to veins more difficult, first choice is the cephalic vein.

What effect do vascular access devices have on collection?

Phlebotomists never prefom collections on the arm with an arterial line, a stunt, or an IV

What do you do when a patient is: allergic to latex?

non-latex and non-powdered gloves

What do you do when a patient is: allergic to rubbing alcohol?

povidone iodine, chlorohexidine

What do you do when a patient is: allergic to adhesives?

paper tape, gauze

What do you do when a patient has: excessive bleeding?

1. apply pressure on site

2. call supervisor after 5 minutes if bleeding fails to stop

What do you do when a patient has: fainted?

1. stop procedure

2. support Px

3. Call for help if Px doesn’t respond

What do you do when a patient has: nausea or vomited?

1. stop procedure

2. ask to breath slowly

3. offer water

What do you do when a patient has: pain?

1. Ice pack to reduce inflammation

What do you do when a patient has: petechiae?

What do you do when a patient has: a seizure?

1. Stop procedure

2. Don’t restrict patient’s movements

3. Turn Px on their side

4. Call first aid personnel