Ch. 13 arterial blood collection

S14. List five ABG sampling errors

ABG sampling errors include: - using too much or too little heparin; - insufficient mixing; - allowing air bubbles to enter the syringe; - using an improper plastic syringe; - using an improper anticoagulant; - punctuating a vein instead of an artery; - exposing the specimen to the atmosphere after collection

Warfarin

Anticoagulant

heparin

Anticoagulant

S1. Arterial collection is most often used for what type of testing?

Arterial blood gases (ABGs)

respiratory steady state

State required for arterial blood gas collection, in which blood gas concentrations are steady

The arteries in the arm consist of?

The Brachial Artery (at the elbow), Radial Artery (outside of wrist) and the Ulnar Artery (inside of wrist).

partial pressure of oxygen (PO2)

The absolute amount of oxygen

radial artery

The major artery in the forearm; it is palpable at the wrist on the thumb side.

femoral artery

The principal artery of the thigh, a continuation of the external iliac artery. It supplies blood to the lower abdominal wall, external genitalia, and legs. It can be palpated in the groin area.

S3. What is a normal blood pH?

7.35-7.45

normal blood pH

7.35-7.45

S15. name five reasons that ABG specimens may be rejected

- Air bubbles in the specimen - Clotting - Failure to ice the specimen - Improper or absent labeling - Inadequate volume of specimen for the test

Arterial Puncture Complications

- arteriospasm - embolism - hematoma - hemorrhage - infection - lightheadedness - nerve damage - severe pain - thrombosis

site selection

- artery must be located near skin surface - artery must be large enough - site must have collateral circulation - site should be clear - site should not be proximal to a wound

equipment for arterial puncture

- heparized syringe and needle - antiseptic - lidocaine anesthetic - safety equipment - luer tip - ice, water - gauze - thermometer

S6. besides alcohol, which other antiseptic must be used for arterial puncture?

povidone-iodine or Chlorhexidine

The arteries used for arterial puncture, listed in order of preference, are:

1. radial 2. brachial 3. femoral

steps to prepare a heparinized needle

1. use a solution of sodium heparin with concentration 1000u/ml 2. calculate the volume of heparin to draw up. use 0.05 mL of heparin solution for each mL of blood to be drawn. 3. attach a 20-gauge needle to the syringe, and draw up the heparin by pulling back on plunger 4. rotate the liquid in the syringe to coat the barrel 5. remove the 20-gauge needle and replace with the needle you will use for collection 6. expel excess heparin and air

CE9. If lidocaine is injected before an arterial blood collection, wait _______ minutes for the anesthetic to begin working

1/2

S9. what gauge needle is most often used for blood gas collection?

21 to 22 gauge

S11. for an arterial collection, at what angle is the needle inserted into the artery?

45-60

S12. how long must pressure be applied to the puncture site after an arterial collection

5 minutes, 15 minutes for individuals on blood thinners

S4. What is the difference between acidosis and alkalosis?

Acidosis is indicated by a lower pH, whereas alkalosis is indicated for a higher pH.

S13. Define arteriospasm.

An arteriospasm is the spontaneous constriction of an artery in response to pain.

embolism

Blockage of a vessel by a clot or foreign material brought to the site by the blood current.

S2. List four conditions that produce abnormal ABG values

Chronic Obstructive Pulmonary Disorder (COPD), Lung Cancer, Diabetic Coma, Shock, abnormal gas exchange

S10. define collateral circulation and state which test is used to determine whether this is present

Collateral circulation is the accessory supply of blood to a region by more than one artery. Collateral circulation is tested using the modified Allen test.

pH is altered by

EDTA, oxalates, citrates

hemorrhage

Excessive or profuse bleeding

unlike venipuncture, arterial collection uses

a local anesthetic

S5. describe the difference between a syringe used for venipuncture and a syringe used for ABG collection

a syringe used for venipunture is not heparinized, whereas a syringe used for arterial puncture is pretreated with heparin (glass or gas impermeable plastic) to prevent coagulation.

arterial blood gases (ABGs)

a test performed on arterial blood to determine levels of oxygen, carbon dioxide, and measures the pH

tissue plasminogen activator

a thrombolytic that is administered to some patients having a heart attack or stroke

CE2. A normal blood pH is

a. 7.35

capillary blood gas (CBG)

alternative to ABG testing

partial pressure of carbon dioxide (PCO2)

amount of carbon dioxide dissolved in the blood

dorsalis pedis artery

artery that supplies blood to the foot

scalp artery

artery used for arterial blood collection in infants

umbilical artery

artery used for arterial collection in infants

CE8. In an arterial collection, the needle should be inserted at a _______________ degree angle.

b. 45

CE1. arterial blood collection monitors all of the following except

b. glucose

arterial collection in glass syringes may

be kept on ice and delivered to the lab within one hour

thrombosis

blood clot

CE4. A typical needle gauge for ABG collection is

c. 22

CE7. The modified Allen test determines

c. collateral circulation

CBG

capillary blood gas

CBG is not as desirable as ABG because

capillary blood is a mixture between the capillaries, venuoles, and arterioles which may give off inaccurate readings

S16. in what population is capillary blood gas testing most commonly performed, and on what part of the body is this procedure usually done?

children or people not recommended for arterial puncture; the heel

collateral circulation

circulation by secondary channels after obstruction of the principal channel supplying the heart

CE3. the ABG syringe is coated with

d. Heparin

CE5. which artery is most frequently used for ABG collection

d. radial artery

CE6. which of the following is not an ABG sampling error?

d. use of a gas-impermeable plastic syringe

thrombolytic

drug that breaks down blood clots

abnormal results of PO2 and PCO2 indicate

gas exchange in the lungs is impaired

S7. what local anesthetic may be used to numb the site?

lidocaine

flea

mixes capillary collections with a magnet

requisition forms for arterial punctures include

oxygen received by patient

arterial blood

oxygenated blood

alkalosis

pH above 7.45

acidosis

pH below 7.35

CE11. Which of the following is not a complication of ABG collection?

petechiae

anticoagulant

slows coagulation and prevents new clots from forming

arteriospasm

spasm of an artery, prevents blood flow to tissues

heparinized syringe

syringe used for arterial blood collection; treated with heparin to prevent coagulation

Allen test

test that determines the patency of the radial and ulnar arteries by compressing one artery site and observing return of skin color as evidence of patency of the other artery

brachial artery

the major artery of the upper arm. deep, under the basilic vein and near the median nerve.

patency

the state of being open or unobstructed

streptokinase

thrombolytic

urokinase

thrombolytic

unlike venous collection, arterial collections do not need

tourniquets

CE10. the modified Allen test is performed on the ___ and ____ arteries

ulnar and radial

Hyperventilation

ventilation of the lungs beyond normal body needs

S8. what safety precautions must be taken by a phlebotomist when collecting blood from an artery?

wear a fluid-resistant gown, face protection, and gloves; use a puncture-resistant container for sharps and a small rubber or latex block for the needle