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# ADV.D04 Ch.10

# ADV.D04 Ch 10 Venipuncture Procedures

Hand Hygiene Always wash before and after each patient.
physician-patient relationship Confidential relationship between patient and doctor.
Diet Always check diet restrictions before drawing the blood.
alcohol, exercise and smoking can affect coagulation values
Tendency to faint Syncope. Patient should have blood drawn lying down.
Latex sensitivity Allergy to latex. If severe it is called anaphylaxis which can kill.
fasting no food or drink for 8 to 12 hrs. Person can have small amounts of water as needed.
Stress Stress raises blood glucose, WBC, and causes changes in coagulation.
Arm preference collect blood from the nondominant hand or arm
Weight Excessively obese may require a thigh cuff for a tourniquet.
What must be on the test requisition 1. time to be drawn, 2. date to be drawn, 3. patient name, 4. laboratory test ordered, 5. Ordered by
The minimum number of patient identifiers that you must use is: Two patient identifiers
What are patient identifiers Name, DOB, Patient ID#, Address
Computer assisted identification involves Bar codes and QR codes
Inpatient Identification from Emergency Room Must have a MASTER ID number. The name of the patient may not be known right away. The MASTER ID# will not change once the name is discovered.
Ambulatory Patient who is able to move around without assistance.
Outpatient / Ambulatory ID No armband is used. You must determine at least two patient identifiers before collecting the blood.
ID of Comatose patients Nurse can identify. However, these patients have an armband with two patient identifiers so a nurse or relative is not required for ID.
ID of Semiconscious patient Same as for comatose.
ID of sleeping patient Always gently awaken the sleeping patient before drawing the blood.
ID of infants and young children Armband has two patient identifiers, so this is OK. Nurse and/or parents/guardian can also identify.
Emergency Room ID This requires a temporary MASTER ID.
ID of isolation patients and burn patients These may need the armband to be attached to the gown and not as a bracelet around the skin. This is acceptable for these patients only. All other patients must have the ID attached to the patient.
What information can you give the patient? 1. Your name; 2. phlebotomy procedure information; 3. tests ordered. Do not discuss their disease or lab results or give medical advice.
When a patient refuses blood work you should... 1. notify the nurse; 2. document the time and date of the refusal if the nurse cannot get the patient to allow you to draw blood.
Created by: rjmtoss