MIDTERMS MOD 5 part 2

Question 1

_______________ is swelling caused by the abnormal accumulation of fluid in the tissues.

Answer 1

Edema

Question 2

Reasons why specimens collected from edematous areas are avoided:

Answer 2

1. May yield inaccurate test results owing to contamination with tissue fluid or
   altered blood composition caused by the swelling.
2. Veins are harder to locate and are often fragile and easily injured by
   tourniquet and antiseptic application
3. Healing may be prolonged in these areas

Question 2

Reasons why specimens collected from bruised (with hematoma) areas are avoided:

Answer 2

1. The site is painful
2. The site may be contaminated with hemolyzed blood from outside the vein
   (NOTE: never use hemolyzed blood sample for testing as it would lead to
   erroneous results)
3. Obstruction of blood flow may occur as the effects of the clotting process
   may also lead to inaccurate test results.

Question 3

A ____________ is a swelling or mass of blood (often clotted) that can be caused by blood leaking from a blood vessel during or following venipuncture.

Answer 3

hematoma

Question 4

_____________ is the first step to a successful venipuncture.

Answer 4

Proper tourniquet selection and application

Question 5

A ________ may be used to support the location of the vein making it more prominent.

Answer 5

blood pressure cuff

Question 6

T or F
Blood should be drawn from an arm on the same side as a mastectomy

Answer 6

Blood should never be drawn

Question 7

Impaired lymph flow makes the arm susceptible to swelling, called, _________ and to infection.

Answer 7

lymphedema,

Question 8

An ________________ is a catheter that is placed in an artery.

Answer 8

arterial line (A-line or Art-line)

Question 9

An arterial line is a catheter that is placed in an artery. It is most commonly placed in a _______________

Answer 9

radial artery

Question 10

is typically used to provide accurate and continuous measurement of a patient’s blood pressure.

Answer 10

ARTERIAL LINE

Question 11

It may also be used to collect blood gas and other blood specimens and for the administration of drugs such as dopamine.

Answer 11

ARTERIAL LINE

Question 12

T or F

Only specially trained personnel should access arterial lines.

Answer 12

T

Question 13

These devices are permanent surgical connection of an artery and vein by direct infusion resulting in a bulging vein, or with a piece of vein or tubing that creates a loop under the skin.

Answer 13

ARTERIOVENOUS SHUNT, FISTULA, OR GRAFT

Question 14

It is typically created to be used for dialysis, commonly joins the radial artery
and cephalic vein above the wrist on the underside of the arm.

Answer 14

ARTERIOVENOUS SHUNT, FISTULA, OR GRAFT

Question 15

This is a catheter or cannula connected to a stopcock or a cap with a diaphragm (thin rubber-like cover) that provides access for administering medication or drawing blood.

Answer 15

HEPARIN or SALINE LOCK

Question 16

It is often placed in a vein in the lower arm above the wrist and can be left in place for up to 48 hours.

Answer 16

HEPARIN or SALINE LOCK

Question 17

HEPARIN or SALINE LOCK is often placed in a vein in the lower arm above the wrist and can be left in place for up to ____________ hours

Answer 17

48 hours.

Question 18

A ______ ml discard tube should be drawn first when blood specimens are collected from
either HEPARIN or SALINE LOCK

Answer 18

5 mL

Question 19

Intravenous means ______________________

Answer 19

“of, pertaining to, or within a vein.”

Question 20

An __________, referred to simply as an __, is a catheter inserted in a vein to administer fluids.

Answer 20

intravenous line ; IV

Question 21

PROCEDURE: “Performing Venipuncture Below an IV Line”

Answer 21

STEP

1. Ask the patient’s nurse to turn off the IV
   for at least 2 minutes prior to collection
2. Apply the tourniquet distal to the IV
3. Select a venipuncture site distal to the IV
4. Perform the venipuncture in a different
   vein than the one with the IV if possible
5. Ask the nurse to restart the IV after the
   specimen has been collected.
6. Document that the specimen was
   collected below an IV, indicate the type
   of fluid in the IV, and identify which arms
   was used.

