chapter 4 continute

  1. capillary blood has higher amounts of
    hemoglobin and gloucose
  2. venous blood has higher
    amounts of potassium, calcium, and total protein
  3. the veins most commonly used when performing venipuncture are found in the
    antecubital space in front of the elbow

    theses are the median cubital vein, cephalic vein and basilic vein

    the median cubital is large and most commonly used
  4. capillary puncture is also called
    skin puncture or "stick"

    which is a method of collecting blood by puncturing the skin through the epidermis into the dermal layer
  5. capillaries is a bridge betweein
    arteries and vein a skin punctures draws blood from arterioles, venules and capillaries
  6. arterial pressure is greater in
  7. capillary puncture method is usedful in the following situations
    when only a small amount of blood is needed

    when the patient has burns , skin irritation , or small or fragile veins

    cancer , geriatric , or obese patients

    childern because of the risks of venipuncture

    when minimal vlood volume reduction is desirable
  8. capillary puncture method should NOT be used
    if the test require a large amount of blood

    if the patient has poor peripheral circulation

    if interstitial fluid could dilute the test

    blood culture and erythrocyte sedimentation
  9. thromboplastin
    clot-activating substance
  10. the fastes and most current capillary puncture devices are
    retractable nonreuseable lancets
  11. the depth of a lancet for a child
    2 mm
  12. the depth of a lancet for an adult
    2 to 3 mm
  13. POCT
    point of care testing

    test that has expanced byond the laboratory to include the hospital bedside, the home , the nursing home and any other direct-contact patient setting
  14. blood is pulled into the tube by a process called
    capillary action
  15. red-marked capillary tubes contain
    heparin which keeps the blood from clotting
  16. order of draw when using capillary draw
    1. lavender tubes containing EDTA used for hematology tests ared filled first to keep any microclots from forming ( cbc and blood smears)

    2. green-topped , 2 blue topped , 1 gray ( whole blood tubes) 

    3. red and gold  topped  nonadditive tube: ared filled last because the capillary blood will clot in these tubes anyway
  17. a bone puncture can lead to
  18. cyanotic sites
    where the skin and mucous membrane are blue because of oxygen deficiency

    should be warmed before use
  19. the appropriate skin puncture site is
    the middle finger or ring finger
  20. skin puncture site for newborn and infants
    lateral plantar surface of the heel of the foot
  21. blood flow is increase by ___ times by warming the site

    this can be accomplished by massaging the area five or six times or by applying a warmed towel  for 3 to 5 minutes
  22. when performing a capillry puncture always wipe away the _____ of blood because it contains tissue fluid that could dilute the sample
    first drop of blood
  23. pku
    phenylketonuria is mandated for all newborns .

    they lack the enzyme needed for certain metabolic reactions

    screening of newborns should be done 24 and 72 hours after birth
  24. venipuncture
    blood from the vein
  25. venipucture can be accomplished in three ways
    • evacuated tube
    • syringe method
    • butterfly method
  26. the collection container for venipuncture are called
    vacuum tubes the tubes are evacuated meaning the air has been removed to create a vacuum.
  27. the recommended time to allow the blood to clot is
    30 to 45 minutes

    no longer than a hour in a upright postion at room temperature
  28. sst and pst
    • serum separator tube
    • plasma separator tube
  29. tubes must be centrifuged within ___ hours of the blood draw to prevent the living blood cells from metabolizing the chemical in the serum or plasma
    2 hours
  30. pale yellow plastic stopper
    sterile tubed containing preservative and or nutrients used for growing blood cultures
  31. light blue stopper contains
    contains liquid sodium citrate used for coagulation testing
  32. red stopper contains
    no anticoagulants which means blood will automatically clot
  33. gold stopper contains
    contain a silicone coating
  34. green stopper contains
    heparin anticoagulant
  35. lavendar stopper contains
  36. gray stopper contains
    potassiumoxalate / sodiumfluoride
  37. the higher the gauge the smaller the diameter. the most frequently used gauge is
    20 to 22
  38. leaving the tourniquet on for more than a minute causes
  39. syringe method is used
    on fragile veins
  40. syringe needle is also called a
    hypodermic needle
  41. the butterfly method is used on
    very small veins those that are in the hand or for pediatric draws
  42. venipuncture drawing tubes
    • yellow
    • light blue sky
    • red and gold and tiger wich contains a gel rays of sun 
    • green grass
    • lavender bottom of hill
    • gray last rock
  43. hematoma occurs when
    • the needle goes through the vein
    • the needle is only partially in the vein
    • insufficient pressure is applied
  44. if blood is not obtained one of the following problems may have occurred
    • the bevel is against the wall fo the vein
    • the needle pierced all the way through the vein angle is greater than 15 degrees
    • the needle is partially inserted into the vein
  45. a patient should never be stuck more than ___ times by the same phlebotomist
    2 times
  46. hemolysis
    breaking open of red blood cells and the release of hemoglobin

    • using a needle that is too small
    • collapsing the vein
  47. hemolyzed blood release chemicals into the plasma and serum that adversely affect the test results for the following analytes
    • potassium
    • magnesium
    • iron
    • lactate dehydrogenase
    • phosphorus
    • ammonia
    • total protein
  48. one neurological problem that could occur during a phlebotomy procedure is a
  49. obesity and mastectomy
    obses patient veins may be difficult to see and palpate

    donot perform a venipuncture on the arm adjacent to a mastectomy
  50. areas to avoid drawing blood
    • IV in arm
    • edema
    • sclerosed with palque
    • scarred or occluded
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