pre-analytical considerations Flashcards
what are the solutions to avoid the burns, scars and tattoos
look for other probable site
why do some patient’s veins feel hard and cord-like and lack resilience
as they are partially or completely occluded (obstructed)
- Due to numerous punctures or chronic illness.
Or doing illegal intravenous drugs.
true or false:
Medtechs cannot remove the IV fluids. Only nurses.
true
it is a large bruise that eventually spreads over the surrounding area
hematoma
true or false:
it is recommended to use the fishing technique when finding the vein
false - To prevent hematoma, we should not be used to the fishing technique. Only do it when needed due to a difficult vein. If you are fishing for the vein, you are damaging the tissues.
true or false:
Never draw blood from an arm on the opposite side as a masectomy.
false - same side
How would a phlebotomist know that the patient underwent mastectomy?
Under the request form, there is a section for the diagnosis from the physicians. Hence, we really have to read all the information from the request form. To know the appropriate approach.
it is a longer tourniquet designed for the obese
bariatric tourniquet
true or false:
Sometimes you have to puncture the whole needle just to reach the veins and it may take time to locate the veins.
true - especially in obese patients. however, if really cant locate the vei, endorsed to your superior
it can be temporary or permanent and it can be localized in one area of the body or widespread.
paralysis
- result of a stroke or an injury to the spinal cord
they are tubing and other devices that are specifically designed to allow entry to veins or arteries.
Vascular access devices (VADs)
- v. applicable to inpatients
- often used for patients who require frequent venous or arterial access.
- most commonly used for administration of medications, fluids, blood products and sometimes blood collection.
Intravenous (IV) means
of, pertaining to, or within a vein
It is referred to simply as an IV, a quick way to deliver fluids, medications and blood transfusion products and other substances to patients
Intravenous line
Why is it preferred that blood specimens not be drawn from an arm with an IV
As the specimens can be contaminated or diluted with the IV fluid = erroneous test results
What equipment can be used when performing venipuncture below an IV
ETS or syringe system
How do you perform venipuncture below an IV
Tell the nurse to turn off the IV for at least 2 min
Apply tourniquet distal to the IV site
Select venipuncture site
Perform venipuncture in a different vein than the IV
Restart the IV after specimen has been collected
Document that the specimen was collected below w an IV, indicate the type of fluid in the IV and which arm is used
What equipments do patients have allergies to
Adhesive allergy - glue used in adhesive bandages
Antiseptic allergy- many are allergic to povidone iodine
Latex allergy - reaction to certain substances in natural rubber latex
True or false:
There should be a warning sign on the door to the room of any patient known to have a severe latex allergy.
True - Some latex allergies are
seemingly minor and involve irritation or rashes from physical contact with latex products.
How long does the fainting last
Last for as little as a few seconds or as long as half an hour
How does one may state that he or she is feeling nauseous or show signs that are similar to fainting
Becoming pale
Having beads of swear appear in the forehead
True or false:
A small amount of pain is normally associated with routine venipuncture and capillary puncture.
True
Why do you have to put patient at ease before blood collection
To help them relax which can make the procedure less painful
How does the petechiae form
The spots are minute drops of blood that escape the capillaries and come to the surface of the skin below the tourniquet.
True or false:
Venipuncture causes seizures
There is no evidence that they can be caused by venipuncture
What happens if sezuires occur during blood specimens collection
Discontinue the draw immediately
Shout for help immediately if needed
It is an invasive procedure
Venipuncture
- and it involves in risks when it is performed
It is the most common complication of venipuncture
Hematoma formation and bruising
- caused by blood leakage into the tissue during or following venipuncture and is defined by rapid swelling at, near or beneath the venipuncture site.
- It depends on the skill of the phlebotomist.
What are some situations that can trigger hematoma formation
An artery is accidentally punctured.
Excessive or blind probing is used to locate the vein.
Pressure is not adequately applied following venipuncture.
The arm is folded to hold the gauze in place after venipuncture.
The needle is only partly inserted into the vein.
The needle is removed while the tourniquet is still on.
The needle penetrates all the way through the vein.
The site is bandaged without determining that bleeding has stopped.
The vein is fragile or too small for the needle size.
An adjective used to describe an adverse condition brought on by the e ects of treatment.
Iatrogenic anemia
How can we minimize the blood draws in infants as they are more prone to blood loss through blood removed for testing
Take a blood specimen for succeeding request so that we won’t have to draw blood again
Save specimen: in a yellow or red stopper evacuated tube to store the blood.
It is most often associated with deep or blind probing, especially in areas near the basilic vein, which is close to the brachial artery.
Inadvertent Arterial Puncture
- it is rare when proper venipuncture procedures are followed
True or false:
infection is a rare occurrence
True
How to minimize the risk of infection during venipuncture
Use proper aseptic techniques
Not touching the site after sanitizing
It is a serious phlebotomy complication that can result in permanent damage to motor or sensory nerve function of the arm or hand and the probability of a lawsuit.
Nerve injury
What causes vein damage
★ Numerous venipunctures in the same areas over an extended period, however, will eventually cause a buildup of scar tissue and increase the di culty of performing subsequent venipunctures.
★ Blind probing and improper technique when redirecting the needle can also damage veins and impair vein patency.
Hemoconcentration
○ A decrease in fluid content of blood.
○ An increase in nonfilterable large molecules.
What causes hemoconcentration
stagnation of normal venous blood flow due to tourniquet application (venous stasis).
Heavy massaging of the site, probing for veins, long term IV therapy, drawing blood from sclerosed or occluded veins and vigorous hand pumping (making and releasing a fist).
Hemolysis
○ Damage to or destruction of RBCs
○ Hemoglobin escapes into the fluid part of the specimen.
