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| eutectic mixture of local anesthetics |
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| emergency room, emergency department |
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| human immunodeficiency department |
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| peripherally inserted central catheter |
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| collecting blood from pediatric patients presents both |
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| technical and psychological challenges |
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| children have a lower _______ _________ _____ than adults do |
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total blood volume
The younger (and smaller) the child, the lower the volume that can be safely withdrawn |
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| Removal of ________% or less of the total blood volume is the preferred maximum |
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| No more than _________% of the total blood volume should be removed over a 1-month period unless medically necessary |
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| The most common pediatric collection procedure is a _______ _______ |
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| Newborns have a ________proportion of red blood cells than adults do |
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| higher. 60% verses 45% and a lower proportion of plasma (40 % verses 55%) so more blood may need to be needed to obtain enough serum or plasma for testing |
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| Newborns and infants are also more susceptible to infection because of their |
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| immaturity of their immune system |
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| Prolonged crying also affects the |
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| white blood cell count and pH level of the blood; therefore a calm experience ensures accurate test results |
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| Newborns may be identified only by there last name such as "Baby Boy (or Girl) Smith Always use the |
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| hospital ID number , not the name as the ultimate proof of ID. |
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| Be especially careful when identifying twins who are likely to have |
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| similar names and ID numbers |
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| EMLA a topical anesthetic cream must be applied ________ minutes before the draw |
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| 60 minutes. It can take up to 30 minutes to work. Anesthetic is not recommended for PKU testing |
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| ________is a substance produced by the normal breakdown of RBCs |
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| when bilirubin is slightly above normal in a newborn a ____ _______can be used for treatment |
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| Higher levels of bilirubin, or levels that are rising rapidly require a ________ ___________ |
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| Bilirubin is _______ ________. Bili lights must be turned off during collection |
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| light sensitive. The specimen should be shielded from light using an amber-colored container, foil or heavy paper to cover the container |
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| ____________ of the specimen falsely lowers the results, so precautions against this must be taken |
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| Neonatal screening test are used to detect inherited ___________ _____________ that cause severe brain damage. |
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| U.S. law mandates screening for ________ and __________ |
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| Other neonatal screening test include __________, ____________, __________, and ______________ |
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| galactosemia, homocystinuria, maple syrup disease, biotinidase deficiency |
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| how to collect a sample for a neonatal screening through routine heel stick |
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first perform a routine heel stick
wipe away first drop of blood
apply one large drop of blood directly to the circle
drop must be spread evenly
Although applied to only one side of filter paper, blood should be visible from both sides
air day specimen in horizontal position
keep away from direct sunlight and at room temperature until it can be delivered to lab |
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| when a larger volume of blood is required blood can be collected from newborns or children younger than 2 by |
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| venipuncture of the dorsal hand veins |
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| What are some physical changes that occur as we age |
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| skin becomes less elastic, amount of collagen in the skin is reduced, layers of skin become thinner,. Bruising is more likely and it takes longer to replace cells, so longer healing time is needed. |
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| _________ are often closer to the skin in geriatric patients |
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| Many patients may be on anticoagulant therapy for previous heart attacks and strokes. Be aware of this possibility especially because the delay in ________ __________ |
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| clotting time. These patients have an increased risk of hematomas |
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| Patients in the ICU or ER are likely to have some type of _________ __________ __________ |
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| vascular access device (VAD). A VAD is a tube that is inserted into either a vein or an artery and used to administer fluids and medications, monitor blood pressure, or draw blood. |
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| A central venous catheter (CVC) also called a ________ _______ _________ |
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| central venous line.A Central venous line is the most common type of VAD. Central refers to the large veins emptying into the heart, into which the CVC is inserted. |
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| Types of central venous catheters include ________, _________, ____________ and ______________ |
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| Broviac, Groshong, Hickman and triple luman |
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| An implanted port is a chamber located under the skin and connected to an |
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| A ____________ ______________ __________ ____________ is threaded into a central vein after insertion into a peripheral (noncentral) vein usually the basilic or cephalic, accessed from the antecubital area |
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| peripherally inserted central catheter (PICC) line commonly used for angioplasty proceduresin which the lumen of a obstructed central vein is rewidened |
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| An arterial line is placed in an artery for continous monitoring of |
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| blood pressure or frequent collection of samples for blood gas testing |
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| A heparin lock or a saline lock is |
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| a tube temporarily placed in a peripheral vein to administer medication or draw blood |
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| An arteriovenous (AV) shunt |
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| is an artificial connect between and artery and a vein it is used for dialysis only |
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consist of a cannula with a rubber septum
through which a needle may be inserted for blood draw. |
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| An internal (AV) shunt consist of |
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| fistula, or permanent internal connection between the artery and the vein using the patients tissue, a piece of bovine tissue or a synthetic tube |
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| VADs are periodically flushed with _________ to keep the line open |
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| The order of draw when drawing from a vascular access device (VAD) |
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| blood cultures, anticoagulation tubes, and then clotted tubes |
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