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?
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?
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Symptoms of needle phobia can include:
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A basic step that can be taken to minimize any trauma associated with a venipuncture is to:
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Proper use of hand sanitizer includes:
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To examine by touch or feel is to:
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In most cases, needle insertion should be performed how?
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To 'seat' the needle in the vein means to:
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Going without food or drink except for water for 8-12 hours is defined as:
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The reason a test is ordered 'timed' is to:
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Examples of timed tests include:
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A test is ordered 'fasting' to:
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Bending the arm up to apply pressure to the site after venipuncture has not been shown to:
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The unique number assigned to a specimen request is called the:
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Failure of the patient to follow required diet restrictions before specimen collection could lead to:
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Which individual has legal authority to authorize patient testing?
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Test requisition information must include the:
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Which type of requisition often serves as a test request, report, and billing form?
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Information represented by a patient ID bar code typically includes the patient's:
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Outpatient requisitions are typically of this type:
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When received by the laboratory, inpatient requisitions are typically sorted according to:
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Steps taken to unmistakably connect a specimen & the accompanying paperwork to a specific individual are called:
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Which priority does a timed test typically have?
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A test that is ordered stat should be collected:
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Which of the following tests is commonly ordered stat?
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If a test is ordered stat, it may mean that the patient is in:
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When a test is ordered ASAP, it means that:
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A preop patient:
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Tests are classified as routine if they are ordered:
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This term means the same as stat:
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A patient who is NPO:
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An example of a test that is commonly ordered fasting is:
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Which liquid is acceptable to drink when one is fasting?
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Which is a common postop test?
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What should you do if the patient's door is closed?
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What should you do if there is a sign that reads, 'No blood pressure or venipuncture, right arm'?
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A code is a way to:
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What does DNR stand for?
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How should you proceed if the patient initially responds negatively to blood collection?
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Which test is used to identify protein disorders that lead to nerve damage?
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What should you do if your inpatient is asleep when you arrive?
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How can laboratory results be negatively affected by the phlebotomist?
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When collecting from an unconscious patient, it's unnecessary to:
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What should you do if a physician is with the patient and the specimen is ordered stat?
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What is the best course of action if family or visitors are with the patient?
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What should you do if the patient is not in the room when you arrive to collect a timed specimen?
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Which test's misidentification is most likely to have fatal consequences?
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How do you verify a patient's identity in 302B named John Doe?
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Which requisition information must match the patient's ID band?
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What should you do if the medical record number on the ID band matches your requisition, but the patient's name is spelled differently?
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What should be done when an unconscious inpatient doesn't have an ID band?
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What is the system of choice to identify laboratory specimens from an unconscious woman in the ER?
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Which type of inpatient is most likely to have more than one ID band?
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What is the most critical error a phlebotomist can make?
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What should you do if your patient isn't wearing an ID band?
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Which type of patient is least likely to need his or her identity confirmed?
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How should you verify a patient's identity upon check-in?
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A cheerful, pleasant bedside manner and exchange of small talk are unlikely to:
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What should you do when your patient is cranky and rude?
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Which of the following is part of informed consent for specimen collection?
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How should you respond if the patient asks if the test is for diabetes?
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What should you do if an inpatient vehemently refuses to allow you to collect a blood specimen?
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What should you do if you arrive to draw a fasting specimen and the patient is just finishing breakfast?
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What should you do after selecting and cleaning the blood collection site?
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When is hand decontamination required?
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What should you do if your hands are visibly contaminated?
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What should you do if you must collect a specimen on a 6-year-old child who is a little fearful?
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If the patient asks whether the procedure will hurt, you should say that it:
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What is the proper arm position for routine venipuncture?
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Outpatients who have previously fainted during a blood draw should be:
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Which of the following acts can lead to liability issues?
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Never leave the tourniquet on for more than:
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Where is the best place to apply the tourniquet?
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If the tourniquet is too tight, it can cause:
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Which of the following actions is prohibited during the vein selection process?
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How can you tell a vein from an artery during site selection?
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What does a sclerosed vein feel like?
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It's acceptable to use an ankle vein if:
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Which of the following will help you avoid inadvertently puncturing an artery during venipuncture?
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What is the best action if the vein can be felt but not seen, even with the tourniquet on?
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Why should you release the tourniquet as soon as blood flow is established?
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What is the CLSI-recommended way to clean a venipuncture site?
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Which of the following is the least important reason to wait for the alcohol to dry before needle insertion?
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What happens if you advance the tube past the guideline on the holder before needle insertion?
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What can be detected by visual inspection of the needle tip before inserting it?
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Which steps are in the right order for the venipuncture procedure?
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What should you do if you touch the needle to the skin but change your mind and pull the needle away?
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What is the best angle to use for needle insertion during routine venipuncture?
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In performing venipuncture, how should the needle be inserted?
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How can you tell when the needle is in the vein as you insert it into the patient's arm?
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When is the best time to release the tourniquet during venipuncture?
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Which analyte is least affected by prolonged tourniquet application?
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Which of the following is considered improper specimen collection technique?
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Why is it important to fill anticoagulant tubes to the proper level?
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Why is it important to mix anticoagulant tubes immediately after filling them?
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What should you do if you fill an EDTA tube and still have a green-top tube to collect?
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How many times do you mix non-additive tubes?
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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.
Patient Interaction and Consent
- 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
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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.