L5: Arterial Puncture

Question 1

blood is obtained/ widrawn from a patient’s artery

Answer 1

arterial puncture

Question 2

blood sample is collected without tourniquet

Answer 2

arterial puncture

Question 3

arterial puncture is used in?

Answer 3

blood gas analysis/ arterial blood gas analysis (ABGA)

Question 4

oxygenated blood with a bright red color

Answer 4

arterial blood

Question 5

arterial puncture is performed by whom?

Answer 5

MD
Nurses
Medical technologists & technicians
Respiratory therapists
Emergency medical technicians
Level II phlebotomists

Question 6

sites for arterial puncture

Answer 6

radial, brachial, femoral, scalp, umbilical, dorsalis pedis arteries

Question 7

• Good collateral circulation (radial & ulnar arteries)
• Easy to palpate (close to surface of skin)
• Less chance of hematoma formation after collection

what artery?

Answer 7

radial artery

Question 8

• Requires considerable skill to puncture it successfully due to small size
• Difficult to locate on patients with hypovolemia or low cardiac output

what artery?

Answer 8

radial artery

Question 9

• Large & relatively easy to palpate & puncture
• Sometimes the preferred artery for a large volume of blood
• Adequate collateral circulation (but not as good as radial)

what artery?

Answer 9

brachial artery

Question 10

• Deeper & can be harder to palpate than radial artery
• Lies close to basilic vein; risk of mistakenly puncturing it
• Lies close to median nerve; risk of pain & nerve damage
• Increased risk of hematoma formation

what artery?

Answer 10

brachial artery

Question 11

Largest artery used for arterial puncture

Answer 11

femoral artery

Question 12

• Located superficially in groin, lateral to pubis bone
• Performed primarily by physicians & specially trained emergency room personnel
• Generally used only in emergency situations or when no other site is available

what artery?

Answer 12

femoral artery

Question 13

• Large & easily palpated & punctured
• Sometimes, only site where arterial sampling is possible

what artery?

Answer 13

femoral artery

Question 14

• Poor collateral circulation
• Lies close to femoral vein; risk of mistakenly puncturing it
• Increased risk of infection due to location & pubic hair
• Risk of dislodging plaque buildup from inner artery walls
• Requires extended monitoring for hematoma formation

Answer 14

femoral artery

Question 15

disadvantages of arterial puncture

Answer 15

• Technically difficult
• Potentially more painful & hazardous than venipuncture
• Thus, not normally used for routine blood tests

Question 16

• Best specimen for evaluating respiratory function
• Has high oxygen content & consistency of composition

Answer 16

arteial blood

Question 17

used in diagnosis and management of respiratory disorders

Answer 17

Arterial Blood Gas

Question 18

Provide valuable info. about patient’s:
- Oxygenation
- Ventilation
- Acid-base balance

Answer 18

Arterial Blood Gas

Question 19

• Used in management of electrolyte & acid-base balance in patients with diabetes & other metabolic disorders
• Specimens are sensitive to effects of preanalyticalerrors

Answer 19

arterial blood gas

Question 20

a measure of acidity/ alkalinity of blood (acidosis or alkalosis)

analyte? range?

Answer 20

analyte: pH
normal range: 7.35-7.45

Question 21

Partial pressure of O2 dissolved in arterial blood

analyte? normal range?

Answer 21

analyte: PaO2
normal range: 80 - 100 mm Hg

Question 22

partial pressure of CO2 dissolved in blood

analyte? normal range?

Answer 22

analyte: PaCO2
normal range: 35-45 mm Hg

Question 23

a measure of bicarbonate in blood

analyte? normal range?

Answer 23

analyte: HCO2
normal range: 22-26 mEq/ L

Question 24

percent O2 bound to hemoglobin

analyte? normal range?

Answer 24

analyte: O2 sat
normal range: 97% - 100%

Question 25

a calculation of nonrespiratory part of acid base balance analyte? normal range?

Answer 25

analye: base excess normal range: -2 to +2 mEq/ L

Question 26

in arterial puncture, what are the infos concerning conditions at a time of collection is needed?

Answer 26

- current body temp - respi rate - ventilation status - fraction of inspired oxygen - prescribed flow rate in liters per minute

Question 27

PPE for arterial puncture

Answer 27

- Fluid-resistant lab coat, gown, or apron - Gloves - Face protection

Question 28

equipment and supplies for arterial puncture

Answer 28

- Antiseptic Local anesthetic (optional) - Sharp, short-bevel hypodermic needle - 1- to 5-mL self-filling syringe - Luer-tip normal or bubble removal cap - Coolant - 2- by 2-in. gauze squares - Self-adhering gauze bandage - ID & labeling materials - Puncture-resistant sharps container

Question 29

Modified Allen test procedure 1. Have patient make a tight ____ 2. Compress patient’s ____ & ____ arteries at same time 3. Maintaining _____, have patient open hand slowly 4. Lower patient’s hand & release pressure on ____ artery only 5. Assess results: +hand flushes pink; -hand does not flush pink 6. Record results on _______

Answer 29

1. fist 2. radial, ulnar 3. pressure 4. ulnar 5. requisition

Question 30

in doing arterial puncture, apply pressure on the wrist using the ___ and ___ fingers of both hadns. Simultaneously compress the patient's ___ and ___ arteries

Answer 30

middle, index radial, ulnar

Question 31

in arterial puncture, what artery do you release first?

Answer 31

ulnar artery

Question 32

how do you evaluate the resultsof modified allen test procedures?

Answer 32

+ if the hand flushes pink - if the hnd does not flash pink; the circulation of ulnar artery is not sufficient thus, radial artery should not be punctured.

Question 33

in arterial puncture, when preparing and administering local anesthetic, insert the needle into the skin at site at angle of __ degrees

Answer 33

10

Question 34

how many mins before proveeding w arterial puncture

Answer 34

1 -2 mins

Question 35

in doing radial ABG procedure, insert the needle at __ to ___ degree angle, slowly direct it toward ___, and stop when a flash of bood appears

Answer 35

30 - 45 pulse

Question 36

hazards and complications involving arterial puncture

Answer 36

Arteriospasm Artery damage Discomfort Infection Numbness Thrombus formation Vasovagal response

Question 37

sampling errors involving arterial puncture

Answer 37

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

Question 38

criteria for ABG specimen rejection

Answer 38

air bubbles in the specimen clotted specimen hemolyis of the specimen improper/ absent ID improper transpo temp inadequate volume for the test prolonged delay in the delivery to lab wrong type of syringe used