Venipuncture

Question 1

Use the thumb of the nondominant hand to anchor the selected vein while inserting the needle. Place the thumb 1 or 2 inches below and slightly to the left of the insertion site and
the four fingers on the back of the arm and pull the skin taut.

Answer 1

Anchoring the vein

Question 2

Return of blood into the hub of the needle

Answer 2

Flash of blood

Question 3

Lateral aspect; located on the thumb side of the arm; second choice; hard to palpate but fairly well anchored & the only vein can be felt in large patients

Answer 3

Cephalic Vein

Question 4

Impeding venous blood flow that causes blood to accumulate in the veins making them more easily located and provides a larger amount of blood for collection.

Answer 4

Tourniquet Application

Question 5

Needles used for the evacuated tube system are also known

Answer 5

Multi-sample needles

Question 6

made up of a beveled needle that is attached to a length of tubing with a luer adapter on the opposite end. Just below the needle on the butterfly system are two “wings” that are made of hard plastic.

Answer 6

Winged infusion sets or Butterfly system

Question 7

May be used if antecubital fossa veins are
unsuitable or unavailable.

Answer 7

Site Selection in Hand

Question 8

Inversion per tube

Answer 8

Culture tubes - 8 to 10
Sodium Citrate (Light blue) - 3 to 4
Red (Plain) - 5
SST (Yellow) - 5
Heparin (Green) - 8 to 10
EDTA (Purple) - 8 to 10
Sodium Flouride (Gray) - 8 to 10

Question 9

Return the bed and bed rails to the original position if they have been moved. Failure to replace bed rails that results in patient injury can result in legal action

Answer 9

Leaving the patient

Question 10

Dispose of the contaminated needle and holder in an acceptable sharps container conveniently located near the patient.

Answer 10

Dispose the needle

Question 11

When a tourniquet is used during preliminary vein selection, it should be released and reapplied after 2 minutes.

Question 12

Failure to remove the tourniquet before removing the needle may produce a bruise

Answer 12

Hematoma

Question 13

Maximum time for tourniquet application: 1 minute

Question 14

The phlebotomist disposes of all contaminated supplies such as alcohol pads and gauze in a biohazard container and needle caps and paper in the regular waste container, removes gloves and disposes of them in the biohazard container, and washes his or her hands.

Answer 14

Disposing the used supplies

Question 15

Needle must be bevel up

Answer 15

Examine the needle

Question 16

Patient Identification

Answer 16

Identify the patient verbally by having him or her state both the first name and last name and compare the information on the patient’s ID band with the requisition form.

Question 17

The most important procedure in phlebotomy is correct identification of the patient.

Question 18

Medial side; not well anchored & rolls easily, ↑ risk of puncturing median cutaneous nerve or the brachial artery

Answer 18

Basilic Vein

Question 19

When the vein is securely anchored, align the needle with the vein and insert it, bevel up, at an angle of 15 to 30 degrees depending on the depth of the vein.

Answer 19

Inserting the needle

Question 20

Most frequently used solution

Answer 20

povidone-iodine and tincture of iodine or chlorohexidine gluconate

Question 21

The most common and most efficient method of performing venipuncture is the use of the evacuated tube system.

Answer 21

Evacuated Tube System

Question 22

Required Information in Requisition Forms

Answer 22

1. Patient’s name and last name
2. Identification number
3. Patient’s date of birth
4. Patient’s location
5. Ordering healthcare provider/ physician
6. Test requested
7. Date and time that is requested
8. Date and time of extraction
9. Status of sample

Question 23

The last resort for blood collection is from the foot veins after the arm veins have been determined unsuitable.

Answer 23

Site Selection in Foot

Question 24

Site Selection

Answer 24

Preferred site for venipuncture: antecubital fossa (located anterior and below the bend of the elbow)

Question 25

Bleeding at the venipuncture site should stop within 5 minutes. Before applying the adhesive bandage, the phlebotomist should examine the patient’s arm to be sure the bleeding has stopped.

Answer 25

Bandaging the patient’s arm

Question 26

Located near the center; preferred vein for venipuncture because it is large and stationary

Answer 26

Median Cubital Vein

Question 27

Made of a hollow plastic barrel with graduated measurements in cubic centimeters (cc) or milliliters (mL) printed on the side.

Answer 27

Syringe

Question 28

Patient Tube Labels

Answer 28

Patient’s name and identification number
Date and time of collection
Phlebotomist’s initials

Question 29

Post-Venipuncture

Answer 29

The patient’s arm is examined to see if bleeding has stopped. An adhesive bandage or tape is applied on the site (following institutional policies).

The patient is instructed to leave the bandage on for a minimum of 15 minutes.

Out patients should be advised not to carry a purse or other heavy object or lift heavy objects with that arm for 1 hour.

The patient should be thanked for his or her cooperation –this helps leave the patient with a positive feeling.

Contaminated materials should be disposed of in approved biohazard containers following the institutional policies before attending to the next patient.

Question 30

RELEASE TOURNIQUET BEFORE NEEDLE

Question 31

What finger is used to palpate a vein?

Answer 31

Tip of the index finger

Question 32

Angle of bevel for puncture

Answer 32

15 - 30 degrees

Question 33

Prolonged time of tourniquet can cause

Answer 33

Hemoconcentration

Question 34

Maximum time for tourniquet application

Answer 34

1 minute

Question 35

Reapplication of tourniquet

Answer 35

After 2 minutes

Question 36

Tourniquet be applied twice, first when vein selection is made, second when puncture is performed.

Question 37

Apply the tourniquet 3 to 4 inches above the antecubital fossa.

Question 38

HAI means

Answer 38

Health-care acquired infections

Question 39

Assembly of Puncture Equipment

Answer 39

Check equipment for defects
Check needle and syringe if properly screwed
Extra tubes should be near at hand
Do not place collection tray on patient’s bed