Lesson 8

• Removal of more than 10% of total blood volume can cause cardiac arrest.
• Infants and children should not have more than 5% of their blood volume removed within a 24-hour period unless medically necessary.
• Removal of 3% or less is the preferred maximum.
• maximum. No more than 10% should be removed over a 1-month period unless medically necessary.
• For blood culture in infants and small children, a sample of 1 to 5 mL is required.
• Newborns also have a higher proportion of (RBCs) than adults do (60% versus 45%)
• a lower proportion of plasma (40% versus 55%)
• (eutectic mixture of local anesthetics), a mixture of lidocaine and prilocaine.
• EMLA It must be applied 60 minutes before the draw, however, which means that the site must be chosen at that time.
• Anesthetic is not recommended for phenylketonuria (PKU) testing
• The packet contains sodium thiosulfate and glycerin, which undergo a chemical reaction when activated by squeezing.
• Bilirubin is a substance produced by the normal breakdown of RBCs.
• The liver is responsible for further processing of bilirubin so that it does not reach excessive levels in the blood.
• Buildup of bilirubin causes jaundice, or yellowing of the skin.
• jaundice can lead to brain damage if untreated, a condition called

  kernicterus.
• When bilirubin is slightly above normal in a newborn, a Bili light can be used.
• Higher levels, or levels that are rising rapidly, require blood transfusion.
• Bilirubil testing are frequntly collected as stat specimens.
• In 2006- American-college-of-medical-genetics-29
• Blood for neonatal screening is collected by capillary stick on special filter paper
• Phenylalanine-capillary reference valuse
• Both the ink and the paper are biologically inactive.
• Blood can be collected from newborns or children younger than 2-dorsalhandvein
• Using a gauge-23, gently insert the needle 3-5 distal to the vein.
• Scalp vein venipuncture can be used when other venipuncture sites are not accessible.
• Sickle cell anemia is an inherited disorder of the hemoglobin that may also be screened for in newborns from eth ic groups with the highest risk
• These challenges may include chronic illness, loss of mobility, or cognitive impairment or dementia.
• institutionalization may engender feelings of anger, confusion, combativeness, or hopelessness.
• Geriatric patient's Vessels may narrow because of atheroscle-

  rosis.
• Loss of supporting connective tissue leads to “loose skin,”
• Arthritis may prevent your patient from fully straightening his or

  her arm or fingers.
• Many patients may be on anticoagulant therapy for previous heart attacks or strokes - These patients have an increased risk of hematoma.
• Poor nutrition or chronic degenerative disease may lead to emaciation.
• Tremor is common in advanced old age and may make it difficult for the patient to hold his or her arm steady during the blood collection process.
• Patients in the ICU or ER are likely to have some type of vascular access device or indwelling line in place that may affect your collection.
• A VAD is a tube that is inserted into either a vein or an artery and is used to administer fluids
• The name of the VAD is based on the location of the tubing in the vascular system.
• A central venous catheter also called a central venous line,
• A central venous catheter is the most common type of VAD.
• Central refers to the large veins emptying into the heart, into which

  the CVC is inserted.