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Terms in this set (48)
What are some ways to make a vein more palpable or to enhance the vein selection process?
massage the arm from wrist to elbow to force blood into the area or wrap a warm, wet towel around the site for few minutes to increase blood flow
a good vein has what?
resilience and bounce
what is the best way to clean a venipuncture site, why do you let it dry?
clean with antiseptic with 70% alcohol in concentric circles, allow to dry since it will sting or burn when needle is inserted, evaporation kills the bacteria
three things not to do to avoid contamination when cleaning a venipuncture site?
do not dry the alcohol with unsterile gauze, do not fan the site with hand or blow on it, do not touch the site after cleaning
how to tell from a vein from an artery
artery will have a pulse and vein will not have a pulse
why do you anchor the vein?
help the vein from rolling or moving, needle passes through taut skin more easily with less pain
how to clean the venipuncture site and what to use
concentric circles, and use 70% alcohol antiseptic pad
what is a requisition? name the types
-forms on which test orders are entered into, part of patient's medical record
manual, computer, bar-code
what is accessioning or to accession?
the process of recording in the order received, to take steps unmistakably connect the specimen and accompanying paperwork with specific individual
what is the info required on a requisition?
ordering physician's name, patient's first and last name and middle initial, patient's date of birth, type of test to be performed, test status, special precautions
should you tell a patient that the procedure won't hurt or should you be honest?
you should not tell the patient that it won't hurt
2 situations where you might not be able to draw blood on hospital rounds?
sleeping patient, patients with ID discrepancies
what is a bar-code and what information does it contain?
series of black stripes and white spaces of varying widths that corresponds to letters and numbers, it contains patient information, patient's ID number, name and tests
do not attempt resuscitation
as soon as possible
most important step in specimen collection?
identifying the patient
how do you label a tube?
must be labeled in the presence of the patient immediately after blood collection, never before
Minimum information on ID
first and last name, ID number or date of birth, date and time of collection, phlebotomist's initials, pertinent additional information such as fasting
common timed tests
GTT, blood cultures, Therapeutic drug monitoring
common fasting tests
glucose, cholesterol, triglycerides
which test is FATAL if misidentified?
type and crossmatch
what should you do if the patient's ID band is missing
ask the patient's nurse to attach and ID band before collection or ask the nurse to verify the patient
informing the patient that you are a student is part of what?
if the patient refuses to let you draw blood, what should you do?
to let them feel in control, keep off of them
the arm should be in what position for blood draw?
extend downward in a straight line from shoulder to wrist and not be bent at the elbow
how many times do you invert a tube?
why do you use a butterfly?
used for small and difficult veins
where is the tourniquet placed when drawing a hand vein?
above the wrist
what is the proper technique when transferring blood from a syringe to the tubes?
remove the needle into the sharps container, attach transfer device for filling the tubes at the syringe, place ETS tube in the transfer device in the order of draw, pushed into the internal needle until stopper is pierced
what must you do before drawing blood on a child?
earn the parent's trust, reduce the child's anxiety by being friendly, remove the least amount of blood needed
how much blood from children?
the minimum of blood required for testing
why is the butterfly method the best for children?
since it allows flexibility if the child struggles or twists, minimizes chance of clotted specimen and inadequately filled tubes, also reduce risk of creating too much vacuum draw on the vein causing it to collaspe
the hand vein technique
-tourniquet above wrist, use butterfly,
how do you immobilize children properly?
infants can wrap in blanket, parents or other phlebotomist can steady the child's arm, sit on parent's lap to prevent children from twisting, hold the child's arm down
4 challenges of geriatric venipuncture
mental impairment, hearing impairment, visual impairment, skin changes
what are some of the changes that happen in the elderly that make venipuncture more difficult?
arthritis, diabetes, coagulation problems (blood-thinning medications), parkinson disease
what disease causes tremors?
refrain from drawing from an elderly patient if
you have a cold or wear a mask
can you take blood on the arm with a fistula or graft?
what is the name of the care given to terminally ill patients?
what sit he proper patient position from drawing blood?
must be seated or laid down on well supported furniture, patient's arm should extend downward in a straight line from shoulder to wrist and not be bent at elbow.
proper placement of tourniquet?
3-4 inches above the intended venipuncture site
how long should be left on?
not more than 2 minutes
function of tourniquet?
slow down flow without affecting arterial flow, allows more blood to flow into area than out, vein backs up into the veins, enlarging them
when entering the vein what angle should it enter?
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