what sites should be avoided when performing venipuncture quizlet

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Do not bend, break, recap, or resheath needles to avoid accidental needle puncture or splashing of contents. Verify the patient's condition. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. (Partial penetration may allow blood to leak into the soft tissue surrounding the vein by way of the needle bevel). This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Phelan MP, Reineks EZ, Berriochoa JP, Schold JD, Hustey FM, Chamberlin J, Kovach A. True or False? When there is an IV line present, blood can be drawn from this line. IV lines are very useful in hospitals because some patients require frequent blood tests. The creatine kinase (CK), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and platelet count may increase. D. All of the above, Needles are sterile until: Position the infant with the head slightly elevated. Please enable cookies on your browser and try again. Provide for their comfort as much as possible, and gain the patient's cooperation. Do not use excessive pressure or heavy massaging because the blood may become diluted with tissue fluid. Several essential steps are required for every successful collection procedure: Patient comfort. })(); The cephalic vein is a safe secondary option if the median cubital vein is not working. It is large and near the skins surface, making it easier for phlebotomists to see before anchoring the vein. Do not use a previous puncture site. In the case of an accidental stick, immediately wash the area with an antibacterial soap,express blood from the wound, and contact your supervisor. 8. 4. Contaminated surfaces must be cleaned with freshly prepared 10% bleach solution. 9. var d = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas"); Compare and contrast the two major types of neuronal pathways. A typical single vial contains about five milliliters, which is about one teaspoon. Have the patient position their arm on the armrest. Am J Clin Pathol. If the blood flow is diminished, repeat the capillary PUNCTURE to complete the collection. 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: Press down on the gauze once the needle is out of the arm, applying adequate pressure to avoid formation of a hematoma. Venipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. It is not uncommon for adults and children to feel some fear when having blood drawn, which is why any discussion of venipuncture should at least bring this topic to focus. Some images used in this set are licensed under the Creative Commons through Flickr.com.Click to see the original works with their full license. increase the circulation of blood to the area. Be sure to dispose of the lancet in the appropriate sharps container. Never draw over scars or a new tattoo sites. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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\u00a9 2023 wikiHow, Inc. All rights reserved. Feel for the median cubital first, the cephalic vein second, and the basilic vein third. Extensive scarring or healed burn areas should be avoided Specimens should not be obtained from the arm on the same side as a mastectomy. Blood Specimen Collection and Processing 8. } Gloves are to be worn during all blood collection procedures, and changed betweenpatient collections. Arteries pulsate, are very elastic, and have a thick wall. Describe and perform the venipuncture process including: Appropriate clothing and protective equipment. In some cases, a phlebotomist may have to switch sites if they find the blood is not properly flowing from the vein. f.style.width="100%"; This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Lancets are disposed of in an appropriate sharps container as one unit. Firmly grasp the flanges of the tube holder to avoid advancing the needle further into the vein as you change tubes. 13 Websites to Avoid If You Value Your Time | PCMag var iframe = document.getElementById("zf_div_SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas").getElementsByTagName("iframe")[0]; f.style.height="352px"; Hyperextend the patient's arm. X=[Ar]4s23d5Y=[Ar]4s23d104p1Z=[Ar]4s23d104p6. 5 Common Capillary Puncture Blood Collection Sites - Neoteryx The service requires full JavaScript support in order to view this website. Identify the patient. Sanders AM, Agger WA, Gray AM, Fischer CM, Kamprud EA. Compared to the standard blood donation which is about sixteen ounces, one ounce is really small. For operation at steady state, determine for the motor, each in kW\mathrm{kW}kW antecubital fossa What are the best veins for venipuncture? Have the patient drink fluids if dehydrated. How to Avoid Dangerous Websites - Lifewire Our courses are designed to provide students with the skills and knowledge necessary to work in a variety of medical settings including: Hospitals, Clinical Laboratories, Clinics, Physicians Offices, Blood Banks and much more. EDTA and sodium citrate tubes should still be filled to the marked fill line to ensure a correct blood-to-additive ratio. Hematoma - may cause erroneous test results. Therapeutic Drug Monitoring: different pharmacologic agents have patterns of administration, body distribution, metabolism, and elimination that affect the drug concentration as measured in the blood. Warning: Make sure you are confident that the structure you're palpitating is indeed a vein. