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Phlebotomy > Chapter 11 Venipuncture Complications > Flashcards

Chapter 11 Venipuncture Complications Flashcards

1
Q

____ is the most important procedure in phlebotomy.

A

Positive ID

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2
Q

If patient not in their room always verify with the ____ the location.

A

Nursing station

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3
Q

List 4 situations that can make positively identifying a patient difficult.

A
  1. Emergency requisitions
  2. ER collections
  3. Orders telephoned in to lab
  4. Requisitions picked up at site
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4
Q

Any discrepancies determining the info on the requisition and on the patient ID band must be resolved ____ collection.

A

Before

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5
Q

ID band missing contact the ____.

A

Nursing station

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6
Q

If patient ID band is detached but in the room you ____.

A

Cannot draw blood

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7
Q

A ____ has the ID band come with matching labels for the specimens.

A

Commercial ID system

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8
Q

A sleeping patient cannot give ____ so ____ should happen to get them oriented.

A

Informed consent

One or two attempts to wake the patient

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9
Q

Drawing from a patient without consent may ____.

A

Lead to assault charges

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10
Q

Treat an unconscious patient as you would a ____. Including ____ and ____, because unconscious patients may ____.

A

Conscious patient
Identifying yourself
Describing the procedure
Be able to hear you

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11
Q

If physician or clergyman is in the room ____, unless it’s a ____ or ____.

A

Return at another time
Stat
Timed collection

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12
Q

If a physician enters as you are preparing to draw, you should ____.

A

Leave until they are finished with the patient

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13
Q

If a patient has visitors you should ____.

A

Politely ask them to leave the room

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14
Q

If a patient cannot understand you, ____ to try and obtain consent. If not, then seek a ____.

A

Show them what you’re going to do

Translator

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15
Q

If patient refuses with you and after you have attended with the nurse to try and draw blood, ____ along with ____ and notify the ____.

A

Document this on the request
Nurse’s name
Health care provider

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16
Q

The ____ is the most common site for routine venipuncture.

A

Antecubital fossa

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17
Q

Veins that are ____ (____) or ____ (____) feel hard or cordlike and lack resiliency.

A

Occluded, blocked

Sclerosed, hardened

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18
Q

Occlusion and sclerosis can be caused by 5 things, list them. These types of veins are susceptible to ____, and may produce ____.

A
  1. Inflammation
  2. Disease
  3. Chemotherapy
  4. Prolonged IV therapy
  5. Repeated venipunctures

Infection
Erroneous results

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19
Q

A hematoma (____) can be caused by 4 things, list them. This makes the blood ____ and can ____ the vein slowing blood flow. All of which can ____.

A

Collection of blood out of the vessel

  1. Needle going through vein
  2. Bevel opening partially in vein
  3. Not applying pressure after withdrawal
  4. Repeated punctures

No longer fresh from the vein
Obstruct
Alter test results

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20
Q

____ appears swollen from the collection of fluid.

A

Edematous tissue

21
Q

Areas with ____, ____, or ____ have impaired ____, are susceptible to ____, and may be painful or difficult to penetrate.

A

Burns, scars, tattoos
Circulation
Infection

22
Q

____ is a surgical operation to remove a breast.

A

Mastectomy

23
Q

____ is the lack of lymph fluid movement such as in the removal of lymph tissue on the side of a mastectomy.

A

Lymphostasis

24
Q

Lymphostasis ____ test results and can be painful to the patient as well as increase ____.

A

Can affect

Risk of infection

25
Q

Blood ____ be drawn from an arm if there is an IV device in place. If no other sites are available you must draw from a site ____ (____) the IV site.

A

Should not

Distal (away from)

26
Q

Any condition resulting in disruption of ____ means that the site should be avoided. Give 4 examples.

A

Skin integrity

  1. Open lesions
  2. Skin rashes
  3. Recent tattoos
  4. Stitches not fully healed
27
Q

Name 4 techniques to use when having difficulty finding a vein.

