Venepuncture

Question 1

Why is Aseptic Non Touch Technique (ANTT) used?

Answer 1

to avoid transfer of microbes to key body sites from clinicians, equipment or immediate environment

Question 2

what should be written on a pt’s wristband?

Answer 2

Full name - surname first in block capitals

DOB

NHS number

Question 3

how do endothelial cells reduce friction in vessels?

Answer 3

they are packed together but lie flat creating a smooth surface for blood flow -> prevents abnormal blood clots forming

Question 4

semilunar folds of the tunica intima form

Answer 4

VALVES in veins

Question 5

will valves repair themselves if damaged?

Answer 5

NO

Question 6

What stimulates the smooth muscle of the tunica media?

Answer 6

Stretch - when overstretched they contract in resistance

Question 7

which blood vessel layer is sensitive to irritation?

Answer 7

tunica media - if irritated causes spasm which makes insertion difficult

Question 8

what happens when the tourniquet is left on too long?

Answer 8

SM in the tunica media overstretches and contracts in resistance causing blood to pool

Question 9

6 characteristics of good veins for venepuncture

Answer 9

Soft&bouncy - indicates not damaged/sclerosed

Palpable - shldn’t pulsate

Visible

Straight

Non-mobile

Good location - not too superficial, starts in antecubital fossa, not surrounded by too many structures

Question 10

Where should you avoid taking blood from?

Answer 10

fine veins in the back of the hand too close to the

Question 11

Why is taking blood from an AV fistula contraindicated?

Answer 11

because it increases risk of thrombosis + damage to the fistula itself

Question 12

Why should you avoid taking blood from a site near an IV?

Answer 12

it may dislodge the IV

Question 13

3 approaches to improving venous access

Answer 13

keep area warm

encourage patient to be well hydrated

encourage pt to relax

Question 14

What should be disposed of in a red top sharps bin?

Answer 14

sharps contaminated with blood only

Question 15

What should be disposed of in a purple top sharps bin?

Answer 15

sharps contaminated with cytotoxic medications

Question 16

What should be disposed of in a yellow top sharps bin?

Answer 16

sharps contaminated w meds

Question 17

What happens if I get a needlestick injury

Answer 17

bleed it by squeezing

wash well w warm soapy water

apply waterproof occlusive dressing

report to nurse in charge/occupational health etc.

Question 18

When should a blood sample be labelled?

Answer 18

immediatley after it has been taken at the pt’s bedside

Question 19

What is the correct order of draw? (B B P G)

Answer 19

• • 1- Brown bottle
    
    • serum gel - brown monovette bottle
    • use: biochemistry => urea+electrolyte lvls (Us&Es)
  • 2- Blue bottle
    
    • citrate
    • use - for coagulation tests
  • 3 - Purple bottle
    
    • use - for haematology tests incl. FBCs
  • 4 - Grey
    
    • use - glucose

Question 20

What’s used to cleanse the skin prior to venepuncture?

Answer 20

2% chlorhexidine wipe

Question 21

What causes bruising?

Answer 21

blood infiltrating into surrounding tissues

Question 22

What is a haematoma?

Answer 22

uncontrolled bleeding into surrounding tissues causing painful swelling

Question 23

What causes bruising during venepuncture?

Answer 23

poor technique: start-stop –> makes multiple holes in vein OR too much force push needle through both vein walls

not releasing the tourniquet before removing the needle

poor vein selection: choosing a site to close to valves, sml/thready veins, using a needle too lrg for vessel