review lab 6-10

• POSITION THE PATIENT:

  • Finger puncture: arm supported on the firm surface; hand extended and palm up
  • Young child: held on parent's or guardian's lap
  • Infant heel puncture: supine position with foot lower than torso
• Select the puncture/incision site: GENERAL CRITERIA

  • Skin is warm, pink, and of normal color
  • No scars, cuts, bruises, rashes, cyanosis, edema, and infection
• Select the puncture/incision site: ADULTS AND OLDER CHILDREN

  • Palmar surface of distal or end segment of middle or ring finger of the non-dominant hand
  • Central, fleshy portion of the finger
• Select the puncture/incision site: INFANTS

  • Plantar surface of heel, on medial or lateral edge to avoid bone damage
  • <2.0 mm deep
• Warm the site if applicable:

  • warming increases the blood flow up to sevenfold
  • essential for pH and blood gas specimens and recommended for heel stick
  • Wrap site for 3 to 5 minutes with a warm, moist, washcloth, towel, or diaper
• Clean and air-dry the site: CAPILLARY PUNCTURE

  • cleanse site with an antiseptic (70% isopropyl alcohol)
  • allow the site to air dry
• Why is it necessary to wipe away the first blood drop?

  To avoid contamination with excess tissue fluid
• Clean the site: BLOOD CULTURE

  • clean with antiseptic- 70% isopropyl alcohol for a minimum of 30 seconds
  • use tincture of iodine for 30 seconds or a povidone-iodine for 60 seconds
• Mark minimum and maximum fill lines:

  • Adult: 5-10 ml/bottle
• For butterfly:

  • aerobic vial first
• For syringe method:

  • anaerobic vial first
• Intermediate Collection Tube:

  • a Sodium Polyanethol Sulfonate (SPS) yellow top is acceptable
• Fill out forms using a black or blue pen to write legibly:

  • Drug Test
  • Drug Test Certification
  • Custody and Control Form 001: Consent form
  • Custody and Control Form 002A: Copy for the donor
  • Custody and Control Form 002B: Copy for the collection site
  • Custody and Control Form 002C: Copy for the laboratory
  • Custody and Control Form 002D: Copy for the confirmatory laboratory
• Most important in blood culture: Skin Antisepsis
• Give 1 disease or state what is the purpose of bleeding time:

  • Disease: von Willebrand disease (vWD)
  • Purpose of bleeding time: help assess the time it takes for blood to clot
• (BLEEDING TIME) example of medication he/she took during the past 2 weeks: Aspirin
• (BLEEDING TIME) puncture to a depth of 3mm
• (BLEEDING TIME) normal values: 2 to 4 minutes
• Bacteremia - bacteria in the blood
• What method is used to draw blood from an infant? What position?

  • Method: Capillary Puncture
  • Position: Supine