Module 6

Question 1

How can venous blood be collected?

Answer 1

Evacuated tubes

Syringe technique

Both can be adapted with butterfly needles

Question 2

Why must reqs be checked?

Answer 2

To determine the priority status for testing and reporting.

Question 3

Where are expected TATs listed?

Answer 3

Guides to services

Question 4

What are critical values?

Answer 4

Abnormal results, require special reporting.

Question 5

What are alert values?

Answer 5

Abnormal results, require special reporting but not life threatening.

Question 6

What are routine tests?

Answer 6

Those used for diagnosis and treatment.

Question 7

What are STAT test?

Answer 7

Those that need to be collected and tested immediately.

Results must be reported immediately.

Question 8

What is a medical emergency?

Answer 8

The situation is life threatening, results are required immediately.

Question 9

What are urgent tests?

Answer 9

Similar to STAT and medical emergency but associated with transfusion medicine.

Question 10

What are ASAP tests?

Answer 10

The situation is serious but not critical, tests can be run with the next routine batch.

Question 11

What is fasting?

Answer 11

Requires the patient refrain from eating a certain number of hours prior to testing.

Question 12

What are preop tests?

Answer 12

Done to determine the patient’s condition before surgery.

Question 13

What are the steps of collection?

Answer 13

Identify yourself

Identify the patient

Check pretest protocol

Position patient

PPE

Assess vein

Collect

Question 14

Which arm is blood normally drawn from?

Answer 14

The nondominant

Question 15

What vein is chosen for venipuncture?

Answer 15

The largest in diameter, most turgid and well secured in tissue.

Normally median

Question 16

How do you assess the veins of obese patients?

Answer 16

Rotate arm so cephalic is the upper most and accessible.

Question 17

What can you do if the vein isn’t readily apparent?

Answer 17

Check tourniquet is tight enough

Have the pt. open their hand

Tap the skin

Lower the arm

Gently massage the arm

Apply a warm wash cloth

Question 18

What sites should be avoided for venipuncture?

Answer 18

Scars

Burns

Abrasions- infection

Mastectomy- lymph disruption

Hematoma

Hardened/sclerosed

Question 19

When can phlebotomy be performed on an arm with an IV line?

Answer 19

The IV is turned off for two min

Tourniquet is applied distal to the site

Performed on a different vein

First 5mL are discarded

Note is made on the req

Question 20

What alternate sites can blood be collected from?

Answer 20

Hand veins- radial, more painful

Foot- great saphenous vein, not if pt. is diabetic or has a history of thrombophlebitis or leg vein clotting

Vascular access devices- require special training

Renal dialysis pt.- cannula or fistula (avoid this arm)

Question 21

What VADs are there?

Answer 21

Central venous line- subclavian

Peripherally inserted central catheter- basilic or cephalic, not used for collection

Implanted port- beneath skin

Heparin lock- inserted into VAD to enable access

Question 22

What is the vacutainer collection technique?

Answer 22

Assemble equipment
Assemble needle, holder and tube
Disinfect
Reapply tourniquet 
Loosen needle guard and inspect
Pt. close hand
Anchor vein
Deep breath
Insert needle
Push tube on
Fill tubes, mix as they're filled
Pt. open hand
Release tourniquet
Disengage vacuum
Withdraw needle
Activate safety device and discard
Mix tubes
Label tubes (always after)
Make notes on req
Clean up
Check on pt. (two point check)

Question 23

If blood doesn’t fill the tube when activated what can be checked?

Answer 23

Tube is seated properly

Change needle position

Check tourniquet

New tube

Rotate needle

Collapsed vein- twist tourniquet or use smaller vacuum

Pull needle back and reinsert if needle is beside the vein

Different site

Question 24

Why is venipuncture the method of choice for blood specimens?

Answer 24

Veins are readily accessible

A large vol can be collected

Samples are free of interfering substances

Adequate for the performance of many tests from one collection