patient prep Flashcards
Before blood collection
1 review lab requestion
2 pt. identification and explanation
3 evaluates pts. ability to understand the 4 procedure and obtain consent
4 determine appropriate site for collection based on overall condition and age
5 position pt. in way that facilitates successful venipuncture
who can order lab test?
Physicians (M.D. or D.O.), physician assistants,
and nurse practitioner
check lab order form for?
Provider information
Patient’s full name
DOB
Sex
MRN
forms can also include precautions or concerns of what ?
latex allergy
tendency to faint
excessive bleeding
sites to avoid
forms will have space to document what?
date and time of collection
billing information
diagnostic coding
examine the requestion form for ?
1 fasting
2 stat, medical emergency, asao
3 verify tests ordered comply with appropriate testing
4discrepancies ( duplicate testing/missing information )
Determine correct order of draw – not doing so can
Lead to preanalytical errors, skewed test results, unnecessary venipunctures
If no label
write pt. name, dob, date and time of collection, your initials
PATIENT IDENTICATION
Display caring and compassionate demeaner
* Treat all patients with respect, individual attention, and professionalism
* Greet the patient warmly
* Tell them your name, that you are a phlebotomist in the lab department, and that you
will be collecting a blood sample
* ID badge should be visible
* Use 2 patient identifiers (name, DOB, home address, telephone number)
* Do not use the patient’s bed # or room# as an identifier
* Adhere to HIPAA – patient privacy and confidentiality
* Confirm patient’s identity by viewing their wristband – if patient cannot state their
name and identifying information
INFORMED CONSENT
pt. has received full info about the procedure
Required for high risk, invasive, and surgical procedures
expressed consent
pt. gives explicit consent to a procedure orally or in writing
implied consent
- pts. actions indicate they are giving consent
- adequate for low risk procedures (vital signs, collecting blood)
- necessary in an emergency situation
pts. w nothing to eat or drink for 8-12 hours
encourage pt. to drink plenty of water for hydration
pt. interview
ask questions to prevent or mange predicable complications
allergy to latex or adhesives
ever felt faint during blood collection
feelin faint
reclining chairs or exam tables
locking arm on venipuncture chair, helps with fall prevention
STOP IF FEELING FAINT
lower head and take deep breaths
loosen tight clothing
may need to document
call rapid response team if pt. loses consciousness
nausea / vomiting
facial wipes, washclothes go in biohazard container
mastectomy
if both sides, may need to vein on back of hand or wrist
central venous access ports
a device for receving fluids or medications into a large vein OR av fistula/shunt (fo rhemodialysis)
ask pt which arm they prefer
ask pts meds. bc of blood thinners (anticoagulant)
affecting testing
alcohol use
cigarette smoking
exercise
document if you suspect intoxication
Patient Education
- If patient has never had venipuncture
Discuss the steps
Inform them that they will feel a slight bit of pain, like a
pinprick, when the needle is inserted
Tell the patient to say something immediately if they feel
severe pain
Explain the complications
o Hematoma
o Infection
o Prolonged bleedin
excessive bleeding
apply pressure and ice
severe pain
pt. should be further evaluated
risk of nerve involvement is increase when drawing blood from the basilic vein
infection
redness, swelling, painful, hot to touch
finger stick location
tip of the third or fourth finger
hand veins
next choice after antecubital fossa
often roll and small in circumference
ankle or foot veins
last choice for venipuncture
difficult to access, easy to injure and often painful
Three veins in the antecubital fossa most often
used for venipuncture
Median cubital vein (first choice)
Cephalic vein (usually second choice)
Basilic vein (last choice
