Phlebotomy Chapter 8 Flashcards

Questions and Answers

When properly anchoring a vein, where should the thumb be positioned?

1 to 2 inches below the intended site pulling the skin toward the wrist.

Which of the following actions is unlikely to help a phlebotomist gain a patient's trust?

Explaining the procedure

Showing empathy

Collecting a specimen before the requested time (correct)

Engaging in small talk

It's unlikely that misidentifying a patient specimen would result in what?

No reprimand if no one was hurt.

Needle phobia is defined as what?

Intense fear of needles and being stuck. Signup and view all the answers

Symptoms of needle phobia can include:

All of the above Signup and view all the answers

A basic step that can be taken to minimize any trauma associated with a venipuncture is to:

Choose the most skilled phlebotomist available to perform the venipuncture. Signup and view all the answers

Proper use of hand sanitizer includes:

All of the above Signup and view all the answers

To examine by touch or feel is to:

Palpate. Signup and view all the answers

In most cases, needle insertion should be performed how?

Using a smooth, steady motion forward. Signup and view all the answers

To 'seat' the needle in the vein means to:

Thread part of the needle within the lumen. Signup and view all the answers

Going without food or drink except for water for 8-12 hours is defined as:

Fasting. Signup and view all the answers

The reason a test is ordered 'timed' is to:

Draw it at the best time for accurate results. Signup and view all the answers

Examples of timed tests include:

All of the above Signup and view all the answers

A test is ordered 'fasting' to:

Eliminate the effects of diet on test results. Signup and view all the answers

Bending the arm up to apply pressure to the site after venipuncture has not been shown to:

Enable the site to quickly stop bleeding after needle removal. Signup and view all the answers

The unique number assigned to a specimen request is called the:

Accession number. Signup and view all the answers

Failure of the patient to follow required diet restrictions before specimen collection could lead to:

All of the above Signup and view all the answers

Which individual has legal authority to authorize patient testing?

Patient's physician. Signup and view all the answers

Test requisition information must include the:

Ordering physician. Signup and view all the answers

Which type of requisition often serves as a test request, report, and billing form?

Manual. Signup and view all the answers

Information represented by a patient ID bar code typically includes the patient's:

Medical record number and name. Signup and view all the answers

Outpatient requisitions are typically of this type:

Manual. Signup and view all the answers

When received by the laboratory, inpatient requisitions are typically sorted according to:

Collection priority, date & time, & patient location. Signup and view all the answers

Steps taken to unmistakably connect a specimen & the accompanying paperwork to a specific individual are called:

Accessioning the specimen. Signup and view all the answers

Which priority does a timed test typically have?

Second. Signup and view all the answers

A test that is ordered stat should be collected:

Immediately, without hesitation. Signup and view all the answers

Which of the following tests is commonly ordered stat?

Lytes. Signup and view all the answers

If a test is ordered stat, it may mean that the patient is in:

Critical condition. Signup and view all the answers

When a test is ordered ASAP, it means that:

Results are needed soon for an appropriate response. Signup and view all the answers

A preop patient:

Will soon be going to surgery. Signup and view all the answers

Tests are classified as routine if they are ordered:

In the course of establishing a diagnosis. Signup and view all the answers

This term means the same as stat:

Med Emerg. Signup and view all the answers

A patient who is NPO:

Can't have any food or drink. Signup and view all the answers

An example of a test that is commonly ordered fasting is:

Glucose. Signup and view all the answers

Which liquid is acceptable to drink when one is fasting?

Plain water. Signup and view all the answers

Which is a common postop test?

H&H. Signup and view all the answers

What should you do if the patient's door is closed?

Knock lightly, open the door slowly, and ask whether it's all right to enter. Signup and view all the answers

What should you do if there is a sign that reads, 'No blood pressure or venipuncture, right arm'?

Collect the specimen from the left hand by finger puncture. Signup and view all the answers

A code is a way to:

All of the above Signup and view all the answers

What does DNR stand for?

Do not resuscitate. Signup and view all the answers

How should you proceed if the patient initially responds negatively to blood collection?

Determine the problem first. Signup and view all the answers

Which test is used to identify protein disorders that lead to nerve damage?

SPEP. Signup and view all the answers

What should you do if your inpatient is asleep when you arrive?

Call out the patient's name softly and shake the bed gently. Signup and view all the answers

How can laboratory results be negatively affected by the phlebotomist?

By startling a patient who is asleep. Signup and view all the answers

When collecting from an unconscious patient, it's unnecessary to:

Move the patient to a special phlebotomy collection area. Signup and view all the answers

What should you do if a physician is with the patient and the specimen is ordered stat?

Introduce yourself and ask for permission to draw the specimen. Signup and view all the answers

What is the best course of action if family or visitors are with the patient?

Ask them to wait outside of the room until you are finished. Signup and view all the answers

What should you do if the patient is not in the room when you arrive to collect a timed specimen?

