Blood Collection – Nursing is a profession within the healthcare sector focused on the care of individuals, families, and communities so they may attain, maintain, or recover optimal health and quality of life. Nurses may be differentiated from other healthcare providers by their approach to patient care, training, and scope of practice. Nurses practice in many specialisms with differing levels of prescriber authority.
Many nurses provide care within the ordering scope of physicians, and this traditional role has shaped the public image of nurses as care providers. However, nurses are permitted by most jurisdictions to practice independently in a variety of settings depending on training level. In the postwar period, nurse education has undergone a process of diversification towards advanced and specialized credentials, and many of the traditional regulations and provider roles are changing.
Nurses develop a plan of care, working collaboratively with physicians, therapists, the patient, the patient’s family, and other team members, that focus on treating illness to improve quality of life. Nurses may help coordinate the patient care performed by other members of an interdisciplinary healthcare team such as therapists, medical practitioners, and dietitians. Nurses provide care both interdependently, for example, with physicians, and independently as nursing professionals.
Blood Collection
Blood:
Blood is a specialized fluid connective tissue, composed of plasma (Fluid portion) & formed elements (RBC, WBC & Platelets) circulating through the cardiovascular system.
or
Blood is the familiar red fluid in the body that contains white and red blood cells, platelets, proteins, and other elements. The blood is transported throughout the body by the circulatory system.
Or
The normal total circulating blood volume is about 8% of the body weight (5600 ml in a 70 kg man). About 55% of this volume is plasma.
Composition of blood:
A. Blood cells (Formed element) -45%
- Red blood cell (RBC).
- White blood cells (WBC).
- Platelets.
B. Plasma – 55%
- Plasma protein.
- Plasma lipid
- Enzyme & hormones.
- Electrolytes etc.
Composition of Blood:
Function of Blood:
Blood has three main functions:
1. Transport,
2. Protection and
3. Regulation.
A. Transport
Blood transports the following substances:
- Gases, namely oxygen (O2) and carbon dioxide (CO2), between the lungs and rest of the body
- Nutrients from the digestive tract and storage sites to the rest of the body
- Waste products to be detoxified or removed by the liver and kidneys
- Hormones from the glands in which they are produced to their target cells
- Heat to the skin so as to help regulate body temperature
B. Protection
Blood has several roles in inflammation:
- Leukocytes, or white blood cells, destroy invading microorganisms and cancer cells
- Antibodies and other proteins destroy pathogenic substances
- Platelet factors initiate blood clotting and help minimise blood loss
C. Regulation
- Blood helps regulate:
- pH by interacting with acids and bases
- Water balance by transferring water to and from tissues
Properties of Blood:
Blood volume 5-6 Liters.
Normal reaction Slightly alkaline, PH: 7.36-7.45.
Specific gravity 1.052-1.060.
Viscosity 4.5 times more viscus more than water.
Temperature 36-38° C.
Osmotic pressure Average 25 mm of Hg.
Taste Salty.
Color Red, due to presence of haemoglobin inside RBC.
Definition of Blood Collection:
The taking of a blood sample to determine its character as a whole, to identify levels of its component cells, chemicals, gases, or other constituents, to perform pathological examination, etc.
Common Sites of Blood Collection:
A. Inner Arm:
- Median cubital vein of forearm
- Cephalic Vein
- Basilic Vein
- Radial Vein
B. Dorsal surface of hand:
- Superficial dorsal vein
- Dorsal venous arch
- Basilic vein
- Cephalic vein,
C. Dorsal surface of foot:
- Dorsal arch
- Dorsal plexus
- Great saphenous vein.
Figure: Common sites of intravenous injection.
Procedure of Blood Specimen Collection for Routine Examination:
A. Materials:
- Tourniquet.
- Small mackintosh.
- Syringes: 3ml 5ml, 10ml.
- No 20 Gauge needles.
- Alcohol swabs.
- Disposable gloves.
- Specimen container- test tube or bottle,
- Laboratory requisition form
- Sterile gauze pads (2″X2″)
- Adhesive tap
B. Procedure:
➤ Check the physician’s order, progress, notes, and nursing care plan.
➤ Identify the patient.
➤ Explain the procedure to the patient.
➤ Collect and prepare equipment.
➤ Ensure patient’s privacy.
➤ Wash and dry hands.
➤ Put on clean, disposable gloves.
➤ To avoid hemolysis, the needle used for venepuncture should have a short bevel, the syringe and needle must be dry, and the container into which the specimen is placed must be dry.
➤ For some tests whole, clotted blood is required, whilst for others it should be anti- coagulated, so that the laboratory may obtain the fraction of the blood for examination that they require.
➤ Each laboratory should issue specimen bottles containing the correct anticoagulant for each test, with instructions as to the quantity of blood required.
➤ Heparin, potassium oxalate and sodium citrate are fairly common anticoagulants.
► For blood sugar estimation fluoride is added to the tube to prevent the disappearance
of the sugar from the blood.
➤ Once the blood has been added to the anti-coagulant, it must be inverted gently so that it is thoroughly mixed with the specimen.
➤ When sending blood for examination, care must be taken to avoid haemolysis of the specimen, for haemolysis renders the specimen useless.
➤ Shaking causes haemolysis.
➤ Document the procedure appropriately
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