Objectives

The participant will:

• Name the stage in the coagulation cascade in which factor XIII stabilizes the fibrin clot leading to clot retraction.

• Identify the type of blood used to determine reference (normal) ranges for laboratory tests.
• Indicate the type of blood sample most suitable for tests related to blood cells, such as a complete blood count (CBC).
• Specify the substance present in serum or plasma that causes icterus.

• Identify the needle gauge that has a bigger needle diameter and is often used to collect units of blood for transfusion.
• Recognize the needle gauge often used for children and patients with small veins.
• Indicate how Occupational Safety and Health Administration (OSHA) directs that tube holders be discarded.
• Specify how VACUETTE indicates their tube is a partial-draw tube.
• Identify a visual cue to indicate proper tube mixing.
• Specify the number of times you should invert the light blue stopper tube.
• Indicate why underfilling a light blue stopper tube would be a cause for rejection.
• Specify the number of times most tubes should be inverted immediately following collection.

• List the order of draw in a patient scenario.

• Indicate the proper order to transfer blood from a syringe to a blood collection tube.

• Specify proper procedure when using a winged blood collection set.

Objectives

The participant will:

• Identify proper procedure when others are in the room with the patient.
• Indicate if a wristband taped to the bedside table can be used to identify a sleeping patient.
• Identify information that should be provided to a patient before performing a venipuncture procedure.
• Recognize appropriate placement of the blood collection tray when drawing blood from a patient in a hospital bed.
• Detail the recommended procedure for proper tourniquet application.
• Specify veins that should be used as the last choice for venipuncture, according to the CLSI.
• Name the vein of choice for blood collection, according to the CLSI.
• State reasons why hardened or sclerosed veins should be avoided.
• Specify the CLSI recommendation for performing a venipuncture on a patient with an Intravenous (IV) line.
• Recognize an action that can eliminate the stinging sensation felt by patients during venipuncture.
• Specify the angle that the needle should be inserted into the patient’s vein for a venipuncture.
• List strategies to prevent blood from leaking into surrounding tissue and causing a hematoma during blood collection procedures.
• Recognize appropriate time to label specimen tubes.
• List information that must be included on the specimen label.
• Specify the stability of coagulation specimens for activated partial thromboplastin times (APTTs) for patients not on heparin.

Objectives

The participant will:

• Identify the stage of laboratory testing for processes that occur during blood collection.
• Specify when blood glucose levels return to normal after a meal.
• Recognize the effect of fasting for 8 to 12 hours on laboratory test results.
• Specify the likely scenario that occurred for the patient who had an increase of 6 percent or more in total cholesterol.
• Name the analyte that exhibits diurnal variation.

• Specify remedies that should be taken for a collapsed vein.
• Recognize the number of collection attempts that should be employed for a successful venipuncture.

• Name the condition in which blood accumulates within the tissues of the muscles that surround the arm or hand and causes increased pressure in the area that can occur to patients receiving anticoagulants.

• Specify the proper action when a patient complains of an electric-like shock and burning sensation during blood collection.

• Indicate a strategy to help prevent iatrogenic anemia in critically ill pediatric or elderly patients.

• Name the most common error made in the preexamination/preanalytic stage.
• Identify the sensitive analyte affected by hemolysis not visibly noticeable.

• Detail appropriate actions to take in the event of a patient fainting.
• Identify an alternative for patients with an alcohol allergy.

Chapter 6: Dermal Puncture