Fill out a delay slip stating you were unable to collect the specimen. Signup and view all the answers

Which test's misidentification is most likely to have fatal consequences?

Type and screen. Signup and view all the answers

How do you verify a patient's identity in 302B named John Doe?

Ask him for his name and date of birth and match it to the requisition. Signup and view all the answers

Which requisition information must match the patient's ID band?

Medical record number. Signup and view all the answers

What should you do if the medical record number on the ID band matches your requisition, but the patient's name is spelled differently?

Do not collect the specimen until the difference is resolved. Signup and view all the answers

What should be done when an unconscious inpatient doesn't have an ID band?

Don't start any procedure until the nurse attaches an ID bracelet. Signup and view all the answers

What is the system of choice to identify laboratory specimens from an unconscious woman in the ER?

Use a three-part identification band with special tube labels. Signup and view all the answers

Which type of inpatient is most likely to have more than one ID band?

Newborn. Signup and view all the answers

What is the most critical error a phlebotomist can make?

Misidentify the patient's specimen. Signup and view all the answers

What should you do if your patient isn't wearing an ID band?

Ask the patient's nurse to attach an ID band and proceed when it's attached. Signup and view all the answers

Which type of patient is least likely to need his or her identity confirmed?

Geriatric patient Signup and view all the answers

How should you verify a patient's identity upon check-in?

Ask the woman to state her complete name and date of birth to confirm her identity. Signup and view all the answers

A cheerful, pleasant bedside manner and exchange of small talk are unlikely to:

Keep the patient from fainting during the venipuncture procedure. Signup and view all the answers

What should you do when your patient is cranky and rude?

Be as professional as you can and collect the specimen in a normal way. Signup and view all the answers

Which of the following is part of informed consent for specimen collection?

Informing the patient that you are a student. Signup and view all the answers

How should you respond if the patient asks if the test is for diabetes?

Explain that it's best to discuss the test with the physician. Signup and view all the answers

What should you do if an inpatient vehemently refuses to allow you to collect a blood specimen?

Notify the patient's nurse and document the patient's refusal. Signup and view all the answers

What should you do if you arrive to draw a fasting specimen and the patient is just finishing breakfast?

Check with the patient's nurse to see if the specimen should be collected or the draw rescheduled. Signup and view all the answers

What should you do after selecting and cleaning the blood collection site?

Assemble equipment afterward Signup and view all the answers

When is hand decontamination required?

Before and after each patient. Signup and view all the answers

What should you do if your hands are visibly contaminated?

Wash them with soap and water. Signup and view all the answers

What should you do if you must collect a specimen on a 6-year-old child who is a little fearful?

Explain what you are going to do to the child in simple terms. Signup and view all the answers

If the patient asks whether the procedure will hurt, you should say that it:

Might hurt just a little, but only for a short time. Signup and view all the answers

What is the proper arm position for routine venipuncture?

Downward in a straight line from shoulder to wrist, palm up. Signup and view all the answers

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

Asked to lie down, or sit in a reclining drawing chair. Signup and view all the answers

Which of the following acts can lead to liability issues?

Lowering a bed rail to make access easier Signup and view all the answers

Never leave the tourniquet on for more than:

1 minute. Signup and view all the answers

Where is the best place to apply the tourniquet?

About 3-4 inches above the venipuncture site. Signup and view all the answers

If the tourniquet is too tight, it can cause:

All of the above Signup and view all the answers

Which of the following actions is prohibited during the vein selection process?

Having a patient pump his or her fist. Signup and view all the answers

How can you tell a vein from an artery during site selection?

An artery has a distinct pulse. Signup and view all the answers

What does a sclerosed vein feel like?

Hard and cord-like. Signup and view all the answers

It's acceptable to use an ankle vein if:

The physician gives permission. Signup and view all the answers

Which of the following will help you avoid inadvertently puncturing an artery during venipuncture?

All of the above Signup and view all the answers

What is the best action if the vein can be felt but not seen, even with the tourniquet on?

Look for visual clues on the skin to remind you where the vein is. Signup and view all the answers

Why should you release the tourniquet as soon as blood flow is established?

To decrease hemoconcentration of the specimen. Signup and view all the answers

What is the CLSI-recommended way to clean a venipuncture site?

Cleanse with a circular motion from the center to the periphery. Signup and view all the answers

Which of the following is the least important reason to wait for the alcohol to dry before needle insertion?

It gives the phlebotomist time to prepare equipment and supplies Signup and view all the answers

What happens if you advance the tube past the guideline on the holder before needle insertion?

The ETS tube will fail to fill with blood because of the loss of tube vacuum. Signup and view all the answers

What can be detected by visual inspection of the needle tip before inserting it?

That the needle is out of date. Signup and view all the answers

Which steps are in the right order for the venipuncture procedure?