Question 22

Blood specimens should not be collected from a known previous IV site within ____ to ___ hours of the time the IV was discontinued.

Answer 22

24 to 48

Question 23

A __________ also called an __________ consists of tubing inserted into a main vein or artery.

Answer 23

central vascular access device (CVAD), ; indwelling line,

Question 24

Having a _________ is practical for patients who need IV access for an extended time and is especially beneficial for patients who do not have easily accessible veins.

Answer 24

Central vascular access device (CVAD)

Question 25

Three types of CVADs:

Answer 25

Central venous Catheter (CVC) Also called central venous line

Implanted port

Peripherally Inserted central catheter (PICC)

Question 26

Is a line inserted into a large vein such as the subclavian and advanced into the superior vena cava, proximal to the right atrium.

Answer 26

Central venous Catheter (CVC) Also called central venous line

Question 27

A small chamber attached to an indwelling line that is surgically implanted under the skin and most commonly located in the upper chest or arm.

Answer 27

Implanted port

Question 28

A line inserted into the peripheral venous system (veins of the extremities) and threaded into the central venous system.

Answer 28

Peripherally Inserted central catheter (PICC)

Question 29

T or F

It is preferred that specimens for coagulation tests not be drawn from CVADs.

Answer 29

T

Question 30

(Type of Allergy)

some are allergic to the glue used in adhesive bandages.

Answer 30

Adhesive Allergy

Question 31

(Type of Allergy)
Allergy in Povidone-iodine

Answer 31

Antiseptic Allergy

Question 32

(Type of Allergy)
Increasing numbers of individuals are allergic to latex.

Answer 32

Latex Allergy

Question 33

In Adhesive Allergy, one solution is to place a clean,_________ over the site and wrap
with self-adherent bandaging material such as __________

Answer 33

folded gauze ; Coban

Question 34

What to do when there is an excessive bleeding?

Answer 34

What to do?
✓ Apply pressure onto puncture site until the bleeding stops
✓ Appropriate personnel should be notified immediately if the bleeding continues after 5 minutes.

Question 35

______ or ________, is described as a loss of consciousness and postural tone resulting from insufficient blood flow to the brain.

Answer 35

Fainting ; “syncope”

Question 36

SUDDEN FAINTNESS OR LOSS OF CONSCIOUSNESS DUE TO A NERVOUS SYSTEM RESPONSE TO ABRUPT PAIN, STRESS, OR TRAUMA

Answer 36

VASOVAGAL SYNCOPE

Question 37

In a possible fainting patient;

What to do?

Answer 37

1. Ask the patient if he or she has a history of fainting experiences during venipuncture.
2. Routinely ask the patient how he is doing or feeling.
3. Watch for signs of fainting, and be prepared to protect them from falling.

Question 38

Some signs that a person will possibly faint during blood extraction

Answer 38

Signs:
o Paleness
o Perspiration
o Hyperventilation
o Vertigo (ask the patient if he is experiencing a sensation of spinning)
o Dizziness
o Light-headedness
o Nausea

Question 39

PROCEDURE: Steps to Follow if a Patient Starts to Faint During Venipuncture

Answer 39

STEP

1. Release the tourniquet and remove and discard the needle as quickly as possible
2. Apply pressure to the site while having the patient lower the head and breathe deeply
3. Talk to the patient
4. Physically support the patient
5. Ask permission and explain what you are doing if it is necessary to loosen a tight collar or tie
6. Apply a cold compress or wet wash-cloth to the forehead and back of the neck
7. Have someone stay with the patient until recovery is complete.
8. Call first aid personnel if the patient does not respond
9. Document the incident according to facility protocol

Question 40

Goal of AV shunt, fistula and graft

Answer 40

Increase blood pressure