Phleb - Routine Venipuncture And Dermal Puncture

Front 1

The pts wristband

Back 1

Before drawing blood, information on the requisition form should be matched against what?

Front 2

Pt identification

Back 2

The single most important step of the blood collection procedure

Front 3

15-30 degrees

Back 3

What angle should the venipuncture needle be inserted

Front 4

True

Back 4

Select equipment, identify pt, collect specimen, stop bleeding, label tubes is the correct order of steps for blood draw. T/f

Front 5

Contact the pt nurse to attach a proper id wristband to pt

Back 5

If the number on the requisition doesn't match the arm band, what should you do?

Front 6

Ask pt when was the last time they ate/drank

Back 6

If a blood test requires a fasting specimen, whats the best way to verify that the pt is fasting

Front 7

Explain the procedure and ask if he will consent

Back 7

When you tell a pt you need to draw their blood and they refuse, whats the best course of action

Front 8

3 to 4 inches

Back 8

How far from the puncture site should the tourniquet be left on

Front 9

1 minute

Back 9

What is the max amount of time a tourniquet can be left on

Front 10

Hemoconcentration

Back 10

Term for increased ratio of formed elements to plasma

Front 11

Petechiae

Back 11

Term for small red spots on the skin that are caused by a too tight toirniquet

Hint 11

Most likely in pt w platelet dysfunction

Front 12

Hemolysis

Back 12

Term for destruction of red blood cells due to a too tight tourniquet

Front 13

Tourniquet was on for over a minute

Back 13

What is a reason for hemoconcentration due to a scenario with tourniquet

Front 14

Tourniquet is too tight or on too long

Back 14

While having blood drawn, the pt complains of pain and tingling in the fingers. Likely cause?

Front 15

Cephalic vein

Back 15

What vein is most common second choice when median cubital vein isnt appropriate for blood draw

Front 16

Basilic

Back 16

Which vein lies on top of brachial artery

Front 17

Spongy and firm

Back 17

What does a vein feel like upon palpation

Front 18

30 to 60 seconds

Back 18

After applying alcohol, how long should you allow it to dry before collecting from the site

Front 19

Bevel up, in a smooth quick motion

Back 19

How should a needle be inserted for venipuncture

Front 20

Hematoma

Back 20

If the needle is withdrawn before the tourniquet is removed, what is likely to occur

Front 21

While the first tube is filling

Back 21

When should the tourniquet be removed

Front 22

Hematoma

Back 22

What is the term for collection of blood under the skin at the site of a venipuncture

Front 23

Remove the needle and apply pressure to gauze over the site

Back 23

How should bleeding be stopped at a venipuncture site

Front 24

At the pts bedside, after taking blood

Back 24

When should blood collection tubes be labeled

Front 25

Wash your hands

Back 25

After removing your gloves, what is the next step

Front 26

Pull the plunger back to break the seal, then expel all the air

Back 26

What step should be taken with a syringe before using it to collect blood

Front 27

A flash of blood will automatically fill in the syringe hub

Back 27

When using a syringe, how do you tell when you have entered a vein

Front 28

Remove the needle and attach a needless transfer device to the syringe

Back 28

How should blood be transferred from a syringe to a vacuum tube

Front 29

Pt room and bed number

Back 29

Mandatory info on a specimen label includes pt name, time date, phlebotomist initials. What doesnt it include

Hint 29

Not diagnosis or id number

Front 30

Use a three part id band w a special tube labels

Back 30

What would be the system of choice to identify laboratory specimens from an unconscious woman in the er

Front 31

Asked to lie down or the drawing chair should be reclined if possible

Back 31

Outpatients who have previously fainted during a blood draw should be:

Front 32

It may hurt a little but only for a short time

Back 32

If the pt asks if the procedure will hurt what do you say

Front 33

Gently shake the bed and call out their name

Back 33

Your inpatient is sleep when you arrive to draw blood. What should you do

Front 34

Dr name, pt medical record, pt name and dob

Back 34

Information on a test requisition must include what

Front 35

Immediately

Back 35

A test that is ordered stat should be collected

Front 36

Dermal puncture

Back 36

What is the preferred collection site for lab testing on a pt at high risk for venous thrombosis

