Phlebotomy

Question 1

phelobotomy

Answer 1

practice of drawing blood

required informed consent.

Question 2

shaft length

Answer 2

3/4 inch - 1/5 inches

Question 3

gauge

Answer 3

23-16 g

larger gauge = smaller needle

most common gauge = 21 g

Question 4

types of needles

Answer 4

Multisample (double ended)
syringe
winged infusion “butterflies”

Question 5

Order of draw:

Answer 5

Tube top color
additive

tests

Question 6

order of draw: 1
Color: yellow

Answer 6

additive: SPS - inhibits complement and phagocytosis

test: Blood culture

Question 7

order of draw: 2
Blue

Answer 7

additive: Sodium citrate

test: Coagulation tests

Question 8

Order of draw: 3
red

Answer 8

additive: clot activators (serum)

test: chemistry, serology, blood bank

Question 9

order of draw: 4

SST (gold/gray)

Answer 9

additive: clot activators and gel seperator (serum)

test: chemistru

Question 10

order of draw: 5
green

Answer 10

additive: heparin

test: Stat chemistry, ammonia, blood gases

Question 11

order of draw:
purple

Answer 11

additive: EDTA

Test CBC, ESR

Question 12

order of draw: 7
gray

Answer 12

addiitve; antiglycolytic agent
test: lactic acid, glucose, fasting blood sugar. blood alcohol

Question 13

1.

Answer 13

greet and identify patient

check two patient identifiers (name and DOB)

Question 14

2.

Answer 14

position and prepare patient

Fasting? Abstaining from medications?

NEVER draw blood from a standing patient ot sitting on a high stool

support the chosen arm under the elbow

Question 15

3.

Answer 15

perform hand hygiene + gloves

wash/sanitize dry hands properly
put on gloves

Question 16

4.

Answer 16

assembly equipment

required items:
- antiseptic pad
- torniquet
- needle
- adapter/syringe
- tubes
- gauze
- bandage/coban
- disposal system

Question 17

5.

Answer 17

apply tourniquet

3-4 inches above the puncture site
form an X

should NOT% be left on for over 1 min

Occludes venous flow NOT arterial flow

Question 18

6.

Answer 18

select the site

site should not be scarred, bruised or IV arm

Question 19

7.

Answer 19

palpate the vein

• locate by palpitation, feel

push up and down with non dominant index finger
- feel small bounce back
- should not feel pulse or rigidity (artery or bone tendon)

Question 20

8 .

Answer 20

clean the site

Question 21

9.

Answer 21

examine needle

• blunted
• barbed
• obstruction
• bent shaft

Question 22

10.

Answer 22

perform venipuncture

anchor vein 1-2 inches below puncture site

insert needle
-15-30 degrees above skin

Question 23

11.

Answer 23

fill first tube/remove touniquet

push in tube with non dominant hand

TORNIQUET must be removed before removing the needle

Question 24

12.

Answer 24

advance and change tubes

mix 8-10 times

Question 25

13.

Answer 25

prepare for needle removal

make sure last tube is removed from adapter and TORNIQUET

Question 26

14.

Answer 26

withdraw the needle

Question 27

14.

Answer 27

withdraw the needle

apply gauze to puncture site w pressure(non-dominant hand)
hold for 3-5 min.
prevents hematoma

Question 28

15.

Answer 28

dispose of the used needle properly

Question 29

16

Answer 29

label the tube

2 patient ID (name, DOB)

Question 30

best veins for venipunctureare

Answer 30

located in antecubital fossa

Question 31

1st choice of vein

Answer 31

Medial Cubital Vein
- middle of arms surface / large and well anchored

Question 32

2nd choice of vein

Answer 32

cephalic vein
- same side of arm as the THUMB / not well anchored

Best for obese pateints

Question 33

3rd choice of vein

Answer 33

Basilic vein
- same side of arm as pinky finger
- even less anchored/ near briachial artery

Question 34

antiseptic

Answer 34

any agent used to clean LIVING tissue

70% isoprpyl alcohol

allow site to dry
- “bacteriostatic action”
- bacteriostatic - inhibits growth or reproduction of bacteria without killing

Question 35

___ must be removed before the needle

Answer 35

tourniquet

Question 36

if you have a problem with safety mechanism..

Answer 36

dispose of needle without safety