58 terms

Chemistry and Lab Tests

Routine Venipuncture
Butterfly Venipuncture
Butterfly with syringe
Straight syringe
Use iodine when testing for alcohol
ETOH tube?
FBS - Glucose
fasting blood sugar
Site Selection - Site problems
burns, tattos, scars they are hard to palpate and penetrate, impaired circulation, painful
Site problems - damaged veins
schlerosed or thrombosed - difficult to penetrate, impaired circulation, may yield bad lab results
accumulation of fluids in tissues, may cause bad lab results due to excess fluid
swelling and blood that has leaked into surrounding tissue
Masectomy site problems
do not draw blood on same side as mastecomy due to lymphostasis.
stoppage of lymph flow - caused by lymph node removal
Masectomy site problems may cause...
infection, tourniquet may cause injury,
Obseity site problems
veins too deep and difficult to palpate, tourn. may not fit, use blood pressure cuff.
What to do when drawing an obese patient
two creases in the anticubital area, may find median cubital vein there. may turn arm so hand is prone to find cephalic vein, cephalic vein is usually the vein of choice
IV therapy pts problems. NEVER DRAW ABOVE IV SITE BECAUSE:
blood sample may be contaminated with IV fluids (drugs) If not other site is available draw below IV site.
Follow facility protocol for drawing below an IV - 7 steps
Turn off IV for 2 min, tourn below IV (distal), choose site distal to IV, look for vein other than one with IV, Discard first 5 cc of blood (10 for coag tests), notify RN when done, document
VAD (vascular access devices)
tubing inserted under skin then inserted into an artery or vein
VAD is used for (2)
administering fluids/medications and drawing blood
VAD patient procedures
Only done by trained personnel, discard first 5cc of blood, do not draw from this for coag tests because lines are flushed with heparin
Types of VADs
CVC, implanted port, PICC, Arterial line, Heparin, AV shunt, Fistula
Do not collect blood for 24 hours after IV is discontinued.
central vascular access device
CVAD is used for what?
line in main artery or vein, flushed with heparin to prevent thrombosis, must discard first 5cc of blood to remove contamination, do not use for coag testing
Types of CVADs
CVC (central venous catheter), implanted port, PICC
CVC abbrev
Central venous catheter
PICC abbrev
peripherally inserted central catheter
Lavender Tubes - EDTH
blood does not clot, tests are done on whole blood.
Lavender Tubes - dept.
Lavender tube tests (anything that has to do with counting blood cells & their characteristics)
CBC, WBC, RBC, Hemoglobin, Hematocit, Platelets, sed rate, Retic count, differential (slide made to look at cells)
Blue Tubes - sodium citrate
blood does not clot, tests are performed on the plasma
Blue tube dept.
coagulation dept.
Coagulation Dept. studies what?
blood clotting mechanism and blood clotting factors in plasma
Blue tube blood tests (anything that has to do with coagulation studies)
PT, PTT, d-dimer, DIC panel, Fibrinogen, Factor Assays
Green tube - heparin
blood does not clot, tests are performed on the plasma
Green tube dept
Chemistry studies what?
plasma analytes
Green tube tests
STAT (cause blood does not clot so it can be processed quicker), electrolytes (sodium, potassium, chrloride, CO2), basic metobolic panel (BUN, creat, electrolytes, Ca) Ammonia (must be on ice)
Examples of electrolytes
sodium N+, potassium K, Chloride, C02
BMP abbrev
basic metabolic panel
examples of BMPs
BUN, creat, electrolytes, Ca)
BUN abbrev
blood urea nitrogen
SST tubes (no anticoag, so the blood clots) additives
clot activator (some have the gel)
SST tubes dept.
chemistry (study of serum analytes)
SST the tests are done on the serum NOT the plasma
but this can vary with labs
SST tests
MI Panel (heart attack) this is a stat test that will be done in a green tube, Lipid Panel , Liver panel, Nutrition, basal metabolic panel, comprehensive metablic panel, renal panel, electrolytes, diabetes, thyroid.
CMP abbrev
comprehensive metabolic panel
Chemistry tubes include:
SST (serum), Green (plasma), PST (plasma), Gray (plasma)
SST tube has a
clot activator and gel in it
Green has
sodium or lithium heparin
haparin and gel
Gray has
sodium flouride & potassium oxalate
PST or green tubes are used for STAT testing because
it is ready for testing sooner. SST tubes you must waitfor it to clot before spinning in a centrifuge
Gray tube tests
glucose, ETOH (alcohol), HgB, A1C,FBS (fasting blood sugar)
Other common chemistry tests
amylase, lipase, ammonia (NH3), iron, enzymes, uric acid, drugs of abuse (ETOH), therapeutic drugs, hormones, tumor markers
Drugs of abuse abbrev
NH3 abbrev