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pmls 2 by puso > arterial puncture procedures > Flashcards

arterial puncture procedures Flashcards

1
Q

Primary reason why we need to obtain arterial blood is for

A

arterial blood gas test / arterial blood gas analysis (ABGA)

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2
Q

arterial puncture is requested commonly to asses and evaluate…

A

respiratory function

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3
Q

Puncturing the artery to collect blood

A

arterial puncture

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4
Q

is tourniquet needed?

A

no

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5
Q

how much arterial blood is needed for ABGA

A

usually 1 to 1.5 mL

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6
Q

oxygenated blood with a bright red color

A

arterial blood

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7
Q

people who perform arterial puncture

A
  • MD
  • Nurses
  • Medical technologists & technicians
  • Respiratory therapists
  • Emergency medical technicians
  • Level II phlebotomists
  • must have an extensive training
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8
Q

are MTs allowed to perform arterial puncture in the PH?

A

hinde wag kang desisyon. doctors or physicians and respiratory therapists lang

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9
Q

Individuals allowed to perform arterial puncture
must undergo ___________

A

periodic evaluation

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10
Q

sites for arterial puncture

A
  • Radial artery
  • Brachial artery
  • Femoral artery
  • Scalp artery
  • Umbilical artery
  • Dorsalis pedis arteries
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11
Q

Site Collection Criteria

can be evaluated by performing modified ___________ or by using a portable instrument or
ultrasound instrument

A

Allen test

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12
Q

first choice and most commonly used site

A

Radial Artery

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13
Q

where is radial artery located

A

thumb side of the wrist

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14
Q

advantages of radial artery

A
  • Good collateral circulation
  • Easy to palpate
  • Less risk also of accidentally puncturing a vein or damaging a nerve
  • Less chance of hematoma
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15
Q

disadvantages of radial artery

A
  • Requires considerable skill
  • Difficult to locate on patients with hypovolemia or low cardiac output
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16
Q

second choice artery located in the medial anterior of the antecubital fossa

A

brachial artery

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17
Q

advantage: large and relatively easy to palpate and puncture

A

brachial artery

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18
Q

advantage: used for a large volume

A

brachial artery

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19
Q

disadvantage: deeper and can be harder to palpate than radial

A

brachial artery

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20
Q

disadvantage: close to basilic vein and median nerve

A

brachial artery

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21
Q

largest artery for arterial puncture

A

femoral artery

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22
Q

where is the femoral artery located?

A

superficially in groin, lateral to pubis bone

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23
Q

least artery to be used

A

femoral artery since for emergencies or if walang other sites na siya ginagamit

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24
Q

advantage: large, easy to palpate and puncture

disadvantage: poor collateral circulation, lies to the femoral vein, increased risk of infection

A

femoral artery

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25
Q

blood supply from more than 1 artery

A

collateral circulation

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26
Q

Has high oxygen content & consistency of composition

A

arterial blood

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27
Q

Used in diagnosis & management of respiratory disorders

A

Arterial Blood Gas (ABG)

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28
Q

Used in management of electrolyte & acid-base balance in patients with diabetes & other metabolic disorders

A

ABG

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29
Q

ABG specimens should be collected in an _______________

A

anaerobic manner (not exposed to air)

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30
Q

pH result lower than 7.35 is termed as ________

pH higher than 7.45 as ___________

A

acidosis, alkalosis

31
Q

COMMONLY MEASURED ABG ANALYTES

partial pressure of oxygen dissolved in arterial blood

A

PaO2

32
Q

COMMONLY MEASURED ABG ANALYTES

Partial pressure of CO2 dissolved in arterial blood

A

PaCO2

33
Q

COMMONLY MEASURED ABG ANALYTES

A measure of bicarbonate in blood

A

HCO3

34
Q

COMMONLY MEASURED ABG ANALYTES

percent O2 bound to hemoglobin

A

O2 sat

35
Q

COMMONLY MEASURED ABG ANALYTES

A calculation of non-respiratory part of acid-base balance

  • based on the PCO2, HCO3 and O2 stat
A

base excess

36
Q

determines if hemoglobin is carrying the among of oxygen

A

O2 Saturation

37
Q

With a purpose of numbing or to numb the site to be used for arterial puncture

A

Antiseptic Local anesthetic

  • Usual local anesthesia to be used is 1%
    lidocaine
  • isopropanol or isopropyl alcohol or chlorhexidine for cleaning the site
38
Q

