ch 8
What penetration depth does CLSI recommend when performing heels sticks for infants in order to avoid penetrating bone?
2.0mm or less
What are the most common sizes for butterfly needles?
21- 22- or 23- gauge; ranging from 1/2 to 3/4 long
How many hours after last ingestion of food is best for blood draw?
approx 8-12hrs
What is the #1 patient safety goal for Joint Commission?
at least 2 unique patient identifiers (Ex: Name & DOB)
What colored tube contains sodium citrate and is required to be full?
light blue
What types of antiseptics are needed for blood collection?
70% isopropyl alcohol prep pad
iodine swab sticks
chlorohexadine or chloroprep (for blood cultures)
What is the basal state and why is it important in phlebotomy?
early morning, approx 12hrs after last ingestion of food. lab results based on basal state is most reliable
what is the term for abstinence from nutritional support such as food and beverages (except water)?
fasting
what colored tube contains EDTA or K2 EDTA?
purple topped
What are good reasons to use butterfly needles?
Geriatric patients may prefer them because of their small veins or difficult to locate veins
for pediatric patients, blood cultures, or hand draw
Where should you draw blood from if a patient has a mastectomy on one side?
on the other side
If a patient begins to faint or you hit a nerve during blood collection, what should you do?
stop the procedure and attend to the patient
What colored tube contains no anticoagulants?
red topped
What are good reasons NOT to use butterfly needles?
increased risk for needlestick injury
someone has good/large size veins
Why may a serum temporarily appear lipemic or cloud/milky?
If a patient has eaten fatty substances recently, he/she may have temporarily elevated lipid levels
What is hemolysis?
when RBCs are lysed, hemoglobin is released, and serum (usually straw colored) turns pink or red
What colored topped tube contains anticoagulants sodium heparin, ammonium heparin, and lithium heparin?
green
If a patient has a double mastectomy, where should you draw the blood?
foot
Name 3 common causes of hemolysis.
-collection of blood equipment is loose
-syringe plunger is pulled out too fast
-prolonged tourniquet application
-too small or too large needle is used
-needle readjusted
-tube shaken or mixed vigorously rather than gently inverted
-blood collection performed before alcohol dried at collection site
-lack of proper handling and transport after collection
Name 3 ways a hematoma can occur during blood collection.
-Needle goes completely through a vein
-Bevel opening is partially in the vein
-Pt's vein is fragile; the needle is pulled out when tourniquet is still in place
-worker fails to hold firm pressure over venipuncture site
-a "blind stick" is performed
-Worker probes for vein