A
  1. Check the other arm
  2. Enhance vein prominence
  3. Use a blood pressure cuff (sphygmomanometer)
  4. Use alternative arm
28
Q

When checking for veins it’s ok to ____.

A

Ask patient about sites of previous successful phlebotomy

29
Q

List 4 ways a phlebotomist could enhance vein prominence.

A
  1. Massage upward from wrist to elbow
  2. Dangle arm downward to increase blood
  3. Apply heat but not moist heat
  4. Rotate wrist to increase cephalic vein prominence
30
Q

You can use a ____ instead of a tourniquet for hard-to-find veins. It should be placed ____ the venipuncture site, and inflated ____ but ____.

A

Blood pressure cuff
3-4 inches above
Above the diastolic
Below the systolic

31
Q

When a suitable vein cannot be found in the ____, you will have to collect from the ____, ____, or ____.

A

Antecubital fossa

Hand, foot, leg

32
Q

The ____ and ____ are more susceptible to ____ and ____, and they are not recommended sites for patients with ____ or patients on ____ (____ or ____).

A 
Leg, Foot
Clot, Infection
Diabetes
Anticoagulant therapy
Warfarin, heparin
33
Q

Collection from the leg or foot usually requires ____.

A

Physician permission

34
Q

Hand veins are small and fragile so if drawing from them use a ____ (____) with a smaller gauge needle and tube or a ____.

A

WIS (winged infusion set), butterfly

Syringe

35
Q

A butterfly is ideal for hand drawing because tubing allows for ____.

A

Lower angle of insertion

36
Q

A ____ allows for suction control, pulling the blood slowly which is important for elderly and pediatric patients.

A

Syringe

37
Q

____ cannot be used for cleaning when drawing a ____. It is also not a strong enough antiseptic for drawing ____, ____, or ____. Instead use ____, and for patients allergic to this, use ____.

A 
Alcohol
Blood alcohol test
Blood cultures, blood gases, blood donations
Povidone-iodine
Chlorhexidine gluconate
38
Q

When you use an alternative antiseptic ____.

A

Note it on the requisition

39
Q

____ is not recommended for dermal punctures, because it may elevate test results for ____, ____, ____, and ____ (____).

A

Povidone-iodine

Bilirubin, uric acid, phosphorus, potassium, BURPP

40
Q

A tourniquet should not remain in place for more than ____. This is to prevent ____, or alteration in the ____ in the blood.

A

1 minute
Hemoconcentration
Ratio of elements

41
Q

When a tourniquet is on too long, the ____ portion of the blood filters into the tissue, increasing the ____ left in the vein. This affects determinations of large molecules, such as ____, ____, and ____. It also increases ____ and ____.

A

Plasma
Proportion of cells
Plasma proteins, enzymes, lipids
RBC, iron and calcium levels

42
Q

Leaving a tourniquet on too long can alter ____ and ____ levels by a different mechanism.

A

Potassium, lactic acid

43
Q

The tourniquet should be released ____.

A

As soon as blood flow starts

44
Q

Hemoconcentration can also be caused by ____, ____ or ____, ____, or ____.

A

Pumping the fist
Sclerosed, occluded veins
Long-term IV therapy
Dehydration

45
Q

____ are small, nonraised red spots that appear on the skin when the tourniquet is applied to a patient with a ____ or ____ disorder.

A

Petechiae

capillary wall, platelet

46
Q

Petechiae indicates that ____ will occur after the procedure and ____ is required.

A

Excessive bleeding

Extended gauze pressure

47
Q

If there is no ____, or the patient complains of pinching or arm numbing, the tourniquet is ____.

A

Arterial pulse

Too tight

48
Q

____ is becoming more common therefor all patients must be asked if they have a ____. Alternate forms of this material can be substituted in phlebotomist’s ____, ____, and ____.

A

Latex allergies
Latex allergy
Gloves, tourniquets, bandages

Phlebotomy (6 decks)

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