FINALS: PROPER BLOOD COLLECTION AND HANDLING USING ROUTINE VENIPUNCTURE AND OTHER TECHNIQUES

Question 1

State the venipuncture procedures

Answer 1

1. Identify the patient.
2. Assess the patient’s physical disposition (i.e.
   diet, exercise, stress, basal state).
3. Check the requisition form for requested tests,
   patient information, and any special
   requirements.
4. Select a suitable site for venipuncture.
5. Prepare the equipment, the patient and the
   puncture site.
6. Perform the venipuncture.
7. Collect the sample in the appropriate container.
8. Recognize complications associated with the phlebotomy procedure.
9. Assess the need for sample recollection and/or rejection.
10. Label the collection tubes at the bedside or drawing area.
11. Promptly send the specimens with the requisition to the laboratory.

Question 2

Labeling the Sample ( CONTENTS): 5

Answer 2

• Patient’s Complete Name (family name first)

-Patient’s ID number (if applicable)
- Age and Sex
-Date and Time of Collection
-Initials of the phlebotomist

Question 3

Complete set for any test; sometimes bring at least 5 microtainers for short draw

Answer 3

Evacuated collection tubes

Question 4

EQUIPMENT NEEDED FOR BLOOD COLLECTION: (STATE AT LEAST 5)

Answer 4

1. Evacuated collection tubes
2. Needles
3. Holder/Adapter
4. Tourniquet
5. 70% Alcohol
6. Povidone-iodine (for blood culture)
7. Gauze/cotton
8. Adhesive bandages/tape
9. Needle disposal unit
10. Gloves
11. Syringes
12. Mask

Question 5

Order Of Draw (w/ color):

Answer 5

1. Blood Culture (Color Varies)
2. Sodium Citrate ( light blue)
3. No additive (red)
4. With additives (gold)

Question 6

Implies voluntary permission for a medical
procedure, test, or medication will be given

Answer 6

Informed consent

Question 7

May be given verbally or in writing

Answer 7

Expressed consent

Question 8

Does not require a verbal expression of consent.
Actions can imply consent (e.g., the patient
holds out an arm after being told a blood
specimen is to be collected)

Answer 8

Implied consent

Question 9

Laws specify exactly what type of information
must be given to inform the client properly

Answer 9

HIV consent

Question 10

Parent or guardian consent is required (health
care personnel who do not obtain it are liable
for assault and battery)

Answer 10

Consent for minors

Question 11

An individual has a constitutional right to refuse
a medical procedure such as venipuncture

Answer 11

Refusal of consent

Question 12

fear of immediate harm

Answer 12

Assault

Question 13

deliberate offensive touching

Answer 13

battery

Question 14

violation of one’s right to be alone

Answer 14

invasion of privacy

Question 15

failure to keep private information confidential

Answer 15

Breach of confidentiality

Question 16

Medical Negligence

Answer 16

Malpractice

Question 17

otherwise known as
the Data Privacy Act Is a law that seeks to
protect all forms of information, be it private,
personal, or sensitive.

Answer 17

Republic Act No. 10173/ DATA PRIVACY LAW

Question 18

Difficult to palpate and draw from; Have impaired circulation

Answer 18

Extensive scars from burns and surgery

Question 19

________ contain dyes that may interfere
in testing (should be avoided unless no

other site is available.

Answer 19

Tattoos

Question 20

Sclerosed (hardened) or thrombosed
(clotted) veins are re occluded
(obstructed) they feel hard and cordlike,
lacking resilience

Answer 20

Damaged veins

Question 21

Swelling caused by the abnormal
accumulation of fluid in the tissues.

Answer 21

Edema

Question 22

A swelling or tourniquet blood that
escaped from vein during/following
venipuncture, (Traumatic
venipuncture)

Answer 22

Hematoma

Question 23

A patient’s physician should be
consulted before drawing blood from
an arm on the same side as the
_____________

Answer 23

mastectomy

Question 24

(common for
in-patients)
○ Arterial line
○ Arteriovenous shunt or fistula
○ Heparin or saline lock
○ Intravenous line
○ Central Vascular Access Device (CVSD)
or indwelling line

Answer 24

Vascular Access Device

Question 25

Fluid may dilute the specimen, so
collect from the opposite arm if
possible.

Answer 25

Intravenous therapy (IV) / blood transfusions

Question 26

Expensive and it can bleed the patient
and lose a lot of blood because the
pressure in that area is too strong.

Answer 26

Arteriovenous Fistula

Question 27

If you have a coagulation test like PTT
and PT please take note that do not

extract blood in that area and the dame
line with the __________ because it
prolongs the coagulation test.

Answer 27

Heparin Lock

Question 28

We should avoid extracting blood
where ___________ is attached

Answer 28

CVAD

Question 29

Patients that are undergoing
hemodialysis.

