Podcast
Questions and Answers
Which of the following pre-collection variables is MOST critical for accurate laboratory results?
Which of the following pre-collection variables is MOST critical for accurate laboratory results?
What is the PRIMARY reason for using an antiseptic during blood collection?
What is the PRIMARY reason for using an antiseptic during blood collection?
Why do men typically have higher levels of creatine kinase compared to women?
Why do men typically have higher levels of creatine kinase compared to women?
Which of the following analytes is typically found at lower concentrations in women due to menstrual cycles and hormonal changes?
Which of the following analytes is typically found at lower concentrations in women due to menstrual cycles and hormonal changes?
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When should gloves be worn during blood collection?
When should gloves be worn during blood collection?
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Of the options below, what is the MOST likely reason for a phlebotomist to use a syringe instead of a vacuum tube system for blood collection?
Of the options below, what is the MOST likely reason for a phlebotomist to use a syringe instead of a vacuum tube system for blood collection?
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Which of the following is NOT a standard material required for routine blood collection?
Which of the following is NOT a standard material required for routine blood collection?
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What accounts for differences between sexes in analyte concentration?
What accounts for differences between sexes in analyte concentration?
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How can differences between males and females affect test results?
How can differences between males and females affect test results?
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Which of the following parameters is likely to be LOWER in women compared to men?
Which of the following parameters is likely to be LOWER in women compared to men?
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Flashcards
Analyte Concentration
Analyte Concentration
The level of a specific substance in the blood.
Sex-Specific Hormones
Sex-Specific Hormones
Hormones that differ in levels between men and women.
Men's Higher Levels
Men's Higher Levels
Men tend to have higher levels of alkaline phosphatase and creatine kinase.
Women's Lower Levels
Women's Lower Levels
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Patient Identification
Patient Identification
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Blood Collection Materials
Blood Collection Materials
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Antiseptic Use
Antiseptic Use
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Blood Collection Techniques
Blood Collection Techniques
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Cotton or Gauze
Cotton or Gauze
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Disposable Container
Disposable Container
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Study Notes
Patient Preparation, Specimen Collection, and Processing
- Pre-collection Variables: Factors affecting lab results before blood collection, categorized as controllable (lifestyle, diet) and uncontrollable (age, sex, race, biological factors, environmental factors).
- Sex Differences: Men tend to have higher levels of certain enzymes (alkaline phosphatase, aminotransferase, creatine kinase, aldolase) due to greater muscle mass. Women often have lower levels of magnesium, calcium, albumin, hemoglobin, serum iron, and ferritin.
- Race Differences: Leukocyte counts are typically lower in Black populations compared to fair-skinned populations. Granulocytes and monocytes concentrations may also vary. Alpha-amylase concentrations differ between North-West Europeans and people from the Antilles and Asia.
- Age Differences: Analyte concentrations vary significantly across different age groups. Hormones change during puberty and menstruation. Neonates have higher RBCs, hemoglobin, and bilirubin levels. Young people (growth period) have higher alkaline phosphatase levels. LDL-cholesterol increases with age.
- Lifestyle Effects: Occupational stress and sports activity have short-term impacts on analytes, mostly related to increased metabolic activity for energy expenditure. Long-term chronic activity causes higher plasma concentrations of muscle enzymes in athletes.
- Pregnancy: Plasma volume increases by approximately 50%. Blood lipids may elevate, electrolytes may decrease, and copper may double.
- Stimulants: Coffee drinking can significantly increase cortisol. Smoking affects leukocytes, lipoproteins, enzymes, hormones, and heavy metals. Excessive drinking increases liver enzyme activity.
- Diurnal Variation: Fluctuations during the daily cycle affect parameters like osteocalcin, prolactin, ADH, cortisol, ANP, cholesterol, and triglycerides. Fertility hormones and vitamin D levels are often highest in summer.
- Stress: Mental and physical stress trigger the production/release of various hormones, potentially affecting acid-base balance via hyperventilation. A calm environment before blood collection positively impacts results.
Materials for Blood Collection
- Antiseptic: 70% isopropyl alcohol is commonly used. However, chlorhexidine gluconate (ChloraPrep) and povidone-iodine may be used in specific instances.
- Cotton/Gauze: Used for cleansing the puncture site and applying pressure afterward.
- Tourniquet: Used to constrict blood flow, used for no more than one minute.
- Needles: Various gauges (smaller diameter = higher gauge) and types (hypodermic, winged infusion, multisample).
- Syringes: Clear barrel, graduated scale, are disposable.
Blood Collection Techniques (e.g., Venipuncture):
- Patient Identification: Crucial to verify patient identity verbally and physically using ID bands/cards.
- Site Selection: Venipuncture usually occurs in the cubital fossa (elbow bend), with the median cubital vein being the preferred site. Other veins are utilized if necessary (median basilic, median cephalic). Alternatives for infants and patients with specific conditions are considered.
- Procedure: Hand hygiene, antiseptic application, tourniquet placement, vein palpation, needle insertion, blood collection, tourniquet removal, pressure application to the puncture site, and cleaning the wound before finishing.
- Arterial Puncture: Techniques used to collect blood from arteries focus on the radial artery with techniques (Allen test).
- Skin Puncture (finger/heel prick): Techniques used for collecting blood from patients with specific physical issues or circumstances.
Blood Collection Tubes
- Types: Categorized by the additive present (e.g., clot activator, anticoagulant), which affect blood clotting. Different colored stoppers (e.g., red, gold, lavender, green, light blue, gray) indicate specific additives.
- Transportation: Unstable constituents require refrigeration (4°C) immediately after collection for proper transport.
- Order of Draw: Collection order is crucial to avoid cross-contamination and follow specific requirements for certain tests.
- Tube Inversion: Involves inverting the tubes to mix the contents and prevent separation.
Specimen Handling and Transport
- Specimen Handling: Proper handling to prevent biohazard exposure, contamination (broken/leaking specimens), or other delays in a process that may affect results. Maintain stability of analyte constituents/analytes.
- Transport: Refrigerating, using ice packs/cold methods, are important for specimen stability. Avoid excessive shaking or jolting handling.
Interfering Conditions
- Hemolysis: Red blood cell rupture, which might happen from using the incorrect needle gauge, incorrect technique, or vigorous shaking and affects assay color and results.
- Icterus: Indicates a high concentration of bilirubin resulting in yellowing of samples or plasma, thus affecting results in absorbance.
- Lipemia: High lipid concentration results in milky turbidity, impacting spectrophotometry and other assay results/accuracy.
Other Important Points
- Detailed criteria for the time to take specimens is provided for procedures such as medication dosing, monitoring, and intoxication.
- Proper procedures for blood collection handling and transport are paramount and are critical.
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Description
This quiz delves into the critical aspects of patient preparation prior to blood collection, focusing on how various factors like age, sex, and race can influence lab results. It also covers the importance of understanding these differences in managing and assessing laboratory analyses effectively.
