Phlebotomy: Venipuncture and Capillary Puncture

120 terms by NanaCynthiaBurton

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Chapter 40 of Thomson Delmar Learning's Comprehensive Medical Assisting; 3rd edition

aliquot

part of the whole specimen that has been taken off for use or storage

anticoagulant

chemical in a blood tube that prevent the clotting of the blood by removing the calcium from the blood or by stopping the formation of thrombin

Buffy coat

layer of white blood cells and platelets that forms at the interface between the plasma and red blood cells in a tube of blood containing an anticoagulant

cannula

the blunting member in a bio-plexus puncture-guard needle

centrifuge

device that spins tubes using centrifugal force to separate the fluid portion of blood from the formed elements

constrict

to become smaller in diameter

dilate

to enlarge in diameter

edematous

abnormal accumulation of fluid in the tissues resulting in swelling

hematoma

accumulation of blood around the venipuncture site during or after venipuncture caused by the leakage of blood from where the needle punctured the vein

lipemia

excessive amount of fat (lipids) in the blood, resulting in a blood sample that has a milky appearance

palpate

to search for a vein using the fingertips with a pressure and release touch

phlebotomy

process of collecting blood

primary container

container that directly contains the specimen

serum

liquid portion of blood obtained after blood has been allowed to clot

thixotrophic separator gel

gel material capable of forming an interface between the cells and fluid portion of the blood as a result of centrifugation

tourniquet

device used to facilitate vein prominence

viscosity

degree of thickness of a liquid

hemolysis

rupturing of the red blood cells during the process of blood collection. The serum on plasma becomes contaminates and has a reddish color

hypoglycemia

increased levels of blood glucose. Does not mean diabetic but mabe an indication of prediabetics

how long can tourniquet stay on arm

60 seconds

which tubes contain anticoagulants

light blue, lavendar and green

most common type of venipuncture

vaccum tube

where are red blood cells produced

bone marrow

what does SST stand for

strain specific typing

what is the controversy over with plastic adapters/holders

if they are reuseable after disinfecting

MA responsibility with phlebotomy

collect blood as efficiently as possible, show concern for patients and provide high quality care

what should MA show toward patients

concern

how should MA collect blood

as efficiently as possible

how do you know what anticoagulants or additives are in the tube

by the color of the stopper

why are additives used in tubes

to accelerate specimen processing

what must be done to ensure quality control

each specimen has own label, label complete, no needle attached, appropriate tube, full tube, free of hemolysis

each specimen must have

own label

label must have completed

Patient name, birthdate, the date and time of venipuncture, ID number and MA initials

on preprinted labeled tubes the MA must still add

date and time of collection and their initials

what percentage must have blood to be a full container

75%

what percentage in a coagulation study tube must have blood to be a full container

90%

phlebotomy tray that is transported must have what

label indicating biohazard

order of site selection

ac, forearm, back of hand, wrist, and then with Dr. permission foot

AC means

antecubital

where is the antecubital space

opposite of elbow, in bend of arm

other then foot, what site selection did we not practice on and what number is it in the order of selection

wrist, 4

forearm falls where in the order of site collection

second

back of hand falls where in the order of site collection

third

what do we call the system that combines with either the syringe or the evacuated tube?

butterfly collection system

what is the usual capillary puncture site for adults

finger, normally ring or index

what is the most important step to a successful venipuncture

put the patient at ease

why do we use safety needles

to prevent accidental needle stick

what is first step in the proper method to palpate a vein

identify patient and introduce yourself

what do you do right before applying tourniquet when following the proper method to palpate

wash hands

when using method to palpate after you apply tourniquet what may you have patient do

make a fist

when palpating what are you feeling with

tip of index finger

when palpating what are you feeling for

soft, bouncy and roundness of vein

last two steps of the proper method to palpate a vein

mentally map and remove tourniquet

what are you mentally mapping

location of intended puncture

what is the 3rd step in the proper method to palpate a vein

apply tourniquet

what starts with introducing yourself and identifying patient and ends with removing the tourniquet

what is proper method to palpate a vein

list some factors that can affect laboratory values

alcohol not dry, diurnal rhythm, exercise, fasting or non-fasting, hemolysis, hemoconcentratio, insufficient volume of specimen

