Site selection and 3 chapters Flashcards
Site selection/ Venipuncture/ complications/ Factors to consider and Quality assurance and specimen handling (18 cards)
What is the preferred site for venipuncture?
Antecubital fossa of the upper extremities.
The vein should be large enough to receive the shaft of the needle and should be visible of palpable after tourniquet is placed.
What are three major veins located in the antecubital fossa?
- Median cubital vein: its the preferred vein because its large and doesn’t ten to move when the needle is inserted
- Cephalic vein: the second preferred vein, its it difficult to locate and has a tendency to move but its usually the only vein that can be palpated in obese patients.
- Basilic vein: last vein because it is the least anchored and located near the brachial artery. If the needle is inserted too deep it can puncture the artery.
What the three most unsuitable veins?
- Sclerosed veins: they feel hard or cordlike, can be caused by disease, inflammation, chemotherapy, or repeated venipunctures.
- Thrombotic veins
- Tortuous veins: they are winding or crooked veins, they are susceptible to infection and since the blood flow is impaired the specimen can produce erroneous test results.
True or false: can you draw blood from an arm that has IV fluid running into it.
False: the fluid can alter the test results
What is the basic step in preforming venipuncture?
Having the necessary supplies and or equipment organized for proper collection of specimen and to ensure the patients safety and comfort.
What are the recommended supplies for venipuncture?
Lab requisition slip (patient info and tests form) and pen
Antiseptic (prepackaged alcohol pads; povidone-iodine solution is commonly used)
Vacutainer tubes (specimen tubes)
Vacutainer needles,
Needle adaptor (tube holder)
Winged infusion sets (butterfly needles; used on small veins like in the hand, used on elderly and pediatric patients, common size is 23 gauge)
Sterile syringes and needles (used when vacutainer method cannot be used)
Tourniquet
Chux
Specimen lab
Gloves
Needle Disposal container
What is a hematoma?
It is a most common complication, it means that the blood has accumulated in the tissue surrounding the vein. Two common causes are the needle going through the vein and or failure to apply enough pressure on the site after the needle withdrawal.
What is hemoconcentration?
It is the increase of formed elements to plasma caused by the tourniquet being left on too long (more than 2 minutes)
What is phlebitis?
It is inflammation of a vein as a result of repeated venipuncture on the vein.
What is petechiae?
They are tiny non-raised red spots that appear on the skin form rupturing of the capillaries due to the tourniquet being left on too long or tight.
What is thrombus?
This is a blood clot usually a consequence of insufficient pressure applied after the withdrawal of the needle.
What is thrombophlebitis?
Inflammation of a vein formation of a clot.
What is septicemia?
This is a systemic infection associated with the presence of a pathogenic organism introduced during the venipuncture.
What is trauma?
This is an injury to underlying tissues caused by probing of the needle.
What are some factors to consider before preforming a venipuncture and why?
Fasting: Some test like glucose or cholesterol require the patient abstain from eating for at least 12 hours.
Edema: it’s the accumulation of fluid in the tissues, collection form edematous tissue can alter test results
Fistula: It’s the permanent surgical connection between an artery and vein, fistulas are used for dialysis and must never be used for venipunctures fue to possible infection.
What is quality assurance (QA)?
It is defined as a program that guarantees quality patient care by tracking the outcomes through scheduled audits in which areas of the hospital look at the appropriateness, applicability, and timeliness of patient care.
What type of program is a QA program?
It is a continuous program established by the healthcare facility, which provides guidelines, protocols and continuing education for their employees.
What areas in phlebotomy that are subject to quality control?
Patient preparation procedures.
