PHINMA-UNIVERSITY OF PANGASINAN

COLLEGE OF ALLIED HEALTH SCIENCES

DEPARTMENT OF NURSING

ACTIVITY NO.
BLOOD

NAME: PAULINE JOY B. CALPITO

Prince Charles B, Abalos
DATE: 10-30-
20
1

GROUP NO.: C1-1BSN-34I SCORE:

I. DISCUSSION
A. BLOOD COLLECTION
B. BLOOD SMEAR
C. BLOOD TYPING
II. PROCEDURES
A. BLOOD COLLECTION
➔ VENIPUNCTURE PROCEDURE
1. Prepare the accession (TEST REQUEST) order.
2. Greet the patient and identify the patient by having the patient verbally state his or
her full name and confirm with the patient’s unique identification number, address,
and/or birth date. Ensure the same information is on the request form.
3. Sanitize hands.
4. Verify that any dietary restrictions have been met (e.g. fasting, if appropriate) and
check for latex sensitivity.
5. Assemble supplies and appropriate tubes for the requested tests. Verify paperwork
and tube selection.
6. Reassure and position the patient.
7. If necessary to help locate a vein, request that the patient clench his or her first.
8. Apply the tourniquet and select an appropriate venipuncture site, giving priority to
the median cubital or median vein. Ensure the tourniquet is on for no longer than 1
minute.
9. Put on gloves.
10. Cleanse the venipuncture site with 70% isopropyl alcohol using concentric circles
from the inside to outside. Allow skin to air-dry.
11. Inspect the equipment and needle tip for burrs and bends.
12. Perform venipuncture by anchoring the vein with the thumb 1 to 2 inches below the
side and inserting the needle bevel up, with an angle less than 30 degrees between
needle and the skin. Collect tubes using the correct order of draw, and invert each
tube containing any additive immediately after collection.
13. Release and remove the tourniquet as soon as blood flow is established or after no
longer than 1 minute.
14. Ensure that the patient’s hand is open.
15. Place gauze lightly over the puncture site without pressing down.
16. After the last tube has been released from the back of the multisample needle,
remove the needle and activate the safety device according to the manufacturer’s
directions.
17. Apply direct pressure to the puncture site using a clean gauze pad.
18. Bandage the venipuncture site after checking to ensure that bleeding has stopped.
19. If a syringe has been used, fill the evacuated tubes using a syringe transfer device.
20. Dispose of the puncture equipment and other biohazardous waste.
21. Label the tubes with the correct information. The minimal amount of information
that must be on each tube is as follows:
a. Patient’s full name
b. Patient’s unique identification number
c. Date of collection
d. Time of collection
e. Collector’s initials or code number
NOTE: Compare the labeled tube with the patient’s identification bracelet or
have the patient verify that the information on the labeled tube is correct
whenever possible.

➔ CAPILLARY PROCEDURE
1. Prepare the accession (TEST REQUEST) order.
2. Greet the patient and identify the patient by having the patient verbally state his or
her full name and confirm with the patient’s unique identification number, address,
and/or birth date. Ensure the same information is on the request form.
3. Position the patient and the parents (or individual designated to hold an infant or
small child) as necessary.
4. Verify that any dietary restrictions have been met (e.g. fasting), and check for latex
sensitivity.
5. Wash hands and put on gloves.
6. Assemble supplies and appropriate tubes for the requested tests. Check paperwork
and tube selection.
7. Select the puncture site.
8. Warm the puncture site
9. Cleanse the puncture site with 70% isopropyl alcohol using concentric circles,
working from the inside to outside. Allow the skin to dry.
10. Open and inspect the sterile disposable puncture device, and perform the puncture
while firmly holding the heel or finger. Discard the device in the appropriate sharps
container.
11. Wipe away the first drop of blood with a clean, dry gauze pad. This removes any
residual alcohol and any tissue fluid contamination.
12. Make blood films if requested.
13. Collect blood in the appropriate collection tubes and mix as needed.
14. Apply pressure and elevate the puncture site until bleed has stopped.
15. Label each specimen with the required information and indicate skin puncture
collection.
16. Handle the specimens appropriately.
17. Discard all puncture equipment and biohazardous materials appropriately.
18. Remove gloves and wash hands.
19. Deliver the proper labeled specimens to the laboratory.