hemoconcentratio

tourniquet on too long

diurnal rhythm

timed intervals because of medication or daily rhythm

hemolysis know as

destruction of blood cells

what is the usual cause of hemolysis

alcohol not completely dry at site of puncture

how many liters of blood are in the body

six

what is the functions of blood

to carry oxygen to the body tissues, remove waste product and to carry nutrients to all parts of body

name one waste product that the blood carries

carbon dioxide

method for capillary blood draws

select site, gather equipment, cleanse site, perform capillary puncture, wipe away the first drop of blood, collect the following drops of blood for specimen

after capillary puncture, before wiping away the first drop of blood, what must be done

discard lancet in sharps container

why wipe away first drop of blood

it contains tissue fluid which dilutes blood

what do you use to wipe away the first drop of blood

dry, sterile gauze

when selecting site which part of finger is used

along side not across finger

what is the final step in serum formation

the clot contracts and the serum is extracted

serum formation is known as

clotting

what is the usual site of capillary puncture in infants

heel stick

what should the medical assistant do if you have attempted venipuncture twice and are unsuccessful

notify the physician of your attempts

what is the correct order of draw for evacuated tubes

yellow, light blue, red/tiger, green, lavender and gray

what separates the red blood cells from the plasma in anticoagulant tubes

buffy coat

which type of blood cells are responsible for transporting oxygen and carbon dioxide

red blood cells

what are some advantages of using latex tourniquet vs. velcro strips

latex can be cleaned easily and are less expensive to replace

when would the syringe be the most often used technique in venipuncture

when a small volume of blood is needed and only thin fragile surface veins are accessible

what information must be on the specimen tube label

patient name, patient birthdate, patient ID number, date and time drawn, and MA signature (initials)

what is the appropriate degree to inflate the BP cuff to when using a tourniquet?

slightly below diastolic pressure

when using a BP cuff as a tourniquet what extra step is required

blood pressure must be taken first to find the patient's diastalic pressure

what color tube is used for a CBC?

lavendar

a lavender tube is has

EDTA

proper technique for applying a tourniquet has it placed where

3 to 4 inches above intended puncture site

for patient comfort the tourniquet can be placed

over clothing or gauze

what is removed before removing needle from a puncture site

tourniquet

syringe order of draw

yellow, blue, green, lavendar, gray and red

yellow tubes are used for

blood culture

blue tubes used for

coagulation studies

green tubes are

heparin

gray tubes are

exalate/fluoride

red tubes are

nonadditive "clot" tubes

blood culture tubes topper are

yellow

citrate tubes topper are

light blue

non-additive tubes are

red

heparin tube toppers are

green

hematology tube toppers are

Lavendar

gel separator tub with heparin tubes toppers are

green/gray

glucose tube toppers

gray

invert tube

8 to 10 times

PST

plasma separator tubes

BMP

basic metabolic panel

ETOH

ethyl alcohol

FSH

follicle-stimulating hormone

PSA

prostate-specific antigen

RPR

rapid plasma reagin

ACD

acid dextrose citrate

SPS

polyanethoiesulfonate

sodium citrate is for what topper and in what order of draw

light blue, second

found 3rd in order of draw for vacuum tube or last in syringe, the topper color is

red

titers, RPR, blood bank-type and cross match are collected in what color and additive

red, none or glass particles

serum determinations, panels (lipids, thyroid etc) are collected in what combination color tube and what is additive abbreviation

Tiger (red/gray) and with SST

FSH and PSA testing are collected in what color tube (common and color name)

Tiger (red/gray)

prothrombin time (PT)-coumadin therapy, partial thromboplastin time (PTT)-heparin therapy are collected in what color tube and with what additive

light blue with sodium citrate

electrolytes and platelet counts are collected in what color tube

green

CBC, WBC and differentials are collected in what tubes with what additive abbreviation added

Lavendar, EDTA

EDTA

ethylenediaminetetraacetic

lavendar with EDTA are used for

hematocrits, glycohemoglobins, hemoglobins and sedimentation rates

tube used for DNA and paternity testing and with what additive abbrev

yellow, SPS

tube used for viral loads (cell morphology) and with what additive abbrev

yellow, ACD

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