what sites should be avoided when performing venipuncture quizlet

\u00a9 2023 wikiHow, Inc. All rights reserved. If using a needle and syringe, avoid drawing the plunger back too forcefully. Stress: May cause transient elevation in white blood cells (WBC's) and elevated adrenal hormone values (cortisol and catecholamines). A face mask reduces risk for blood culture specimen contamination. The key elements in labeling are: NOTE: Both of the above MUST match the same on the requisition form. A 21-gauge needle (e.g. https://www.ncbi.nlm.nih.gov/books/NBK138650/pdf/Bookshelf_NBK138650.pdf (Accessed June 13, 2022). 5. Avoid prolonged tourniquet application or fist clenching. Tubes with different additives are used for collecting blood specimens for specific types. 2009 Feb;131(2):195-204. Elderly patients often have fragile skin and veins that roll quite easily, When a vein rolls, the needle tends to push the vein aside rather than penetrating through. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. D. Both A and B, A sharps container is identified by its bright ____ color Specimens; Approved StandardSixth Edition. Avoid a probing, traumatic venipuncture. C. the seal is broken Collect the drops of blood into the collection device by gently massaging, Avoid excessive pressure that may squeeze tissue fluid into the drop of, When full, cap and then gently invert the collection device 5-10 times to, Hold a gauze pad over the puncture site for a short time to stop the, Dispose of the contaminated materials and lancet in the appropriate waste, Place a band-aid on the patients finger or have someone continue to hold, gauze on the finger. The service requires full cookie support in order to view this website. D. after needle removal, When drawing blood you should always follow universal ______ Take enough time to assess the vein before beginning the venipuncture procedure. By using our site, you agree to our. An OSHA acceptable, puncture proof container markedBiohazardous. You may also remove the tube, wait a few seconds for blood flow to resume, and then engage a short drawtube. Certain areas are to be avoided when choosing a site: Extensive scars from burns and surgery - it is difficult to puncture the scar tissue and obtain a specimen. if ( prevIframeHeight != zf_ifrm_ht_nw ) { B. the needle is inserted into the patient's arm Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best. -use a smaller gauge needle Position the patient. Otherwise, satisfactory samples may be drawn below the IV by following these procedures: Turn off the IV for at least 2 minutes before venipuncture. Phlebotomy Essentials 5th Edition Chapter 9. 2004;24(4):979-96, vii. Venipuncture requires good skills in order to perform the procedure not only correctly, but also painlessly. Carry out hand hygiene before and after each patient procedure, before putting on and after removing gloves. Source of specimen. Remove your gloves and wash your hands. Hematoma - may cause erroneous test results. Airborne precautions may be considered to provide a level of safety against infectious diseases such as tuberculosis, influenza, and COVID-19. The median cubital vein is used the most for its accessibility. Collect drops of blood into the collection device by gently massaging the finger. How far above a venipuncture sight should you place a tourniquet? How many time should you invert them? The median cubital creates less bruising and pain than other draw sites. If this is not successful, remove the needle, take care of the puncture site, and redraw. This is very painful, risks damage to underlying structures, and widens the needle hole to prolong bleeding time. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Certain other sites should also be avoided. The creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and platelet count may increase. D. Butterfly, Before leaving the patient's bedside, you must make sure that: Impact of Use of Smaller Volume, Smaller Vacuum Blood Collection Tubes on Hemolysis in Emergency Department Blood Samples. However, if there is no alternative and an arm with an IV line in place must be used for venipuncture, try to choose a site away from and below the location of the IV. Allow another large drop of blood to form. Have the patient position their arm on the armrest. The recommended order of draw for plastic collection tubes is: First - blood culture bottle or tube (yellow or yellow-black top). 1. Avoid the side of the finger where there is less soft tissue, where vessels and nerves are located, and where the bone is closer to the surface. Be careful not to withdraw the needle completely or else you risk losing the tube's vacuum and starting a hematoma when the bevel exits the skin. Additionally, blood samples should not be taken on an arm with a fistula used for dialysis treatments. Place labeled specimens in zip lock bag and deliver to the laboratory as soon as possible. Coagulation tests (protime and prothrombin time), Tube is designed to contain no contaminating metals, Trace element testing (zinc, copper, lead, mercury) and toxicology, Antiglycolytic agent preserves glucose up to 5 days, HLA tissue typing, paternity testing, DNA studies, Inactivates thrombin and thromboplastin; contains virtually no lead. Alcohol not dry in the required amount of time B. Veins less prominent and less filling C. Veins more prominent and easier to puncture D. Blood stop flowing to arteries but not veins A The most common site (s) for the venipuncture procedure is/are the following: Failure to do this results in an unequal blood-to-additive ratio, making the specimen unsuitable for analysis. Lancets are disposed of in an appropriate sharps container as one unit. Choosing an appropriate site for venipuncture is crucial for a successful . Hematoma formation is a problem in older patients. PST (light green