Gauge of needle to be used ranges from

A

20 to 23

39
Q

in case of radial or brachial artery, __ gauge is used with 1 inch length of the needle

A

22

40
Q

recommended gauge

A

22

41
Q

what kind of syringe is needed

A

pre-heparinized syringe

42
Q

anticoagulant used for ABG testing

A

lyophilized heparin salt

43
Q

maintains the specimen temperature between 1 - 5C

A

coolants

44
Q

The patient should be on their steady state for at least

A

20 - 30 minutes before puncture

45
Q

factors that affect the amount of oxygen and CO2 in the blood is not in a steady state:

A
  • breathing pattern
  • body temperature
  • oxygen concentration
46
Q

A test to determine if patient has collateral circulation before arterial puncture is performed

A

modified Allen test

47
Q

how long should the blood flow be blocked in Allen Test?

A

30 seconds

48
Q

Positive allen test

A

hand flushes pink

49
Q

if the hand does not return to a pink color…

A

there is blockage on the ulnar artery and puncturing the radial artery may then cause blockage

50
Q

Anesthesia prevents __________

A

vasoconstriction

51
Q

angle of needle in anesthesia administration

A

10 degrees

52
Q

waiting time after administering anesthesia

A

1 - 2 mins

53
Q

amount of anesthesia needed for lessening the pain

A

0.25 to 0.5 mL

54
Q

when does the anesthesia wears off

A

after 15 to 20 mins

55
Q

is physician order needed before administering anesthesia?

A

yes nmn

56
Q

radial and brachial ABG procedure

needle angle insertion

A

30- to 45-degree angle

slowly direct it toward pulse

stop when a flash of blood appears

57
Q

needle angle in femoral artery

A

90 degrees

58
Q

why is tourniquet not needed?

A

there is already a high pressure in the blood circulating in the artery

59
Q

should you pull back the plunger once you see a flash of blood?

A

no, since the blood will flow or pump into the
syringe on its own power

60
Q

can you probe in arterial puncture?

A

no

61
Q

if patient WBC is high after collection of arterial blood, you should analyze the specimen within __________

A

5 minutes of collection

62
Q

time of transportation without delay

A

30 mins

63
Q

transportation with delay

A

collect the arterial blood in a glass syringe and cool it using ice slurry or crushed ice with large amount of water

64
Q

the reflex contraction of the artery caused by pain or irritation which is caused by needle entry on the artery muscle

A

Arteriospasm

65
Q

Common in case of repeated puncture

A

Artery Damage

66
Q

Temporary and minor

  • Extreme pain during puncture may indicate nerve involvement
A

Discomfort

67
Q

Can be a sign of impaired circulation or nerve irritation or damage

A

Numbness

68
Q

blocks the entire lumen of the artery; therefore obstructing blood flow and impairing the circulation

A

Thrombus formation

69
Q

Faintness or loss of consciousness related to hypotension caused by a nervous system response

A

Vasovagal Response

70
Q
  • greatest in older patients
  • common in patients in anticoagulant therapy
  • caused by multiple punctures to a single site
A

Hematoma

71
Q

Sampling Errors

A
  • Air bubbles
  • Delay in analysis
  • Improper mixing
  • Improper syringe
  • Obtaining venous blood by mistake
  • Use of improper anticoagulant
  • Use of too much or too little heparin
72
Q

Too much heparin can cause __________

A

acidosis

73
Q

Too little heparin can result to _____________

A

clotting of the specimen

74
Q

do you accept ABG specimen that used the wrong type of syringe?

A

no!!!!!!!!!!!!!!!!!!!

pmls 2 by puso (6 decks)

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