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment. Why? Tip: Patients who need regular bloodwork (e.g. Always thank the patient and excuse yourself courteously when finished. If it is then heated, what can you say about: b) how often the molecules hit the walls of the can. Specimens; Approved StandardSixth Edition. (a) the electric power required. What is the most common site for blood sampling? C. sterile gauze pads PERFORMING A CAPILLARY PUNCTURE - Akron Children's Hospital You will be redirected once the validation is complete. For an inpatient the nursing staff can be contacted to aid in identification prior to proceeding. The median cubital vein is used the most for its accessibility. A test that has been ordered may be cancelled due to problems unrelated to drawing the specimen, and these are the most common causes for cancellations: A test may be cancelled due to a technical problem in the specimen collection process: Identification of the specimen is suspect. Such terms as "needs to," "must," "require" and "should" are used to explain how medical professionals should perform capillary blood collection procedures. B. just after needle insertion, but prior to vacutainer activation The most commonly used site for a venipuncture is at the bend of the elbow, also called the antecubital fossa 1. To prevent hemolysis when performing a venipuncture, the phlebotomist should: 1. When wearing gloves, change them between each patient and wash your hands frequently. Examples of labeled collection tubes are shown below: THE FOLLOWING ARE NEEDED FOR ROUTINE VENIPUNCTURE: Evacuated Collection Tubes - The tubes are designed to fill with a predetermined volume of blood by vacuum. 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. Include your email address to get a message when this question is answered. What are the complications that can occur when performing a venipuncture? Phlebotomy Essentials 5th Edition Chapter 9. Phlebotomy tutorial for medical education - WebPath HealthStar Press, Inc. 2001, updated 1/08. Safely dispose of potentially infectious materials. Tip: When using a butterfly and sodium citrate is the first to be collected in the order of draw, a discard tube must always be filled first to purge the air from the tubing. if( evntData && evntData.constructor == String ){ C. Iodine Green It brings the entire family A commercial heel warmer may be used. Grasp the patient's arm firmly using your thumb to draw the skin taut and anchor the vein. 11. var prevIframeHeight = iframe.style.height; 2. This process is automatic. Switch to the other arm if you can't find anything. Psychological interventions for needle-related procedural pain and distress in children and adolescents. BD Vacutainer), rather than IV catheter insertions. -do not rapidly insert the needle. This enables the bloodto form as a drop on the fingertip. Areas of the body that look infected, scarred, or burned must also be avoided. A. the tubes are filled and properly labeled Let's take a quick, high-level look at the venipuncture procedure. If none of these veins work, then the phlebotomists use the hand veins. Previous puncture sites should be avoided. d.appendChild(f); Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. Procedure for Capillary Puncture of the Heel: A heel puncture is performed on the lateral or medial plantar surface of the, foot. Predict a possible value of the thickness of the soap bubble. Allow to air dry. How far above a venipuncture sight should you place a tourniquet? C. the needle has penetrated all the way through the vein NHA Exam Questions Flashcards | Chegg.com All of the following are common types of equipment used for venipuncture EXCEPT: chemistries, serology, immunnology, blood bank. Concentrations of fluids and medications could affect baseline test results. Cochrane Database Syst Rev. What are the best veins for venipuncture? The median cubital vein is used the most for its accessibility. Confidentiality of all communications and other records pertaining to the patient's care. What sites should be avoided when drawing blood? McCall, R. E., & Tankersley, C. M. (2016). Mastering Pediatric Phlebotomy. Center, for Phlebotomy Education, Inc. When do you release the tourniquet during venipuncture? Apply an adhesive bandage. The antecubital fossa is a collection of veins located within the arms inner area, opposite of the elbow, where the arm folds in. B. collection device (See, The chlorhexidine is a concern for the premature babies in NICU as it can, be absorbed through the skin. Significant increases can be found in total protein, aspartate aminotransferase (AST), total lipids, cholesterol, iron, Affects packed cell volume and other cellular elements. With risk for blood spatter a face shield provides protection. Collect drops of blood into the collectiondevice by gently massaging the heel. Do not use the central portion of the heel because you might injure the underlying bone, which is close to the skin surface. At least two patient identifiers, such as name and date of birth, are needed. Look at the dorsum of the hand as a last resort. 