reaction to venipuncture
Which common immediate patient sensation during venipuncture is described simply as discomfort at the puncture site and is the most frequent reaction reported?
What is pain?
What term describes serum that appears milky white due to high lipid content?
What is lipemic?
When drawing from an indwelling line, why is the first tube usually discarded?
What is To remove possible contamination from heparin or saline and obtain an uncontaminated specimen?
What is the visible pooling of blood under the skin near the venipuncture site called?
What is hematoma?
Which fingers are appropriate to puncture for capillary sticks?
what are 3rd and 4th?
Name the patient reaction characterized by a sudden loss of consciousness, often preceded by lightheadedness, nausea, or sweating
What is Syncope (fainting)?
Define "hemolysis" in the context of blood specimens.
What is the rupture or destruction of red blood cells releasing hemoglobin into the serum or plasma?
Which tube type (by additive) is most commonly drawn after blood culture bottles in routine venipuncture following standard order-of-draw principles?
what is typically sodium citrate tube ?
List two common causes of hemolysis during specimen collection.
causes: rough handling, shaking, excessive suction/strong plunger pressure, alcohol left on skin, small gauge needle with excessive force,
What is the normal range for blood sugar in capillary puncture?
what is 70-110mg/dl?
What is the recommended first action if a seated patient faints during venipuncture?
What is recline or lower the patient to a supine or trendelenberg position and call for help
What is icteric serum, and what clinical condition most commonly causes it?
what is dark yellow to orange serum caused by high bilirubin/jaundice?
Explain one reason why drawing too quickly from a healthy vein can cause the vein to collapse
Rapid negative pressure can collapse the vein by flattening it's walls and stopping the flow
A patient undergoing a fasting blood draw who is diabetic becomes unresponsive and pale. What is the most likely cause and immediate first aid action?
likely hypoglycemia, give oral glucose if patient is alert, if unconscious, follow emergency protocol and call 911
Which lab sample should be collected first?
What is a STAT specimen?
For a patient on anticoagulant therapy who bleeds longer than expected after venipuncture, what is the appropriate pressure-duration guideline?
What is apply firm pressure until the bleeding stops,for patients on anticoagulants, maintain pressure longer than usual (at least until bleeding stops, longer than standard 5 minutes as clinically needed)
Explain what is meant by a “collapsed vein” and one common cause during blood collection
what is loss of vein integrity/volume often from excessive vacuum or fragile vessel walls leading to vein walls sticking together. Causes: excessive suction or repeated sticks
— A patient requires coagulation studies and a chemistry panel. State the correct order for collecting a sodium citrate tube and a serum tube with clot activator.
what is citrate tube then serum tube? (blue then serum)
Which complication involves absence of pulse and requires immediate CPR, and how does it differ from simple syncope?
what is cardiac arrest? and it differs from syncope in that there is no pulse/circulation in cardiac arrest
What is the type of anemia that is a drop in red blood cells, hemoglobin and hematicrit caused directly by medical care through frequent or large volume blood draws?
What is iatrogenic anemia?
A patient becomes nauseated and is about to vomit during a draw. List three immediate steps the phlebotomist should take to care for the patient and protect the specimen integrity.
What is 1) provide emesis basin and tissues and protect surfaces, pt clothing 2) apply cold compress to forehead and neck as appropriate 3) instruct slow deep breaths and if symptoms persist, stop procedure and maintain safety
Define “hematoma” and distinguish it from external bleeding.
What is. Hematoma: collection of blood outside the vessel into the surrounding tissue; differs from external bleeding which is blood exiting the body surface
Describe how contamination from an IV infusion could alter test results and one procedural step to reduce that risk when possible.
Iv fluid can dilute or contaminate the electrolyte value of the specimen
To reduce risk, draw from the opposite arm when possible or stop the infusion and wait the appropriate time per policy
For a patient with known fragile, collapsing veins, list three alternative strategies or devices that increase the chance of a successful and safe blood draw.
Use a syringe with gentle aspiration, use a butterfly set with smaller tubes, consider capillary collection when appropriate, warm the site, use smaller needles
You have orders to draw a Blood Culture, CBC, PT, Chemistry and blood glucose. Place the tubes in order
Blood Culture, sodium citrate (light blue), sodium heparin (green), EDTA (purple) and grey (potassium oxalate)