Definition
Collecting blood for a peripheral smear is a fundamental diagnostic procedure used to examine the morphology of blood cells under a microscope. It helps detect conditions like anemia, infections, leukemia, malaria, and other hematologic disorders.
Purposes
- To detect malarial parasites.
- To detect blood cell abnormalities.
Why Peripheral Smear Matters
A peripheral smear provides a morphological snapshot of blood cells—red cells, white cells, and platelets—under a microscope. It helps detect:
- Anemias (e.g., microcytic, macrocytic, hemolytic)
- Leukemias and lymphomas
- Infections (e.g., malaria, filariasis)
- Platelet disorders
- Blood parasites and cellular abnormalities
Articles
- Disposable lancets.
- Pipette and tubing.
- Slides.
- Cotton swabs/alcohol prep pads.
- Alcohol.
- Disposable gloves.
- Laboratory forms.
Procedure
| NURSING ACTIONS | RATIONALE | |
| 1. | Before procedure Check the physician’s order and nursing care plan. | Obtain specific instructions and information. |
| 2. | Identify the patient. | Ensures that right procedure is performed for right patient. |
| 3. | Explain the procedure to the patient. | Obtains patient’s cooperation and consent. |
| 4. | During procedure Wash hands and put on gloves. | Protects healthcare workers from possible exposure to blood. |
| 5. | Cleanse the site (ball of finger) with alcohol and dry with sterile cotton swab. | Any residual alcohol will alter red cell morphology. Blood will not collect into a compact drop but will run down the finger if it not dry. |
| 6. | Prick the skin sharply and quickly with sterile, disposable lancet. | Pricking the skin sharply and quickly, minimizes the pain during procedure and helps to obtain a flowing sample. |
| 7. | Release pressure on the finger and wipe off the first drop of blood. | Epithelial and endothelial cells can be found in the first drop of blood and can render the count inadequate. |
| 8. | Allow the blood to flow freely with an adequate puncture. | Pressing out the blood dilutes it with tissue fluid. |
| 9. | Obtain the blood sample, fill the pipette, and make blood smears on the slides. a. Thin smear Put a drop of fresh blood on the middle of the slide. Use another slide end to allow the drop of blood to spread along the slide. Push the spreader quickly from the center to the left of the slide drawing the blood behind it. Leave the film to dry. Do not blow on it. b.Thick smear Put three drops of fresh blood on the left-hand quarter of the slide.With the corner of another slide mis the blood and smear it in a round from about 1 cm in diameter. Leave the film to dry. Do not blow on it or shake the slide. | |
| 10. | After procedure Apply pressure over the puncture site, with a dry cotton ball until bleeding stops. | |
| 11. | When the film is dry, label the slide, wrap it, and dispatch to laboratory. | |
| 12. | Remove gloves, wash hands, and dispose of the articles in approved containers. |
Special Considerations
- Avoid hemolysis by handling the sample gently.
- Use fresh blood—delays can cause cell artifacts.
- For malaria or microfilaria detection, prepare both thick and thin smears.
- Ensure the smear has a feathered edge and is free of streaks or holes.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwer’s, ISBN-13:978-9388313285
Stories are the threads that bind us; through them, we understand each other, grow, and heal.
JOHN NOORD
Connect with “Nurses Lab Editorial Team”
I hope you found this information helpful. Do you have any questions or comments? Kindly write in comments section. Subscribe the Blog with your email so you can stay updated on upcoming events and the latest articles.
