the challenges of phlebotomy and customer service

Question 1

Can happen if the vein is located more deeply

Answer 1

Needle Not Inserted Far Enough

Question 2

how to correct Needle Not Inserted Far Enough

Answer 2

you need to slowly advance the needle forward

Question 3

This is why it’s important to palpate the vein before puncturing – to know the size, depth and direction of the vein

Answer 3

Needle Not Inserted Far Enough

Question 4

Needle not completely under the skin

Answer 4

Bevel Partially out of the Skin

Question 5

Can happen if the veins are superficial and your angle is steep

Answer 5

Bevel Partially out of the Skin

Question 6

The tube vacuum can be lost when the bevel is partially out of the skin

Answer 6

Bevel Partially out of the Skin

Question 7

short hissing sound or slight spurt of blood then the flow goes to a complete stop

Answer 7

Indication that the vacuum is lost

Question 8

how to correct Bevel Partially out of the Skin

Answer 8

discard the tube, advance the needle, then engage a NEW tube

Question 9

Needle not inserted deeply enough – half under the vein, half out

Answer 9

Bevel Partially into the Vein

Question 10

The bevel may be under the skin but only partly through the upper vein wall, resulting to the blood filling the tube very slowly

Answer 10

Bevel Partially into the Vein

Question 11

The blood will leak, and if not corrected quickly, it may cause hematoma

Answer 11

Bevel Partially into the Vein

Question 12

how to correct Bevel Partially into the Vein

Answer 12

insert the needle

Question 13

An angle that is too shallow may be in contact with the upper wall

Answer 13

Bevel Against a Vein Wall

Question 14

An angle that is too steep (bevel down) may be in contact with the lower wall

Answer 14

Bevel Against a Vein Wall

Question 15

how to correct Bevel Against a Vein Wall

Answer 15

remove the tube to preserve vacuum, tilt (rotate) it slightly so that the bevel will face upward, then re-engage the tube

Question 16

Needle slip to the side of the vein slightly under it

Answer 16

Needle Beside the Vein

Question 17

Usually happens if the vein is not anchored well – vein may roll or move slightly

Answer 17

Needle Beside the Vein

Question 18

how to correct Needle Beside the Vein

Answer 18

withdraw the needle slightly until the bevel is just under the skin, then redirect (do not search or probe for the vein or move the needle in a lateral sideways direction to find it)

Question 19

Causes of Unsuccessful Venipuncture: Improper Technique

Answer 19

a.) Bevel on lower wall of vein
b.) Needle rotated 45 degrees
c.) Needle inserted too far
d.) Needle partially inserted

Question 20

causes blood to leak into tissue

Answer 20

Needle partially inserted

Question 21

does not allow blood to flow

Answer 21

Bevel on lower wall of vein

Question 22

To prevent this, apply direct pressure; Before putting adhesive, make sure that the bleeding has stopped

Answer 22

Excessive bleeding

Question 23

Ask the patient to breathe slowly and deeply, then apply the cold wash cloth on the forehead

Answer 23

Nausea and vomiting

Question 24

When you insert the needle, normally, it is painful; If it is very painful, you need to stop

Answer 24

pain

Question 25

very rare Complication of Venipuncture

Answer 25

seizures/convulsion

Question 26

tiny red spots; usually caused by platelet abnormalities and defect in the capillary wall

Answer 26

petechiae

Question 27

loss of consciousness due to insufficiency of blood supply to the brain; second common complication in phlebotomy; apply cold compress on the patient’s forehead

Answer 27

Fainting / vasovagal syncope

Question 28

most common complication

Answer 28

hematoma

Question 29

Blood leaked to the blood vessel following a venipuncture

Answer 29

hematoma

Question 30

Long-term complications in veinipuncture

Answer 30

a.) Iatrogenic anemia b.) Infection c.) Vein damage d.) nerve injury

Question 31

adverse condition brought by the effects of treatment or procedure; iron deficiency anemia

Answer 31

latrogenic

Question 32

Usually happens when the needle used is not sterile

Answer 32

infection

Question 33

SIGNS of nerve injury

Answer 33

a.) Extreme pain b.) Burning / electric shock sensation c.) Numbness of arm d.) Radiating pain

Question 34

is normally recommended for pediatric patients since their veins are small and not well-developed

Answer 34

Capillary collection

Question 35

superficial veins and not deep, hard-to-find veins

Answer 35

1-2 years old

Question 36

Other potential venipuncture sites include?

