pre-analytical considerations

Question 1

what are the solutions to avoid the burns, scars and tattoos

Answer 1

look for other probable site

Question 2

why do some patient’s veins feel hard and cord-like and lack resilience

Answer 2

as they are partially or completely occluded (obstructed)

• Due to numerous punctures or chronic illness.
  Or doing illegal intravenous drugs.

Question 3

true or false:
Medtechs cannot remove the IV fluids. Only nurses.

Answer 3

true

Question 4

it is a large bruise that eventually spreads over the surrounding area

Answer 4

hematoma

Question 5

true or false:
it is recommended to use the fishing technique when finding the vein

Answer 5

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.

Question 6

true or false:
Never draw blood from an arm on the opposite side as a masectomy.

Answer 6

false - same side

Question 7

How would a phlebotomist know that the patient underwent mastectomy?

Answer 7

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.

Question 8

it is a longer tourniquet designed for the obese

Answer 8

bariatric tourniquet

Question 9

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.

Answer 9

true - especially in obese patients. however, if really cant locate the vei, endorsed to your superior

Question 10

it can be temporary or permanent and it can be localized in one area of the body or widespread.

Answer 10

paralysis
- result of a stroke or an injury to the spinal cord

Question 11

they are tubing and other devices that are specifically designed to allow entry to veins or arteries.

Answer 11

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.

Question 12

Intravenous (IV) means

Answer 12

of, pertaining to, or within a vein

Question 13

It is referred to simply as an IV, a quick way to deliver fluids, medications and blood transfusion products and other substances to patients

Answer 13

Intravenous line

Question 14

Why is it preferred that blood specimens not be drawn from an arm with an IV

Answer 14

As the specimens can be contaminated or diluted with the IV fluid = erroneous test results

Question 15

What equipment can be used when performing venipuncture below an IV

Answer 15

ETS or syringe system

Question 16

How do you perform venipuncture below an IV

Answer 16

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

Question 17

What equipments do patients have allergies to

Answer 17

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

Question 18

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.

Answer 18

True - Some latex allergies are
seemingly minor and involve irritation or rashes from physical contact with latex products.

Question 19

How long does the fainting last

Answer 19

Last for as little as a few seconds or as long as half an hour

Question 20

How does one may state that he or she is feeling nauseous or show signs that are similar to fainting

Answer 20

Becoming pale
Having beads of swear appear in the forehead

Question 21

True or false:
A small amount of pain is normally associated with routine venipuncture and capillary puncture.

Answer 21

True

Question 22

Why do you have to put patient at ease before blood collection

Answer 22

To help them relax which can make the procedure less painful

Question 23

How does the petechiae form

Answer 23

The spots are minute drops of blood that escape the capillaries and come to the surface of the skin below the tourniquet.

Question 24

True or false:
Venipuncture causes seizures

Answer 24

There is no evidence that they can be caused by venipuncture

Question 25

What happens if sezuires occur during blood specimens collection

Answer 25

Discontinue the draw immediately
Shout for help immediately if needed

Question 26

It is an invasive procedure

Answer 26

Venipuncture
- and it involves in risks when it is performed

Question 27

It is the most common complication of venipuncture

Answer 27

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.

Question 28

What are some situations that can trigger hematoma formation

Answer 28

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.

Question 29

An adjective used to describe an adverse condition brought on by the e ects of treatment.

Answer 29

Iatrogenic anemia

Question 30

How can we minimize the blood draws in infants as they are more prone to blood loss through blood removed for testing

Answer 30

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.

Question 31

It is most often associated with deep or blind probing, especially in areas near the basilic vein, which is close to the brachial artery.

Answer 31

Inadvertent Arterial Puncture
- it is rare when proper venipuncture procedures are followed

Question 32

True or false:
infection is a rare occurrence

Answer 32

True

Question 33

How to minimize the risk of infection during venipuncture

Answer 33

Use proper aseptic techniques
Not touching the site after sanitizing

Question 34

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.

Answer 34

Nerve injury

Question 35

What causes vein damage

Answer 35

★ 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.

Question 36

Hemoconcentration

Answer 36

○ A decrease in fluid content of blood.
○ An increase in nonfilterable large molecules.

Question 37

What causes hemoconcentration

Answer 37

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).

Question 38

Hemolysis

Answer 38

○ Damage to or destruction of RBCs
○ Hemoglobin escapes into the fluid part of the specimen.