B. BLOOD SMEAR
➔ MATERIALS
● Glass slides
● Spreading slide
● Dryer (cold air) or a fan
➔ PROCEDURE
1. Place a drop of blood (from a finger or capillary tube) on a clean microscope slide
(about 2 cm from one end.
2. Hold the end of another clean slide at a 50 degree angle against the first slide and
push the blood drop away from the middle of the first slide. Now push the second
slide toward the middle of the first slide. This makes an even smear across the slide.
Stop before reaching the end of the slide. Put the spreader directly into the
BIOHAZARD container.
3. When the blood has dried, draw two lines on the sample slide with a wax pencil.
Mark on clean glass, not through the smear. Drop a few drops of Wright stain on the
smear. Drop a few drops of Wright stain, counting them as you do so. After 4
minutes, add an equal number of drops of distilled water to the smear. After 10
minutes, gently rinse the slide under tap water for 30 seconds; then blot it dry with
bibulous paper.
4. Scan the slide under low power on your microscope until you find an area where
the cells are thinly spread. Switch to high power and observe the blood cells on the
slide.
DRAW A BLOOD SMEAR

BLOOD CELL TYPES

DRAW AND COLOR THE FOLLOWING CELLS
OBSERVED UNDER THE MICROSCOPE

RED BLOOD CELLS

NEUTROPHILS
EOSINOPHILS

BASOPHILS

LYMPHOCYTES

MONOCYTES
C. BLOOD TYPING AND RH TYPING
➔ MATERIALS NEEDED
- Lancet, alcohol, cotton, pricker/lancet, glass slides, anti-A,B and anti-
D
➔ PROCEDURE
1. First, scrub the middle finger with cotton saturated with 70% of alcohol.
2. Then, prick the middle finger with a sterilized needle or lancet.
3. After that, place three drops on a clean glass slide.
4. Then after this, add antisera in a sequence of anti- A in the first drop, anti- B in the
second drop and anti- D to the third drop, respectively.
5. Mix the blood with the antisera separately by using a sterilized toothpick.
6. Allow the slide to stand for 2-3 minutes and then note down the results based on
clump formation or agglutination reaction.

INTERPRETATION OF RESULTS

1. BLOOD TYPE: A RH TYPE: POSITIVE

 2. BLOOD TYPE: O RH TYPE: NEGATIVE

3. BLOOD TYPE:B RH TYPE: B - NEGATIVE

ACTIVITY QUESTIONS:
1. What is the equipment’s used in venipuncture?
The equipment’s used in venipuncture are
Tourniquet
70% Alcohol Wipes
Cotton or Gauze
Tape
Vacutainer Tube
Multi-Sample
Straight Needles
(21, 22 or 23 Gauge)

2. What are the complications encountered in venipuncture? Enumerate 3 and explain.

Complications that can arise from venipuncture includes haematoma formation,
nerve damage, and pain.
3. What is the important step in phlebotomy? Explain briefly.
The most important step is Patient identification, it is crucial and it is the
responsibility of the phlebotomist to ensure that blood is drawn from the individual
 designated on the request form and the tube labelling process and patient
identification are essential safety barriers to prevent patient identity mix-up.

4. What will you do if your patient begins to faint during venipuncture? Explain briefly.
If a patient faint during the venipuncture, immediately abort the procedure by gently
removing the tourniquet and needle from the patient's arm, apply gauze and
pressure to the skin puncture site and call for assistance. If the patient is seated,
place the patient's head between his/her knees.

5. Can agglutination occur when Type A blood is given to a person with Type O blood?
Their blood does not discriminate against any other ABO type. Consequently, they
are universal receivers for transfusions, but their blood will be agglutinated when
given to people with every other type because they produce both kinds of antigens.

REFERENCES:
https://www.labce.com/spg549504_what_to_do_if_the_patient_feels_faint.aspx
https://www.eflm.eu/files/efcc/3.%20CCLM-2015%20-
%20Patient%20identification%20WG-PRE.pdf
https://www.news-medical.net/health/Blood-Type-Testing.aspx
https://www.researchgate.net/publication/275989947_Complications_of_venepunctu
re