Capillary Punctures
Capillary punctures are the preferred type of blood draws for which types of patients
- Infants & small children
- The elderly
- Obese patients
- Patients with severe burns
What is the preferred site for venipuncture?
Antecubital Fossa
Bonus:
When it comes to safety, what is the maximum depth allowed for said device?
A lancet
Bonus:
2mm
The gauge of a needle is referring to what?
The Bore size
Who has the authority to order a blood test?
A qualified healthcare practitioner
On an infant what is the preferred puncture site?
Bonus points for why
The outer edge of the heel.
Bonus:
The Calcaneous bone could be punctured resulting in an injury.
What 3 veins do you have to choose from in the Antecubital Fossa?
Bonus:
One of them should be a last resort. Which one is it and why should you avoid it?
- Median Cubital
- Cephalic
- Basilic
Bonus:
The Basilic Vein should be avoided if possible due to its closeness to the Brachial Artery and nerves
After you have properly greeted your patient and obtained informed consent. You set your tray down at the patient's bedside. Where should you place your tubes for your blood draw?
Next to your nondominant hand or on your nondominant side
Name the 4 parts of a needle
- Hub
- Shaft
- Bevel
- Safety device
What 2 patient identifier's are always required to be obtained by the phlebotomist before performing anything?
- Patient's Name
- Date of birth
You have received a requisition slip for a dermal puncture on a child. After gathering all of your equipment, you enter the patient's room and have greeted them. Before starting the procedure, who do you look to for informed consent?
The patient's legal guardian or parent
A properly applied tourniquet should be tight and placed 3-4 inches above where you intend to draw from. You should never leave a tourniquet on for long than 1 minute. What could occur if it is left on longer than the allowed time?
- Hemoconcentration
- Petechiae
You have completed your blood draw procedure and all of your tubes have been collected. Where should you place the label and why?
On top of the manufacturer's label so that the lab is able to see how much blood was collected
When is it appropriate to use a Butterfly Needle (Winged-Infusion Set)?
When your patient has small or fragile veins
In what case does a patient NOT have the right to refuse care?
If the patient is in police custody and has been court ordered to receive it
What conditions may result as a complication of a dermal puncture?
- Infection
- Osteochondritis
- Osteomyelitis
Many patients faint at the sight of blood. This is medically known as syncope, and should be charted as such. If this happens to your patient, what is the very first thing you should do?
Remove the tourniquet and needle
Assuming you have inserted the needle properly into the vein, you have inserted the evacuated tube and you realize that no blood is flowing into the tube. What might be the issue?
The tube has lost vacuum and you must discard it and use a new tube.
A syringe consists of a barrel and a plunger and is used with what two needle types?
- Hypodermic
- Butterfly
You have entered into your patient's room to perform a blood draw. After obtaining the patient's name and date of birth, you scan the patient's ID bracelet code, but the information in the system does not match the information your patient has provided. What should you do?
Immediately alert the nurse assigned to the patient of the problem
You have an elderly patient who has come in for a dermal puncture. After reviewing the requisition slip, you know that capillary tubes are required. What is the correct Order of Draw?
- Lavender or Pink (EDTA)
- Green or Light Green (Heparin)
- Gray (Sodium Fluoride)
- Red or Gold (Nonadditive or Serum Separator)
What is the correct Order of Draw?
- Yellow (SPS)
- Light Blue (Sodium Citrate)
- Red (plastic: nonadditive glass: clot activator)
- Gold or Red/Black {tiger top} (clot activator and gel separator)
- Green (Heparin)
- Purple or Lavender (EDTA)
- Pink (EDTA)
- Gray (Sodium Fluoride and Potassium Oxalate)
Some tubes are amber in color. Why?
To protect specimens from light exposure
- Multi-sample
- Hypodermic
- Winged-Infusion set (Butterfly)
Your patient is coming in to have blood drawn for a blood glucose test that requires the patient to have been fasting. You learn from the patient that they did not follow the fast and had breakfast before coming in. What should you do?
Inform the patient's Dr that they did not follow instructions and ask how they would like to proceed