10. Kiechle, Frederick L. So Youre Going to Collect a Blood Specimen: An, Introduction to Phlebotomy, 11th Edition. Make sure the venipuncture site is dry. Apply the tourniquet below the IV site. Wipe away the first drop of blood with sterile 22 gauze. An outpatient must provide identification other than the verbal statement of a name. What are the green/lavender top containers used for? Complications of venipuncture | How to avoid | Aimvein D. Butterfly, Before leaving the patient's bedside, you must make sure that: A needle is then gently inserted into the vein. Kiechle FL. Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site. Apply blood to the printed side of the filter paper. Ask the patient orcaregiver to state the patients name and date of birth. Edematous extremities - tissue fluid accumulation alters test results. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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\u00a9 2023 wikiHow, Inc. All rights reserved. The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. var zf_perma = zf_ifrm_data[0]; Use a butterfly to compensate for patient movement. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Clean the site to be punctured with an alcohol sponge. Allow thefinger to dry or wipe dry with a sterile 22 gauze. Gloves - can be made of latex, rubber, vinyl, etc. A 21-gauge needle (e.g. Also consider adjusting the angle of the needle. }, false); Cap, rotate and invert the microtainer to mix the blood collected. Failure to do this results in an unequal blood-to-additive ratio, making the specimen unsuitable for analysis. 5. obvious areas of skin infections Apply only ONE drop of blood per circle. Capillary punctures are not suitable for blood culture testing and most coagulation tests. Automated systems may include labels with bar codes. Effective communication - both verbal and nonverbal - is essential. How to Troubleshoot a Difficult Venipuncture. Never draw blood through a hematoma. To request course information, contact PhlebotomyU today. When the last tube to be drawn is filling, remove the tourniquet. 5. The most common complications are bleeding at the puncture site or hematoma formation. A. the plastic sleeve is removed If this is not successful, remove the needle, take care of the puncture site and redraw at another site. D. all of the above, Julie S Snyder, Linda Lilley, Shelly Collins, Zoology Chapter 16 & 17: Invertebrate Deutero. Wait 2 minutes before reapplying the tourniquet. Capillary Specimens may be used immediately for point-of-care testing. If an IV is in place, samples may be obtained below but NEVER above the IV site. var f = document.createElement("iframe"); All other items used for the procedure must be disposed of according to properbiohazardous waste disposal policy. 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. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. When using a syringe inserted into the line, blood must be withdrawn slowly to avoid hemolysis. Wear gloves and a lab coat or gown when handling blood/body fluids. Each phlebotomist generally establishes a routine that is comfortable for her or him. Tip: Lowering the arm below the level of the heart may help to engorge the vessels. Track marks are not only found on IV drug users, but also on chronically ill patients requiring repeated vascular access and blood draws and may be a sign of an anticipated difficult draw. 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. Avoid excessive pressure that may squeeze tissue fluid into the, mix the blood. For example, serum cortisol levels are highest in early morning but are decreased in the afternoon. What are the helpful hints for finding veins? Finally, when the necessary blood is collected, the needle will be removed and properly disposed of in a Sharps container and the puncture site will be covered to stop the bleeding. 9. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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\u00a9 2023 wikiHow, Inc. All rights reserved. C. After all specimens have been collected An assortment of needles and syringes of different sizes Tourniquet Alcohol and alcohol swabs Gauze or cotton balls Laboratory forms and blood-specimen labels Transportation bags and sharps container Step 2: Prepping The Patient Once you have the necessary supplies, it's time to ready the patient. If another site is not available, collect the specimen distal to the hematoma. The diagram below indicates in green the proper area to use for heel punctures for blood collection: Prewarming the infant's heel (42 C for 3 to 5 minutes) is important to obtain capillary blood gas samples and warming also greatly increases the flow of blood for collection of other specimens. Dispose of items in appropriate containers. The phlebotomist's role requires a professional, courteous, and understanding manner in all contacts with the patient. DOC Blood Collection by Venipuncture - Michigan Extremity is edematous. The patient has the right to refuse participation in such activity. Staying safe online: Avoid these types of websites - USWired What is the procedure to draw blood from an arm with an IV in it? Phlebotomy NHA flashcards Flashcards | Chegg.com Which element has the highest ionization energy? The antecubital fossa is a collection of veins located within the arm's inner area, opposite of the elbow, where the arm folds in. } Lines - Drawing from an intravenous line may avoid a difficult venipuncture, but introduces problems. with their hand to stabilize it for the draw. Sharps Disposal Container. Edematous extremities with swollen tissue alter the results. Deliver specimens promptly to the laboratory. Stabilize the needle as you're inserting your tubes. The blood is bright red (arterial) rather than venous. 