NCCT NCPT flashcards
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32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Order of draw
- Sequence for filling evacuated tubes that prevents additive carryover: blood culture, light blue, serum, green, lavender, gray.
- Tourniquet time limit
- Tourniquet should remain on no longer than about one minute to prevent hemoconcentration and falsely elevated potassium and protein.
- Capillary puncture site
- In infants, puncture the lateral or medial plantar heel; avoid the central heel pad and newborn fingers.
- First drop discard
- Wipe away the first drop of capillary blood to reduce tissue-fluid contamination and hemolysis.
- Citrate tube ratio
- Light blue sodium citrate tubes require a 9:1 blood-to-anticoagulant ratio; underfilling falsely prolongs coagulation times.
- EDTA inversions
- Lavender EDTA tubes are gently inverted 8-10 times to mix the anticoagulant without causing hemolysis.
- Serum separator timing
- Allow blood to clot about 30 minutes at room temperature, then centrifuge to form the gel barrier.
- Photosensitive specimens
- Bilirubin and similar analytes require protection from light during processing and transport, using foil or amber containers.
- Cold agglutinin handling
- Collect and transport cold agglutinin specimens at 37 degrees C to prevent antibody binding and inaccurate results.
- Specimen rejection criteria
- Unlabeled tubes, wrong tube type, gross hemolysis, clotted anticoagulated blood, and insufficient volume are rejected per policy.
- Chain of custody
- Legal or forensic specimens stay sealed with signatures, dates, and times documented at every transfer.
- Two patient identifiers
- Verify full name and date of birth verbally and match them to the requisition before collection and labeling.
- Sharps disposal
- Activate the needle safety device immediately after use and place the needle in a puncture-resistant sharps container at point of use.
- Syncope precautions
- Collect with the patient seated or supine and watch for pallor, diaphoresis, and dizziness to prevent injury from fainting.
- Standard precautions
- Wear gloves for all blood contact and perform hand hygiene before and after every patient interaction.
- Confidentiality principle
- Protected health information is shared only on a need-to-know basis and discussed in private areas.
- Butterfly set use
- Winged 21-23 gauge needles with tubing are used for fragile or small veins and for pediatric patients.
- Syringe transfer technique
- When vacuum draw is contraindicated, draw with a syringe and transfer blood into tubes without force to limit hemolysis.
- Tube color additives
- Light blue is citrate, lavender is EDTA, green is heparin, gray is fluoride/oxalate, and red has no additive.
- Needle gauge relationship
- Gauge and diameter are inversely related: an 18 gauge needle is larger than a 23 gauge needle.
- Blood culture antisepsis
- Cleanse the skin with chlorhexidine or iodine and allow full drying before puncture to reduce contamination.
- Bedside labeling
- Label tubes immediately after collection at the bedside, never before, to prevent patient misidentification.
- Documentation elements
- Record patient identifiers, date and time, collector identity, site, tube types, and any complications or adverse events.
- Venipuncture site order
- Prefer the median cubital vein, then cephalic, then basilic; avoid the basilic area near the brachial artery.
- Sites to avoid
- Avoid hematoma, scarring, infection, edema, an active IV line, a dialysis fistula, and the arm on a mastectomy side.
- Capillary collection order
- Fill EDTA tubes first, then other additive tubes, then non-additive tubes when collecting capillary specimens.
- Glucose tube additive
- Gray tubes contain sodium fluoride to inhibit glycolysis and potassium oxalate as the anticoagulant.
- EDTA mechanism
- EDTA binds calcium to block clotting; excess EDTA can falsely lower calcium and elevate potassium results.
- Specimen stability
- Analyte stability varies: potassium and lactate rise with delay, while glucose falls without fluoride preservative.
- Transport temperatures
- Categories are ambient, refrigerated, frozen, and 37 degrees C; each analyte specifies its required transport temperature.
- Needlestick response
- Wash the site with soap and water, report immediately, and follow the facility post-exposure protocol.
- Timed specimen documentation
- Record the exact collection time for timed or therapeutic drug monitoring specimens to support accurate result interpretation.