Term
It is unlikely that misidentifying a patient specimen would result in |
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Definition
No reprimand if no one was hurt |
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Term
Basic step to minimize any trauma associated with a venipuncture |
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Definition
Choose the most skilled phlebotomist available to perform the venipuncture |
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Term
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Definition
Thread part of the needle within the lumen |
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Term
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Definition
Draw it at the best time for accurate results |
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Term
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Definition
Blood cultures, Cardiac enzymes, and Cortisol |
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Term
Unique number assigned to a specimen request |
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Definition
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Term
Individual who has legal authority to authorize patient testing |
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Definition
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Term
Test recquisition info must include |
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Definition
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Term
Info represented by patient ID band typically include |
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Definition
Medical record number and name |
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Term
Inpatient recquisitions are sorted by |
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Definition
Collection priority, date and time, and patient location |
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Term
Steps taken to unmistakably connect a specimen and the accompanying paperwork |
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Definition
Accessioning the specimen |
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Term
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Definition
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Term
Test commonly ordered stat |
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Definition
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Term
When test is ordered ASAP |
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Definition
Results are needed soon for an appropriate response |
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Term
Tests are classified as routine if they are ordered |
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Definition
In the course of establishing a diagnosis |
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Term
Test commonly ordered fasting |
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Definition
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Term
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Definition
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Term
Patient says, OK, but I would rather not |
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Definition
Determine what the problem is and get the patients permission before proceeding |
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Term
Test used to identify protein disorders that lead to nerve damage |
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Definition
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Term
In collecting from an unconscious patient |
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Definition
Move the patient to a special phlebotomy collection area |
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Term
Misidentification of specimen for this test will have fatal consequences |
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Definition
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Term
Recquisition info must match info on patient's band |
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Definition
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Term
System of choice to identify lab specimens from unconscious patient in ER |
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Definition
Use a three-part identification band with special tube labels |
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Term
Inpatient most likely to have more than one ID band |
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Definition
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Term
Patient least likely to need their identity confirmed by nurse |
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Definition
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Term
Part of informed consent for specimen collection |
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Definition
Informing the patient you are a student |
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Term
Proper arm position for routine veil-puncture |
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Definition
Downward in a straight line from shoulder to wrist, palm up |
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Term
Action prohibited during the vein selection process |
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Definition
Patient pumping their fist |
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Term
How to tell a vein from an artery |
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Definition
Artery has a distinct pulse |
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Term
Sclerosed vein feels like |
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Definition
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Term
Will help you to avoid puncturing and artery |
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Definition
Avoid drawing basilic vein in antecubital area
Do not select a site near a pulse
Do not select a site that overlies or close to an artery
ALL OF THE ABOVE |
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Term
Patient with IV in left wrist and dermatitis all over right arm and hand |
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Definition
Apply a tourniquet on right arm over a towel and draw |
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Term
Best thing to do if the vein can be felt but not seen, even with tourniquet on |
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Definition
Look for visual cues on the skin to remind you where the vein is |
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Term
Correct order of steps for venipuncture |
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Definition
Clean the site, prepare equipment, put on gloves, apply tourniquet |
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Term
Analytes least affected by prolonged tourniquet application |
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Definition
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Term
Important to mix anticoagulation tubes immediatiely after filling them |
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Definition
Avoid microclot formation |
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Term
How many times do you mix a non-additive tube |
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Definition
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Term
Use several layers of gauze when removing needle |
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Definition
Pressure is adequete and bruising is prevented |
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Term
Applying pressure on the gauze as the needle is removed can cause |
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Definition
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Term
Specimen requiring routine handling |
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Definition
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Term
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Definition
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Term
Specimen hemolysis can result from |
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Definition
Using a large-volume tube with a 23-gauge needle |
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Term
Success of pediatric blood collection most dependent on |
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Definition
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Term
Least effective way to immobilize a pediatric patient |
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Definition
Allowing child to sit with one arm bracing the other |
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Term
Drawing patient from older child, most important thing |
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Definition
Explaining the importance of holding still |
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Term
Diabetic patient had mastectomy on right arm and cannot straighten left arm from arthritis |
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Definition
Left forearm or hand, using butterfly |
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Term
Proper procedure when dealing with an elderly adult patient |
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Definition
Refrain from drawing if you have a cold, or wear a mask |
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Term
