Heme 1 -- Chapter 26 Blood Collection Test Review
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each of the black spaces below before clicking
on it to display the answer.
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| What is the first thing you do before drawing a Pt's blood? | Identify the Pt using two identifiers (Name and DOB or last 4 of ssn)
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| What is the purpose of using a tourniquet? | Constriction of blood flow to engorge the vein as well as anchor the vein
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| Where is the tourniquet placed? | 2-4" above the venipuncture site
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| Why is it important to not leave a tourniquet on for longer than one minute? | Longer than one minute can cause hemolysis (destruction of blood); can lead to erroneous test results
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| What area of the arm is our primary focus for venipuncture? | The antecubital space of the inner arm (inner crease)
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| What veins in the antecubital space should we palpate for? | 1. Median Cubital (most accessible); 2. Cephalic (thumb side); 3. Basilic (medial/pinkie side)
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| What other sites can the MA perfom venipuncture if the antecubital space is not available? | 1. Wrist (can be difficult due to tendons/ligaments and Pt discomfort); 2. Foot (not ideal due to potential for interstitial fluid interfering with results -- must document this location)
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| What does it mean to palpate and track a vein? | Tapping for a vein followed by tracking to determine angle of needle insertion
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| What should be facing upward on the needle for proper blood draw? | Bevel should always be facing upward and needle should be inserted swiftly and accurately
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| How long should pressure be applied after needle is removed? | Minimum of 30 seconds, to ensure hemostasis (bleeding stops). Arm should remain straight. If these steps are followed you should not see a hematoma (bruise/ecchymosis)
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| When would we use a syringe for venipuncture? | For a patient with tiny veins or potential for collapsing veins
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| When would we use a straight needle for venipuncture? | For faster procedures
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| When would we use a butterfly (also known as winged infusion)? | When precision is needed; small veins such as in the hand
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| What is important about the gauge of the needle? | The smaller the gauge -- the larger the needle. Also note, the larger the vein -- the larger the needle.
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| Venipuncture needle sizes and colors(4): | 21 -- Green (adults); 22 -- Black (adults); 23 Lt. Blue (pediatrics); 25 -- Royal Blue (infants) *colors can vary based on manufacturer*
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| In what order should we draw tubes? | Always draw non-additive tubes prior to additives to ensure no cross-contamination and erroneous test results
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| What must be included on tube labels? | Pt name; Pt DOB; Date/Time of draw; MA's initials
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| What must accompany every sample sent out to a laboratory? | Requisition form
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| Does a Pt have the right to refuse testing/TX? | Pt always has the right to refuse but the MA's job is to gently persuade the Pt as to the necessity of such testing/TX
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| What angle should the needle enter a vein for venipuncture? | 15° - 30° angle
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| Where do we puncture for a capillary blood test? | Pads of the 3rd and 4th fingers; against the grain of the finger print and never to the extreme lateral site of the fingers
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| Is it acceptable for an MA to draw blood from a port or fistula? | MA's should never touch a port or fistula
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| What position should the Pt be in for venipuncture? | Sitting upright in a sturdy chair (no wheels); feet firmly planted on the ground with arm of choice fully extended (straight) with opposite fist placed below elbow for additional support. Never allow Pt to be standing.
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| How should the site be cleaned prior to venipuncture? | Swab site with 70% alcohol in concentric circles working outward; always allow to air dry (never blow on or fan dry)
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| What is the bore or lumen of the needle? | Hole in the needle that allows blood to flow from vein to tube
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| Areas to be avoided during venipuncture site selection: | Scars; side with mastectomy; hematoma; IV therapy/blood transfusions; lines; fistulas; edamatous extremeties
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