Preanalytical Consideration

• Basal state refers to the resting metabolic state of the body early in the

  morning after fasting for approximately 12 hours.
• Basal state is influenced by a number of physiologic patient variables such

  as age, gender, and conditions of the body that cannot be eliminated.
• red blood cell (RBC) and white blood cell (WBC) values are normally higher in newborns than in adults. Some physiological

  functions such as kidney function decrease with age
• Dehydration (decrease in total body fluid), which occurs, for example, with persistent vomiting or diarrhea, causes

  hemoconcentration, a condition in which blood components that cannot easily leave the bloodstream become concentrated

  in the smaller plasma volume.
• Diurna- means daily
• circa-dian having a 24 hour cycle
• melatonin levels are affected by light; they increase at night,

  when it is dark, and decrease during daylight hours.
• Maximum renin and thyroid-stimulating hormone (TSH) levels normally occur

  in the predawn hours of the morning during sleep, while peak cortisol levels

  normally occur later in the morning, around 8:00 A.M.
• Fever affects the levels of a number of hormones. Fever-induced hypoglycemia increases insu- lin levels, followed by a rise in

  glucagon levels. Fever also increases cortisol and may disrupt its normal diurnal variation.
• Hematocrit normal level for men should be 40% to 54%; for woman it should be 36% to 48%
• Hemoglobin normal level for males is 14 to 18 g/dl; for femals is 12 to 16 g/dl
• A recent intramuscular injection can increase levels of creatine kinase (CK) and the skeletal muscle fraction of LDH.
• Jaundice, also called icterus, is a condition characterized by increased bilirubin (a product of the breakdown of RBCs) in the blood, leading

  to deposits of yellow bile pigment in the skin, mucous membranes, and sclerae (whites of the eyes), giving the patient a yellow

  appearance
• Stress?

  ↑ WBC
• Edema is swelling caused by the abnormal accumulation of fluid in the tissues. It sometimes results when fluid from an IV infiltrates the

  surrounding tissues
• A hematoma is a swelling or mass of blood (often clotted) that can be caused by blood leaking from a blood vessel during or

  following venipuncture.
• An arterial line (A-line or Art-line) is a catheter that is

  placed in an artery. It is most commonly placed in a

  radial artery and is typically used to provide accurate

  and continuous measurement of a patient’s blood

  pressure
• A heparin or saline lock is a catheter or cannula connected to a

  stopcock or a cap with a diaphragm (thin rubber-like cover) that

  provides access for administering medication or drawing blood.
• Intravenous (IV) means “of, pertaining to, or within a vein.” An intravenous line, referred to simply as an IV, is a catheter inserted in a vein to administer fluids.
• Peripherally inserted central catheter (PICC): a line inserted into the

  peripheral venous system (veins of the extremities) and threaded into

  the central venous system (main veins leading to the heart
• The medical term for fainting is syncope (sin’ko-pea), described as a loss of consciousness and postural tone

  resulting from insufficient blood flow to the brain
• Petechiae are tiny, nonraised red spots that appear on the patient’s skin when a tourniquet is applied. The

  spots are minute drops of blood that escape the capillaries and come to the surface of the skin below the

  tourniquet,
• Hematoma formation is the most common complication of venipuncture. It is caused by blood leaking into the tissues

  during or following venipuncture and is identified by rapid swelling at or near the venipuncture site
• Iatrogenic is an adjective used to describe an

  adverse condition brought on by the effects of

  treatment
• Inadvertent arterial puncture is rare when proper

  venipuncture procedures are followed. It is most often

  associated with deep or blind probing, especially in

  the area of the basilic vein, which is in close

  proximity to the brachial artery
• Hemolysis results when RBCs are damaged or destroyed

  and the hemoglobin they contain escapes into the fluid

  portion of the specimen
• The red color of the

  hemoglobin makes the serum or plasma appear pink

  (slight hemolysis), dark pink to light red (moderate

  hemolysis), to dark red (gross hemolysis), and the

  specimen is described as being “hemolyzed
• Iron normal range is 60-170
• Calcium normal range is 8.5 to 10.5
• Magnesium normal range is 1.5 - 2.5
• Glucose Tolerance Test- Start of the test 70 - 100, After an hour less than 200, After two hours less than 140
• Ammonia normal range is 9.5 to 49
• Amylase normal range is 23 - 85
• Lipase normal range is 0-160
• Hemaglobin A1c normal range is 5.6 - 7.5
• Implanted port a small chamber attached to an indwelling line that is

  surgically implanted under the skin and most commonly located in the

  upper chest or arm
• Exsanguination - Blood loss to a point where life cannot be sustained
• Acetaminophen or Ibuprofen - Helps relieve discomfort from a hematoma