lab procedures

Question 1

venipuncture indications

Answer 1

health screening
pre-op eval
diagnostic aid

Question 2

venipuncture relative contraindications

Answer 2

patient inability to sit still

skin conditions

Question 3

venipuncture complications

Answer 3

bleeding
infection
arterial/nn injury

Question 4

vacutainer

Answer 4

most common

allows for draw of multiple tubues

Question 5

needle info for venipuncture

Answer 5

10cc syringe

21-22 gauge 1” needle

Question 6

butterfly needles

Answer 6

smaller and less painful

easy to hold

Question 7

venipuncture site and prep

Answer 7

choose v that is distended, usually medial cubital
glove up
clean w/alcohol swab concentric circles from inside out
don’t repalpate

Question 8

venipuncture procedure

Answer 8

non-dominant hand to apply traction below vessel to ancor it
dominant hand to insert needle at 15-30 degrees until flashback is visible
if no flashback partially withdraw and advance again
release tourniquet BEFORE removing needle

Question 9

IV cath indications

Answer 9

administration of fluids and meds

Question 10

IV cath relative contraindications

Answer 10

patient inability to sit still

skin conditions interfering w/access

Question 11

IV cath complications

Answer 11

bleeding
infiltration of fluid into subQ
infection thrombosis

Question 12

selecting IV site

Answer 12

v on non-donminant forearm that is fixed
basilic or cephalic vv on dorsal forearm
metacarpal vv on dorsum of hand are easiest to visualize, but more likely to occlude

Question 13

avoid sites for IV

Answer 13

areas of flexion and boney prominences
near mutliple valves/brr
pre-existing catherter sites
anatomic deformities
ipsilateral mesectomy and/or lymph dissection
ipsilateral AV fistula or graft

Question 14

local anestetic

Answer 14

lidocaine based cream or ointment 30-60min prior
injectable lidocaine (1-2%) 5-10min prior

Question 15

IV cath procedure

Answer 15

-gloves
-tourniquet
-clean w/alcohol or betadine
-hold catheter between thumb and middle finger w/index on top
hold catheter at 30 degree angle w/needle bevel facing upward
-enter the skin
-advance needle until flashback visible
-lower angle of needle advance 3-5mm
-slide catheter sheath of needle into vv, DO NOT ADVANCE NEEDLE
-withdraw needle completely from cateter and occlude blood
-remove tourniquet
-make sure fluid will flow
-tape

Question 16

central venous catheter indications

Answer 16

inability to maintain peripheral vv access
need to access central circulation
infusion of hypertonic or substances that cause sclerosis or peripheral vv (chemo)
hemodialysis

Question 17

central venous catheter contraindications

Answer 17

contralateral pneumonectomy 
bleeding diathesis
operator inexperience
infection at insertion site
recent placement of pacemaker

Question 18

complications

Answer 18

arterial puncture
pneumothorax
thrombosis
infection
cardiac dysarthmia

Question 19

limb leads

Answer 19

white= right and smoke over fire
RA- white
LA- black
LL- red

Question 20

V1

Answer 20

red

4th ICS at RSB

Question 21

V2

Answer 21

yellow

4th ICS at LSB

Question 22

V3

Answer 22

green halfway btwn V2 and V4

Question 23

V4

Answer 23

blue

5th ICS MCL

Question 24

V5

Answer 24

tan

5th ICS AAL

Question 25

V6

Answer 25

violet

5th ICS MAL