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Phlebotomy Chapter 9
Terms in this set (47)
All of The Above
Which is the purpose of the requisition?
-Identifying the patient
-Determining the specimens to be collected
-Allowing the equipment necessary for the collection to be gathered
Which vein is often the only one that can be palpated in an obese patient?
Upon entering a patient's room you should first
Which vein lies close to the brachial artery?
15 to 30 degrees
At what angle should a venipuncture needle penetrate the skin?
All of the Above
Which information must match on the patient's ID band and the requisition?
Before the needle is withdrawn
When should the tourniquet be removed from the arm in a venipuncture procedure?
3 to 4
Tourniquets should be placed ________ inches above the venipuncture site.
The following can occur if the tourniquet is left on the patient too long.
Removing the tourniquet after removing the needle
Hematoma can be caused by
An increase in the ratio of formed elements to plasma is called
Small red spots on the skin are referred to as
Ask the patient's nurse to attach a new ID band before proceeding
If you are asked to perform a venipuncture on an impatient who is not wearing an ID band, you should
Which vein is the first choice for venipuncture?
During the venipuncture procedure, the tourniquet should stay on no longer than
Sometimes a patient who is covered by Medicare may request a service such as a diagnostic test or treatment that is not eligible for reimbursement. In such cases, Medicare regulations require that the patient sign an __________
If the service (such as a blood draw) is performed without an ABN and Medicare rejects the reimbursement claim, your institution is ___ _______ to bill the patient for these services.
Therefore, if you have been given an ABN for a patient, it is very important to obtain the patient's _________ on the form before providing the service.
Correctly and unambiguously
________ and __________ identifying the patient is the most important step in any phlebotomy procedure.
Name, DOB, Hospital ID
The three most important identifiers are _____ _____ _____
All inpatients should be wearing an ___ ______ issued by the hospital
The ID number must _____ the number on the requisition.
Do NOT Draw Blood
If the ID band is not attached to the patient, even if it is on the bedside table _____ _____ ____ _____.
Correct identification requires that ___ available identifiers must match
Steps for a routine Venipuncture
1. Greet and Identify the Patient
2. Position and Prepare the Patient
3. Perform basic hand hygiene, and put on gloves
4. Apply the tourniquet
5. Select the Site
6. Palpate the vein
7. Assemble your equipment
8. Clean the site
9. Reapply the tourniquet
10. Examine the needle
11. Perform the venipuncture
12. Fill the first tube
13. Advance and change the tubes
14. Remove the tourniquet
15. Prepare for Needle Removal
16.Withdraw the needle
17. Dispose of the entire used needle collection system in the needle collection container
18. Label the tubes
19. Attend to the patient
20 Deliver the Specimen
Venipuncture with a syringe
1. Follow the beginning steps for a routine venipuncture
2. Prepare the syringe and perform the venipuncture
3. Fill the Syringe
4. Withdraw the needle and transfer the blood to evacuated tubes.
5. Dispose of the syringe and transfer device together in the appropriate container
6. Complete the procedure
"When was the last time you had anything to eat or drink?"
If the sample requires pretest fasting you should...
Explain the procedure and get a verbal ________ _______ from the patient.
3 to 4 inches
The tourniquet should be applied ___ __ ____ ______ above the puncture site.
can occur if the tourniquet is too tight or left on too long. Destruction of red blood cells can alter test results.
Median Cubital Vein
is the first choice. It is located in the middle of the arm's surface, is large and well anchored, and does not move when the needle is inserted.
on the same side of the arm as the thumb is the second choice.
on the same side of the arm as the pinky finger, is the third choice. It is close to the median nerve and brachial artery.
Bevel up, in one smooth quick motion
Insert the needle...
after blood beings to flow in the first tube
The tourniquet can be removed
The tourniquet must be removed before the needle is removed from the vein to prevent formation of a ________, which is a reddened, swollen area where blood collects under the skin
straight out; same angle
Pull the needle assembly ________ ___ from the patient's arm at the ____ _____ it was inserted
activate the ______ _______ of the needle
Gauze; Press Down
Apply a _____ folded in quarters to the puncture sit. Do not _____ ____ on the site until after withdrawal
Bedside, or drawing room
Label each tube at the patient's _______ or in the _______ ____ in the presence of an outpatient. Do not leave the room without labeling
Bags or Tube holders
Place all specimens in either ____ or ____ _______, and then remove your gloves and wash your hands.
Twist the needle onto the ___ of the syringe
Freely; expel any air
Pull the plunger back and forth to be sure it moves ______, and then push it all the way back in to _____ ___ ___
a _____ of blood should appear in the syringe hub, indicating that the vein has been entered.
Transferring blood to evacuated tubes is done in the ____ _____ as if the evacuated tube system was used. Rubber stoppers should not be removed.
Place tube in ____ ______
Never transfer blood from a syringe with an _______ ______
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