Jojos Patient Services

Question 1

What can cause a haematoma during venipuncture?

Answer 1

Poor technique -improperly placed needle
Using a needle too big for the vein
Tight sleeves
Coagulation conditions
Not enough pressure on site after needle removal 
Tourniquet on for too long (over 1 min)

Question 2

What do you do if a haematoma appears during venepuncture?

Answer 2

Remove the needle immediately and place pressure on the site. It may help to apply ice but not directly on the skin.

Question 3

How do you prevent a haematoma?

Answer 3

Puncture only the uppermost wall of the vein.
Loosening the tourniquet and removing the tube from the needle prior to taking the needle out of the arm.
Use major superficial veins.
Apply pressure to the site until bleeding has stopped completely

Question 4

What are the preferred veins for venipuncture?

Answer 4

Median cubical vein

Cephelic vein

Question 5

Why is it best to avoid the basilic vein?

Answer 5

Because of its close proximity to the Brachial Artery.

Question 6

What veins must not be used in venipuncture?

Answer 6

Veins on the wrist or lower forearms

Question 7

What is the condition odema?

Answer 7

Odema is as abnormal accumulation of fluid in the intercellular spaces of the body.

Question 8

Why should phlebotomists avoid taking blood from areas of odema?

Answer 8

Veins are difficult to palpate.

Specimen may be contaminated with body fluid

Question 9

Why don’t phlebotomists use IV Lines for blood collection?

Answer 9

Because the specimen will be diluted with IV Fluid

Question 10

How long must an IV Line be turned off before you can take blood from that site?

Answer 10

If taking below the IV site 2 mins

If taking above IV SITE 10mins

Question 11

What do you do if your patient feels nausea or vomits?

Answer 11

Instruct patient to breathe slowly and deeply.
Apply a cold press to forehead and back of neck
Make patient comfortable
Give patient a basin and have tissues ready
Offer a glass of Water to rinse their mouth

Question 12

Why avoid burned areas or scarred veins in blood collection?

Answer 12

Burn areas are more susceptible to infections

Scared veins are difficult to palpate and tough to enter.

Question 13

What is a fistula?

Answer 13

A fistula is an abnormal or surgically made passage between an organ and the body surface.

Question 14

Why do some patients have fístulas?

Answer 14

For ease of cannula access- should be reserved for dialysis or blood transfusions. Phlebotomists not to use.

Question 15

Why don’t you draw blood from the same side as a mastectomy?

Answer 15

Because stagnant lymphatic flow (lymphostasis) leaves the área susceptible to infection and blood composition in this area can be different.

Question 16

What vein can you use in a patient who has has a mastectomy on both sides?

Answer 16

The dorsal vein in the foot

Question 17

What is the single most important duty performed by the phlebotomist?

Answer 17

Correct and appropriate checking of patient details.
Name
DOB
Address
Phone number
Hospital no. ( if in hospital and only if worn by patient.

Question 18

What info should be noted on a patients requisition form prior to blood collection?

Answer 18

Fasting/ non fasting (water only 10 -12 hrs)
Drug levels - date, time, amount last dose.
Pregnancy GTT Test - number of weeks gestation.
Woman’s hormone testing -LMP
Thyroid - on medication or not

Question 19

What are the 3 P’s principles of the Treaty of Waitangi?

Answer 19

Partnership- working planning together.
Participation - taking part,decision making and delivery.
Protection - ensuring the same benefit while knowing and respecting other values

Question 20

How do you behave in a culturally competent way?

Answer 20

Practise in a way that acknowledges the dignity, culture, values, beliefs and rights of individuals/groups

Question 21

What arm veins are the last choice in phlebotomy? And why?

Answer 21

The basilic and medium basilic because they are near the median nerve and brachial artery

Question 22

Why do you need to palpate veins before venipuncture?

Answer 22

To judge their suitability, e.g are they unobstructed, what is the size of the vein, the depth of the vein and what direction does it flow

Question 23

Why shouldn’t you use a vein that is hard or cord like?

Answer 23

Because it may be sclerosis (hard) or thrombosis (affected with, or obstructed by a clot).
Such veins roll easily, are hard to penetrate and may not have adequate blood flow and yield insufficient sample

Question 24

What are some methods you can use to locate veins?

Answer 24

Rotating the patients arm slightly
Dimming the lights and using a trans illuminate device.
Use a halogen flashlight
Wipe site with alcohol
Massage arm from wrist to elbow
Place something warm on the site to increase blood flow to area.

Question 25

Why don’t you use sclerosis or thrombosed veins?

Answer 25

Because they roll easily, they can be hard and difficult to penetrate and may yield a slow small blood draw giving a compromised specimen with erroneous results.

Question 26

What is the recommended antiseptic for cleaning a venipuncture site?

Answer 26

70% isopropyl alcohol, it doesn’t steriize however it inhibits microbial growth.

Question 27

What size area should be cleaned around the venipuncture site?

Answer 27

2-3 inches in diameter around the selected site. Drying time is 1 min

Do not dry with unsterile gauze
Do not fan dry with hand or blow on site
Do not touch site after cleaning

Question 28

For a cytology urine smear test what type of urine is required?

Answer 28

A fresh clean catch urine specimen (not first thing in the morning because cells in the bladder my have disintegrated overnight).

Question 29

How can you preserve a cytology urine sample

Answer 29

Adding an equal volume of 50% alcohol

Question 30

Why is urine the preferred sample for drug screening?

Answer 30

Many drugs can be detected in urine but not in blood. A random sample is used in a chemically clean covered container.
Note: alcohol levels are best detected in blood not urine.

Question 31

What is a random urine sample?

Answer 31

A sample of urine collected at any time of the day; this type of sample may be used to detect the presence of various substances in the urine at one particular point in the day.

Question 32

What does it mean if a specimen has a high or low specific gravity?

Answer 32

A high specific gravity is more concentrated than a low specific gravity

Question 33

9ml CPDA Tube what anti coagulant does it have and what colour stopper

Answer 33

CPDA-1- anticoagulant citrate phosphate dextrose 
adenine (ad-e-neen) solution
Yellow top with black ring
Tests: Tissue Typing
Also known as : [HLA-B27 Immunology]

Question 34

What us a sentinel event?

Answer 34

A sentinel event is any unanticipated event in a healthcare setting resulting in death or serious physical or psychological injury to a patient or patients, not related to the natural course of the patient’s illness.

Question 35

What is a synacthen test

Answer 35

A test that involves the injection of synacthen into a muscle.

The synacthen should stimulate your adrenal glands causing a rise in cortisol level. Thirty minutes after the injection the nurse will take another blood sample to measure your cortisol level.