Answer 29

Internal Jugular Vein Catheter

Question 30

Performance of a Venipuncture

Answer 30

1. PREPARE AND ASSEMBLE ALL NECESSARY MATERIAL FOR VENIPUNCTURE
2. APPROACH THE PATIENT IN A FRIENDLY CALM MANNER. PROVIDE FOR THEIR COMFORT AS MUCH AS POSSIBLE AND GAIN THE PATIENT’S COOPERATION
3. IDENTIFY THE PATIENT CORRECTLY
4. PROPER FILL OUT APPROPRIATE REQUISITION FORMS INDICATING THE TEST/S ORDERED
5. VERIFY THE PATIENT’S CONDITION
6. CHECK FOR ANY ALLERGIES TO ANTISEPTICS, ADHESIVES OR LATEX BY OBSERVING FOR ARMBANDS AND/OR BY ASKING THE PATIENT
7. POSITION THE PATIENT. THE PATIENT SHOULD EITHER SIT IN A CHAIR OR LIE DOWN OR SIT UP IN BED. HYPEREXTEND THE PATIENT’S ARM
8. APPLY THE TOURNIQUET 3-4 INCHES ABOVE THE SELECTED PUNCTURE SITE. DO NOT PLACE TOO TIGHTLY OR LEAVE ON MORE THAN 1 MINUTE
9. THE PATIENT SHOULD MAKE A FIST WITHOUT PUMPING THE HAND
10. SELECT THE VENIPUNCTURE SITE. RELEASE THE TOURNIQUET AND ASK THE PATIENT TO OPEN FIST.
11. DISINFECT THE SITE USING 70% ALCOHOL. CLEANSE IN A CIRCULAR FASHION BEGINNING AT THE SITE AND WORKING OUTWARD. ALLOW AIR DRY FOR 30-60 SECONDS
12. PREPARE THE SYRINGE. INSPECT THE NEEDLE FOR ANY DEFECTS. PULL THE PLUNGER 2-3 TIMES TO RELEASE THE AIR.
13. REAPPLY THE TOURNIQUET
14. GRASP THE PATIENT’S ARM FIRMLY USING YOUR THUMB TO DRAW SKIN TAUT AND ANCHOR THE VEIN. THE NEEDLE SHOULD FORM A 15-30 DEGREE ANGLE WITH THE SURFACE OF THE ARM. SWIFTLY INSERT THE NEEDLE THROUGH THE SKIN AND INTO THE LUMEN OF THE VEIN. AVOID TRAUMA AND EXCESSIVE PROBING.
15. ESTABLISH BLOOD FLOW AND PULL BACK THE PLUNGER SLOWLY UNTIL THE DESIRED AMOUNT OF BLOOD IS OBTAINED
16. ASK PATIENT TO OPEN FIST AND RELEASE THE TOURNIQUET
17. REMOVE THE NEEDLE FROM THE PATIENT’S ARM USING A SWIFT BACKWARD MOTION
18. PRESS DOWN THE GAUZE ONCE THE
    NEEDLE IS OUT OF THE ARM AND APPLY ADEQUATE PRESSURE TO AVOID FORMATION OF HEMATOMA. INSTRUCT THE PATIENT TO PRESS THE GAUZE OR
    COTTON BALL ON THE PUNCTURE SITE FOR 3-5 MINUTES WITH THE ARM EXTENDED TO ENSURE THAT BLEEDING STOPS AND HEMATOMA OR SWELLING
    DOES NOT FORM.
19. DISPOSE OF CONTAMINATED MATERIALS/SUPPLIES IN DESIGNATED CONTAINERS.
20. INVERT AND LABEL ALL APPROPRIATE TUBES AT THE PATIENT’S BEDSIDE
21. CHECK THE SITE TO SEE THAT IT HAS STOPPED BLEEDING BEFORE LEAVING THE PATIENT AND SHOULD APPLY A BANDAGE IF NECESSARY
22. DELIVER THE SPECIMENS PROMPTLY TO THE LABORATORY

Question 31

Most lines are flushed with a solution of
heparin to reduce the risk of thrombosis

Answer 31

INDWELLING LINES OR CATHETERS

Question 32

An increase concentration of larger molecules
and formed elements in the blood may be due
to several factors

Answer 32

HEMOCONCENTRATION

Question 33

Primary effect is hemoconcentration of
non-filterable elements

Answer 33

PROLONGED TOURNIQUET APPLICATION

Question 34

there is a antibiotic it will
cause defect in blood constituents and
also if you have a anti platelet
medications it would cause a decrease
platelets

Answer 34

Therapeutic drug monitoring

Question 35

This activity increases CK, AST, LDH, Platelets and
Neutrophils

Answer 35

Effects if Exercise

Question 36

Elevated adrenal hormone values
(cortisol and catecholamines) that’s
why it’s keeping you awake; results in hyperventilation
may cause acid-base imbalance and
increase lactate

Answer 36

stress

Question 37

Are body fluids and analyte fluctuations
during the day

Answer 37

Diurnal rhythms

Question 38

known to vary lab
results of some analytes; Enzymes, proteins, lipids, iron and calcium significantly increases

Answer 38

Posture

Question 39

Other factors affecting test results

Answer 39

age, gender, pregnancy