what sites should be avoided when performing venipuncture quizlet12 Jun what sites should be avoided when performing venipuncture quizlet

17. Foot veins are a last resort because of the higher probability of complications. 14. List five circumstances that would lead to recollection or rejection of a microcollection sample. However, if there is no alternative and an arm with an IV line in place must be used for venipuncture, try to choose a site away from and below the location of the IV. 2. Uni- versal precautions should be observed at all times to protect the patient and health care provider. Green B. Yellow C. Red D. Blue D 11. This preliminary action allows you to safely adjust the needle's position. Document that the venipuncture was performed distal to (below) an infusion site. Thus, 56% of all procedures in the neonatal unit are performed using capillary blood samples, making it the most frequent invasive procedure performed . 4- apply pressure to the venipuncture site to prevent hemolysis what should you do ? Hematoma - A venipuncture should not be performed on a hematoma, regardless of how small it may be. Perform venipuncture using the correct order of draw. 11. 12. A key element for successful venipuncture is choosing the best vein. Using an improperly attached needle on a syringe so that frothing occurs as the blood enters the syringe. Gather Equipment 4. • The alcohol must be allowed to air dry for approximately one minute prior to venipuncture to properly disinfect site, prevent hemolysis of the specimen, and avoid Thus, most students found it appropriate to perform venipuncture in the hand, which is a skill taught during in-class instruction in some of the health science programs. A 25-gauge needle is recommended for performing . Using a needle with too small diameter (above 23 gauge) 2. Talk now. Unsafe phlebotomy can cause adverse effects for patients; such effects are rare, but range from pain or bruising at the site of puncture, to fainting, nerve damage and haematoma. Veins in the legs and feet should only be used with physician approval and can only be drawn by a RN or appropriately trained personnel; training must be documented…. Using a small needle with a large evacuated tube. Question 4. 15. When collecting a blood specimen using the vacuum tube method of venipuncture, venous reflux is prevented by: make the patient's veins more visible and easier to palpate. • Serum tubes should be centrifuged in a timely manner according to protocol. Also avoid performing venipuncture in an extremity with an actual or a planned fistula access or one affected by stroke, injury, or deformity. The cephalic, median cubital and basilic veins are the three most common arm veins used in phlebotomy. Inspect the needle and other equipment. Several veins in the antecubital fossa provide excellent access. Unscrew the needle directly into a puncture-proof container. Don't probe for a vein. Perform the venipuncture. Extensive scarring or healed burn areas should be avoided; Specimens should not be obtained from the arm on the same side as a mastectomy. It's a minimally invasive way to collect blood cells and plasma, the liquid component of blood, for analysis. Wear gloves, be sure patient is laying down while taking blood ARTERY A blood vessel that carries blood from the heart to the capillaries CEPHALIC VEIN A superficial vein of the arm commonly used for venipuncture GAUGE A measure of the diameter of a needle VENIPUNCTURE SITE SELECTION: Although the larger and fuller median cubital and cephalic veins of the arm are used most frequently, the basilic vein on the dorsum of the arm or dorsal hand veins are also acceptable for venipuncture. This causes patient discomfort. Sites to avoid: Extensive scarring from burns or surgery The upper extremity on the side that a mastectomy was performed. Why is 70% alcohol allowed to dry on the venipuncture site? antecubital fossa What are the best veins for venipuncture? Observe Hand Hygiene Procedures 3. 2. cannula insertion. 12). 16. Additional Considerations: Hemolysis: To prevent hemolysis when performing a venipuncture: • Mix anticoagulated specimens thoroughly by inverting tube gently 5 to 10 times. -obvious skin infection (including newly tattooed areas) -extensive scarring -don't use same side as mastectomy -avoid previous hematoma -avoid arm w/ fistula/cannula -edamtous extremity What is the most common site for blood sampling? Position the patient's arm in a comfortable extended position that provides adequate access to the planned cannulation site. Obtaining blood by skin puncture instead of venipuncture can be especially important in pediatric patients in order to avoid the effects of blood volume reduction and reduce the risk of anemia . 19. Back the needle out until the bevel is just below the skin. Don't use the dorsum of the hand, the wrist, fingers, antecubital fossa, or other areas of flexion; previously damaged areas; or areas with compromised circulation. Site Selection and Vein Dilation Vein dilation techniques Catheterization or Catheter Insertion 1. 