what sites should be avoided when performing venipuncture quizlet

\u00a9 2023 wikiHow, Inc. All rights reserved. Perform the venipuncture. We use cookies to make wikiHow great. B. the needle is inserted into the patient's arm remove needle The first step to choosing the right vein is to select the appropriate needle gauge. Never draw over scars or a new tattoo sites. Significant increases can be found in total protein, aspartate aminotransferase (AST), total lipids, cholesterol, iron, Affects packed cell volume and other cellular elements. Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. Position the patient with the arm extended to form a straight-line form shoulder to wrist. site. Patient identification is critical for safety. But since each patient's medical condition varies, so does their veins. window.addEventListener('message', function (){ The venipuncture procedure is complex, requiring both knowledge and skill to perform. Tourniquet - Wipe off with alcohol and replace frequently. A. the plastic sleeve is removed Do not use the tip of the finger or the center of the finger. Also consider adjusting the angle of the needle. Tip: Patients who need regular bloodwork (e.g. Syringes - may be used in place of the evacuated collection tube for special circumstances. List several effects of exercise, posture, and tourniquet application upon laboratory values. Subcutaneous tissue feels squishy and muscle feels hard. 9. The first drop contains excess tissue fluid and must be wiped away. 7. Antiseptic. Avoid excessive pressure that may squeeze tissue fluid into the drop of blood. Move it forward (it may not be in the lumen). A commercial heel warmer may be used. LTD: Performing a Capillary Puncture Version 7, General Guidelines for a Capillary Puncture: Capillary punctures are ideal for, small children when only a small volume of blood is needed. www.mlo-online.com is using a security service for protection against online attacks. Finger - Usually the third or fourth finger is preferred in adults and children. Begin by selecting the proper, approved lancet, such as: BD Microtainer Quikheel Lancet, 2.5 mm for full-term babies (green), BD Microtainer Quickheel Preemie Lancet, 1.75 mm for neonatal, Unistick2 Neonatal 18G, 1.2mm Lancet for neonatal babies less than, Prepare the heel by cleaning it with a Chlorhexadine wipe. Allow another large drop of blood to form. If superficial veins are not readily apparent, you can force blood into the vein by massaging the arm from wrist to elbow, tap the site with index and second finger, apply a warm, damp washcloth to the site for 5 minutes, or lower the extremity over the bedside to allow the veins to fill. var zf_perma = zf_ifrm_data[0]; https://www.ncbi.nlm.nih.gov/books/NBK138650/pdf/Bookshelf_NBK138650.pdf (Accessed June 13, 2022). -obvious skin infection (including newly tattooed areas) -extensive scarring -don't use same side as mastectomy -avoid previous hematoma -avoid arm w/ fistula/cannula -edamtous extremity What is the most common site for blood sampling? Hematoma - may cause erroneous test results. 2011-2023 Phlebotomy Coach. Focus on what you do best, and find someone who can help you communicate that with your target market. Certain larger molecules are not filterable into the tissue, therefore they are more concentrated in the blood. Drawing the patient in a reclined position. The maximum number of times an individual should attempt a venipuncture on a patient is two, True or False? Source of specimen. A requisition form must accompany each sample submitted to the laboratory. } Within the antecubital fossa, this vein poses the least amount of risk. Heparin light or dark green top tube, 5. This vein can be found along the upper arm to the thumb, but it is commonly drawn from the forearm or antecubital fossa area. Capillary specimens are collected in microtainers with colored caps that are used to. Blood samples drawn from an IV line should be documented and analyzed with care. The use of a tourniquet during a venipuncture procedure makes: The most common site(s) for the venipuncture procedure is/are the following: The tourniquet should not be left on a patient more than 1 minute when performing a venipuncture because it is uncomfortable and causes: The needle should always be inserted at the puncture site with the: The correct needle position for a venipuncture is a ______ degree angle with the bevel facing _____. When finished, clean the site and apply pressure with a clean gauze to stop the bleeding. Patients in these populations are often nervous and may flail their limbs. This seats the bevel into the lumen of the vein, and is also the technique used to insert an IV catheter. Ask the patient to lie on their back. If a vein feels hard, it may be scarred or sclerosed. Select the proper approved lancet: The BD Microtainer Contact-Activated. When multiple vials of blood are collected it can seem like a large amount. 11. 1. If multiple blood samples are to be taken, the phlebotomist must be careful to follow the proper order of draw. var evntData = event.data; *NEVER BEND THE ARM*. Veins on the underside of the wrist should be avoided. Gauze sponges - for application on the site from which the needle is withdrawn. -antiseptic swabs All rights reserved. 