Pmls Flashcards
not advisable to choose a site.
Veins in the area may difficult to examine and blood circulation may be impaired.
Burns, scars, tattoos
Puncturing damaged veins may also produce inaccurate results.
Damaged veins
Also known as oedema.
Abnormal swelling caused by the accumulation of fluid in the tissues
Edema
Solid swelling or mass of blood in tissue cause by leakage of blood from the vessels.
Obstruct the blood flow
Hematoma
Breast cancer and removed of the breast.
The lymph flow is obstructed and tourniquet cannot be applied
Mastectomy
Grossly overweight
Solution using a longer tourniquet or locating cephalic veins
Obesity
Critically ill patients where thin catheter is inserted into an artery.
Neither tourniquet nor venipuncture is allowed in arm with arterial line
Arterial Line
Passageway created through surgery and connecting the artery and a vein directly.
Arteriovenous Shunt or Fistula
Used to avoid the use of needle sticks, prevents infections and reduces wastage.
Collect blood from the arterial or central venous catheter
Blood sampling device
Hep-lock is an intravenous catheter attached to stopcock or cap with diaphragm.
Provide access administering medicine. Peripheral vein lower arm above the wrist 48 hours
Heparin
Thin plastic tube insert into vein in the forearm. Avoid collecting blood from the arm with IV. Should below the IV and avoided for 24 to 48 hours
Intravenous Sites
Known as indwelling lines, the main vein or artery used for blood collection, monitoring the patient pressure.
Central Vascular Access Devices
Three types of CVAD
- Central venous catheter line
- Implant port
- Peripherally inserted central catheter
Known as central line inserted (subclavian)
Central venous catheter
Surgically implanted disk shaped chamber and usually placed on upper chest
Implanted port
Flexible tube inserted into the veins of extremities and central veins
PICC or Peripherally inserted Central catheter
Adhesive allergy, gauze should be placed over site and removed after 15 mins. Look for alternative materials.
Allergies to equipment and supplies
Patient is on aspirin or anticoagulant, the bleeding may take a longer time. Apply pressure until bleeding stops and ask for help if still bleeding after 5 mins
Excessive bleeding
Patient prone of fainting during venipuncture asked to lie down during the procedure
Fainting
Patient feels nauseous and tendency to vomit, phlebotomist has to discontinue the procedure. Emesis basin or wastebasket should be provided.
Nausea and Vomiting
Warned before the needle inserted, extreme pain or numbness, removed the needle and apply ice to the site
Pain
Small red or purple spots that look like rashes which appear when tourniquet is applied
Petechiae
Discontinue quickly. There must be pressure held over the site.
Seizure or convulsions
Hold pressure over the site
Hematoma