Clean the site, prepare equipment, put on gloves, apply tourniquet Signup and view all the answers

What should you do if you touch the needle to the skin but change your mind and pull the needle away?

Stop & obtain a new needle before trying again. Signup and view all the answers

What is the best angle to use for needle insertion during routine venipuncture?

30 degrees or less. Signup and view all the answers

In performing venipuncture, how should the needle be inserted?

Bevel facing up. Signup and view all the answers

How can you tell when the needle is in the vein as you insert it into the patient's arm?

You will feel a slight 'give'. Signup and view all the answers

When is the best time to release the tourniquet during venipuncture?

As soon as blood begins to flow into the tube. Signup and view all the answers

Which analyte is least affected by prolonged tourniquet application?

Red cell count Signup and view all the answers

Which of the following is considered improper specimen collection technique?

Position the arm so tubes fill from the stopper end first Signup and view all the answers

Why is it important to fill anticoagulant tubes to the proper level?

To ensure that there is a proper ratio of blood to anticoagulant additive. Signup and view all the answers

Why is it important to mix anticoagulant tubes immediately after filling them?

To avoid microclot formation. Signup and view all the answers

What should you do if you fill an EDTA tube and still have a green-top tube to collect?

Draw several milliliters into a discard tube, then fill the green one. Signup and view all the answers

How many times do you mix non-additive tubes?

None. Signup and view all the answers

Study Notes

Venipuncture Techniques and Procedures

Properly anchoring a vein requires the thumb to be positioned 1 to 2 inches below the site, pulling the skin toward the wrist.
Collecting specimens before the requested time does not help build patient trust.
Misidentifying a patient's specimen may lead to no reprimand if no harm occurs.
Needle phobia refers to an intense fear of needles and injections, possibly leading to symptoms like arrhythmia, fainting, or light-headedness.
Minimizing trauma during venipuncture can be achieved by selecting the most skilled phlebotomist.
Hand sanitizer should be rubbed in thoroughly, and allow the alcohol to evaporate completely before proceeding.

Palpating means examining by touch to locate veins.
Needle insertion should be done with a smooth, steady forward motion.
To "seat" the needle means to thread it appropriately within the vein's lumen.
Fasting for 8-12 hours means going without food or drink, except water.
Timed tests, such as blood cultures and cardiac enzymes, are ordered for accuracy in results.
Test requisitions must contain the ordering physician's information for processing.

Identification and Specimen Handling

The unique accession number is assigned to each specimen request for tracking.
Failing to follow diet restrictions before specimen collection can result in compromised care and erroneous test results.
The patient's physician is the individual who has the legal authority to authorize testing.
Patient identification can be verified by matching the medical record number with its requisition.
Inpatient requisitions are sorted by collection priority, date, time, and location upon laboratory receipt.

Safety and Accuracy in Specimen Collection

Misidentification of specimens, especially for type and screen tests, can have fatal consequences.
Steps to connect a specimen to its paperwork are termed accessioning.
Use a preoperative (preop) label to classify patients who will soon undergo surgery.

Patient Comfort and Emergency Protocols

Leave the tourniquet on for no more than one minute to avoid complications.
The best place to apply the tourniquet is approximately 3-4 inches above the venipuncture site.
To differentiate a vein from an artery, note that arteries typically pulse.
A sclerosed vein feels hard and cord-like, making it difficult for venipuncture.
In emergency situations, introduce yourself to physicians and ask for permission before drawing specimens.

Techniques and Best Practices

While drawing blood, clean the venipuncture site with a circular motion from the center outward.
Use a 30-degree angle or less for needle insertion for optimal access.
Always insert the needle with the bevel facing up and feel for a slight "give" indicating successful vein entry.
Mix anticoagulant tubes immediately after collection to avoid microclot formation, ensuring blood-to-additive ratios are balanced.

Pediatric and Special Considerations

Explain the procedure simply to apprehensive children and maintain a cheerful demeanor to alleviate fears.
A patient who is NPO (nothing by mouth) cannot have any food or drink.
For a patient without an ID band, do not commence with specimen collection until verification with nursing staff occurs.

Administrative Duties and Documentation

Notify the patient's nurse for specimen refusals, and document these refusals appropriately.
If a test is ordered ASAP, this indicates that results are needed soon for effective patient care.
Manual requisition forms often serve multiple functions, including test requests and billing.

Final Notes

Ensure hands are cleaned with soap and water if visibly contaminated.
When drawing blood, avoid lowering bed rails or any actions that may lead to liability issues.
Properly track and manage any delays in specimen collection by filling out appropriate slips for documentation.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on venipuncture procedures with this set of flashcards covering essential concepts from Chapter 8 of Phlebotomy. Each card addresses critical actions and considerations for successful blood collection. Perfect for students preparing for exams or reviewing key techniques in phlebotomy.