ACT 3 - Venipuncture

Question 1

Two patterns of veins in the antecubital fossa

Answer 1

H and M pattern

Question 2

Order of the preferred vein for venipuncture in H pattern

Answer 2

Median cubital, cephalic vein, basilic vein

Question 3

Order of preferred vein for venipuncture in M pattern

Answer 3

Median vein, median cephalic vein, median basilic vein

Question 4

Sites deferred for venipuncture

Answer 4

• Tattooed, burns, scars
• Edematous arm
• Arm adjacent to mastectomy
• Burns

Question 5

Means “in front of the elbow”

Answer 5

Antecubital

Question 6

Why is locating the proper site for venipuncture important?

Answer 6

To avoid erroneous lab results and affect the overall outcome

Question 7

Typically larger, closer to the surface, better anchored, and more stationary than the others

Answer 7

Median antecubital vein

Question 8

Easiest and least painful site to puncture

Answer 8

Median antecubital vein

Question 9

Site to collect blood when the Median antecubital vein fails

Answer 9

Cephalic vein

Question 10

Movable and not embedded in the muscle

Answer 10

Cephalic vein

Question 11

Often well-anchored but harder to palpate that the median cubital vein. Often vein that is found in obese patients

Answer 11

Cephalic vein

Question 12

Most painful site for extraction

Answer 12

Basilic vein

Question 13

Last resort vein for venipuncture

Answer 13

Basilic vein

Question 14

Easy to palpate, not as well anchored, rolls more easily

Answer 14

Basilic vein

Question 15

Materials for locating the proper site for venipuncture

Answer 15

Gloves, mask, tourniquet

Question 16

A constricting device applied to a patient’s arm prior to venipuncture with the aim of inflating the veins by restricting venous blood for a period of time

Answer 16

Tourniquet

Question 17

The position of the tourniquet above antecubital area

Answer 17

3-4 fingers above

Question 18

Where does the loop of the tourniquet point?

Answer 18

Antecubital area

Question 19

Where does the tail of the tourniquet point?

Answer 19

Above

Question 20

A properly applied tourniquet is what?

Answer 20

Tight enough to restrict venous flow out of the area but not so tight as to restrict arterial flow into the area

Question 21

Restriction of venous flow helps what?

Answer 21

• inflate veins, making it larger and easier to find,
• Stretches the vein walls so they are thinner and easier to pierce with a needle

Question 22

How many minutes will it take to change the blood components of the restriction of blood flow by a tourniquet?

Answer 22

1 minute

Question 23

2 types of positions for patients

Answer 23

• Seated patient
• Supine patient

Question 24

Position of a Seated patient

Answer 24

• Patient’s arm supported
• Arms not bent at the elbow

Question 25

Position of a Supine patient

Answer 25

• Arm extended
• Not bent at elbow

Question 26

Types of tourniquet

Answer 26

• Strap tourniquet
• Single use latex free tourniquet
• rubber tubing

Question 27

type of tourniquet that is less painful

Answer 27

rubber tubing

Question 28

type of tourniquet that is a flat strip of stretchable material such as latex nitrile or vinyl

Answer 28

strap tourniquet

Question 29

steps of the pre-analytical procedure

Answer 29

1. identify the patient properly
2. orient the patient on the procedure to be performed
3. wash hands thoroughly
4. prepare all the materials needed
5. reassure the patient
6. position the patient

Question 30

steps of applying the tourniquet

Answer 30

1. sanitize hands, wear appropriate PPE
2. position the arm for venipuncture (proper position and support)
3. as the patient to make a fist
4. apply tourniquet
5. palpate the vein using your index fingertip
6. pull the skin and anchor the vein using the thumb
7. select suitable vein for extraction
8. release tourniquet and prepare puncture site

Question 31

T/F you should caress the vein while palpating the patient’s arm

Answer 31

False

Question 32

T/F Bruising signifies a traumatic extraction

Answer 32

False

Question 33

T/F The priority vein is the medial antecubital vein

Answer 33

True

Question 34

T/F Making a fist helps locate the veins

Answer 34

True

Question 35

T/F both the phlebotomist ant patient should be comfortable while doing the procedure

Answer 35

True

Question 36

painful to the patient and could cause tissue and vascular damage at and around the phlebotomy site

Answer 36

fishing

Question 37

usually located in old and skinny patients with loose and thin skin

Answer 37

rolling veins