MIDTERM LAB: VENIPUNCTURE Flashcards
act of drawing or removing blood from the circulatory system through a cut (incision) or puncture to obtain a sample for analysis and diagnosis
PHLEBOTOMY
PURPOSE OF PHLEBOTOMY:
- To obtain blood for diagnostic purposes.
- To monitor levels of blood components.
- To administer therapeutic treatments including medications, nutrition, or chemotherapy.
- To remove blood due to excess levels of iron or erythrocytes
- To collect blood for later uses, mainly transfusion either in the donor or in another person.
MATERIALS/EQUIPMENT:
- 21-gauge syringes, 2-way needle, & Feather lancet
- Tourniquet
- Wet and dry cotton balls
- 70% alcohol
- Micropore tape/plaster
- Evacuated Collection Tubes:
- Puncture-proof container for sharp objects
- Gloves, Mask, and Lab gown
- Marking pen (for labelling)
The essential elements of the requisition form are:
- Patient’s surname, first name, and middle initial.
- Patient’s ID number
- Patient’s DOB and sex.
- Requesting physician’s complete name.
- Source of specimen. This information must be given when requesting microbiology, cytology, fluid analysis, or other testing where analysis and reporting is site specific.
- Date and time of collection.
- Initials of phlebotomist.
- Indicating the test(s) requested
The key elements in labeling are:
- Patient’s surname, first, and middle
- Patient’s ID number
- Date and time of extraction and initials of the phlebotomist
The tubes are designed to fit with a predetermined volume of blood by vacuum. The rubber stoppers are color-coded according to the additive that the tube
contains. Various sizes are available. Blood should NEVER be poured from one tube to another
since the tubes can have different additives or coatings
Evacuated Collection Tubes
- The gauge number indicates the bore size: the larger the gauge number, the smaller
the needle bore. Needles are available for evacuated systems and for use with a syringe, single
draw or butterfly system.
Needles
use with the evacuated collection/tube system.
Tube Holder/Adapter
used if blood culture is to be drawn.
Povidone-iodine wipes/swabs
For application on the site from which the needle is withdrawn
Gauze sponges
protects the venipuncture site after collection.
Adhesive bandages/tape
can be made of latex, rubber, vinyl, etc; worn to protect the patient and the phlebotomist
Gloves
– may be used in place of the evacuated collection tube for special circumstances.
Syringes
ORDER OF DRAW:
- blood culture bottle(yellow-black top)
- coagulation tube (light blue)
- non-additive (red top)
- Serum separator tube (gold top/red-gray top)
- Sodium heparin (black-green top)
- PST/Plasma Separator Tube (light green top)
- EDTA (lavender top)
- ACDA (Acid Citrate Dextrose solution “A”)/ACDB (Acid Dextrose solution “B”)
- Oxalate/fluoride (light gray top)
Contains a gel separator and clot activator
SST/Serum Separator Tube (red-gray or gold top)
Contains lithium heparin anticoagulant and a gel separator.
PST/Plasma Separator Tube (light green top)
____________ may be obtained when the blood is not thoroughly mixed with the additive.
Erroneous test results
Patient’s Bill of Rights has been adopted by many hospitals as declared by the ____________
Joint Commission on Accreditation of Healthcare Organizations (JCAHO
most frequently used site for venipuncture
median cubital and cephalic veins
last resort for venipuncture
FOOT VEINS
it is difficult to puncture the scar tissue and obtain a
specimen.
Extensive scars from burns and surgery
test results may be affected because of lymphedema.
upper extremity on the side of a previous mastectomy
fluid may dilute the specimen, so collect from the opposite arm if possible
Intravenous therapy (IV) / blood transfusions
blood should not be drawn from an arm with a fistula or cannula without ?
consulting the attending physician
tissue fluid accumulation alters test results.
Edematous extremities
may cause erroneous test results.
Hematoma
An increased concentration of larger molecules and formed elements in the blood
Hemoconcentration
________________are body fluid and analyte fluctuations during the day
Diurnal Rhythms:
Areas to be avoided when performing venipuncture and the reasons for the restrictions
- Burns, Scars, and Tattoos
- Damaged Veins
- Edema
- Hematoma
- Mastectomy
- Vascular Access Devices (arterial line, Arteriovenous (AV) shunt or fistula, Heparin or saline lock, Intravenous line, Central Vascular Access Device (CVAD) or indwelling line)
may be difficult to palpate and draw from, and the areas are have impaired circulation that can affect
test results
Burns, Scars, and Tattoos
Sclerosed (hardened) or thrombosed (clotted) veins re-occluded (obstructed) they feel hard and cordlike, lacking resiliency. They are difficult to puncture, have impaired blood flow that leads to erroneous results and should be avoided
Damaged Veins
swelling caused by the abnormal accumulation of fluid in the tissues, makes veins harder to locate.
EDEMA
A swelling or mass of blood that escaped from a vein during or following venipuncture
Hematoma
Mastectomy: A patient’s physician should be consulted before drawing, blood from an arm on
the same side as the mastectomy. Lymph node removal, typically part of the procedure can
cause
lymphostasis
most common way to collect blood specimens
Venipuncture
Venipuncture three basic methods
– evacuated tube system (ETS), needle and syringe, and winged infusion set (butterfly).
the preferred method because blood is collected directly from the vein into a tube, minimizing the risk of specimen contamination and exposure to the blood.
Evacuated tube system (ETS)
ORDER OF DRAW
YOU (YELLOW TOP)
BETTER (LIGHT BLUE TOP)
REMEMBER - (RED)
GOD (GREEN)
LOVES (LAVENDER)
GOOD (GREY)
BEE (BLACK)