1. previous experience with vomiting or fainting When using a syringe inserted into the line, blood must be withdrawn slowly to avoid hemolysis. if ( zf_ifrm_data.length == 2 ) { While hand veins may be utilized for blood draws and intravenous infusions, veins in the feet and legs should be avoided for adults. Make sure the venipuncture site is dry. Since newborns do not often bleed immediately, use gentle pressure to produce a rounded drop of blood. However, drawing blood from the hand is affiliated with higher levels of pain and less control. The line must be flushed first. The puncture should be made perpendicular to the ridges of the fingerprint so that the drop of blood does not run down the ridges. These may include listening to music or a story, watching a video, playing with a toy, having a parent provide distraction with talk or touch, using flash cards, and squeezing a rubber ball. This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Cap, rotate and invert the microtainer to mix the blood collected. Check the requisition form for requested tests, patient information, and any special requirements. Which element has the highest ionization energy? Answer. Confidentiality of all communications and other records pertaining to the patient's care. Blood clots, and the serum is separated by centrifugation, Chemistries, Immunology and Serology, Blood Bank (Crossmatch), Serum separator tube (SST) contains a gel at the bottom to separate blood from serum on centrifugation, Plasma Separating Tube (PST) with Lithium heparin, Anticoagulates with lithium heparin; Plasma is separated with PST gel at the bottom of the tube, Hematology (CBC) and Blood Bank (Crossmatch); requires. 9. 6. To enhance students careers, meet the needs of healthcare providers and improve patient care by providing high quality, cost effective phlebotomy education through industry leading curriculum, current technology and extensive hands on experience. 2013 Oct 10;(10):CD005179. Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients. Consult the nursing unit or your facility's resources prior to drawing from an IV or PICC line or performing venipuncture on an arm with an IV line in place. Observe all applicable isolationprocedures. Why? When do you release the tourniquet during venipuncture? Warning: Some phlebotomists use a method of anchoring called the "C-hold", in which the index finger pulls upwards superiorly while the thumb pulls downwards inferiorly. 3. 3. puncture site downward and gently applying intermittent pressure to the surrounding tissue (or proximal to the puncture site when the blood is obtained from a finger). The blood is bright red (arterial) rather than venous. f.src = 'https://forms.zohopublic.com/healthservicesacademy/form/RequestCourseInformationCPTIAccelerated/formperma/SBGg-3DTNCwt65i9A6n_zU3SneyGD89SSqM_7F_nCas?zf_rszfm=1'; Re-anchor the vein. } After the needle selection, phlebotomists begin to look and feel for a viable vein. Avoid areas of hematoma. Precautions include a medical grade face mask. 10. Have the patient position their arm on the armrest. -Vacutainer barrel 2017;50(10-11):568-573. Hematoma - A venipuncture should not be performed on a hematoma, regardless of how small it may be. The median cubital vein and the cephalic vein in the wrist area should be avoided when possible. Place a pillow under the patient's arm if additional support is needed. Perform the venipuncture, collecting the sample(s) in the appropriate container(s). For example, serum cortisol levels are highest in early morning but are decreased in the afternoon. Using the requisition for reference, ask a patient to provide additional information such as a birthdate. 9. Step 3: Venipuncture. Be informed of the hospital rules and regulations regarding patient conduct. While venipuncture is considered to be reasonably safe, the present study investigated the incidence of serious complications occurring in an outpatient setting. Phlebotomists are considered to have occupational exposure to blood borne pathogens. By holding the needle either by the plastic wings or the hub, phlebotomists can achieve a shallower angle, typically 10-15 degrees. Using the smallest acceptable needle size can help reduce the risk of bleeding or hematoma . Collect drops of blood into the collectiondevice by gently massaging the heel. The service requires full JavaScript support in order to view this website. Using a sterile lancet, puncture the most medial or lateral portion of the plantar surface of theheel, medial to a line drawn posteriorly from the mid great toe to the heel. Kiechle FL. A. Syringe This image is not<\/b> licensed under the Creative Commons license applied to text content and some other images posted to the wikiHow website. Assess the patient's physical disposition (i.e. B. sterilized and reused A face mask reduces risk for blood culture specimen contamination. The most commonly used site for a venipuncture is at the bend of the elbow, also called the antecubital fossa 1. B. the needle is only partially in the vein Ask the patient orcaregiver to state the patients name and date of birth. Additionally, a hematoma may compress the nerve and lead to long-term damage. 5. As part of presenting a professional appearance, an institutional dress code may include wearing of a laboratory coat or smock. For an inpatient the nursing staff can be contacted to aid in identification prior to proceeding. C. Red Determine the final temperature of the R-134a and the final specific internal energy. Pre-warm the region of the vein to reduce vasoconstriction and increase blood flow. A variety of techniques can be employed to reduce pain and anxiety. Larger tube sizes typically provide for collection of samples from 6 to 10 mL. Impact of Use of Smaller Volume, Smaller Vacuum Blood Collection Tubes on Hemolysis in Emergency Department Blood Samples. Do not use excessive pressure or heavy massaging because the blood may become diluted with tissue fluid. B. Betadine Arm with fistula or cannula placement Procedure for Capillary Puncture of the Finger: The best site for a finger puncture is just off the center of the finger pad of. B. Hematoma Start with the arm closest to you and palpate the antecubital fossa. They are also. However, if there is no alternative and an arm with an IV line in place must be used for venipuncture, try to choose a site away from and below the location of the IV. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. Document that the venipuncture was performed distal to (below) an infusion site. D. mandates, The most common antiseptic used in venipuncture is: 2. Gloves are to be discarded in the appropriate container immediately after the bloodcollection procedure. This image may not be used by other entities without the express written consent of wikiHow, Inc.
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