chapter 14 sections 3 venipuncture problems

Question 1

Failure to obtain blood

Answer 1

1. Check if a tourniquet is as tight as possible without causing pain to the patient or rolling and becoming a cord.
2. Palpate the vein
3. Never mark your patient with a pen

Or failure due to a manufacturing defect, an expired tube, or a very tiny crack in the tube itself.
The bevel may be resting against the vein wall and needs a slight increase in the angle of insertion.

needle may not be fully in the vein

the needle may have passed the vein.

Question 2

Hematoma

Answer 2

The bevel is not entirely in the vein and some blood leaks under the skin or it may also be going through the vein and slightly pulling back leaving a hole or puncture on the vein’s bottom side.

The best thing to do is remove everything.

Question 3

Rolling Veins

Answer 3

The median vein is the best choice for venipuncture. If the vein is too deep in the tissue or the vein too scarred. you can use the cephalic vein.
(Cephalic Vein) you must “anchor” either vein so that they do not roll. enter the vein swiftly and smoothly.

Question 4

Collapsing vein

Answer 4

Small, fragile veins tend to collapse. the problem can be due to the vacuum tube used as the vein wall may collapse under the pressure of the vacuum, causing a loss of blood flow into the collection tube.

If you notice this remove everything and start over.

Question 5

Inappropriate puncture site

Answer 5

Any skin areas that are scarred, bruised, or adjacent to infected areas should not be used for venipuncture

Question 6

Addressing issues in the middle of venipuncture

Answer 6

Don’t pull the needle out right away you have other options. For example, you may only need to slightly withdraw the needle, push the needle in more, or change your angle.

Redirect/calculate
1. Pull the needle back slightly but leave it under the skin.
2. feel the vein with your non-dominant hand and create a 3-dimensional image.
3. imagine the anatomy and palpate the missed vein

REMINDER: NEVER ATTEMPT TO REDIRECT WHEN TAKING FROM THE BASLIC VEIN. THERE ARE MANY NEVERS AND THE BRACHIAL ARTERY IS CLOSE TO THE VEIN.