top). (function() { As part of presenting a professional appearance, an institutional dress code may include wearing of a laboratory coat or smock. Unlike the cephalic and basilic veins, the median cubital vein is not near major nerves or arteries. A clinical study is performed to determine the optimal time for application of the tourniquet during phlebotomy. True or False? wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. (c) the rate of heat transfer. Lightly touch the microtainer capillary collectiondevice (or filter paper) to the LARGE drop of blood. When using a syringe inserted into the line, blood must be withdrawn slowly to avoid hemolysis. Clin Chem Lab Med. Individually packaged 70% isopropyl alcohol wipes. Loosen the tourniquet. Wait 2 minutes before reapplying the tourniquet. It is an employer's responsibility to provide, clean, repair, replace, and/or dispose of personal protective equipment/clothing. Websites that masquerade as the ones you trust. 1-kg of R-134a initially at 600 kPa and 25C25^{\circ} \mathrm{C}25C undergoes a process during which the entropy is kept constant until the pressure drops to 100 kPa. Laboratory coats or work smocks are not typically needed as personal protective equipment during routine venipuncture, but an employer must assess the workplace to determine whether certain tasks, workplace situations, or employee skill levels may result in an employee's need for laboratory coats or other personal protective equipment to prevent contact with blood. However, drawing blood from the hand is affiliated with higher levels of pain and less control. D. all of the above, Common causes of hematomas that form during a venipuncture include: B. the needle is only partially in the vein 2. followed pre-lab instructions. Focus on what you do best, and find someone who can help you communicate that with your target market. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Observe all applicable isolationprocedures. BD Eclipse black-capped) have a smaller diameter and may be more suitable for smaller veins. 9. Within the antecubital fossa, this vein poses the least amount of risk. C. at a mastectomy site Kiechle FL. The patient has the right to refuse participation in such activity. Procedures and Devices for the Collection of Diagnostic Capillary Blood. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. proteins). Allow filter paper to air dry for two (2) hours at room temperature. Do not use the tip of the finger or the center of the finger. Joslin JO. Confidentiality of all communications and other records pertaining to the patient's care. 9. We use cookies to make wikiHow great. Over 52 percent of all web traffic is from mobile devices . While the median cubital, cephalic, and basilic veins are the most popular draw sites for blood draws, phlebotomists may resort to other draw sites if their ability to draw is restricted. Intravenous therapy (IV) / blood transfusions - fluid may dilute the specimen, so collect from the opposite arm if possible. B. sterilized and reused Diagn Microbiol Infect Dis. -hemorrhage/hematoma. For operation at steady state, determine for the motor, each in kW\mathrm{kW}kW Please enable JavaScript on your browser and try again. Last draw - additive tubes in this order: SST (red-gray or gold top). C. sterile gauze pads Certain areas are to be avoided when choosing a site: Extensive scars from burns and surgery - it is difficult to puncture the scar tissue and obtain a specimen. The vein may have collapsed; resecure the tourniquet to increase venous filling. Avoid placing sample onhot surfaces such as bili-lights or monitors. Try rotating the arm to better expose the cephalic or basilic vein. f.style.width="100%"; In this elbow pit, phlebotomists have easy access to the top three vein sites used in phlebotomy: Median cubital vein. To prevent hemolysis when performing a venipuncture, the phlebotomist should: 1. 6. 8. Patient care following completion of venipuncture. therapy is usually associated with acidic or alkaline solutions or solutions that have a high osmolarity. A. C. Red 2. Hematoma - may cause erroneous test results. Clin Biochem. Provide for their comfort as much as possible, and gain the patient's cooperation. Venipuncture sites should be carefully assessed for contraindications, such as pain, wounds, decreased circulation, a previous cerebral vascular accident (CVA), dialysis fistulas, or a mastectomy on the same side. Phlebitis is inflammation of a vein. Hematoma - A venipuncture should not be performed on a hematoma, regardless of how small it may be. Once you establish blood flow, slightly modify your hand position to stabilize the needle against the arm and prevent further movement. D. all of the above, Julie S Snyder, Linda Lilley, Shelly Collins, Zoology Chapter 16 & 17: Invertebrate Deutero. Proper patient identification MANDATORY. A. the plastic sleeve is removed B. Hematoma Although the larger and fuller median cubital and cephalic veins of the arm are used most frequently, the basilic vein on the dorsum of the arm or dorsal hand veins are also acceptable for venipuncture. Performing a venipuncture on a child under one year of age . Have the patient hold a small gauze pad over the puncture site for a couple of minutes to stop the bleeding. Which element has the highest ionization energy? diet, exercise, stress, basal state). (b) How would you prepare tetracaine from p-nitrobenzoic acid? As a countermeasure, phlebotomists. (a) the electric power required. Approach the patient in a friendly, calm manner. Contains a gel separator and clot activator. Always thank the patient and excuse yourself courteously when finished. Never draw above an IV site. 5. If you stick yourself with a contaminated needle: Remove your gloves and dispose of them properly. 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