patient prep

Question 1

Before blood collection

Answer 1

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

Question 2

who can order lab test?

Answer 2

Physicians (M.D. or D.O.), physician assistants,
and nurse practitioner

Question 3

check lab order form for?

Answer 3

Provider information
Patient’s full name
DOB
Sex
MRN

Question 4

forms can also include precautions or concerns of what ?

Answer 4

latex allergy
tendency to faint
excessive bleeding
sites to avoid

Question 5

forms will have space to document what?

Answer 5

date and time of collection
billing information
diagnostic coding

Question 6

examine the requestion form for ?

Answer 6

1 fasting
2 stat, medical emergency, asao
3 verify tests ordered comply with appropriate testing
4discrepancies ( duplicate testing/missing information )

Question 7

Determine correct order of draw – not doing so can

Answer 7

Lead to preanalytical errors, skewed test results, unnecessary venipunctures

Question 8

If no label

Answer 8

write pt. name, dob, date and time of collection, your initials

Question 9

PATIENT IDENTICATION

Answer 9

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

Question 10

INFORMED CONSENT

Answer 10

pt. has received full info about the procedure
Required for high risk, invasive, and surgical procedures

Question 11

expressed consent

Answer 11

pt. gives explicit consent to a procedure orally or in writing

Question 12

implied consent

Answer 12

1. pts. actions indicate they are giving consent
2. adequate for low risk procedures (vital signs, collecting blood)
3. necessary in an emergency situation

Question 13

pts. w nothing to eat or drink for 8-12 hours

Answer 13

encourage pt. to drink plenty of water for hydration

Question 14

pt. interview

Answer 14

ask questions to prevent or mange predicable complications

allergy to latex or adhesives
ever felt faint during blood collection

Question 15

feelin faint

Answer 15

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

Question 16

nausea / vomiting

Answer 16

facial wipes, washclothes go in biohazard container

Question 17

mastectomy

Answer 17

if both sides, may need to vein on back of hand or wrist

Question 18

central venous access ports

Answer 18

a device for receving fluids or medications into a large vein OR av fistula/shunt (fo rhemodialysis)

Question 19

ask pt which arm they prefer
ask pts meds. bc of blood thinners (anticoagulant)

Question 20

affecting testing

Answer 20

alcohol use
cigarette smoking
exercise
document if you suspect intoxication

Question 21

Patient Education

Answer 21

• 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

Question 22

excessive bleeding

Answer 22

apply pressure and ice

Question 23

severe pain

Answer 23

pt. should be further evaluated
risk of nerve involvement is increase when drawing blood from the basilic vein

Question 24

infection

Answer 24

redness, swelling, painful, hot to touch

Question 25

finger stick location

Answer 25

tip of the third or fourth finger

Question 26

hand veins

Answer 26

next choice after antecubital fossa
often roll and small in circumference

Question 27

ankle or foot veins

Answer 27

last choice for venipuncture
difficult to access, easy to injure and often painful

Question 28

Three veins in the antecubital fossa most often
used for venipuncture

Answer 28

Median cubital vein (first choice)
Cephalic vein (usually second choice)
Basilic vein (last choice