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Med Procedures - Quiz 2 > Venipuncture ABGs IVs Injections > Flashcards

Venipuncture ABGs IVs Injections Flashcards

1
Q

What disorder can venipuncture be used to treat?

A

Polycythemia

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2
Q

Indication for venipuncture

A

Sample of venous blood is needed in larger amounts than finger stick can provide

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3
Q

MC used veins for venipuncture

A

Superficial veins in antecubital fossa (median cubital vein)

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4
Q

Why is the median cubital vein MC used for venipuncture?

A
  • Less likely to roll
  • Lies more superficially
  • Skin over it is less sensitive than other veins
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5
Q

Light blue venipuncture tube

A
  • 3.2% Na citrate

- Used for coagulation studies

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6
Q

Red or gold venipuncture tubes

A
  • Serum tube with or w/o clot activator or gel
  • Promotes blood clotting with glass or silica particles
  • Used for chemistry, serology, immunology
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7
Q

Which blood tubes promote clotting?

A

Red or gold tops

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8
Q

Green venipuncture tubes

A
  • Na or Li heparin with or w/o gel

- Stat and routine chemistry

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9
Q

Lavender or pink venipuncture tubes

A
  • Potassium EDTA

- Hematology and blood bank

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10
Q

Gray venipuncture tubes

A

Used for glucose testing, blood alcohol, lactic acid

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11
Q

Blood culture contraindications

A
  • Warfarin patients
  • Site of an active skin infection
  • Failure of previous blood cultures to identify infecting agent
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12
Q

When should a contaminated blood culture sample be suspected?

A
  • Common skin flora (S. epidermis)
  • Mix of several kinds of bacteria
  • Growth found in only 1 of several specimens from separate venipunctures
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13
Q

What does S. epidermis indicate in a blood culture sample?

A

Contamination

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14
Q

Standard blood culture bottles consist of what?

A
  • 1 aerobic culture media bottle

- 1 anaerobic culture media bottle

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15
Q

How should skin be prepped for blood culture?

A
  • Sterile 70% isopropyl alcohol starting at site and moving out in circles
  • Repeat twice using new wipes each time
  • Apply chlorhexidine in same manner
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16
Q

If 2 blood cultures must be drawn from the same site, how long should you wait in between samples?

A

At least 10 minutes

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17
Q

Where are ABGs usually performed?

A

Radial artery

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18
Q

What must be done prior to ABG?

A

Allen’s test to show adequate collateral circulation

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19
Q

What is the Allen’s test?

A
  • Performed prior to ABG

- Shows adequate collateral circulation

20
Q

What does an ABG reliably determine?

A

Ventilation (CO2 content)

21
Q

What is the only to accurately determine alveolar-arterial oxygen gradient?

A

ABG

22
Q

Absolute contraindications to ABG

A
  • Abnormal Allen’s test
  • Local infection or distorted anatomy at potential puncture site
  • AV fistula or vascular graft
  • Known or suspected severe PVD of limb involved
23
Q

Relative contraindications to ABG

A
  • Severe coagulopathy
  • Anticoag therapy
  • Use of thrombolytics
24
Q

MC complication of ABG

A

Hemorrhage or hematoma formation at puncture site (MC in femoral and brachial arteries)

25
Q

When do errors in ABG analysis occur?

A
  • Excess or incomplete removal of air bubbles (falsely high PO2)
  • Excess heparin in syringe (falsely low PCO2)
  • Delays in placing sample on ice
26
Q

What error can cause falsely elevate PO2 levels in ABG?

A

Excess or incomplete removal of air bubbles

27
Q

What error can falsely lower PCO2 values in ABG?

A

Excess heparin in syringe

28
Q

How does excess heparin in syringe affect ABG results?

A

Falsely low PCO2

29
Q

What is the least preferred site of ABG?

A

Brachial artery (runs deeper and is relatively small)

30
Q

Why is the brachial artery a less desired ABG site?

A
  • Runs deeper (harder to identify and achieve hemostasis after)
  • Small and does not have extensive collateral circulation
31
Q

MC used antiseptic skin solutions for ABG?

A
  • Chlorhexidine

- Povidone-iodine

32
Q

What results does an ABG provide?

A
  • Blood pH
  • PCO2 and PO2
  • Calculated serum HCO3 and base excess
33
Q

Define hypoxemia

A

PO2 less than 11 kPa on room air (not usually clinically important unless below 8 kPa)

34
Q

What is considered respiratory failure?

A

PO2 less than 8 kPa

35
Q

Define Type I respiratory failure

A

Hypoxemia WITHOUT hypercapnia

36
Q

Define Type II respiratory failure

A

Hypoxemia AND hypercapnia (indicating hypoventilation)

37
Q

Examples of intradermal injection

A
  • TB PPD testing
  • Allergy testing
  • Sentinel node biopsies
38
Q

What type of injection is TB PPD testing?

A

Intradermal

39
Q

When are subcutaneous injections used?

A

For drugs requiring slow absorption and long duration of action (insulin, hormones, vaccines, heparin)

40
Q

Risks of subcutaneous injections

A
  • Dermatitis

- Cellulitis

41
Q

Where are SQ injections given?

A
  • Infants: thighs

- Older children and adults: deltoid, upper outer thighs, abdomen

42
Q

When are IM injections indicated?

A

-Drugs not easily absorbed
-Intermediate rate of onset and duration of action
(abx, narcotics, hormones, vaccines)

43
Q

IM injection sites

A
  • Children: UOQ of buttocks, deltoid

- Adults: anterior thigh, UOQ of buttocks, deltoid

44
Q

Why are IM injections given in UOQ of buttocks?

A

To avoid sciatic nerve

45
Q

Where is the MC choice for IO placement?

A

Antero-medial aspect of upper tibia

46
Q

How long can an IO be left in place?

A

Up to 72-96 hours

Med Procedures - Quiz 2 (2 decks)

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