Utilizing tubes that have expired may result in which of the following?

Choice A Reason:
SST, or Serum Separator Tube, contains a gel at the bottom to separate the blood from the serum upon centrifugation. It does not indicate plasma; rather, it is used to collect serum after the blood has clotted. The SST allows for the blood to clot and the serum to be separated for various tests that require serum instead of plasma.

Choice B Reason:
Sodium fluoride is a common additive in collection tubes that serves as a glycolysis inhibitor. It preserves glucose levels and is not specifically indicative of serum. However, it is often used in grey-top tubes, which are typically used for glucose testing and may contain plasma, not serum.

Choice C Reason:
Sodium citrate is an anticoagulant that binds calcium in the blood, preventing clotting. Tubes with sodium citrate are used to collect plasma for coagulation studies, not serum. Therefore, this statement is incorrect as sodium citrate indicates plasma, not serum.

Choice D Reason:
EDTA, or Ethylenediaminetetraacetic acid, is an anticoagulant that binds calcium ions, preventing blood from clotting. Tubes with EDTA are used for collecting plasma because they prevent clotting and allow for the separation of plasma from the blood cells upon centrifugation. This is the correct choice as EDTA indicates plasma.

Choice A Reason:
Explaining the procedure to both the parent and the child is crucial. It helps in preparing the child psychologically and ensures that the parent is informed and can provide support during the process. Clear communication can reduce anxiety and make the child more cooperative. It is also a part of informed consent, where the parent understands what the procedure entails and why it is necessary¹².

Choice B Reason:
Choosing not to tell the child when the needle insertion is coming might seem like a way to avoid causing them anticipatory anxiety. However, this approach can lead to mistrust. Children need to be prepared for what to expect, and surprising them can be more traumatic in the long run. It is better to be honest and use age-appropriate language to describe the sensation as a 'quick pinch' or 'poke'¹².

Choice C Reason:
Obtaining a heel stick is a common method for blood collection in infants, particularly newborns, as their veins are not as developed. However, for preschoolers, venipuncture is usually the preferred method because they have more developed veins, and it allows for a larger volume of blood to be collected if needed³.

Choice D Reason:
Obtaining a thumb stick is not a standard practice for blood collection in preschoolers. The thumb has bones and tendons close to the surface, which can increase the risk of injury. The preferred sites are the antecubital fossa of the arm or the back of the hand where the veins are more accessible and there is less risk of hitting bone³.