Troubleshooting Failed Venipuncture

Question 1

Troubleshooting Failed Venipuncture

Answer 1

TUBE POSITION
NEEDLE POSITION
COLLAPSED VEIN
TUBE VACUUM

Question 2

TUBE POSITION

Answer 2

Make sure that the:
● tube is properly seated
● needle in the tube holder has penetrated the tube stopper
● needle sleeve is not pushing the tube off the needle

Question 3

Tube holder end has ___ that
help in the insertion and removal of tube

Answer 3

flanges

Question 4

NEEDLE POSITION
Correct Needle Position:

Answer 4

●Bevel is correctly positioned within the vein
● Needle adjustments must be made slowly and precisely to avoid
injuring the patient

Question 5

NEEDLE POSITION
Correct Needle Position: Needle adjustments must be made ___ to avoid
injuring the patient

Answer 5

slowly and precisely

Question 6

NEEDLE POSITION
Correct Needle Position:
●___ is correctly positioned within the vein

Answer 6

Bevel

Question 7

NEEDLE POSITION
Needle Not Inserted Far Enough

Answer 7

● Happens if the vein is located more deeply than normal

Question 8

HOW TO CORRECT NEEDLE NOT INSERTED FAR ENOUGH

HOW TO CORRECT THIS??

Answer 8

slowly advance the needle forward

Question 8

Bevel not completely under the skin

angle of needle entry is ___

Answer 8

too steep

Question 9

NEEDLE POSITION
Bevel partially out of the skin

Answer 9

Bevel not completely under the skin

○ using superficial vein/hand veins

○ angle of needle entry is too steep

● Note: tube vacuum can be lost if the bevel backs out of the skin slightly

Question 9

Bevel not completely under the skin

Answer 9

○ using superficial vein/hand veins
○ angle of needle entry is too steep

Question 10

Bevel not completely under the skin

using ____

Answer 10

superficial vein/hand veins

Question 11

how to correct bevel partially out of the skin

Answer 11

Discard the tube,

advance the needle slowly

insert a new tube

Question 12

blood filling the tube very slowly

Answer 12

Bevel Partially into the Vein

Question 13

Bevel Partially into the Vein

Answer 13

bevel partly through the upper vein

blood filling the tube very slowly

Question 13

Bevel Partially into the Vein

blood filling the tube very ___

Answer 13

slowly

Question 13

Bevel Partially into the Vein

bevel partly through the ___

Answer 13

upper vein wall

Question 13

bevel partly through the upper vein wall

Answer 13

Bevel Partially into the Vein

Question 14

how to correct bevel partially into the vein

Answer 14

gently push the needle forward into the vein

Question 15

Bevel Partially into the Vein

remember to:

Answer 15

partial needle insertion can cause
blood to leak into the tissue and form hematoma

Question 16

partial needle insertion can cause
blood to leak into the tissue and form hematoma

Answer 16

bevel partially into the vein

Question 16

Vein not anchored well may roll slightly

Answer 16

Needle Beside the Vein

Question 16

how to correct Needle Beside the Vein

Answer 16

● disengage the tube to preserve the vacuum
● withdraw the needle slightly
● anchor the vein, redirect the needle into the vein, and reengage the tube
● Do not move the needle in a lateral (sideways) direction

Question 17

Undetermined Needle Position

Answer 17

● remove the tube from the holder needle
● withdraw the needle until the bevel is just under the skin
● palpate the arm above the needle entry site
○ not too close to the needle (painful)
● relocate the vein, anchor, then redirect the needle into it

Question 18

first step in Undetermined Needle Position

Answer 18

remove the tube from the holder needle

Question 19

Undetermined Needle Position last step

Answer 19

relocate the vein, anchor, then redirect the needle into it

Question 20

Collapsed Vein ● Causes

Answer 20

○ Too much vacuum on small veins ○ Excessive pulling of the plunger walls draw together temporarily, shutting off the blood flow ○ Tourniquet is tied too tightly ○ Tourniquet is removed during the draw

Question 21

collapsed vein collapse more easily

Answer 21

elderly patients (fragile veins)

Question 22

clue that a vein has collapsed?

Answer 22

vein disappears as soon as the tube is engaged or when the tourniquet is removed

Question 23

clue that a vein has collapsed? ○ vein disappears as soon as the tube is ____

Answer 23

engaged or when the tourniquet is removed

Question 24

Tubes can lose vacuum:

Answer 24

○ during shipping and handling ○ if pushed too far onto the needle prior to venipuncture

Question 25

TUBE VACUUM failed to establish blood flow during a draw?

Answer 25

-reposition the needle -if this doesn’t help, try using a new tube

Question 26

NEEDLE POSITIONS:

Answer 26

Correct Needle Position: Needle Not Inserted Far Enough Bevel Partially out of the Skin Bevel Partially into the Vein Needle Beside the Vein Undetermined Needle Position