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Chapter 14
Arterial Puncture Procedures
| Question | Answer |
|---|---|
| Arteriospasm is defined as | artery contraction due to pain, irritation by a needle, or anxiety |
| Formation of a thrombus during arterial puncture can result from an | injury to the arterial wall |
| Significantly inaccureate ABG values can result from | microclots that are undetected |
| The inegrity of a blood gas specimen can be affected by | ratio of blood to anticoagulant |
| The thumb shoud not be used to feel for an artery because it | has a pulse |
| A patient complication associated with arterial | numbness |
| The radial artery is located in the | thumb side of the wrist |
| Why is arterial blood better for blood gas determination than venous blood | composition of arterial blood is more consistent |
| The blood gas parameter HCO3 measures the amount of | bicarbonate circulating in the blood |
| Which of the following test requies an arterial specimen | Blood gases |
| Which of the following analytes is routinely part of a blood gas analysis | PaO2 |
| Arterial blood gas evaluation would most likely be performed on a patient with | pulmonary disease |
| Arterial puncture instruction typically includes | observation of procedures |
| Arterial puncture site selection is based on the | existence of collaterial circulation |
| One reason to favor a site as a choice for arterial puncture is | that it has very little tissue covering the artery |
| The preferred and most common site for arterial puncture is the | radial artery |
| Which aratery is generally easiest to access during low cardiac output | femoral |
| The biggest advantage of choosing the radial artery for ABG collection is that | it usually has good collateral circulation |
| Which of the following is a disadvantage of using the radial artery for ABG collection | it is small and difficult to feel |
| Which of the following is an advantage of using the brachial artery for arterial blood collection | it is large and fairly esy to palpate |
| One disadvantage of puncturing the brachial artery is that it | lies near the median nerve |
| Which arterial site poses the greatest risk of infection | femoral |
| Arterial specimens can also be collected from the | dorsalis pedis arteries of most adults |
| Supplemental information on an arterial blood gas requisition typically includes | patient activity and body postion |
| Which of the following is requied for ABG collection | 1- to 5-mL self-filling syringe |
| Arterial blood gas specimens are collected in syringes rather than tubes because | evacuated tube pressure can change results |
| PPE used when collecting arterial specimens includes | lab coat and gloves |
| Commercialloy prepared arterial smapling kits rarely contain a | 1% lidocaine-filled syringe |
| Heparin is used in arterial sample collection to | prevent clotting of the specimen |
| Lidocaine is sometimes used during arterial puncture | anesthetize the site prior to the puncture |
| Prior to ABG collection, a patient should have been in a steady state for at least | 20 to 30 minutes |
| A patient in a steady state for ABG collection has | had no suction changes in 20 minutes |
| The purpose of performing the modified Allen test prior to arterial specimen collection is to | determine collateral ciuculation |
| When performing the modified Allen test, which artery is released first | Ulnar |
| What constitutes a positive modified Allen test | the hand color returns to normal in 15 seconds |
| Which of the following is proper procedure if the Allen test is negative | check for collateral circulation in the other arm |
| A patient who has collateral circulation | has multiple arteries supplying blood to an area |
| Which of the following actions assoicated with the radial ABG procedure are in the correct order | assess, positon, clean, puncture, fill, expel, label |
| Which one of the following radial ABG specimen collection steps is optional | administration of local anesthetic |
| Positioning of the arm for radial ABG specimen collection includes | extending the wrist approximately 30 degrees |
| Which of the following would be a reason to terminate an arterial puncture | the patient's complaints of extreme pain and discomfort |
| In performing arterial puncture, the neelde must be directed | away from the hand, facing the blood flow |
| Which of the following is an acceptable angle of needle insertion for drawing radial arterial blood gases | 45 degress |
| The typical needle used to collect blood from a radial artery is | 22-gauge, 1 inch |
| How do yo know when you have "hit" an artery during arterial blood gas collection | A flash of blood appears in the syringe nub |
| Which of the following is the best way to tell if a specimen is arterial? As the specimen is collected the blood will | pump or pulse into the syringe |
| As soon as the needle is withdrawn following ABG specimen collection the | apply site pressure for 3 to 5 minutes |
| Proper specimen handling immediately following collection involves | mixing the specimen to prevent clotting |
| After performing arterial puncture, the therapist should check the pulse | distal to the puncture site |
| What should thetherapist do if the pulse is absent or faint following ABG collection | Notify the patient's nurse or the lab supervisor |
| Which of the following is a common arterial puncture complication even when proper procedure is used | arteriospasm |
| Blood gas specimen rejection criteria include | improper lableing or missing lable inadequate volume of the speciemn visible hemolysis of the specimen |
| Which of the following is most likely to cause erroneous ABG results | microclots present in the specimen |
| ABG | Arterial blood gases |
| Allen test | A simple noninvasive test to assess collateral circulation before collecting a blood specimen from the radial artery |
| Brachial artery | artery located in the medial anterior aspect of the antecubital fossa near that insertion of the biceps muscle; the second choice for arterial puncture |
| Collateral circulation | An area supplied with blood from more than one artery so that circulation can be maintenaced if one vessel is obstructed |
| Fi02 | Fractional inspired oxygen as in oxygen therapy |
| L/M | Liters per minute ,as in oxygen therapy |
| Radial artery | The artery located at the thumb side of the wrist, which is the first choice and most common site used for arterial puncture |
| Steady state | stable condition required before obtaining blood gas specimens; that is a condition in which there has been no exercise, suctioning or repsirator change for at least 20 to 30 minutes |
| Ulnar artery | artery located on the medial aspect or little finger side of the wrist |
| Arteriospasm | A reflex (involuntary) contraction of the artery that can be caused by pain or irritation during needle penetration of the artery muscle or that may result from a patient's anxiety during arterial puncture |
Created by:
mmfleischer