14). and the adapter. The device used to hold the tube during venipuncture is known as: the tube holder, the barrel. Palpate the vein you have identified to assess if it is suitable: Tapping the vein and asking the patient to repeatedly clench their fist can make the vein easier to visualise and palpate. Apply the tourniquet approximately 4-5 finger-widths above the planned venepuncture site. Draw up appropriate units from NPH very carefully as you can not return excess if too . Click to see full answer. 1. Avoid areas of hematoma. carries out hand hygiene, applies gloves, and informs the patient about the procedure. 9. Perform venipuncture using the following steps: Place your thumb BELOW the venipuncture site to anchor the vein. Ear lobe - The ear lobe has been used for capillary blood sampling, but . 8. The e-module mainly focuses on venipuncture at the antecubital fossa and students were instructed to find any appropriate site during their psychomotor skill testing. 7. The needle may go through the vein by puncturing the posterior wall. Main vein sites used by nurses veins of the extremities, arms are most commonly used. Patient Assessment and Psychological Preparation Patient Information to Consider 5. A. However, if there is no alternative and an arm with an IV line in place must be used for venipuncture, try to choose a site away from and below the location of the IV. Dry the cleaned area with a dry gauze pad. To become truly proficient in venipuncture techniques, you must. Please mark the location of the antecubital fossa: A. 5. 13. Part 1Redirecting the Needle. • Avoid drawing blood from a hematoma. The purpose of applying a tourniquet when performing venipuncture is to: placing the tourniquet 3-4 inches above the bend . Describe the action which should be taken prior to deciding on whether or not to use the veins in a patient's feet or ankles. Draw 5 ml of blood and discard before drawing the specimen tubes for testing. All who perform phlebotomy on the youngest patients must master a delicate balance of technique and compassion. Pre-Catheterization or Preparation 1. Review Physician's Order 2. Ensure the patient's hand is open. The veins of a patient are the main source The purpose of applying a tourniquet when performing venipuncture is to make the patient's veins stand out. 10. A. wiping away the fi rst drop of blood. The most commonly used site for a venipuncture is at the bend of the elbow, also called the antecubital fossa 1. Venipuncture STUDY PLAY Before performing venipuncture the nurse. Choose a vein, other than the vein with the IV. 17 . keeping the patient's arm in a downward position. Alternative sites for venipuncture include cephalic vein and saphenous vein. 1 Answer to When performing venipuncture you should always: A. enter the vein with the bevel of the needle placed downward. In most circles, the terms venipuncture and phlebotomy are used interchangeably. D. all of the above. Select the vein site. Choosing an appropriate site for venipuncture is crucial for a successful . B. occasionally wiping the site with a plain gauze pad to avoid the buildup of platelets. To assess your expertise, consider downloading . Outline steps for successful I.V. 3. Hold the baby's foot firmly to avoid sudden movement. State the reason for warming the site for performing a skin puncture site. Release and remove the tourniquet. 7. 6. Proper Procedure for Drawing Beneath an IV. Remember -- the first vein found is not always the best vein. Venipuncture (sometimes referred to as venapuncture, venepuncture or even venu puncture) is the collection of blood from a vein which is usually done for laboratory testing. Place the gauze pad over the puncture site. Potential effects of unsafe phlebotomy. Avoid venipuncture on the side of breast surgery with axillary node dissection, after radiation therapy to that side, or with lymphedema. 5. Prewarming the infant's heel (42° C for 3 to 5 minutes) is important to increase the flow of blood for collection. avoid using a tourniquet. Notes. Describe four acceptable methods for warming the skin puncture site. Cephalic vein Shown in both forearm and arm, it can be followed proximally where it empties into the axillary vein. Errors in performing venipuncture that may cause hemolysis: 1. The alcohol must be allowed to air dry for approximately one minute prior to venipuncture to properly disinfect site, prevent hemolysis of the specimen, and avoid discomfort for the . Apply the tourniquet approximately 4-5 finger-widths . Therefore, an arm containing an IV should not be used to draw blood specimens if it can be avoided. Venepuncture should be performed with care. Avoid venipuncture on the side of breast surgery with axillary node dissection, after radiation therapy to that side, or with lymphedema. The needle should then be removed from the jugular vein. State the special precautions which should be taken when performing venipuncture on veins of the hands, The blood is normally drawn from a vein on the top of the hand or from the inside of the elbow. • This technique pushes the bacteria away from the inside of the venipuncture site to the outside. 9.The needle is moved after inserting it. 15). 