Most common reason a patient undergoes dialysis |
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Definition
End stage of renal disease |
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Term
According to CLSI, it is not necessary to attempt to locate median cubital in both arms before considering alternative location |
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Definition
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Term
Patients need to understand the procedure before giving informed consent |
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Definition
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Term
Once a patient consents to a procedure they can not change their mind |
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Definition
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Term
When properly anchoring a vein |
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Definition
Thumb is 1 to 2 in. below the intended site and is pulling the skin toward the wrist |
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Term
Action unlikely to help a phleb gain patient trust |
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Definition
Collecting specimen before requested time |
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Term
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Definition
Intense fear of needles and being stuck |
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Term
Symptoms of needle phobia |
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Definition
Arrythmia
Fainting
Light-headedness
ALL OF THE ABOVE |
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Term
Proper use of hand sanitizer |
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Definition
Allowing the alcohol to evaporate completely
Rubbing it in between and around the fingers
Using a very generous amount of sanitizer
ALL OF THE ABOVE |
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Term
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Definition
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Term
Needle insertion should be performed |
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Definition
Using a smooth, steady motion forward |
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Term
Going without food or drink except water for 8-12 hours |
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Definition
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Term
Test ordered "fasting" to |
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Definition
Eliminate effects of diet on test results |
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Term
Bending arm up to apply pressure to the site has not been shown to |
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Definition
Enable the site to quickly stop bleeding after needle removal |
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Term
Failure of patient to to follow required diet restrictions before specimen colelction could lead to |
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Definition
Compromised patient care and treatment
Erroneous and meaningless test results
Misinterpreted test results by the physician
ALL OF THE ABOVE |
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Term
Type of recquisition often serves as a test request, report, and billing form |
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Definition
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Term
Outpatient recquisitions are typically of this type |
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Definition
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Term
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Definition
Collected immediately, without any hesitation |
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Term
If test ordered stat, could mean patient is in |
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Definition
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Term
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Definition
Will soon be going to surgery |
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Term
|
Definition
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Term
|
Definition
Cannot have any food or drink |
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Term
Liquid acceptable to drink when fasting |
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Definition
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Term
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Definition
Knock lightly, open door slowly, and ask whether it is all right to enter |
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Term
Patient door reads "No blood pressure or venipuncture right arm" |
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Definition
Collect specimen from left hand by finger puncture |
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Term
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Definition
Convey important information without alarming the public
Transmit messages over the facility's public system
Use numbers or words to represent important info
ALL OF THE ABOVE |
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Term
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Definition
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Term
Inpatient asleep when arrive |
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Definition
Call out patient's name softly and shake bed gently |
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Term
Lab results negatively affected if phleb |
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Definition
While preparing specimen, startles a patient who is asleep |
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Term
Physician is with patient and specimen ordered stat |
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Definition
Introduce yourself and ask permission to draw specimen |
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Term
Family or visitors with a patient |
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Definition
Ask them to wait outside of room until finished |
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Term
Patient out of room and not available for several hours for timed specimen |
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Definition
Fill out delay slip stating unable to collect specimen |
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Term
How to verify patient in 302B is John Doe |
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Definition
Ask him for his name and DOB and match it to recquisition |
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Term
ID number matches but name is spelled differently |
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Definition
Do not collect specimen until difference is resolved |
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Term
Unconscious inpatient has no ID band |
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Definition
Do not start any procedure until nurse attaches ID bracelet |
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Term
Most critical error phleb could make |
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Definition
Misidentify patient's specimen |
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Term
Patient not wearing ID band and its taped to nightstand |
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Definition
Ask patient's nurse to attach ID band and proceed when attached |
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Term
Woman only patient in waiting room |
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Definition
Ask her to state her complete name and DOB to confirm identity |
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Term
Cheerful, pleasant bedside manner and exchange of small talk unlikely to |
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Definition
Keep the patient from fainting during the venipuncture procedure |
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Term
Patient is cranky and rude |
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Definition
Be as professional as you can and collect specimen in normal way |
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Term
Patient asks if test you are drawing is for diabetes |
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Definition
Explain it is best to discuss the test with the physician |
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Term
Inpatient vehementely refuses to allow you to collect |
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Definition
Notify patient's nurse and document patient's refusal |
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Term
Arrive to draw fasting specimen and patient just finished breakfast |
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Definition
Check with nurse to see if it should be drawn or rescheduled |
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Term
If you assemble equipment after selecting and cleand site |
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Definition
Be more apt to allow alcohol to dry
Have better idea of what equipment to use
Waste less equipment by knowing exactly what is needed
ALL OF THE ABOVE |
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Term
When performing venipuncture, hand decontamination is required |
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Definition
Before and after each patient |
