Week 3 Flashcards
When doing a blood culture test you feel which tube first and which tube second?
Aerobic is number one
Anaerobic is number two
Can a pt order their own blood work?
No, a pt can not.
- The insurance companies will not pay for it if they do.
- pt also cannot dx the interpret the result
Tear drop or palm leaf in image over pt bed
The baby died
If pt is unconscious do you silently draw?
No, talk to them like they are awake. They may still hear you.
What if the pt is not able to communicate their name and DOB
Ask family member or nurse
What is the most important step of the entire procedure?
Patient identification
What if there are any discrepancy on info?
“I’m sorry it’s against labeling policy”
Don’t draw!!!
Is it your job to explain the reason for the test?
No. Do not explain purpose of test-refer to MD or nurses
“I’m not really sure, you can ask the Doc or nurse”
If pt refuses to allow you to draw
Don’t force draw unless, under 18, involuntary committed (pinked), mentally challenged, demented pt (Alzheimer’s)
“Ok, but you did know Dr. Smith ordered this?”
If they still refuse tell nurse
Proper arm position
Arm straight
Feet and ankle draw
Must have MD order/permission
Three fav vein
1 median cubital
What does a good vein feel like
When palpitating with index finger it should feel like it has a good bounce to it
How far do you insert a needle
Most of the time a 1 inch needles put a little under a half an inch into the vein
Determine direction of the needle by palpitating the vein
If you’re having a hard time locating a vein what should you do?
Warm the area with A warm compress.
(Warm heat pack for eight seconds in the microwave in on the site for about a minute and bada boom a vein)
Massage in an upward motion
Gently tap area unless it is a PT or a PTT then don’t tap
Ask a more experienced coworker
Check hand veins
When venipuncture in hand veins and wrist what spot can you not use
The veins on the underside of the rest must not be used, as nerves and tendons are close to the surface of the skin in this area
If using an alcohol antiseptic to clean the venipuncture site comes away from the skin dirty what do you do
Get a new pad and continue to sanitize the area until the alcohol pads come away clean
What alcohol on the skin causes what
Causes stinging when the needle is inserted if alcohol is still wet and also can cause hemolysis to the specimen
Anchoring the vein helps
Detract from the pain
Failure to obtain blood by going to deep what do you need to do?
Pull the needle back a little bit, don’t tell the patient it doesn’t hurt.
Tell your to obtain blood because the needle is too shallow, what are you do?
Tell the patient, and push it in a little bit further. Pushing in hurts so patient needs to be warned
Failure to obtain blood, the needle has gone beside the vein. What do you tell the patient
This might be a little Pinchy, do I have your permission to move the needle?
Do not re-position if you are using the basilic vein
How to prevent hemolysis
- allow alcohol to dry
- use large needles versus small needles when possible
- invert tubes gently, handle like a raw egg
- do not squeeze fingertip sights too hard
- never draw from a hematoma
Accidental arterial puncture
Will probably cause one of the following,
- rapidly forming hematoma, this can cause nerve damage
- rapid filling of tube with a pulsating movement
- A bright cherry red colored blood
