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venipunture final
| Question | Answer |
|---|---|
| order of draw | lt blue, red, gold/red gray, green, lavender/pink, gray |
| light blue | sodium citrate, invert 3-4x, stand time 0, centrifuge 15 min, plasma |
| red | clot activator, invert 5x, stand time 30min, centrifuge 10min/2hrs, serum |
| gold/red gray | gel/clot activator, invert 5x, stand time 30 min, centrifuge 10min/2hrs serum |
| green | heparin, invert 8-10x, stand time 0, centrifuge 0, plasma |
| lavender/pink | edta, invert 8-10x, stand time 0, centrifuge 0, plasma |
| gray | sodium fluoride, invert 8-10x stand time 0, centrifuge 0, plasma |
| what is serum | the liquid portion with clotting factors removed |
| what types of test are run from a serum specimen | red/gold- chemistry |
| what is plasma | liquid portion of blood |
| what types of test are run from a plasma specimen | (green ,gray), (lav,pink), (blue)- chemistry, hematology, coagulation |
| how much blood do you need to draw to collect 2ml of serum? | 4ml |
| what is a separator tube? | separates cells/clots from plasma or serum |
| what does a separator tube contain | synthetic gel |
| why is it important to draw in the correct order | avoid contamination of additives |
| which would be drawn first; cbc or coagulation study | coagulation |
| whole blood specimens used for blood counts (RBC, WBC, etc.) should be refrigerated and tested with in | 72 hrs |
| what size needle is used on a child under 2yrs of age | 23g butterfly, dorsal hand |
| local anesthetic cream may be applied on a child before drawing blood. when should it be applied before the procedure | 1hr |
| when a pt is diabetic and a glucose test is required, which tube is used and what is the correct draw | gray first |
| cbc, rbc, platelet count, HgB, Hct | hematology, lavender, plasma |
| cholesterol, sodium chloride, potassium, electrolytes | chemistry, gold, serum |
| PT/NR | coagulation, light blue, plasma |
| why do we chart what we have done or not done | if its not in the chart it didn't happen |
| what info is recorded in the pt chart | date, time, what was done, site, what was done w/ the specimen |
| what info is recorded on the tube | pt name. DOB, date, time |
| in which types of situations would you choose to perform a syringe blood draw? | fragile veins, young child, suction might collapse vein, dehydrated pt, poor distention, elderly |
| how do you know you are "pulling" the blood at the correct speed? | no more than 1ml of head space |
| what might occur if you are "pulling" the blood to quickly | hemolysis |
| are these tubes sterile | yes |
| where are blood cultures in the order of draw | 1st |
| is the venipuncture procedure an aseptic or sterile procedure | aseptic |
| why is hand-hygiene important during venipuncture | reduce risk of transmitting infection |
| when are hands washed | before and after procedure |
| when are gloves worn | during actual VP - ok to palpate and prepare without gloves on |
| how do you make sure you have the correct patient | verify name and dob |
| what are appropriate communication to tell or ask your pt before beginning a procedure | ask permission to draw their blood, explain the procedure, ask if patient has a history of problems with blood draw |
| where should your supplies be during the procedure | on your non-dominate side |
| the median vein is most commonly used and is located | in the antecubital area |
| the basilic vein is located is avoided due to its proximity to the | brachial artery and median nerve |
| the best vein to draw blood from are those that you can | palpate |
| 70% alcohol should not be used for | blood cultures alcohol allergy blood alcohol test |
| what can happen if you perform the procedure before the alcohol is dry | hemolysis, stinging |
| what is the correct tourniquet placement | 3-4 inches above the elbow |
| the tourniquet should be released when | the last tube is 1/2 to 3/4 full |
| can the tourniquet be placed over clothing | yes |
| what are the complications of leaving a tourniquet on too long | hemoconcentration, altered test results, petechiae, pain, nerve damage, hemolysis |
| how long should you observe the vp site before applying the gauze and tape | 5 to 10 sec |
| what is the purpose of asking the patient to "pump and hold twice" | distend the vein with blood |
| what is SESIP | self sheathing retractacle needle |
| what do you do if the needle comes out | partially-push it back in; completely-stop procedure |
| what is frothing | blood come out so fast it froths or bubbles |
| what causes frothing | needle lumen too long, loose connection of equipment, removing the needle while tube still intact, tourniquet in tight |
| why is frothing avoided | hemolysis |
| what are possible causes of hematoma | excessive probing, failure to insert the needle far enough into the vein, needle goes through the vein |
| what is hemoconcentration | concentration of blood cells is increased in proportion to the plasma |
| how do u avoid this complication | don't leave tourniquet on longer than 1 min |
| what is hemolysis | breakdown of rbc release of hemogloblin from cell |
| how do you know when a specimen is hemolyzed ? | rosy color to bright red serum or plasma |
| what are petechiae | small pin-point hemorrhage in the skin |
| how do you avoid this complication | tourniquet is on too long or too tight |
| what would you do if you saw petechiae developing while drawing blood | loosen tourniquet and keep drawing |
| what to do if the antecubital space has been recently burned | choose another site because these areas are prone to infections |
| what must you consider when drawing blood from an obese pt | veins are deeper, difficult to palpate, deeper angle |
| what does it mean when your pt becomes nauseous during the procedure | talk through it, offer emesis basin, cool compress deep breaths |
| what must you consider with a pt with a history of fainting or become light-headed during venipuncture | lay them down for procedure |
| how do smelling salts work | ampule filled with ammonium carbonate |
| how are smelling salts applied | break ampule, wave it back n forth 4 inches under nostrils until regain consciousness |
| what must you consider with a pt taking anti-coagulant medication | bleeding is more likely and requires extended pressure |
| what causes collapsing veins | suction in tube is too great |
| your pt complains of a stinging sensation with the venipuncture procedure most likely cause | alcohol not dry |
| what is necessary prior to drawing blood specimens from the lower extremity | doctors order |
| list 3 ways you can cause nerve damage during the venipuncture procedure | wrong site excessive probing inserted too deeply |
| what percent of physicians base their treatment decisions on blood test | 80% |
| how does this apply to you | DO IT RIGHT !! |
Created by:
t4achange
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