what sites should be avoided when performing venipuncture quizlet

\u00a9 2023 wikiHow, Inc. All rights reserved. 1. previous experience with vomiting or fainting Label the specimens before leaving the patients bedside. Psychological interventions for needle-related procedural pain and distress in children and adolescents. Adapted from Phlebotomy for Nurses and. Never leave a tourniquet on for more than two minutes. Extremity is edematous. Include your email address to get a message when this question is answered. 2009;18(2):117-139. Tubes with different additives are used for collecting blood specimens for specific types. Similarly, it's quite easy to get lost in a "Wikipedia wormhole." Indeed, Wikipedia's depth is infinite, as you link from subject to subject, never able to stop. If using a needle and syringe, avoid drawing the plunger back too forcefully. A test that has been ordered may be cancelled due to problems unrelated to drawing the specimen, and these are the most common causes for cancellations: A test may be cancelled due to a technical problem in the specimen collection process: Identification of the specimen is suspect. Using a sterile blood lancet, puncture the side of the heel in the appropriate regions shown above in green. With risk for blood spatter a face shield provides protection. Airborne precautions may be considered to provide a level of safety against infectious diseases such as tuberculosis, influenza, and COVID-19. Observe universal (standard) safety precautions. Effects of Exercise: Muscular activity has both transient and longer lasting effects. The venipuncture procedure is complex, requiring both knowledge and skill to perform. 9. Extensive scarring or healed burn areas should be avoided Specimens should not be obtained from the arm on the same side as a mastectomy. Feel for the median cubital first, the cephalic vein second, and the basilic vein third. Using the requisition for reference, ask a patient to provide additional information such as a birthdate. Hold a gauze pad over the puncture site for a couple of, minutes to stop the bleeding, and then tie gauze around the foot. Which of the following actions should the technician take? The maximum number of times an individual should attempt a venipuncture on a patient is two, True or False? A 21-gauge needle (e.g. B. just after needle insertion, but prior to vacutainer activation While hand veins may be utilized for blood draws and intravenous infusions, veins in the feet and legs should be avoided for adults. Automated systems may include labels with bar codes. Track marks are not only found on IV drug users, but also on chronically ill patients requiring repeated vascular access and blood draws and may be a sign of an anticipated difficult draw. Have the patient make a fist and flex the arm, which helps engorge muscles to fill veins. Remember that veins should ideally feel bouncy. Blood samples drawn from an IV line should be documented and analyzed with care. If you are using a butterfly, try to retie the tourniquet around the patient's arm to increase pressure and re-establish blood flow. Back the needle out until the bevel is just below the skin. The phlebotomist's role requires a professional, courteous, and understanding manner in all contacts with the patient. if ( prevIframeHeight != zf_ifrm_ht_nw ) { -cotton sponges Mix and label all appropriate tubes at the patient bedside. Apply firm pressure for more than 5 minutes. Make sure the venipuncture site is dry before proceeding with draw. Capillary Specimens may be collected on filter paper and sent to lab for testing for. Cleanse the fingertip of the 3rd (middle) or 4th (ring) finger with an alcohol prep. Blood collection tubes must be drawn in a specific order to avoid cross-contamination of additives between tubes. Keep in mind that elderly patients often have fragile veins. Phlebitis is inflammation of a vein. Capillary Specimens may be used immediately for point-of-care testing. Antiseptic. 