BLOOD COLLECTION: EVACUATED TUBE SYSTEM

Question 1

Preferred because efficient, relatively it is direct, safe for the patient allows and the blood drawer, and multiple tubes to be easily collected.

Answer 1

EVACUATED TUBE SYSTEM

Question 2

ETS PURPOSE

Answer 2

To obtain a blood specimen for patient diagnostic or monitoring purposes from an antecubital vein using the evacuated tube system (ETS)

Question 3

Parts of 2 way needle

Answer 3

Bevel
Shaft
Threaded hub
Rubber sleeve over needle

Question 4

ETS materials needed

Answer 4

Evacuated blood collection tubes (various types depending on the required tests)

Tourniquet

Sterile gauze pad

Antiseptic prep pad

ETS needle (2-way needle)

ETS adapter

Sharps container

Permanent pen

Biohazard container

Disposable gloves

PPE

Question 5

A test request must be reviewed for (4)

Answer 5

completeness
date and time of collection
status
priority

Question 6

The______ process records the request and assigns it a unique number used to identify the specimen, related processes, and paperwork.

Answer 6

accession

Question 7

The right approach for a successful patient encounter includes a: (3)

Answer 7

professional bedside manner

being organized and efficient

looking for signs that convey important inpatient information or infection-control precautions.

Question 8

is vital to patient safety and meaningful test results.

Answer 8

Correct ID

Question 9

(3) must be verified and matched to the test order and inpatient’s ID band.

Preparing the patient by explaining procedures and addressing inquiries helps reduce patient anxiety.

Answer 9

Name
Date if Birth
Medical Record number

Question 10

Test results can be meaningless or misinterpreted and patient care compromised if_____ requirements have not been met.

Answer 10

diet

Question 11

Exposure to____ can trigger a life-threatening reaction in those allergic to it.

Answer 11

latex

Question 12

Proper_______ plays a major role in infection control by protecting the phlebotomist, patient, and others from contamination.

Answer 12

hand hygiene

Question 13

______are required by OSHA to protect the phlebotomist from potential bloodborne pathogen exposure.

Answer 13

Gloves

Question 14

Proper positioning is important to (2)

Answer 14

patient comfort
venipuncture success

Question 15

The patient’s arm should be placed_____ in a straight line from shoulder to wrist to aid in vein selection and avoid reflux as tubes are filled.

_______enlarges veins and makes them easier to see, feel, and enter with a needle.

A ______make the veins easier to see and feel and helps keep them from rolling.

Answer 15

downward

Tourniquet application

clenched fist

Question 16

Select a large, well-anchored vein.

The ______should be the first choice, followed by the_____.
The_____ should not be chosen unless it appears that no other vein can be safely or successfully accessed.

Answer 16

median cubital

cephalic

basilic

Question 17

Releasing the tourniquet and opening the fist helps prevent________.

Answer 17

hemoconcentration

Question 18

Cleaning the site with an______ helps avoid contaminating the specimen or patient with skin-surface bacteria picked up by the needle during venipuncture.

Answer 18

antiseptic

Question 19

Letting the site____ naturally permits maximum antiseptic action, prevents contamination caused by wiping, and avoids stinging or burning on needle entry.

Answer 19

dry

Question 20

Selecting appropriate equipment for the (3) of the vein is easier after vein selection.

Preparing it while the site is_____ saves time.

Attach a needle to an_____.

Put the first tube in the holder now or wait until after needle entry.

Gloves must be put on now if not already on.

Answer 20

size
condition
location

drying

ETS holder

Question 21

The_____ aids needle entry. Pick up the tube holder with your____ hand, placing your____ on top near the needle end and____ underneath.

Uncap and inspect the needle for defects and discard it if flawed.

Answer 21

tourniquet

dominant

thumb; fingers

Question 22

The fist aids needle entry.

______stretches the skin so the needle enters easily and with less pain, and keeps the vein from rolling.

____the patient.

Line the needle up with the vein and insert it _____into the skin using a smooth forward motion.

Stop when you feel a decrease in resistance, often described as a “pop,” and press your fingers into the arm to anchor the holder.

Answer 22

Anchoring

Warn

bevel up

Question 23

Blood will not flow until the_____ pierces the tube stopper.

Place a tube in the holder and push it part way onto the needle with a_____ twist.

Grasp the holder’s____ with your middle and index fingers, pulling back slightly to keep the holder from moving, and push the tube onto the needle with your_____.

Releasing the_____ and _____allows blood flow to normalize.

Answer 23

needle

clockwise

flanges

thumb

tourniquet; opening the fist

Question 24

Blood will not flow until the needle pierces the____.

Place a tube in the holder and push it part way onto the needle with a_____ twist.

Grasp the holder’s____ with your middle and index fingers, pulling back slightly to keep the holder from moving, and push the tube onto the needle with your____.

Releasing the_____ and _____allows blood flow to normalize.

Answer 24

tube stopper

clockwise

flanges; thumb

tourniquet; opening the fist

Question 25

According to_____ standards, the____ should be released as soon as possible after blood begins to flow and should not be left on longer than____

Answer 25

CLSI

tourniquet

1 minute

Question 26

Fill additive tubes until the vacuum is exhausted to ensure correct_______ and mix them immediately upon removal from the holder using three to eight gentle inversions to prevent clot formation.

Follow the CLSI order of draw to prevent ______between tubes.

Answer 26

blood-to-additive ratio

additive carryover

Question 27

A clean, folded gauze square is placed over the site so pressure can be applied immediately after needle removal.

Remove the needle in one smooth motion without lifting up or pressing down on it.

Immediately apply pressure to the site with your free hand while simultaneously activating the needle safety feature with the other to prevent the chance of a_____.

Answer 27

needlestick

Question 28

According to_____, the _______ and ______must go into the sharps container as a unit because removing a needle from the holder exposes the user to sharps injury.

Answer 28

OSHA

needle and the tube holder

Question 29

To avoid mislabeling errors, label tubes…

Answer 29

before leaving the bedside or dismissing the patient

Question 30

For accurate results, some specimens require special handling such as:

Answer 30

cooling in crushed ice (e.g., ammonia)

transportation at body temperature (e.g., cold agglutinin)

protection from light (e.g., bilirubin).

Question 31

The patient’s arm must be examined to verify that____ has stopped.

The site must also be checked for signs of bleeding…

Answer 31

bleeding

beneath the skin.

Question 32

If bleeding has stopped, apply a bandage and advise the patient to keep it in place for at least_____

Note: If bleeding persists beyond_____, notify the patient’s nurse or physician.

Answer 32

15 minutes

5 minutes

Question 33

Materials such as_____ and ____ are normally discarded in the regular trash.

Some facilities require that contaminated items such as blood-soaked gauze be discarded in_____

Answer 33

needle caps and wrappers

biohazard containers

Question 34

______the patient is courteous and professional.

Gloves must be removed in an_____ manner and_____ or decontaminated with_____ as an infection-control precaution

Answer 34

Thanking

aseptic

hands washed

hand sanitizer

Question 35

________to the lab protects specimen integrity and is typically achieved by personal delivery, transportation via a______ or ______

Answer 35

Prompt delivery

pneumatic tube system, or by a courier service