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Questions and Answers
A phlebotomist is preparing to draw blood from a patient. Which of the following veins is generally the first choice for venipuncture?
A phlebotomist is preparing to draw blood from a patient. Which of the following veins is generally the first choice for venipuncture?
- Femoral vein
- Basilic vein
- Cephalic vein
- Median cubital vein (correct)
Why is it essential to follow a standard procedure for blood specimen collection during venipuncture?
Why is it essential to follow a standard procedure for blood specimen collection during venipuncture?
- To minimize patient discomfort during the procedure.
- To ensure accurate laboratory results and prevent erroneous results. (correct)
- To reduce the risk of infection for the healthcare worker.
- To expedite the blood collection process.
A patient has an IV line in their left arm. Under what circumstance is it acceptable to draw blood from the same arm?
A patient has an IV line in their left arm. Under what circumstance is it acceptable to draw blood from the same arm?
- It is never acceptable to draw blood from an arm with an IV line.
- If not possible on the opposite arm, blood should be drawn below and distal to the IV site. (correct)
- If the IV is administering blood, draw above the IV site.
- If the IV is turned off for at least 30 seconds before performing venipuncture.
You are about to perform venipuncture on a patient and notice a small hematoma on their forearm. What is the appropriate course of action?
You are about to perform venipuncture on a patient and notice a small hematoma on their forearm. What is the appropriate course of action?
In which of the following scenarios would it be most appropriate to avoid using a particular arm for venipuncture?
In which of the following scenarios would it be most appropriate to avoid using a particular arm for venipuncture?
When performing venipuncture on a patient with an existing intravenous (IV) line, what is the minimum amount of time the IV infusion should be stopped before drawing blood above the IV site?
When performing venipuncture on a patient with an existing intravenous (IV) line, what is the minimum amount of time the IV infusion should be stopped before drawing blood above the IV site?
A phlebotomist is preparing to draw blood from a patient who has a cast on their left arm. What is the most appropriate action?
A phlebotomist is preparing to draw blood from a patient who has a cast on their left arm. What is the most appropriate action?
Which of the following is the primary reason for wearing appropriate Personal Protective Equipment (PPE) during venipuncture?
Which of the following is the primary reason for wearing appropriate Personal Protective Equipment (PPE) during venipuncture?
A patient has undergone a mastectomy on their right side. From which arm should the phlebotomist attempt to draw blood and why?
A patient has undergone a mastectomy on their right side. From which arm should the phlebotomist attempt to draw blood and why?
When applying a tourniquet during venipuncture, where should it be positioned in relation to an existing IV site?
When applying a tourniquet during venipuncture, where should it be positioned in relation to an existing IV site?
Why is it important to palpate a vein both vertically and horizontally before venipuncture?
Why is it important to palpate a vein both vertically and horizontally before venipuncture?
What is the primary risk associated with applying a tourniquet for longer than one minute during venipuncture?
What is the primary risk associated with applying a tourniquet for longer than one minute during venipuncture?
Why should a patient be instructed to make a fist, but specifically told not to pump it, during venipuncture?
Why should a patient be instructed to make a fist, but specifically told not to pump it, during venipuncture?
What is the correct technique for sanitizing the venipuncture site?
What is the correct technique for sanitizing the venipuncture site?
What is the most appropriate action if you cannot locate, palpate, and extract blood within one minute of applying the tourniquet?
What is the most appropriate action if you cannot locate, palpate, and extract blood within one minute of applying the tourniquet?
Why is it important not to blow or fan the venipuncture site after it has been sanitized?
Why is it important not to blow or fan the venipuncture site after it has been sanitized?
In which scenario would the basilic vein be considered a suitable alternative venipuncture site?
In which scenario would the basilic vein be considered a suitable alternative venipuncture site?
How far above the selected puncture site should the tourniquet be applied?
How far above the selected puncture site should the tourniquet be applied?
Why is it important to ensure that the free end of the tourniquet is away from the puncture area?
Why is it important to ensure that the free end of the tourniquet is away from the puncture area?
What is the most important consideration when selecting a venipuncture site?
What is the most important consideration when selecting a venipuncture site?
