Chapter 8
STAT
Immediate before any sample
Prevent vein from collapsing
Using a syringe slooooowly
Reasons why capillary puncture over venipuncture
Severely burned patients,
Cancer patients
Patients with obesity
Older patients
Patients who need special procedures
Fasting
Nothing to eat for 8-12 hours
Vector
Infection transmission transmitted by insects like malaria
VAD
Vascular access device arterial lines give flu8id and meds
Patient with anticoagulant therapy
Hold pressure for 5 extra minutes and observe for 15 min
Define Medial/ Lateral/ Plantar
vessel on medial plantar surface for dermal puncture
Medial towards the middle
Lateral towards the side of the body
Plantar sole of the foot
Posterior tibial artery
autologous donation
Donor is donating blood possibly rein fuse into themselves no more than 72 hours before
Effective analgesic effect for infant
breast feeding
Place in ice and deliver within 20 minutes
What to do if patient
Cardiac arrest
Continues bleeding
Allergy
Hematoma
Anemia
1. Cardiac- CPR
2. Bleeding longer that 5 min apply pressure with coband
3. Hematoma Discontinue veni puncture and apply pressure
4. ask if allergic to latex iodine or tape allergy
5. idk you tell me
Pediatric retraining techniques (appropriate)
parent may hold child
supine position to approach child
pappoose board
Special collection types and definitions
Alcohol- use disinfectant other than alcohol
Chain of custody- must sign forma and lock box
Heavy metal (trace elements)- no syringe royal blue tube
Blood donor- min hg 12.5 g/dL
Stat sample and timing
Jaundice and lipemia appearance and definition
Jaundice excess bilirubin in blood icteric sample, serum and plasma is yellow or orange
Lipemia- large amount of fats or lipid in the blood serum and plasma appearance in white or milky
Patient experiences nerve pain
Syncope
Nausea
Diabetic shock
Convulsion
1. nerve pain avoid deep probing viniculture and stop immediately
2. stop remove tourniquet and needle keep on chair cushion or if on floor Lowe head and arm
3. Offer OJ or cola cola
4. Move objects and cushion patient
Hemolysis causes
1. Alcohol not dry
2. Finger or heel squeeze to vigorously
3. Newborn increased red cell fragility and high RBC 4. Blood was scraped off not allowed to flow
what is diurnal? what ate diurnal test and how many hours apart?
Daily variation in blood levels at a particular time of day
serum iron, corticosteroids other hormones
12 hours apart
Allen test
checks patient for collateral arterial circulation
Options if you fail to obtain blood sample
1. retire tourniquets
2. Use BP cuff
3. use different tube
4. Stretch vein
5. Lower arm
6. advance or rotate or pull back needle
Avoid errors on patients with IV
Avoid arm with iv , capillary puncture
Ask for IV to be turned off
Ask physician to draw from ankle or foot
Order of draw for micro collection
blood gasses - EDTA (lavender) - Heparin (green) - Other additive microcollecetion container- non additive (red)
TDM
Peak definition and time of collection
Trough definition and time of collection
Therapeutic range
Collection and testing of blood to evaluate and manage meds therapy effectively and safely
Peak=postdose 15-30 minutes after dosage
Trough = prepose 30 minutes before
Therapeutic concentration of medication that is effective and not toxic in patient management
Blood culture septicemia 1. definition 2.antiseptic used, 3. dry time, bottle drains order for 4. syringe and 5. butterfly
Septicemia condition in which microorganisms aciculate and multiply in patients blood
2. Alcohol then iodine
3. 30-60 seconds
4. anaerobic -> aerobic
5. aerobic -> anaerobic