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Fall 2024 > CS2 - Venipuncture and Blood cultures > Flashcards

CS2 - Venipuncture and Blood cultures Flashcards

1
Q

What is venipuncture and who is specially trained in it?

A

A procedure in which a needle is inserted into a vein to remove venous blood; Phlebotomists

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2
Q

When is venipuncture indicated?

A
  1. Obtain venous blood sample for laboratory testing
  2. Therapeutic (polycythemia/hemachromatosis)
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3
Q

When is venipuncture contraindicated?

A
  1. thrombosed vein or phlebitis
  2. lymphedema or hx of mastectomy
  3. scars
  4. recent tattoos
  5. rash/cellulitis
  6. hematoma
  7. artery
  8. proximal to IV site
  9. vascular anomaly
  10. cannula placement
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4
Q

What are the potential complications with venipuncture?

A
  1. Hematoma
  2. discomfort
  3. vasovagal syncope
  4. cellulitis
  5. phlebitis
  6. thrombosis
  7. bleeding
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5
Q

What are the best and second best sites for venipuncture?

A

1 - median cubital vein

#2 - Cephalic vein

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6
Q

Which vein is not ideal and why?

A

Basilic vein; median nerve and brachial artery complications

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7
Q

What is the provider’s role in venipuncture?

A

Educate whether labs are fasting vs non-fasting and medication instructions

Review any previous complications, contraindications, gather all materials, and gain verbal consent

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8
Q

Instructions for tourniquet?

A

Apply 3 inches above the venipuncture site and have patient make a fist
Do not leave it on longer than 1-2 minutes

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9
Q

How should the needle be inserted?

A

at a 15-30 degree angle, parallel to the vein with the needle bevel facing up

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10
Q

What should be considered if there is no blood return?

A

May have missed the vein or the needle is against the wall
Can slightly move needle but should stop if you see a hematoma forming

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11
Q

What should be done once all the tubes are filled?

A

Always remove the tourniquet first before removing the needle

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12
Q

How long should pressure be applied after removing the needle and why?

A

3 minutes to prevent a hematoma

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13
Q

What patient education should be given?

A
  1. Minor discomfort
  2. Care instructions: clean and dry
  3. Potential complications
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14
Q

What does clean up consist of ?

A

All sharps in sharps container
Blood contaminated material in biohazard waste container
Dispose of gloves and wash hands

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15
Q

What should be done if there is difficulty locating a vein for venipuncture?

A
  1. extremity below heart x few minutes
  2. apply warm towel
  3. blood pressure cuff inflation
  4. rub or tap veins
  5. vein imaging
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16
Q

What is a blood culture + sensitivity

A

A test to identify microorganisms in the bloodstream; sensitivity identifies effectiveness of antimicrobial agents to offending microorganism

17
Q

What is important to remember about blood cultures as a provider?

A
  1. Obtain them BEFORE AB initiation
  2. must obtain from at least 2 sites
  3. be mindful of false positives
18
Q

When are blood cultures indicated?

A
  1. diagnosing sepsis
  2. identifying microorganism causing septicemia
  3. treatment monitoring
  4. fever of unknown origin or concerns of systemic infection
19
Q

When are blood cultures contraindicated?

A
  1. site of skin infection like cellulitis or abscess
  2. Be cautious in those that are anticoagulated
20
Q

What are some potential complications of blood cultures?

A
  1. hematoma
  2. discomfort
  3. vasovagal syncope
  4. cellulitis/phlebitis
  5. bleeding
  6. contaminated sample
21
Q

What are some signs of a contaminated blood culture?

A
  1. non-pathogenic skin flora microorganisms are reported
  2. multiple different microorganisms are noted on report
  3. negative blood culture results in the presence of a positive result
22
Q

What sites are preferred for a blood culture?

A
  1. antecubital fossa
  2. median cubital veins
23
Q

What vein is not preferred but can be used, and why?

A

cephalic veins; may roll

24
Q

What vein should not be used and why?

A

basilic vein; close to brachial nerve and artery

25
Q

What may be used when a suitable arm vein cannot be located?

A

hand or wrist veins

26
Q

How should an area be cleaned before a blood culture?

A
  1. 70% isopropyl alcohol wipes x 3
  2. Chlorhexidine x 3
27
Q

What must be done if site needs touched after cleaning?

A

must have sterile gloves on

28
Q

In what order should blood be drawn for a blood culture?

A
  1. aerobic blood culture
  2. anaerobic blood culture
  3. additional tubes
29
Q

What should be done prior to completion of the blood cultures?

A

wipe the opening of culture with alcohol

30
Q

What are the correct blood collection volumes?

A

10 mL for adults
1-5mL for infants

31
Q

What should the culture tube be labeled with?

A

patient info, site location, date and time, and initials

32
Q

Blood cultures should always be done _____

A

First

Fall 2024 (34 decks)

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