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Introduction:
When evaluating anemia, physicians may order both a hemoglobin and hematocrit test. These tests provide valuable information about the patient’s blood composition and can help determine the presence and severity of anemia. In addition, various lab results need to be analyzed to identify whether they are within the normal range, high, or low. The understanding of different blood collection tubes and their purpose, as well as the correct order of draw, is crucial in phlebotomy. In this context, this answer will address the questions regarding the evaluation of anemia and the interpretation of specific lab results, as well as the concepts related to blood collection.

1. Explain why a physician would order both a hemoglobin and hematocrit test as a means of evaluating anemia. Be specific.
A physician would order both a hemoglobin and hematocrit test to evaluate anemia because they provide complementary information about the patient’s red blood cell (RBC) levels. Hemoglobin is the protein in RBCs responsible for transporting oxygen throughout the body. By measuring hemoglobin levels, the physician can assess the oxygen-carrying capacity of the blood. Hematocrit, on the other hand, represents the percentage of total blood volume occupied by RBCs. It indirectly reflects the RBC count and their ability to deliver oxygen. When evaluating anemia, it is important to assess both hemoglobin and hematocrit to obtain a comprehensive understanding of the patient’s RBC status and oxygen-carrying capacity.

2. Grace Sifuentes, age 4, has a hematocrit of 38%. Is that normal, high, or low?
Based on the information provided in Table 48.5, a hematocrit level of 38% is considered normal for a child aged 4.

3. Christian Washington, age 45, has a WBC count of 14,200/mm3. Is that normal, high, or low?
Referring to the lab report form in Fig. 48.7 and Table 48.5, a WBC count of 14,200/mm3 is considered high. The normal range for WBC count is typically between 4,000/mm3 to 11,000/mm3.

4. Brigitte Mulrooney, age 29, has a hematocrit of 32% and a hemoglobin of 10 g/dL. Are these results normal, high, or low?
Both the hematocrit level of 32% and hemoglobin level of 10 g/dL are considered low based on the information provided in the resources.

5. Eleanor Jackson, age 81, has 23% bands in her white blood cell differential. Is that normal, high, or low?
Referring to the lab report form in Fig. 48.7, a result of 23% bands in a white blood cell differential is considered high. In a healthy individual, the percentage of bands should be minimal. Elevated levels of bands usually indicate an ongoing infection or inflammation.

6. Define plasma and serum in your own words.
Plasma refers to the liquid component of blood that remains after the removal of cells and clotting factors. It contains water and various dissolved substances, including electrolytes, proteins, hormones, and waste products. Serum, on the other hand, is the liquid component of blood obtained after the coagulation process. It does not contain fibrinogen, a clotting factor that is converted to fibrin during clot formation. Serum contains similar components as plasma, but without the clotting factors.

7. Explain the correct ‘order of draw’ regarding blood collection tubes and list the blood culture bottles.
The correct order of draw regarding blood collection tubes is as follows:
1. Blood culture bottles
2. Light Blue Top
3. Red Top
4. Green Top
5. Lavender Top
6. Gray Top

8. Describe the purpose of each blood collection tube.
– Light Blue Top: This tube contains sodium citrate as an anticoagulant and is used for coagulation testing, specifically for prothrombin time (PT) and activated partial thromboplastin time (aPTT).
– Red Top: This tube does not contain any anticoagulant or additive. It is used for various general chemistry tests, including liver function tests, lipid profile, and blood glucose.
– Green Top: This tube contains heparin as an anticoagulant and is commonly used for plasma chemistry tests, such as electrolytes, blood gases, and some enzyme studies.
– Lavender Top: This tube contains ethylenediaminetetraacetic acid (EDTA) as an anticoagulant and is used for complete blood count (CBC) and blood cell morphology evaluations.
– Gray Top: This tube contains an anticoagulant, usually sodium fluoride, and an additive like potassium oxalate. It is primarily used for glucose testing and preserving certain analytes.

9. Create a mnemonic device or create your own saying to remember the order of the draw. Share it in the discussion.
One possible mnemonic device to remember the order of the draw is: “Cats Love Real Good Treats Graciously” (Cats-Love-Real-Good-Treats-Graciously), with each word representing the first letter of the corresponding tube color.

10. It is important to use a tourniquet to properly locate veins for phlebotomy. List three advantages of using a tourniquet to help locate veins.
– Improved vein visibility: The application of a tourniquet helps dilate the veins, making them more visible and prominent. This aids in locating a suitable vein for blood collection.
– Increased blood flow: The pressure exerted by the tourniquet helps increase blood flow to the area, enhancing the filling of the veins and making them easier to access.
– Reduced risk of hematoma formation: By restricting venous outflow, the tourniquet helps minimize blood leakage during needle insertion. This reduces the risk of hematoma formation, which can occur when blood leaks from the vein into the surrounding tissues.

In summary, understanding the rationale behind ordering hemoglobin and hematocrit tests for evaluating anemia, interpreting lab results, and comprehending the proper order of draw and blood collection tubes are fundamental aspects of a medical college student’s education. These skills are essential for effective patient care and accurate laboratory analysis.