Front 37

Dermal puncture

Back 37

What is the preferred collection site for newborns and infants

Front 38

Blood cultures

Back 38

What type of test cannot be collected using a dermal puncture

Front 39

Glucose

Back 39

What has higher levels in capillary blood than in venous blood

Hint 39

Sugar/diabetes stick

Front 40

Potassium

Back 40

What has higher levels in venous blood than in capillary blood

Hint 40

Bananas

Front 41

3 to 5 minutes

Back 41

How long should a heel warmer be applied to an infants heel

Front 42

Osteomyelitis

Back 42

Puncture of a bone during dermal puncture can result in what potentially serious and sometimes fatal bone infection

Front 43

2 mm

Back 43

What is the maximum acceptable depth for a heel puncture

Front 44

3 mm

Back 44

What is the maximum acceptable depth for a dermal puncture on an adult

Front 45

0.65 to 0.85 mm

Back 45

What is the recommended depth of a heel puncture on a premature infant

Front 46

Calcaneus

Back 46

What bones is close to the surface and at risk of being damaged during a heel puncture

Front 47

2.4 mm

Back 47

What is the maximum acceptable width for a dermal puncture

Front 48

Medial and lateral borders of plantar surface

Back 48

What is an appropriate site for dermal puncture on an infants foot

Front 49

Ring finger, perpendicular (vertical) to the ridges

Back 49

If not collected at the middle finger, what is the next appropriate site for dermal puncture on adults

Hint 49

Marry me or **** off

Front 50

Povidone iodine

Back 50

What antiseptic may affect the results of tests for bilirubin, uric acid, potassium, and phosphorus from a dermal puncture and should therefore not be used on dermal puncture

Hint 50

Think salt (sodium iodine) but wo the sodium

Front 51

Bilirubin, uric acid, phosphorus, potassium

Back 51

Betadine may elevate the results of which tests if used to clean the skin for a dermal puncture

Front 52

Wipe away the first drop of blood with a dry, clean gauze pad

Back 52

What is an acceptable step during collection of blood by dermal puncture

Front 53

CBC

Back 53

Blood smear, CBC, hemoglobin, glucose.

Which should be collected first in a dermal puncture

Front 54

Bleeding time

Back 54

What screening test measures the overall integrity of primary hemostasis

Hint 54

1. Vasoconstriction

2. Platelets

Front 55

Aspirin

Back 55

What over the counter medicine is known to increase bleeding time

Front 56

2-10 minutes

Back 56

What is the standard bleeding time

Front 57

Diabetes

Back 57

Bedside glucose testing is usually performed on pt w what condition

Hint 57

Sugars

Front 58

40 mm hg

Back 58

When performing a bleeding time test, to what pressure should the blood pressure cuff be inflated

Front 59

Forearm, just below antecubital crease

Back 59

What is usual site for performing a standard bleeding time test

Front 60

True

Back 60

Record the time when blood is no longer absorbed by the filter paper is the proper technique when performing a bleeding time test. T/f

Front 61

Heparin

Back 61

A microhemarocrit tube that has a red band on it contains what type of anticoagulant

Front 62

30 seconds

Back 62

At what intervals should blood be wicked with filter paper when performing a bleeding time test

Front 63

False

Back 63

A 21G 1" needle is used for capillary collection. T/f

Hint 63

Too big. 21g is common in routine venipuncture in adults. 23 is smallest common used

Front 64

True

Back 64

In microcapillary collection, the first drop of blood should be wiped away. T/f

Front 65

2.0 mm

Back 65

The depth of a cut made by a lancet for a heel stick should be no more than:

Front 66

The specimen will be diluted w tissue fluid. Hemolysis can occur

Back 66

What can happen if you squeeze the pts finger too vigorously during a capillary puncture

Hint 66

2 things can happen

Front 67

Lavendar top

Back 67

You are to collect by fingerstick a green top, a lavendar top and a red top microcollection container. What container do you get first

Hint 67

For the little ones, order of draw is:

Platelet counts, CBCs, and other hematology tests are first. Then chemistry tests

Front 68

Increases the blood flow through the arterioles and capillaries sevenfold

Back 68

Warming the skin puncture site:

Front 69

True

Back 69

Fingerstick is appropriate collection on a toddler. T/f

Front 70

False

Back 70

Heel stick procedure on a 3 year old is appropriate dermal (capillary) collection. T/f

Hint 70

Children younger than 1 yr old, tissue too little in fingers