Question

Critical Thinking Application (4.5 points each) Answer the following questo 59. Maria, who was recently hired in her first job as a phlebotomist, has been sent to the ICU to collect a stat hemoglobin and hematocrit (H&H) and protime on a patient. The patient is an elderly woman whose left arm has an intravenous (IV)line Maria checks the right arm and finds a small but suitable vein. She decides to use a butterfly with the evacuated tube system and selects the following tubes from her blood collection equipment carrier a light-blue top for the protime, which is a coagulation test, and a lavender top for the H&H, which is a hematology test. The patient's nurse asks Maria how long she thinks it will take because she wants to give the patient a shot in that arm. Maria tells her that she has only two tubes to collect, so it shouldn't take long The nurse leaves. Maria makes a successful venipuncture, fills the light-blue-topped tube and mixes it gently by inverting it four times. Then she fills the lavender-top tube. After finishing the draw, properly labeling the tubes, and checking and bandaging her patient, she returns to the lab. Specimen processing immediately rejects the protime and asks her to recollect it. Owestions A. Why do you think specimen processing rejected the protime? B. How did the way Maria collected the specimen cause the problem? C. Why does the lab reject tubes with this problem? D. What can Maria do differently when she recollects the specimen?

Answer 1

A)The reason for rejection of the specimen is due to the improper specimen collection method.here the light blue top bulb is used for protime test which contain citerate .it is very necessary that the evacuated citerate bulb should filledproper volume with the recommended ratio of 9 part of blood to 1 part of anticoagulant .improper volume is the reason for sample rejection.

B)here the sample collection done by using a butterfly with a evacuated tube system it is an accurate method but here the phlebotomist doesn't discard a draw tube first to remove the air from the tubing .if the air should not removed the specimen bulb should not get filled in an appropriate amount .

C)the lab reject this because the if the evacuated collection tube are underfilled results in increased anticoagulant in blood and can extend clot based coagulation assay ,which results false result.

D)Her when recollecting the sample Maria should need to use a discard tube that is the coagulation sample or the protime sample should the second tube .she has to use plain tube or a non additive tube as a discard tube .