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Term
Hands visibly contaminated |
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Definition
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Term
Collect on 6 year old and child is fearful |
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Definition
Explain what you are going to do to the child in simple terms |
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Term
Patient asks if procedure will hurt |
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Definition
Might hurt just a little, but only for a short time |
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Term
Outpatients who have previously fainted |
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Definition
Asked to lie down, or sit in a reclining chair |
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Term
Can lead to liabiity issues |
|
Definition
Lowering a bed rail to make access to patient's arm easier |
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Term
Never leave tourniquet on more than |
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Definition
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|
Term
Best place to apply tourniquet |
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Definition
3-4 in. above venipuncture site |
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Term
|
Definition
Arterial flow below it may be stopped
Blood below it may hemoconcentrate
Pressure can cause the arm to ache
ALL OF THE ABOVE |
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Term
Acceptable to use ankle vein |
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Definition
Physician gives permission |
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Term
Release tourniquet as soon as blood flow established |
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Definition
Decrease hemoconcentration of specimen |
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Term
CLSI way to clean venipuncture site |
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Definition
Cleanse with circular motion from center to periphery |
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Term
Least important reason to wait 30 seconds for alcohol to dry |
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Definition
Allow phleb time to prepare equipment and supplies |
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Term
Advanced tube past guideline on holder before needle insertion |
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Definition
Tube will fail to fill with blood because of vacuum loss |
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Term
Visual inspection of needle unable to detect |
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Definition
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Term
Touch needle to skin but change your mind and pull away |
|
Definition
Stop and obtain a new needle before trying again |
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Term
Best angle to use for needle insertion |
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Definition
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Term
|
Definition
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|
Term
How to tell needle is in vein |
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Definition
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|
Term
Best time to release tourniquet |
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Definition
As soon as blood begins to flow into tube |
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Term
Improper specimen collection technique |
|
Definition
Position arm so tubes fill stopper end first |
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Term
Important to fill anticoagulant tubes to proper level |
|
Definition
Proper ratio of blood to anticoagulant additive |
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Term
Filled EDTA before green-top |
|
Definition
Draw several milliliters into discard tube, then fill green |
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Term
|
Definition
|
|
Term
|
Definition
Cotton balls may pull platelet plug away from site |
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Term
Needle safety feature, other than blunting needle |
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Definition
Immediately after needle is withdrawn |
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Term
Right venipuncture procedure order |
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Definition
Establish blood flow, release tourniquet, fill and mix tubes, remove needle |
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Term
Proper needle disposal involves |
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Definition
Disposing of needle and tube holder in sharps container as one unit |
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Term
Label of routine specimens should take place |
|
Definition
At the bedside immediately after collection |
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Term
Information on specimen label considered optional |
|
Definition
Patient room number and bed |
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Term
Patient's ID number included on tube to |
|
Definition
Avoid confusing specimens from patients with same name |
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Term
Information unnecessary to be given after venipuncture |
|
Definition
Do not drink or eat for 2 hours after collection |
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Term
Not a valid reason for failure to obtain blood |
|
Definition
Didn't have right equipment on tray |
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Term
Made two unseccessful attempts to collect |
|
Definition
Ask another phleb to collect fasting specimen |
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|
Term
Where tourniquet applied when drawing hand |
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Definition
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|
Term
Advantage of using butterfly |
|
Definition
Butterflies make it easier to draw difficult veins |
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Term
May be necessary to use syringe when |
|
Definition
Patient's veins are very fragile |
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Term
How to tell when in a vein using a syringe |
|
Definition
A "flash" of blood will appear |
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Term
Doing this before obtaining blood from child is bad idea |
|
Definition
Telling the child it will not hurt |
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Term
Butterfly and 23-gauge needle best choice for young child |
|
Definition
Flexible tubing allows for arm movement |
|
|
Term
Transferring blood from syringe to evacuated tubes |
|
Definition
Use specially designed engineering device called syringe transfer device |
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|
Term
Criteria do decide which gauge needle to use |
|
Definition
Size and condition of vein |
|
|
Term
|
Definition
As soon as it is removed from tube holder |
|
|
Term
Tremors associated with this disease can make collection difficult |
|
Definition
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|
Term
Care for patients who are terminally ill |
|
Definition
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|
Term
Always ask patient to state their name, never offer name |
|
Definition
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|
Term
Never verify patient's identity from ID band they're not wearing |
|
Definition
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|
Term
Phleb that lowers bed rail is responsible if patient falls out of bed |
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Definition
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|
Term
Veins on underside of wrist are ideal location |
|
Definition
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|
Term
Once cap is removed, do not allow needle to touch anything, otherwise it will become contaminated |
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Definition
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|
Term
Butterfly is inserted at 30 degree angle |
|
Definition
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|
Term
ETS is inserted at 10 degree angle |
|
Definition
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|
Term
If patient does not stop bleeding after 5 minutes, phleb should consult with nurse |
|
Definition
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|
Term
Studies show bending an arm after venipuncture in antecubital area increases chance of bruising |
|
Definition
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|
Term
If tube holder not securely anchored, needle can push through back of vein or pull out |
|
Definition
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|
Term
Once site has been decontaminated it is ok to repalpate the area before inserting needle |
|
Definition
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|
Term
Site is cleaned forming concentric circles outward working inward |
|
Definition
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|
Term
Dialysis patient most likely to have an Arteriovenous fistula or graft |
|
Definition
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|
Term
Labeling of tubes can be done back at nurse's station |
|
Definition
|
|