Ateneo de Zamboanga University Name:____________________________________________________________ Date:_____________ Year and Section:___________________________________________________

Complete Blood Count A complete blood count includes enumeration of the cellular elements of the blood, evaluation of red blood cell indices and determination of cell morphology by means of stained smears. Counting is performed automated electronic devices capable of rapid analysis of blood samples with a measurement error of less than 2 percent. Purpose: It is used to evaluate: Suspected hematologic disorder, neoplasm, or immunologic abnormality History of suspected hereditary hematologic abnormality Suspected infection Monitoring effects of physical or emotional stress Monitoring desired responses to drug therapy and undesired reactions to drugs that may cause blood dyscrasias Monitoring progression of nonhematologic disorders such as chronic obstructive pulmonary disease, malabsorption syndromes, malignancies, and renal disease

Materials needed:
1

Tourniquet Skin disinfectant Gauze pads or cotton balls Materials for labeling

Syringe and needle1 or vacuumized tube with a lavender or purple cover2, holder and needle1 Bandage

A gauge 20 needle is usually used to prevent damage to blood cells but a gauge 21 to 23 may also be used depending on the clients age, vein size and the size of the vacuumized tube
2

indicates that the anticoagulant used is ethlyenediaminetetraacetic acid Steps Performed Yes No Remarks

1. Introduce yourself to the patient. 2. Confirm the identity of the patient using two patient identifiers according to hospital policy. 3. Explain to the patient: The complete blood count evaluates the number of

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red blood cells which detects possible blood disorders and white blood cells to detect infection or inflammation. Tell him/her that a blood sample will be taken and a slight discomfort may be felt from the tourniquet and the needle puncture. Place the patient in a position of comfort and safety, either lying or sitting down. A pillow may be placed to improve positioning of the extremity or to promote comfort. Apply the tourniquet 1 to 1.5 in above the site to be used. Check the pulse if absent reapply tourniquet. The tourniquet should not be kept in place for more than 1 minute prior to the venepuncture and for more than 2-3 minutes for the entire procedure. If a vein in the arm is to be used, ask the patient to open and close the hand a few times and then to clench the fist. If the puncture cannot be made within a minute, remove and reapply the tourniquet when the site is definitely located. Cleanse the skin with an antiseptic such as povidone-iodine or 70% alcohol and is allowed to dry. Insert the needle approximately in below the point where the needle is expected to enter the vein. If the needle is smaller than the vein, insert with bevel up at a 15 to 45 degree angle through the skin If the needle is larger than the vein, insert with bevel up and almost parallel to the skin. For a vacuumized tube, the tube is pushed into the holder until the rubber stopper is punctured and blood flows into it. If the syringe is to be used, pull back on the plunger until the desired amount of blood is obtained. The blood is transferred to a tube with EDTA as its additive. Release the tourniquet and ask the client to unclench the fist. Remove the needle and pressure is applied to the puncture site with a gauze pad or cottonball. Maintain pressure for 3 minutes to prevent hematoma formation. If the puncture site is on the dorsum of the hand, the hand is elevated while pressure is applied. Pressure is maintained until bleeding has stopped. Label the sample with the patients name and other required identifying information and sent promptly to the laboratory.

Reference: Nurses Manual of Laboratory and Diagnostic Tests by Watson and Jaffe page 18 and 955

Ateneo de Zamboanga University Name:____________________________________________________________ Date:_____________ Year and Section:___________________________________________________

Radioallergosorbent Test This test measures immunoglobulin E antibodies in serum by radioimmunoassay and identifies specific allergens that cause rash, asthma, hay fever, drug reactions and other atopic complaints. It is easier to perform and has less pain and danger than skin testing. Purpose: It is used: To identify allergens to which the patient has an immediate hypersensitivity.

Materials needed: Tourniquet Skin disinfectant Gauze pads or cotton balls Materials for labeling Syringe and needle1 or vacuumized tube with a lavender or purple cover2, holder and needle1 Bandage

Steps 1. Introduce yourself to the patient. 2. Confirm the identity of the patient using two patient identifiers according to hospital policy. 3. Explain to the patient: a. The test may detect the cause of allergy or monitor the effects of allergy treatment b. Inform the patient that he/she need not to restrict food and fluids. c. Tell him/her that a blood sample will be taken and a slight discomfort may be felt from the tourniquet and the needle puncture. 4. If the patient is to receive a radioactive scan, make sure that the blood sample is collected before the scan. Venipuncture 5. Place the patient in a position of comfort and safety, either lying or sitting down. A pillow may be placed to improve positioning of the extremity or to promote comfort. 6. Apply the tourniquet 1 to 1.5 in above the site to be used.

Performed Yes No

Remarks

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Check the pulse if absent reapply tourniquet. The tourniquet should not be kept in place for more than 1 minute prior to the venepuncture and for more than 2-3 minutes for the entire procedure. If a vein in the arm is to be used, ask the patient to open and close the hand a few times and then to clench the fist. If the puncture cannot be made within a minute, remove and reapply the tourniquet when the site is definitely located. Cleanse the skin with an antiseptic such as povidone-iodine or 70% alcohol and is allowed to dry. Insert the needle approximately in below the point where the needle is expected to enter the vein. a. If the needle is smaller than the vein, insert with bevel up at a 15 to 45 degree angle through the skin b. If the needle is larger than the vein, insert with bevel up and almost parallel to the skin. Pull back on the plunger of the syringe until the desired amount of blood is obtained. The blood is placed in a tube with no additives or per laboratory preference. Release the tourniquet and ask the client to unclench the fist. Remove the needle and pressure is applied to the puncture site with a gauze pad or cottonball. Maintain pressure for 3 minutes to prevent hematoma formation. If the puncture site is on the dorsum of the hand, the hand is elevated while pressure is applied. Pressure is maintained until bleeding has stopped. Label the sample with the patients name and other required identifying information and sent promptly to the laboratory. Note on the laboratory request the specific allergens to be tested.