Jojos Patient Services Flashcards
What can cause a haematoma during venipuncture?
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)
What do you do if a haematoma appears during venepuncture?
Remove the needle immediately and place pressure on the site. It may help to apply ice but not directly on the skin.
How do you prevent a haematoma?
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
What are the preferred veins for venipuncture?
Median cubical vein
Cephelic vein
Why is it best to avoid the basilic vein?
Because of its close proximity to the Brachial Artery.
What veins must not be used in venipuncture?
Veins on the wrist or lower forearms
What is the condition odema?
Odema is as abnormal accumulation of fluid in the intercellular spaces of the body.
Why should phlebotomists avoid taking blood from areas of odema?
Veins are difficult to palpate.
Specimen may be contaminated with body fluid
Why don’t phlebotomists use IV Lines for blood collection?
Because the specimen will be diluted with IV Fluid
How long must an IV Line be turned off before you can take blood from that site?
If taking below the IV site 2 mins
If taking above IV SITE 10mins
What do you do if your patient feels nausea or vomits?
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
Why avoid burned areas or scarred veins in blood collection?
Burn areas are more susceptible to infections
Scared veins are difficult to palpate and tough to enter.
What is a fistula?
A fistula is an abnormal or surgically made passage between an organ and the body surface.
Why do some patients have fístulas?
For ease of cannula access- should be reserved for dialysis or blood transfusions. Phlebotomists not to use.
Why don’t you draw blood from the same side as a mastectomy?
Because stagnant lymphatic flow (lymphostasis) leaves the área susceptible to infection and blood composition in this area can be different.
What vein can you use in a patient who has has a mastectomy on both sides?
The dorsal vein in the foot
What is the single most important duty performed by the phlebotomist?
Correct and appropriate checking of patient details.
Name
DOB
Address
Phone number
Hospital no. ( if in hospital and only if worn by patient.
What info should be noted on a patients requisition form prior to blood collection?
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
What are the 3 P’s principles of the Treaty of Waitangi?
Partnership- working planning together.
Participation - taking part,decision making and delivery.
Protection - ensuring the same benefit while knowing and respecting other values
How do you behave in a culturally competent way?
Practise in a way that acknowledges the dignity, culture, values, beliefs and rights of individuals/groups
What arm veins are the last choice in phlebotomy? And why?
The basilic and medium basilic because they are near the median nerve and brachial artery
Why do you need to palpate veins before venipuncture?
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
Why shouldn’t you use a vein that is hard or cord like?
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
What are some methods you can use to locate veins?
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.
Why don’t you use sclerosis or thrombosed veins?
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.
What is the recommended antiseptic for cleaning a venipuncture site?
70% isopropyl alcohol, it doesn’t steriize however it inhibits microbial growth.
What size area should be cleaned around the venipuncture site?
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
For a cytology urine smear test what type of urine is required?
A fresh clean catch urine specimen (not first thing in the morning because cells in the bladder my have disintegrated overnight).
How can you preserve a cytology urine sample
Adding an equal volume of 50% alcohol
Why is urine the preferred sample for drug screening?
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.
What is a random urine sample?
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.
What does it mean if a specimen has a high or low specific gravity?
A high specific gravity is more concentrated than a low specific gravity
9ml CPDA Tube what anti coagulant does it have and what colour stopper
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]
What us a sentinel event?
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.
What is a synacthen test
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.
