PHLEB LEC MODULE 7

• Pre-anaytical-

  Begins when a test is ordered and ends when

  testing begins
• Reference Range / Intervals — consists of range values with high and low limits ● Test confirm health or screen, diagnose, & monitor disease ● For healthy fasting individuals
• Basal State — resting state of the body early in the morning after fasting 12 hours
• Age - RBC, WBC, Creatinine clearance
• Altitude - RBC
• Dehydration - Hemoconcentration, RBC, enzymes, Fe, Ca, Na
• Diet - Glucose, Lipids, Electrolytes
• Diurnal variation - TSH, Cortisol, Fe
• Drug therapy - Enzymes, Hormones
• Exercise / IM injection - pH, PCO2, CK, LDH, Glucose
• Fever - Hormones, cortisol
• Gender - RBC, Hematocrit, Hemoglobin
• Jaundice - Yellow color interfered
• Position - Protein, K
• Pregnancy - RBC
• Smoking - Cholesterol, cortisol, Glucose, GH, TAGS, WBC
• Stress - WBC, Fe, ACTH, Catecholamine, cortisol
• RBC and WBC values are normally higher in newborns than adults , Creatinine levels are higher in elderly patients
• Dehydration causes hemoconcentration (blood that cannot leave the bloodstream become concentrated)
• vigorous exercise shortly before blood collection can temporarily increase cholesterol levels by 6% or more
• fever induced hypoglycemia increases insulin & glucagon levels
• Sclerosed - hardened veins
• Thrombosed - clotted veins
• Edema - Abnormal fluid in tissues = erroneous results
• Hematoma - Clotting blood inside Coagulation = inaccurate results
• Mastectomy – surgical breast removal
• Mastectomy - Causes lymphostasis or stoppage of lymph flow
• Vascular Access Devices

  • Arterial line
  • Arteriovenous AV shunt, fistula, graft
  • Heparin lock
  • BLOOD SAMPLING DEVICE
  • CENTRAL VASCULAR ACCESS DEVICES (CVAD)
• ARTERIAL LINE- Catheter placed in radial artery to measure blood pressure, collect blood gas and administer drugs
• NEVER venipuncture or tourniquet arterial line
• Arteriovenous AV shunt - Surgical connection of artery and vein by fistula (direct fusion)
• Fistula - dialysis
• BLOOD SAMPLING DEVICE - Connected to arterial catheter (VAD) for collecting blood specimens Example: VAMP (venous arterial blood management protection system)
• HEPARIN OR SALINE LOCK - Catheter connected to stopcock for drawing blood and administering drugs
• INTRAVENOUS SITES - Catheter inserted in vein to administer fluids
• PREVIOUSLY ACTIVE IV SITES - Collect 24-48 hours after IV discontinued
• CENTRAL VASCULAR ACCESS DEVICES (CVAD) - Also called indwelling line

  • This long tube is placed in a vein that leads to your heart.
• Central Venous Catheter (CVC) or central venous line - Inserted into large vein (subclavian and superior vena cava)
• Implanted Port - Implanted in skin in upper chest or arm
• Peripherally inserted central catheter (PICC) - Inserted in peripheral nervous system and threaded in central venous system