Phlebotomy Chapter 8 Flashcards
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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?

    <p>Intense fear of needles and being stuck.</p> Signup and view all the answers

    Symptoms of needle phobia can include:

    <p>All of the above</p> Signup and view all the answers

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

    <p>Choose the most skilled phlebotomist available to perform the venipuncture.</p> Signup and view all the answers

    Proper use of hand sanitizer includes:

    <p>All of the above</p> Signup and view all the answers

    To examine by touch or feel is to:

    <p>Palpate.</p> Signup and view all the answers

    In most cases, needle insertion should be performed how?

    <p>Using a smooth, steady motion forward.</p> Signup and view all the answers

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

    <p>Thread part of the needle within the lumen.</p> Signup and view all the answers

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

    <p>Fasting.</p> Signup and view all the answers

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

    <p>Draw it at the best time for accurate results.</p> Signup and view all the answers

    Examples of timed tests include:

    <p>All of the above</p> Signup and view all the answers

    A test is ordered 'fasting' to:

    <p>Eliminate the effects of diet on test results.</p> Signup and view all the answers

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

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

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

    <p>Accession number.</p> Signup and view all the answers

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

    <p>All of the above</p> Signup and view all the answers

    Which individual has legal authority to authorize patient testing?

    <p>Patient's physician.</p> Signup and view all the answers

    Test requisition information must include the:

    <p>Ordering physician.</p> Signup and view all the answers

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

    <p>Manual.</p> Signup and view all the answers

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

    <p>Medical record number and name.</p> Signup and view all the answers

    Outpatient requisitions are typically of this type:

    <p>Manual.</p> Signup and view all the answers

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

    <p>Collection priority, date &amp; time, &amp; patient location.</p> Signup and view all the answers

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

    <p>Accessioning the specimen.</p> Signup and view all the answers

    Which priority does a timed test typically have?

    <p>Second.</p> Signup and view all the answers

    A test that is ordered stat should be collected:

    <p>Immediately, without hesitation.</p> Signup and view all the answers

    Which of the following tests is commonly ordered stat?

    <p>Lytes.</p> Signup and view all the answers

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

    <p>Critical condition.</p> Signup and view all the answers

    When a test is ordered ASAP, it means that:

    <p>Results are needed soon for an appropriate response.</p> Signup and view all the answers

    A preop patient:

    <p>Will soon be going to surgery.</p> Signup and view all the answers

    Tests are classified as routine if they are ordered:

    <p>In the course of establishing a diagnosis.</p> Signup and view all the answers

    This term means the same as stat:

    <p>Med Emerg.</p> Signup and view all the answers

    A patient who is NPO:

    <p>Can't have any food or drink.</p> Signup and view all the answers

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

    <p>Glucose.</p> Signup and view all the answers

    Which liquid is acceptable to drink when one is fasting?

    <p>Plain water.</p> Signup and view all the answers

    Which is a common postop test?

    <p>H&amp;H.</p> Signup and view all the answers

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

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

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

    <p>Collect the specimen from the left hand by finger puncture.</p> Signup and view all the answers

    A code is a way to:

    <p>All of the above</p> Signup and view all the answers

    What does DNR stand for?

    <p>Do not resuscitate.</p> Signup and view all the answers

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

    <p>Determine the problem first.</p> Signup and view all the answers

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

    <p>SPEP.</p> Signup and view all the answers

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

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

    How can laboratory results be negatively affected by the phlebotomist?

    <p>By startling a patient who is asleep.</p> Signup and view all the answers

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

    <p>Move the patient to a special phlebotomy collection area.</p> Signup and view all the answers

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

    <p>Introduce yourself and ask for permission to draw the specimen.</p> Signup and view all the answers

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

    <p>Ask them to wait outside of the room until you are finished.</p> 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?

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

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

    <p>Type and screen.</p> Signup and view all the answers

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

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

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

    <p>Medical record number.</p> 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?

    <p>Do not collect the specimen until the difference is resolved.</p> Signup and view all the answers

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

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

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

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

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

    <p>Newborn.</p> Signup and view all the answers

    What is the most critical error a phlebotomist can make?

    <p>Misidentify the patient's specimen.</p> Signup and view all the answers

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

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

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

    <p>Geriatric patient</p> Signup and view all the answers

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

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

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

    <p>Keep the patient from fainting during the venipuncture procedure.</p> Signup and view all the answers

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

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

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

    <p>Informing the patient that you are a student.</p> Signup and view all the answers

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

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

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

    <p>Notify the patient's nurse and document the patient's refusal.</p> 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?

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

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

    <p>Assemble equipment afterward</p> Signup and view all the answers

    When is hand decontamination required?

    <p>Before and after each patient.</p> Signup and view all the answers

    What should you do if your hands are visibly contaminated?

    <p>Wash them with soap and water.</p> 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?

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

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

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

    What is the proper arm position for routine venipuncture?

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

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

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

    Which of the following acts can lead to liability issues?

    <p>Lowering a bed rail to make access easier</p> Signup and view all the answers

    Never leave the tourniquet on for more than:

    <p>1 minute.</p> Signup and view all the answers

    Where is the best place to apply the tourniquet?

    <p>About 3-4 inches above the venipuncture site.</p> Signup and view all the answers

    If the tourniquet is too tight, it can cause:

    <p>All of the above</p> Signup and view all the answers

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

    <p>Having a patient pump his or her fist.</p> Signup and view all the answers

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

    <p>An artery has a distinct pulse.</p> Signup and view all the answers

    What does a sclerosed vein feel like?

    <p>Hard and cord-like.</p> Signup and view all the answers

    It's acceptable to use an ankle vein if:

    <p>The physician gives permission.</p> Signup and view all the answers

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

    <p>All of the above</p> 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?

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

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

    <p>To decrease hemoconcentration of the specimen.</p> Signup and view all the answers

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

    <p>Cleanse with a circular motion from the center to the periphery.</p> 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?

    <p>It gives the phlebotomist time to prepare equipment and supplies</p> Signup and view all the answers

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

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

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

    <p>That the needle is out of date.</p> Signup and view all the answers

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

    <p>Clean the site, prepare equipment, put on gloves, apply tourniquet</p> 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?

    <p>Stop &amp; obtain a new needle before trying again.</p> Signup and view all the answers

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

    <p>30 degrees or less.</p> Signup and view all the answers

    In performing venipuncture, how should the needle be inserted?

    <p>Bevel facing up.</p> 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?

    <p>You will feel a slight 'give'.</p> Signup and view all the answers

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

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

    Which analyte is least affected by prolonged tourniquet application?

    <p>Red cell count</p> Signup and view all the answers

    Which of the following is considered improper specimen collection technique?

    <p>Position the arm so tubes fill from the stopper end first</p> Signup and view all the answers

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

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

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

    <p>To avoid microclot formation.</p> 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?

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

    How many times do you mix non-additive tubes?

    <p>None.</p> 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.

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    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.

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