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pmls 2 by puso > arterial puncture procedures > Flashcards

arterial puncture procedures Flashcards

1
Q

Primary reason why we need to obtain arterial blood is for

A

arterial blood gas test / arterial blood gas analysis (ABGA)

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2
Q

arterial puncture is requested commonly to asses and evaluate…

A

respiratory function

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3
Q

Puncturing the artery to collect blood

A

arterial puncture

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4
Q

is tourniquet needed?

A

no

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5
Q

how much arterial blood is needed for ABGA

A

usually 1 to 1.5 mL

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6
Q

oxygenated blood with a bright red color

A

arterial blood

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7
Q

people who perform arterial puncture

A
  • MD
  • Nurses
  • Medical technologists & technicians
  • Respiratory therapists
  • Emergency medical technicians
  • Level II phlebotomists
  • must have an extensive training
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8
Q

are MTs allowed to perform arterial puncture in the PH?

A

hinde wag kang desisyon. doctors or physicians and respiratory therapists lang

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9
Q

Individuals allowed to perform arterial puncture
must undergo ___________

A

periodic evaluation

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10
Q

sites for arterial puncture

A
  • Radial artery
  • Brachial artery
  • Femoral artery
  • Scalp artery
  • Umbilical artery
  • Dorsalis pedis arteries
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11
Q

Site Collection Criteria

can be evaluated by performing modified ___________ or by using a portable instrument or
ultrasound instrument

A

Allen test

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12
Q

first choice and most commonly used site

A

Radial Artery

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13
Q

where is radial artery located

A

thumb side of the wrist

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14
Q

advantages of radial artery

A
  • Good collateral circulation
  • Easy to palpate
  • Less risk also of accidentally puncturing a vein or damaging a nerve
  • Less chance of hematoma
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15
Q

disadvantages of radial artery

A
  • Requires considerable skill
  • Difficult to locate on patients with hypovolemia or low cardiac output
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16
Q

second choice artery located in the medial anterior of the antecubital fossa

A

brachial artery

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17
Q

advantage: large and relatively easy to palpate and puncture

A

brachial artery

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18
Q

advantage: used for a large volume

A

brachial artery

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19
Q

disadvantage: deeper and can be harder to palpate than radial

A

brachial artery

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20
Q

disadvantage: close to basilic vein and median nerve

A

brachial artery

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21
Q

largest artery for arterial puncture

A

femoral artery

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22
Q

where is the femoral artery located?

A

superficially in groin, lateral to pubis bone

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23
Q

least artery to be used

A

femoral artery since for emergencies or if walang other sites na siya ginagamit

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24
Q

advantage: large, easy to palpate and puncture

disadvantage: poor collateral circulation, lies to the femoral vein, increased risk of infection

A

femoral artery

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25
blood supply from more than 1 artery
collateral circulation
26
Has high oxygen content & consistency of composition
arterial blood
27
Used in diagnosis & management of respiratory disorders
Arterial Blood Gas (ABG)
28
Used in management of electrolyte & acid-base balance in patients with diabetes & other metabolic disorders
ABG
29
ABG specimens should be collected in an _______________
anaerobic manner (not exposed to air)
30
pH result lower than 7.35 is termed as ________ pH higher than 7.45 as ___________
acidosis, alkalosis
31
COMMONLY MEASURED ABG ANALYTES partial pressure of oxygen dissolved in arterial blood
PaO2
32
COMMONLY MEASURED ABG ANALYTES Partial pressure of CO2 dissolved in arterial blood
PaCO2
33
COMMONLY MEASURED ABG ANALYTES A measure of bicarbonate in blood
HCO3
34
COMMONLY MEASURED ABG ANALYTES percent O2 bound to hemoglobin
O2 sat
35
COMMONLY MEASURED ABG ANALYTES A calculation of non-respiratory part of acid-base balance - based on the PCO2, HCO3 and O2 stat
base excess
36
determines if hemoglobin is carrying the among of oxygen
O2 Saturation
37
With a purpose of numbing or to numb the site to be used for arterial puncture
Antiseptic Local anesthetic - Usual local anesthesia to be used is 1% lidocaine - isopropanol or isopropyl alcohol or chlorhexidine for cleaning the site
38
Gauge of needle to be used ranges from
20 to 23
39
in case of radial or brachial artery, __ gauge is used with 1 inch length of the needle
22
40
recommended gauge
22
41
what kind of syringe is needed
pre-heparinized syringe
42
anticoagulant used for ABG testing
lyophilized heparin salt
43
maintains the specimen temperature between 1 - 5C
coolants
44
The patient should be on their steady state for at least
20 - 30 minutes before puncture
45
factors that affect the amount of oxygen and CO2 in the blood is not in a steady state:
- breathing pattern - body temperature - oxygen concentration
46
A test to determine if patient has collateral circulation before arterial puncture is performed
modified Allen test
47
how long should the blood flow be blocked in Allen Test?
30 seconds
48
Positive allen test
hand flushes pink
49
if the hand does not return to a pink color...
there is blockage on the ulnar artery and puncturing the radial artery may then cause blockage
50
Anesthesia prevents __________
vasoconstriction
51
angle of needle in anesthesia administration
10 degrees
52
waiting time after administering anesthesia
1 - 2 mins
53
amount of anesthesia needed for lessening the pain
0.25 to 0.5 mL
54
when does the anesthesia wears off
after 15 to 20 mins
55
is physician order needed before administering anesthesia?
yes nmn
56
radial and brachial ABG procedure needle angle insertion
30- to 45-degree angle slowly direct it toward pulse stop when a flash of blood appears
57
needle angle in femoral artery
90 degrees
58
why is tourniquet not needed?
there is already a high pressure in the blood circulating in the artery
59
should you pull back the plunger once you see a flash of blood?
no, since the blood will flow or pump into the syringe on its own power
60
can you probe in arterial puncture?
no
61
if patient WBC is high after collection of arterial blood, you should analyze the specimen within __________
5 minutes of collection
62
time of transportation without delay
30 mins
63
transportation with delay
collect the arterial blood in a glass syringe and cool it using ice slurry or crushed ice with large amount of water
64
the reflex contraction of the artery caused by pain or irritation which is caused by needle entry on the artery muscle
Arteriospasm
65
Common in case of repeated puncture
Artery Damage
66
Temporary and minor - Extreme pain during puncture may indicate nerve involvement
Discomfort
67
Can be a sign of impaired circulation or nerve irritation or damage
Numbness
68
blocks the entire lumen of the artery; therefore obstructing blood flow and impairing the circulation
Thrombus formation
69
Faintness or loss of consciousness related to hypotension caused by a nervous system response
Vasovagal Response
70
- greatest in older patients - common in patients in anticoagulant therapy - caused by multiple punctures to a single site
Hematoma
71
Sampling Errors
* Air bubbles * Delay in analysis * Improper mixing * Improper syringe * Obtaining venous blood by mistake * Use of improper anticoagulant * Use of too much or too little heparin
72
Too much heparin can cause __________
acidosis
73
Too little heparin can result to _____________
clotting of the specimen
74
do you accept ABG specimen that used the wrong type of syringe?
no!!!!!!!!!!!!!!!!!!!

pmls 2 by puso (6 decks)

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