Flashcards
Arm Position for Venipuncture
Arm Position for Venipuncture
Arm position slightly bent in a downward position
Upper Arm Venipuncture Sites
Upper Arm Venipuncture Sites
Basilic, Cephalic, or Median veins
Tourniquet Placement
Tourniquet Placement
Apply 3 to 4 inches above puncture site
Maximum Tourniquet Time
Maximum Tourniquet Time
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Patient Makes a Fist
Patient Makes a Fist
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Why avoid fist pumping?
Why avoid fist pumping?
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Palpating the Vein
Palpating the Vein
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Skin Preparation
Skin Preparation
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Drying Venipuncture Site
Drying Venipuncture Site
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Preferred Venipuncture Veins
Preferred Venipuncture Veins
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Venipuncture
Venipuncture
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Who performs venipuncture?
Who performs venipuncture?
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Key to Accurate Lab Results
Key to Accurate Lab Results
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Median Cubital Vein
Median Cubital Vein
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Venipuncture: Sites to Avoid
Venipuncture: Sites to Avoid
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Mastectomy arm: avoid
Mastectomy arm: avoid
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Hematoma and venipuncture
Hematoma and venipuncture
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Drawing Blood Near an IV
Drawing Blood Near an IV
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Sites to Always Avoid.
Sites to Always Avoid.
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Tourniquet Placement Near IV
Tourniquet Placement Near IV
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Study Notes
- Locating the proper site and anchoring veins ensures the best blood return during venipuncture.
Resources for Venipuncture:
- 70% Isopropyl Alcohol
- Tourniquet
- Wet & Dry Cotton
- Gloves
Venipuncture Explained:
- Involves accessing a vein intravenously for therapy or blood sampling.
- Typically performed by medical laboratory scientists, medical practitioners, phlebotomists, or nursing staff.
- Adhering to standard procedure is vital for accurate lab results as collection errors or misfiled tubes can cause inaccuracies.
Primary and Alternative Vein Sites:
- The median cubital vein is the primary vein used in venipuncture.
- Other viable sites include the basilic, cephalic, or median veins in the upper arm.
- Median Cubital and Cephalic veins are most commonly used for venipuncture
Other considerations for Venipuncture sites:
- Alternative sites include basilic veins on the dorsum of the arm or dorsal hand veins.
- The basilic vein is close to the brachial artery and median nerve and should only be used if there is no other prominent arm vein.
- Foot and ankle veins are the final option.
- Under-wrist veins should be avoided.
Sites to Avoid for Venipuncture:
- Areas with extensive scarring due to burns or surgery.
- Edematous arms.
- On the upper extremity where a mastectomy was performed.
- Avoid hematomas; if unavoidable, draw distally and below the hematoma,.
- Areas near IV therapy or blood transfusions; if necessary, draw below and distal to the IV, after turning it off for 2 minutes.
- Areas with cannulas or fistulas.
- Arms in casts.
- Sites with birthmarks, moles, and tattoos.
- A tourniquet should be positioned between the IV site and the venipuncture location.
Venipuncture Procedure:
- Wear appropriate PPE.
- Prepare all required equipment.
- Select the best puncture site.
- Position the patient's arm slightly bent downwards.
- Apply the tourniquet 3-4 inches above the selected puncture site.
- Tourniquet placement too close to the puncture site can collapse the vein
- Ensure the free end of the tourniquet points away from the puncture area and is free of folds.
- Tourniquet application should not exceed 1 minute to prevent hemoconcentration and hemolysis.
- Ask the patient to make a fist to make the vein more visible, but never tell them to pump their fist since this will cause hemoconcentration.
- Palpate the vein vertically and horizontally with the index or middle finger to assess its depth, direction, and size.
- Release the tourniquet and have the patient open their fist unless immediate extraction is possible.
- Sanitize the area from the center outwards using 70% alcohol in a circular motion.
- Let the area air dry before puncture.
- Do not blow or fan the venipuncture site to dry.
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Description
Venipuncture involves accessing a vein for therapy or blood sampling, typically by trained medical staff. The median cubital vein is the primary site, with alternatives including the basilic and cephalic veins. Proper site selection and procedure adherence are crucial for accurate results.