8. If using a syringe, make sure the needle is fitted securely on a syringe to avoid frothing. Try another tube. Some DNS services support web filtering, too. 6. Asking the patient about their previous blood draw experiences is beneficial, especially if they are a hard stick and know which area works best. Sign up for wikiHow's weekly email newsletter. A. excessive probing with the needle The median cubital creates, The dorsal venous network is the next most common vein site for phlebotomists. WHO guidelines on drawing blood: best practices in phlebotomy. Identify the patient using two different identifiers, asking open ended questions such as, "What is your name?" The patient should make a fist without pumping the hand. (b) the power developed by the output shaft. Cleanse in a circular fashion, beginning at the site and working outward. Label the specimens before leaving the patients bedside. Palpate and trace the path of veins with the index finger. Patient care following completion of venipuncture. Be informed of the hospital rules and regulations regarding patient conduct. Filter paper should touch only the blood and not the heel or finger. If you are using a butterfly, try to retie the tourniquet around the patient's arm to increase pressure and re-establish blood flow. Blood is commonly obtained from the median cubital vein on the anterior forearm. What are the light blue top containers used for? Check for timing instructions for drawing the appropriate samples. It is not as close to the skin surface as the median cubital and cephalic veins, which poses a greater risk of damage to the median nerve and brachial artery. This information must be given when requesting microbiology, cytology, fluid analysis, or other testing where analysis and reporting is site specific. Each time a vein is accessed with a needle, scar tissue forms as part of the body's healing process. Select the appropriate microtainers for the specimens to be collected. 3. 2. 7. The service requires full cookie support in order to view this website. 4. Lippi G, Salvagno GL, Montagnana M, Franchini M, Guidi GC. He previously worked in a high-volume outpatient lab and is currently employed in an acute care hospital and Level III trauma center in downtown Vancouver. site. Arteries pulsate, are most elastic, and have a thick wall. Position the patient. containers. 11. Lippi G, Blanckaert N, Bonini P, Green S, Kitchen S, Palicka V, Vassault AJ, Mattiuzzi C, Plebani M. Causes, consequences, detection, and prevention of identification errors in laboratory diagnostics. 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. Swiftly insert the needle through the skin and into the lumen of the vein. 2009;47(2):143-53. The patient should either sit in a chair, lie down or sit up in bed. Observe universal (standard) safety precautions. Remove the needle from the patient's arm using a swift backward motion. 12. Know the identity and professional status of individuals providing service and to know which physician or other practitioner is primarily responsible for his or her care. D. Both A and B, A sharps container is identified by its bright ____ color We use cookies to make wikiHow great. 2017;148(4):330-335. (See picture.) What two things should you make sure you discuss with your patients prior to venipuncture? Source of specimen. Normal reference ranges are often noted according to age. This vein lies close to the surface of the skin and there is not a large nerve supply. try{ Occupational Safety and Health Administration, United States Department of Labor. Many drugs will have "peak" and "trough" levels that vary according to dosage levels and intervals. After cleansing, allow the venipuncture site to air dry. When finished, clean the site and apply pressure with clean gauze to stop the bleeding. Giavarina D, Lippi G. Blood venous sample collection: Recommendations overview and a checklist to improve quality. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Position the patient so that the hand is easily accessible. While this may be effective in some difficult draws, the risk of a needlestick injury is higher if the patient has a withdrawal reflex and the needle recoils back into your finger. are known to vary lab results of some analytes. Blood is collected into an attached vial or tube that is airtight and the flexible band is then removed from the arm. This makes every subsequent poke harder and harder because scar tissue is more fibrous and tougher to puncture. B. Yellow Previous puncture sites should be avoided. 3. Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. jugular) or a central venous catheter is out of the scope of practice of a certified phlebotomist and should only be performed by a physician or advanced nurse. Expect that any discussion or consultation involving the patient's case will be conducted discretely and that individuals not directly involved in the case will not be present without patient permission.

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