Phlebotomy Chapter 8

plasma

Another major use of anticoagulants and preservatives is in the collection of _______________ for lab analysis.

citrate-phosphate-dextrose

An additive commonly used in specimens collected for blood donations to prevent clotting. It ensures that the red blood cells maintain their oxygen-carrying capacity.

antiglycolytic agent

An additive used in blood collection tubes that prevents glycolysis.

glycolytic inhibitor

An additive used in blood collection tubes that prevents glycolysis. Grey tubes

heparin

An anticoagulant that prevents blood clotting by inactivating thrombin and thromboplastin, the blood-clotting chemicals in the body.

ethylenediamine tetra-acetic acid (EDTA)

Anticoagulant additive used to prevent the blood-clotting sequence by removing calcium and forming calcium salts. It prevents platelet aggregation and is useful for platelet counts and platelet function tests. Fresh EDTA samples are also useful for making blood films or microscopic slides, because there is minimal distortion of platelets and white blood cells.

capillary tubes

Disposable narrow-bore pipettes that are used for pediatric blood collections and/or microhematocrit measures. The tubes may be coated with anticoagulant such as heparin, and for safety reasons are usually made of plastic.

fibrin and cells

During centrifugation, the polymer barrier moves upward to the serum-clot interface, where it forms a stable barrier separating the serum form ____________ and ___________.

A

For capillary collection from newborns, a lancet of which of the following lengths should be used to avoid penetrating bone? a. 1.75 mm b. 2.75 mm c. 3.00 mm d. 3.25 mm

2.0 mm

For infants a penetration depth of less than _________ on heel sticks to avoid penetrating bone.

D

From the listed needle gauges, which one has the smallest diameter? a. 19 b. 20 c. 21 d. 23

30

It takes at least ______ minutes for the fibrin clot to form.

fill lines

Light-blue-topped vacuum tubes are designed with designated _________________.

light-blue

Many coagulation procedures, such as PT and APTT, are done on blood collected in ______ topped vacuum tubes, which contain sodium citrate at various concentrations.

False (They cannot be substituted)

Specific anticoagulants or preservatives must be used depending on the test procedure ordered. True or false: Anticoagulants can be substituted for one another or mixed from one vacuum tube to another.

D

Specimens for which of the following tests must be collected in gray-topped blood collection tubes? a. PT b. trace elements c. molecular diagnostics d. glucose

disposable sterile lancet

Sterile sharp device, preferably retractable, used in skin puncture collections to penetrate the skin at specified depths (e.g., no more than 2.0 mm for infant heelsticks).

red-topped

The ____________ tubes indicate a tube without an anticoagulant or polymer (gel) barrier and is used for the collection of serum.

purple-topped

The _____________________ vacuum tubes contain EDTA and are used for most hematology procedures.

BMP LeukoChek

The ______________________ microdilution system serves as a microcollection and dilution unit for blood samples, which increases the speed and simplicity of leukocyte and platelet counting.

royal-blue

The ______________________-topped tubes are used to collect samples for nutritional studies of toxicology.

tourniquet

The _______________________ is a key to successful venipuncture. These provide a barrier to slow down venous flow. They are also used in specimen collection to apply enough pressure to the arm to slow the return of venous blood to the heart.

tan-topped

The __________________________ tubes are used for lead testing and contains EDTA.

green-topped

The anticoagulants sodium heparin, ammonium heparin, and lithium heparin are found in _______________ vacuum tubes. These tubes are used in various laboratory assays requiring plasma or whole blood, which are mainly chemistry tests.

glycolysis

The breakdown or metabolism of glucose by blood cells.

B

The color coding for needles indicates the a. length b. gauge c. manufacturer d. anticoagulant

butterfly needle

The most commonly used intravenous device. It is a stainless steel beveled needle and tube with attached plastic wings on one end and a Luer fitting attached to the other. Most of these come with safety sheaths for needlestick protection after use. Also referred to as a blood collection set or winged infusion set.

gauge number

The size (diameter) of the internal bore (opening) of a needle. The larger the number, the smaller the bore size, and vice versa.

full

The tube has to be ___________ or the ratio of blood to additive will be inaccurate and can lead to erroneous results.

negative pressure

The vacuum in the tubes creates a ________________________________ that is designed to pull in a precise amount of blood into the tube that is indicated on the tube's label.

butterfly needles

These needles are used for geriatric patients, cancer patients, and pediatric patients.

Rapid serum tubes (RST)

These orange and gray/yellow vacuum-topped tubes have the additive thrombin, which completes clotting of the blood in less than five minutes.

pink-topped

These tubes contain EDTA with the spray-dried K2. They are used for blood banks.

gray-topped

These tubes usually contain potassium oxalate and sodium fluoride, EDTA and sodium fluoride, and just sodium fluoride. They also prevent glycolysis.

heparinized whole blood

This is used in STAT (immediate) situations.

True

True of false: The lancet blade retracts permanently after activation to assure safety to health care worker.

True

True or False: Coagulation of blood can be prevented by the addition of oxalates, citrates, ethylenediamine tetra-acetic acid (EDTA), or heparin.

True

True or false: If a light-blue-topped tube is underfilled, coagulation results will be erroneously prolonged.

True

True or false: The safety device must be activated on the butterfly needle after venipuncture to avoid needle stick injury.

True

True or false: If the light-blue-topped tube is overfilled, coagulation results will be erroneously shortened.

serum separation tube (SST)

Tubes that contain a polymer barrier that is present in the bottom of the tube. These tubes are mottled-topped, speckled-topped, and gold-topped.

multiple-sample needle systems

Used with the evacuated tube method of blood collection, these needles are attached to a holder/adapter and allow for multiple specimen tube fills and changes without blood leakage.

D

Which of the following anticoagulants is found in a green-topped blood collection vacuum tube? a. EDTA b. ammonium oxalate c. sodium citrate d. sodium heparin

A

Which of the following anticoagulants is found in a white-topped blood collection vacuum tube? a. EDTA b. ammonium oxalate c. sodium citrate d. sodium heparin

B

Which of the following blood collection tube tops has sodium fluoride as an additive? a. light-blue-topped tube b. gray-topped tube c. royal-blue-topped tube d. red-topped tube

C

Which of the following is a venipuncture device? a. Terumo Capijet b. Tenderlett c. VACETTE QUICKSHIELD d. BMP LeukoChek

C

Which of the following is an anticoagulant used in blood donations? a. EDTA b. ACD c. Heparin d. Citrate

A

Which of the following vacuum tubes is used to collect blood for STAT (emergency) laboratory procedures requiring serum specimens? a. RST b. EDTA c. SST d. ACD

70% isopropyl

_________________ alcohol preparation and iodine swab sticks, pads, or clorhexidine (for blood cultures) are essential items for blood collection.

gray-topped

______________________ tubes are used for checking blood sugar.

green-topped

______________________________ vacuum tubes should not be used for collections for blood smears on microscope slides that are to be stained with Wright's stain, because the heparin causes the Wright's stain to have a blue background.