Rationalization

• Lipid levels


  Causes serum or plasma to appear milky or turbid
• Accurate testing of triglycerides

  Often requires a 12-hour fast to prevent lipemia
• Collecting stool specimens for occult blood testing


  Special diet eliminating certain food should be followed for several days before
• Analyte levels


  Increased by chronic consumption or recent ingestion of large amounts of alcohol
• Exercise


  Increases cholesterol levels temporarily
• Environmental factors


  • Can affect test value by influencing decomposition of body fluids
• Venipuncture should not be performed through a hematoma
• A buzzing sound or buzzing sensation called a thrill indicates proper fusion of artery and vein in an arteriovenous shunt
• Change in posture from lying to standing

  Decreases total and high-density lipoprotein cholesterol results
• Collecting blood from a patient with an IV

  Turn off the IV for at least 2 minutes to reduce the risk of contamination from IV fluids in the blood sample
• Applying the tourniquet distal to the IV during blood collection is to avoid disturbing the IV
• Selecting a venipuncture site distal to the IV is to prevent backflow of IV fluids to the blood sample
• If IV fluids may still be present in the vein despite turning off the IV

  Choose a different arm for blood collection
• Documenting the collection details when drawing blood below an IV is to provide information for troubleshooting potential issues with test results
• Blood collection should be avoided from an unknown previous IV site for 24-48 hours
• Central vascular access device


  To administer fluids and medications and draw blood
• Avoid applying a tourniquet or performing venipuncture in the same arm as an arterial line
• Drawing blood from an area with edema


  Potential risk of contamination with tissue fluid
• Approaching blood collection from an obese patient

  Use a longer tourniquet or blood pressure cuff
• Hemoconcentration


  Increase in non-filterable large molecule or protein-based blood components such as red blood cells, resulting from venostasis
• Hemoconcentration


  Affects blood specimens
• Preventing hemoconcentration during venipuncture


  Release the tourniquet within 1 minute of application
• Hemolysis


  Escape of hemoglobin from red blood cells into the specimen resulting in a pink appearance
• Allowing the tube to sit horizontally during transport is not a procedural error that can cause specimen hemolysis
• Drawing blood through an IV valve can cause hemolysis of the blood specimen
• Lancet


  Sterile, disposable, sharp-pointed or bladed instrument that either punctures or makes an incision in the skin to obtain capillary blood specimens for testing
• Microtainer


  Often referred to as "bullets" because of their size and shape
• Lasers


  Capillary puncture equipment that typically vaporizes water in the skin to produce a small hole in the capillary bed without cauterizing delicate capillaries
• Microhematocrit tubes


  Disposable narrow bore plastic-clad glass capillary tubes that fill by capillary action and typically hold 50-75µ of blood
• Stirrers often referred to as "fleas"


  Correctly associated with capillary blood gas
• Warming devices


  Provide a uniform temperature that does not exceed 42℃ to avoid burning the patient
• Capillary specimen


  Mixture of arterial, venous, and capillary blood along with interstitial fluid and intracellular fluid from the surrounding tissues
• If the left heel of the newborn baby is swollen and has been previously punctured

  Check the right heel if it is viable for puncture
• Correct order of draw for capillary puncture

  • Blood Gas specimen
  • EDTA specimen
  • Other additive specimen
  • Serum specimen
• Recommended capillary puncture site for adults is not the palmar surface of the dominant hand
• Heelstick procedure


  1. Encircle the heel with your index finger around the arch

  2. Trigger the puncture and discard the lancet in a sharps container

  3. Position the foot downwards and apply gentle pressure to the site

  4. Wipe the first blood drop with the gauze pad
• The paper must not be allowed to touch the surface of the site during blood spot collection
• Do not puncture any deeper than 2 mm during heel puncture
• Perpendicular to the grooves or lines of the fingerprint is not a false statement about finger-stick puncture precautions
• Preanalytical phase in the laboratory testing


  Ensuring specimen quality