Lesson 7 - Venipuncture Complications

Question 1

What are the 3 steps you do when your patient who needs a draw is not in their room?

Answer 1

1. Locate the patient
2. If the requisition is STAT draw blood from the patient in whichever department they are in
3. Inform the nurse of the draw or if you can do it later

Question 2

You can draw blood from a patient even if their Hosptial ID band is not on their wrist.
True or false?

Answer 2

False, all inpatients must be wearing their hospital bands at all times. Do not draw if they are not physically wearing it

Question 3

What’s should you do if you arrive and your patient is asleep?

Answer 3

1. Try to gently wake them to get consent to draw
2. DONT draw from a sleeping patient
3. Let the nurse know if the patient won’t wake up

Question 4

What’s it you do if you arrive at a patient’s room to collect blood but the physician and other persons are present?

Answer 4

1. Return later for the draw
2. If it is STAT, politely interrupt and continue with the draw

Question 5

How is hemoconcentration initiated?

Answer 5

From leaving a tourniquet on a patient for too long over 1 minutes (60 seconds).

Question 6

Define hemoconcentration

Answer 6

When the plasma portion for blood begins to filter into the tissues near by. This is known to alter potassium levels (K) and lactic acid levels causing an alteration in the ratio of the parts of the blood. (Plasma, red blood cells, & serum)

Question 7

Define prefix Hem(o)

Answer 7

Blood

Question 8

In medical terms, define hemoconcentration

Answer 8

A cluster of red blood cells

Question 9

What is the condition of small red spots on skin seen with a capillary platelet disorder which also may require longer application of pressure to stop bleeding?

Answer 9

Petechiae

Question 10

What are the signs of fainting?

Answer 10

Clammy, cold hands, beads of sweat on forehead

Question 11

What do you instruct the patient to do if you see signs of fainting?

Answer 11

To place their head between their legs.

Question 12

What should you do if you patient begins to have a seizure during the draw?

Answer 12

Cushion their head, call for medical help (nurse or Dr.), do not put anything in their mouth, give a basin for throw up

Question 13

What are the 3 possibilities of lack of blood flow?

Answer 13

Defective tube, ill positioned needle, or collapsed vein

Question 14

What are the 2 possibilities of increased blood flow?

Answer 14

Puncture of an artery and a patient on anti coagulation therapy

Question 15

What are the signs of a punctured artery?

Answer 15

Bright red blood and well increased blood flow

Question 16

How long do you apply pressure to a patient in anticoagulation therapy?

Answer 16

5 minutes or longer to stop the bleeding

Question 17

When should you release the tourniquet on the patient?

Answer 17

Before 1 minute elapses or when you see a flash of blood in your needle or syringe.

Question 18

You can leave the patients’ bedrail lowered after the draw. True or false?

Answer 18

False! You must always place the bedrail back in the upward position.

Question 19

What hand do you use to anchor the patient’s vein?

Answer 19

The thumb of your non-dominant hand

Question 20

Define suffix -lysis

Answer 20

Destruction or breaking down

Question 21

What are 3 ways to prevent hemolysis after blood draw?

Answer 21

Invert tubes gently, do NOT shake them, and pull back on your syringe slowly and carefully

Question 22

Low hemoglobin and hematocrit caused by repeat blood tests are symptoms of..
A. Latrogenic anemia
B. Compartment syndrome

Answer 22

A. Latrogenic anemia

Question 23

Bleeding into surrounding tissues and occurring with hemophilia or coagulation disorders are symptoms of..
A. Latrogenic anemia
B. Compartment syndrome

Answer 23

B. Compartment syndrome

Question 24

Needle contact comes in contact with the nerve and shooting pain or numbness in arm are symptoms of..
A. Infection
B. Nerve damage

Answer 24

B. Nerve damage

Question 25

This is caused by lack of aseptic procedures being followed..
A. Infection
B. Nerve damage

Answer 25

A. Infection

Question 26

What is a condition in which collection of which fluid in a combined space that prevents blood flow?

Answer 26

Compartment Syndrome

Question 27

What is the medical term for vomiting and nausea?

Answer 27

Emesis

Question 28

The destruction of blood cells medical term

Answer 28

Hemolysis

Question 29

Lack of movement of lymph fluid medical term

Answer 29

Lymphostasis

Question 30

Occluded also means..

Answer 30

To be blocked

Question 31

The flow of blood from the collection tube back into the needle and then into the patient’s vein is

Answer 31

Reflux

Question 32

Sclerosed also means..

Answer 32

To be hardened

Question 33

Syncope also means..

Answer 33

Fainting

Question 34

Based on the recently updated CLSI standards, how many forms of identification must your verify with the patient before drawing blood?

Answer 34

2 methods AND have them spell their name if they are able

Question 35

What sites do you NOT use when drawing blood?
Hint: there are 6 areas/sites

Answer 35

Palm surface of wrist, infected sites, arm with fistula, any limbs on the same side as a mastectomy, around an IV or VAD, and any lower limbs.

Question 36

According to CLSI, what motion is best used when cleansing the puncture site?

Answer 36

A back and forth motion is best used rather than and circular motion

Question 37

What % of alcohol do you use when cleansing a puncture site?
A. 40%
B. 50%
C. 60%
D.70%

Answer 37

D.70%

Question 38

According to CLSIs’ updated policies, if using a blood pressure cuff as a tourniquet, how far should you inflate the cuff?

Answer 38

Inflate the cuff to below the patients’ diastolic pressure
(Ex: BP is 120/80 = cuff inflated to 70mmHg)

Question 39

Why should you tell a patient to make a fist and not PUMP the fist?

Answer 39

It can cause elevation in potassium levels and concentration