Answer 36

a.) medial wrist b.) the dorsum of the foot c.) the scalp d.) the medial ankle

Question 37

removing more than 10% of an infant’s blood volume at one time can lead to?

Answer 37

shock and cardiac arrest

Question 38

volume of blood to be collected in babies are dependent on?

Answer 38

their weight

Question 39

method of restrain in newborn or young infant

Answer 39

wrapped in a blanket

Question 40

method of restrain in toddlers

Answer 40

sit upright in parent's lap

Question 41

method of restrain in older children

Answer 41

sit by themselves but a parent or another phlebotomist should help steady the child’s arm

Question 42

geriatric

Answer 42

old age

Question 43

Must be treated with compassion, kindness, and treated with respect

Answer 43

geriatric

Question 44

site selection in geriatric

Answer 44

antecubital

Question 45

A Patient Who Is Resistant has what right

Answer 45

right to refuse

Question 46

A Patient Who Is too aggressive should be?

Answer 46

sedated

Question 47

A Patient w/o consent

Answer 47

can lead to charges of assault and battery

Question 48

A Patient Who refuse blood collection

Answer 48

Do not collect blood, the inform the doctor

Question 49

Veins are often difficult to feel through layers of tissue

Answer 49

obese patients

Question 50

usually the most prominent vein to feel in obese patients

Answer 50

median cubital

Question 51

blood collection on Patients with Damaged or Collapsing Veins

Answer 51

syringe method

Question 52

a persistent irrational fear of pins and needles

Answer 52

Belonephobia

Question 53

“belone" means

Answer 53

needle

Question 54

"phobos"

Answer 54

fear

Question 55

heightened sensitivity to pain and can experience a shock type reaction during or immediately following venipuncture

Answer 55

Belonephobia

Question 56

how long should an ice pack be used during Belonephobia

Answer 56

10 - 15 mins

Question 57

most legal actions against healthcare workers

Answer 57

civil actions

Question 58

The most common civil actions in healthcare are based on

Answer 58

tort law

Question 59

came from the Latin word tortum, meaning twisted, crooked, or wrong

Answer 59

tort

Question 60

An act or threat causing another to be in fear of immediate battery

Answer 60

assault

Question 61

An intentional harmful or offensive touching of, or use of force on, another person without consent or legal justification

Answer 61

battery

Question 62

usually both a tort and a criminal offense

Answer 62

battery

Question 63

are both examples of physical violence

Answer 63

assault and battery

Question 64

The violation of ones right to be left alone.

Answer 64

invasion of privacy

Question 65

failure to keep privileged medical information private

Answer 65

Breach of confidentiality

Question 66

failure to exercise due care

Answer 66

Negligence

Question 67

A type of negligence committed by a professional

Answer 67

malpractice

Question 68

Latin for “the thing speaks for itself”

Answer 68

Res ipsa loquitur

Question 69

Latin for “let the master respond”

Answer 69

Respondeat superior

Question 70

When a breach of duty is so obvious that it does not need further explanation, it is said that the situation speaks for itself

Answer 70

Res ipsa loquitur

Question 71

An employer is liable (legally responsible) for the actions of an employee, even though the employee is the one at fault

Answer 71

Respondeat superior

Question 72

Compensates the insured in the event of malpractice liability

Answer 72

Malpractice insurance

Question 73

are not typically targets of lawsuits because of respondeat superior

Answer 73

Malpractice insurance

Question 74

communication skill that the patient will understand

Answer 74

verbal

Question 75

communication skill that uses body language

Answer 75

non-verbal

Question 76

communication skill that limits your talking and focuses on customer

Answer 76

listening

Question 77

Reasons of patients in choosing a phlebotomy area (draw site)

Answer 77

a.) Insurance company b.) Physician’s order c.) Convenient location d.) Image of draw site

Question 77

Reasons of patients in choosing a phlebotomy area (draw site)

Answer 77

a.) Insurance company b.) Physician’s order c.) Convenient location d.) Image of draw site