Chapter 12 Blood Collection in Special Populations Study Questions

Name diseases that neonates may be screened for, besides PKU.

Besides the PKU test, neonates are screened for hypothoidism, galactosemia, hemocystinuria, maple syrup disease, biotinidase deficiency, and sickle cell anemia.

If an infant is under a Bili light, what must the phlebotomist do before collection?

Bilirubin is light sensitive, Bili lights should be turned off during collection, and the specimen should be shielded from light.

Name two safe ways that a child can be immobilized during a draw?

Children can be immobilized during a draw by wrapping newborns or infants in receiving blankets, Older children need to be restrained. They may be seated in the lap of a parent or assistant who hugs the child's body and holds it arm not being used in the draw, or they may be lying down with the parent or assistant leaning over the child, holding the unused arm securely.

List at least two common disorders associated with geriatric patients and special considerations to take when drawing blood from such patients.

Common disorders affecting the elderly population includes hearing loss, stroke, arthritis, and tremors, all of which can make blood collection difficult. Extra care should be taken appropriate to each condition

What is EMLA used for"

EMLA is a topical anesthetic cream used in pediatric patients to numb the venipuncture site.

Name at least two psychologic complications a child may experience during a phlebotomy procedure. List the actions you would take, as a phlebotomist, when drawing blood from a child.

In a phlebotomy procedure, a child may experience a fear of the unknown and a fear of pain. As a phlebotomist, you must explain the procedure in detail to the child, using words the child understands. The phlebotomist should speak to the child during the entire procedure, letting the child know how much longer the procedure will last.

List the special considerations to take when drawing blood from a newborn.

Since a newborn is under revers isolation, additional protection equipment is needed. Blood should be drawn from the infant's heel. The amount collected, tests,m and their frequency must be recorded to prevent blood depletion.

Explain the procedure for drawing blood from a patient who has an IV line.

To draw from a patient who has an IV line, have the nurse turn off the IV drip before the draw (less than 2 minutes) apply the tourniquet distal to the IV insertion site, select a vein distal to the IV insertion site and in a different vein; discard the first 5mL of blood drawn, since it will be contaminated with IV fluid; and on the requisition, note that the specimen was drawn from an arm with an IV and identify the IV solution.

Explain the procedure for drawing blood from a geriatric patient.

To preform a draw on an elderly patent, be especially careful with patient identification; be aware of the frequency of blood draws; be especially gentle; do not apply the tourniquet as tightly; place the arm on a pillow and have the patient grip a washcloth wile the arm is supported by rolled towels, do not slap the arm to find a vein; anchor the vein firmly; and apply pressure longer to ensure bleeding has stopped.

List and explain five strategies you can use to help reduce a child"s anxiety before a draw.

To reduce a child's anxiety before a draw. perform the procedure in a room that is not the child's hospital room, be friendly, cheerful, and empathetic, explain the procedure in child's terms, do not say that they procedure won't hurt, but say that it is ok to say ouch and give children choices whenever possible, such as which arm or finger they want to use or the type of bandage they prefer.

What is VAD?

VAD is the acronym for vascular access device. It is a tube that is inserted into either a vein or an artery and is used to administer fluids or medications, monitor blood pressure, or draw blood.

What type of needle may be used for pediatric patients younger than 2 years?

When preforming venipuncture on patients younger than 2 years, use shorter needles, if possible, and use the smallest gauge consist with the requirements of the tests. Butterflies and smaller tube sizes should be used. If the patient is younger than 1 a heal stick should be performed. rather than venipuncture.

List six types of VADs,

...Types of VADs include CVC (Broviac, Grosehong, Hickman, or triple lumen), implanted port, PICC, arterial line, heparin or saline lock, and AV shunt (external or internal).

How is a PKU sample collected?

A PKU sample is collected via capillary stick onto a special filter paper supplied in a kit provided by the state agency responsible for PKU tests.

Name four physical changes that geriatric patients undergo and the phlebotomist must consider when collecting blood.

Physical changes the elderly undergo include skin that is less elastic and thinner, a tendency to bruise more easily, longer healing times, more fragile, less elastic, and narrower blood vessels, loss of supporting connective tissue, leading to loose skin, loss of muscle tissue, allowing veins to move from their usual locations, and arteries that are closer to the surface.