BB LAB VENIPUNCTURE

Question 1

Is the most integral part in any laboratory procedures

Answer 1

Specimen collection

Question 2

Is a closed system with sterile evacuated tubes, blood flows directly into the tube and no messy specimen transfer is needed

Answer 2

Venipuncture using the vacutainer system

Question 3

Is usually used for beginners and for veins which are not very prominent

Answer 3

Venipuncture using the syringe

Question 4

Materials for vacutainer system

Answer 4

1. Vacutainer adaptor
2. Gloves
3. Vacutainer needles and tube
4. Tourniquet
5. Cotton swab

Question 5

Materials for venipuncture using syringe

Answer 5

1. Syringe
2. Gloves
3. Tourniquet
4. Cotton swab

Question 6

This is the most important step in the venipuncture procedure

Answer 6

Identify the patient

Question 7

Apply tourniquet _______ inches above the elbow

Answer 7

3-4 inches

Question 8

The patient’s arm should be in a _________ position so that blood will go directly to the bottom of the tube

Answer 8

Slightly downward position

Question 9

If veins are still not palpable, you may apply warm, moist cloth about _____•c

Answer 9

40 degree celsius

Question 10

Veins of the arm which are the site of the majority of venipunctures are:

Answer 10

Cephalic
Median cubital
Basilica

Question 11

Preferred vein for venipuncture

Answer 11

Median cubital vein

Question 12

Why is Median cubital vein is the preferred vein for venipuncture?

Answer 12

Because it is the largest and best anchored vein

Question 13

Cleanse the site with ______

Answer 13

70% alcohol

Question 14

Grasp the patient’s arm _____ inches below the puncture site

Answer 14

1-2 inches

Question 15

The needle should be in the ______ position

Answer 15

Bevel up position

Question 16

Degree angle with the arm before puncturing the site

Answer 16

15 degree angle

Question 17

If the site is still bleeding, what will the phlebotomist should do?

Answer 17

Apply direct pressure on the site until bleeding ceased

Question 18

Dispose the needle directly in a ________ or _______

Answer 18

Puncture resistant container or incinerate

Question 19

Do recap the needle of the syringe. T or F.

Answer 19

False. Do not recap the needle of the syringe to avoid finger prick

Question 20

Cause: needle may not be placed at the center of the stopper causing blockage

What is the solution for this?

Answer 20

Remove and reposition the tube correctly

Question 21

Cause: needle bevel may be flushed against the wall of the vein causing blockage

What is the solution for this?

Answer 21

Rotate the needle 1/4 turn clockwise

Question 22

Solution: release pressure slowly

What is the cause?

Answer 22

Tourniquet applied too tightly or too long stopping blood flow

Question 23

Cause: tube may have been prematurely punctured
Tube may have been previously opened

What is the solution for this?

Answer 23

Replace the tube

Question 24

Solution: pull back slightly on the needle holder

What is the cause?

Answer 24

The needle has transfixed the vein

Question 25

Cause: the needle is not completely in the vein or has not reached the vein

What is the solution for this?

Answer 25

Advance the needle forward until you feel the “give” as the needle penetrates the vein

Question 26

Solution: reintroduce tube for collection until vacuum is completely exhausted

What is the cause?

Answer 26

Premature removal of tube

Question 27

Cause: long lines of tubing contain air

What is the solution?

Answer 27

Use “dummy tube” first to ensure accurate test results

Question 28

Cause: vein may have collapsed

What is the solution?

Answer 28

Remove the tube holder for a few seconds to allow the vein to fill again.

Replace tube to continue collection.

Question 29

Solution: repeat venipuncture at different site when hematoma occurs

What is the cause?

Answer 29

Needle may have been repositioned or out of the vein during venipuncture

Question 30

Occurrence of hematoma - causes

Answer 30

• needle not completely in the vein
  -needle transfixed the vein
  -excessive probing resulting in enlargement at the site of entry
  -tourniquet placed too near the venipuncture site

Question 31

Occurrence of hematoma - solutions

Answer 31

• release tourniquet and remove the needle
  -apply firm pressure over swollen area (elevate affected arm)
  -reassure patient that the bruise will resolve
  -repeat venipuncture at a different site

Question 32

Possible causes leading to hemolyzed specimen

Answer 32

• excessive probing
• vigorous mixing of tubes
• under filling of tubes
• transferring from syringe and needle to evacuated tube
• alcohol contamination
• prolonged tourniquet application (> 2mins)