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Clinical Nursing Skills > Venepuncture Module 5 > Flashcards

Venepuncture Module 5 Flashcards

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1
Q

What are the two key determinants to consider when selecting a vein for venepuncture?

A
  1. Selection of a suitable venepuncture site
  2. Selection of a suitable vein for venepuncture
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1
Q

What are the two key determinants to consider when selecting a vein for venepuncture?

A
  1. Selection of a suitable venepuncture site
  2. Selection of a suitable vein for venepuncture
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2
Q

Patients whom have has several cannulation and venepuncture procedures should be assessed by who?

A

An experienced and competent practitioner

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3
Q

How do we select a suitable venepuncture site?

A

– Select veins in non-dominant hand/arm if possible

– Always examine both limbs before making a decision

– Start at the distal sites of the limb so that if a failure occurs other more
proximal attempts can be made

– If frequent venepuncture procedures, alternate access sites and limbs to aid
recovery of previous accessed site

– Before performing venepuncture, palpate for evidence of arterial pulsation to prevent inadvertent arterial puncture. The brachial and ulnar arteries can be shallow and need careful examination

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4
Q

How do we select a suitable vein for venepuncture?

A

Selection of a suitable vein is achieved by examining the veins of the patient’s
forearm/hand. The tourniquet will need to be applied to assist in this assessment.

A suitable vein should feel
* Round
* Firm
* Elastic
* Engorged with blood

Inspect and palpate the vein for any bruising, inflammation, skin disease or other injury. Avoid sites that are thrombosed (hard and/ or Tortous) or distal to a site of phlebitis or joint inflammation

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5
Q

A suitable vein should feel what?

A
  • Round
  • Firm
  • Elastic
  • Engorged with blood
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6
Q

The CDHB promotes the use of what for the venepuncture procedure?

A
  • BD Eclipse blood collection needle and vacutainer holder
  • BD Vacutainer push button collection set
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7
Q

What is the pre-procedure for venepuncture?

A
  1. Wash hands
  2. Apply tourniquet
  3. Assess veins
  4. Prepare/select equipment
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8
Q

Are injurys related to venepuncture covered by ACC?

A

Yes

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9
Q

Any adverse event during venepuncture will often require you to……

A

Complete an incident form
Document in patients medical records
Inform nursing/medical staff

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10
Q

What causes the adverse event of venepuncture - Haematoma?

A
  • Small frail veins (needle to large)
  • Excessive probing to find vein
  • Removing needle prior to relasing tourniquet
  • Needle going through vein and allowing leakage
  • Needle partially entering vein and allowing leakage
  • Applying presure to gauze before the needle has been removed
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11
Q

What are some signs and symptoms of a haemotoma from venepuncture?

A

Collection of blood under the skin. This can be painful and potentially cause nerve damage

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12
Q

What do we do if a haematoma occurs during venepuncture?

A
  1. Release tourniquet
  2. Remove needle
  3. Maintain pressure
  4. Complete incident form
  5. Alert medical staff
  6. Document in patient notes
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13
Q

What causes the adverse event of venepuncture - nerve strike?

A

Using inappropriate sites and excessive probing to find a vein

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14
Q

What are the signs and symptoms of a nerve strike during venepuncture?

A

Patient complaining of severe pain radiating down the arm into the thumb/little finger/whole hand - like hot needles

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15
Q

What do we do if a nerve strike occurs during venepuncture?

A
  1. Release the tourniquet
  2. Remove the needle
  3. Assess the pain once the needle is removed
    - If pain persists
  4. Complete incident form
  5. Alert medical/nursing staff
  6. Document in patient notes
  7. Complete ACC forms
16
Q

What causes the adverse event of venepuncture - accidental arterial puncture?

A

Innapropriate site identification

17
Q

What are the signs and symptoms of an accidental arterial puncture during venepuncture?

A

Bright red blood flow, pulsating blood flow, sample bottles fill immediately

18
Q

What do we do if a accidental arterial puncture occurs during venepuncture?

A
  1. Remove the tourniquet
  2. remove the needle
  3. apply pressure for 5mins or until bleeding stops
  4. alert medical/nursing staff
  5. complete incident form
  6. document in clinical notes
19
Q

What causes a syncope (LOC) during venepuncture?

A

Sight of blood/Anxiety

20
Q

What are the signs and symptoms of a syncope during venepuncture?

A

Patient complains of nauseous, feeling dizzy, weak, sweaty and faint. Pale colour, tremor, and may lose consciousness

21
Q

What are the required actions post syncope during venepuncture?

A
  1. Remove the tourniquet
  2. Remove needle
  3. Lower head below the heart
  4. Give cold water if appropriate
  5. Give reassurance
  6. Alert medical/nursing team
  7. Complete incident form and document in clinical records
22
Q

What is the cause of excessive pain during venepuncture and what are the signs and symptoms?

A

Caused by invasive technique with needle.

Whilst some discomfort is expected pain should not be prolonged - consider a nerve strike

23
Q

What to do is a patient experiences bad pain during venepuncture?

A
  1. Release tourniquet
  2. remove needle
  3. apply pressure and dressing
  4. alert nursing/medical staff if pain does not subside
24
Q

What are the causes of a failed venepuncture?

A
  • Poor venepuncture technique
  • Poor vein access
  • Scaring tissue
  • Bruising
  • Age and condition of patient
25
Q

What are the actions taken after a failed venepuncture?

A

There should be only one more attempt taken.
Refer to a more experienced venepuncturist
at 4 failed attempts seek medical advice regarding alternative options if any
Consider PICC, Midline, or other CVAD device
Document in clinical notes

26
Q

If frequent venepuncture procedures have been undertaken, alternate sites and limbs: True or False?

A

True

27
Q

Examine both limbs before making a decision: True or False?

A

True

28
Q

Before attempting venepuncture, palpate for evidence of arterial pulsation: True or False?

A

True

Clinical Nursing Skills (5 decks)

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