6. Prepare the equipment, the patient and the puncture site. Allow to air dry. If an inpatient is able to respond, ask for a full name and always check the armband or bracelet for confirmation. Expect that any discussion or consultation involving the patient's case will be conducted discretely and that individuals not directly involved in the case will not be present without patient permission. Elderly patients often have fragile skin and veins that roll quite easily, When a vein rolls, the needle tends to push the vein aside rather than penetrating through. Place labeled specimens in zip lock bag and deliver to the laboratory as soon as possible. How to Troubleshoot a Difficult Venipuncture. Stop the procedure if a hematoma occurs. When wearing gloves, change them between each patient and wash your hands frequently. Avoid excessive pressure that may squeeze tissue fluid into the drop of blood. (See picture.) Notify your supervisor or patientsphysician if unsuccessful. What caution should you observe when using a Vacutainer? Diurnal Rhythms: Diurnal rhythms are body fluid and analyte fluctuations during the day. In fact, many search engines provide the option to avoid dangerous sites by turning on a "safer" search. This vein lies close to the surface of the skin and there is not a large nerve supply. Procedures and Devices for the Collection of Diagnostic Capillary Blood. jugular) or a central venous catheter is out of the scope of practice of a certified phlebotomist and should only be performed by a physician or advanced nurse. Punctures to the posterior curvature of the heel cab cause damage to the bones. Hematoma formation is a problem in older patients. 2004;24(4):979-96, vii. A thin soap bubble of index of refraction 1.33 is viewed with light of wavelength 550.0 nm and appears very bright. Giavarina D, Lippi G. Blood venous sample collection: Recommendations overview and a checklist to improve quality. This information must be given when requesting microbiology, cytology, fluid analysis, or other testing where analysis and reporting is site specific. catheter size for the vein, or prolonged use of the same I.V. When finished, clean the site and apply pressure with clean gauze to stop the bleeding. Never draw over scars or a new tattoo sites. As a countermeasure, phlebotomists. Specimens; Approved StandardSixth Edition. Drawing blood from major vessels (e.g. Collect drops of blood into the . Dorsal hand veins are often utilized for intravenous infusions but are viable options for blood draw sites. Do not use excessive pressure or heavy massaging because the blood may become diluted with tissue fluid. Contains lithium heparin anticoagulant and a gel separator. While we are ranked among the best children's hospitals in the country, it's our compassionate approach to treatment that makes us truly exceptional. Stress: May cause transient elevation in white blood cells (WBC's) and elevated adrenal hormone values (cortisol and catecholamines). You must check the timing of these variations for the desired collection point. f.style.border="none"; What are the best veins for venipuncture? World Health Organization. When using a syringe and needle, avoid drawing the plunger back too forcibly. -antiseptic swabs 9. Some images used in this set are licensed under the Creative Commons through Flickr.com.Click to see the original works with their full license. The fluid may dilute the specimen, so collect from the opposite arm. Question. Identify the patient using two different identifiers, asking open ended questions such as, "What is your name?" Additionally, a hematoma may compress the nerve and lead to long-term damage. Matt Garcia is an experienced phlebotomist in Vancouver, Canada. Venipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. A face mask reduces risk for blood culture specimen contamination. 9. Tip: BD Vacutainer tubes use a translucent stopper to identify short draw variants. Once again, please be aware that these are only guidelines for blood draws and nurses should consult with the appropriate hospital personnel regarding performing this procedure on patients. Apply firm pressure. Never draw above an IV site. What Is Venipuncture? Clean up any blood spills with a disinfectant such as freshly made 10% bleach. At least two patient identifiers, such as name and date of birth, are needed. 8. This is a general guide for troubleshooting a venipuncture scenario in which blood flow is not initially established upon needle insertion. -do not rapidly insert the needle. 5. 2009 Feb;131(2):195-204. Do not add blood to a circle already filled orpartially filled with blood. Wikipedia. B. Hematoma C. at a mastectomy site 6. Otherwise, satisfactory samples may be drawn below the IV by following these procedures: Turn off the IV for at least 2 minutes before venipuncture. What equipment is needed for a venipuncture? -use correct angle of needle insertion wikiHow is where trusted research and expert knowledge come together. PROBLEMS OTHER THAN AN INCOMPLETE COLLECTION: A hematoma forms under the skin adjacent to the puncture site - release the tourniquet immediately and withdraw the needle. wikiHow, Inc. is the copyright holder of this image under U.S. and international copyright laws. 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