1- mix the tubes with anticoagulant additive gently 5-10 x 2- avoid drawing blood from a hematoma 3- avoid drawing the plunger back too forcefully, if using a needle and syringe, avoid frothing the sample 4- make sure the venipuncture site is dry The line must be flushed first. The median cubital vein, a superficial vein that forms a connection point between the cephalic and basilic veins of the arm is large, and therefore easier to see and feel. C. use impermeable bedding material that keeps moisture near the skin. Gloves should always be worn when obtaining blood specimens. An ideal vein feels 'springy'. The needle may enter above the vein, preventing puncture. C. recap used needles to avoid accidental needle punctures. Choose the best method for needle disposal. When performing a venipuncture on a patient with thin, fragile veins, the safest option is to use a winged infusion set with a syringe rather than an evacuated tube, as . Wash your hands, and put gloves on. Common causes of hematomas that form during a venipuncture include: A. excessive probing with the needle B. the needle is only partially in the vein C. the needle has penetrated all the way through the vein D. Both A and B C A sharps container is identified by its bright ____ color A. Perform venepuncture using a smooth, clean entry with the needle, as described in step 6 of Section 2.2.3. At no time may phlebotomists perform venipuncture on an artery. The alcohol must be allowed to air dry for approximately one minute prior to venipuncture to properly disinfect site, prevent hemolysis of the specimen, and avoid discomfort for the . the 3 rd (middle) or 4 th (ring) finger of the hand. LymphedemaPrevention: Mastectomies performed for cancer rx usually include removal of some of the axillary (armpit) lymph nodes; this puts one at risk for chronic arm swelling called lymphedema; the more nodes removed, the higher the risk. Pulling the plunger of a syringe back too fast. It is not recommended that blood be drawn from the feet .The Providers permission is required to draw from this site. c. practice on anatomic training arms. These sites are more susceptible to infection and formation of clots, particularly in patients with diabetes, coagulation disorders and cardiac . 11). Therefore, an arm containing an IV should not be used to draw blood specimens if it can be avoided. 8.An angle of more than 15 degrees is used when performing venipuncture. 1. . Inspect the patient's arm for an appropriate venepuncture site: The median cubital vein in the antecubital fossa is commonly used for venepuncture. When performing a venipuncture on an infant, the amount of blood taken from the infant should be monitored to avoid. The puncture is done on the farthest lateral or medial aspect of the plantar surface of the heel, not on the bottom. An understanding of human anatomy (the location of nerves adjacent to veins) and the ability to successfully enter a vein using the fewest number Know-How Skin Puncture vs. Venipuncture pg. Don your gloves 3. The sides and the tip of the. Areas in which two veins join should be avoided where possible, as valves are often present. Blood culture is a microbiological procedure where a blood sample is placed . B. avoid turning or moving the animals too much. List three alternative sites that may be used when veins cannot be located in the antecubital fossa area 8. Common Venipuncture Sites: 13. The bend of the elbow, the front of the arm. Ask the patient's nurse to turn off the IV for about two minutes prior to the venipuncture procedure. Users of these guidelines should read Chapters 2 and 3 before reading the information given below. Which of the following is the most likely result? Also avoid performing venipuncture in an extremity with an actual or a planned fistula access or one affected by stroke, injury, or deformity. a . 8. However, some sites must be avoided due to the risk of complications and/or unnecessary pain to the patient. • The alcohol should be applied using a circular target motion. This chapter covers background information (Section 5.1), practical guidance (Section 5.2) and illustrations (Section 5.3) relevant to arterial blood sampling. anemia. Assess the patient for such . First draw up air equal to number of units and inject into NPH vial, repeat for Reg insulin vial. Routine Venipuncture. These sites are more susceptible to infection and formation of clots, particularly in patients with diabetes, coagulation disorders and cardiac problems. To determine the best vein, use both sight and touch. VENIPUNCTURE SITE SELECTION: Although the larger and fuller median cubital and cephalic veins of the arm are used most frequently, the basilic vein on the dorsum of the arm or dorsal hand veins are also acceptable for venipuncture. B. enter the vein with the needle at a 45 angle. What sites should be avoided when drawing blood? V. Variations Alternatives for venipuncture include drawing blood into a syringe in lieu of a vacutainer system. 2 Know-How Whether you are performing a skin puncture or a venipuncture, some of the more challenging patients to draw blood from are children. The bend of the elbow, back of the arm. The most common needle gauge used for venipuncture is ___________. Punctures done on the plantar surface can damage cartilage or bone. 3. Be sure not to touch the venipuncture site or you will need to repeat the cleaning process. B. Needle Selection 2. Identify nursing interventions for postvenipuncture care. Select the proper approved lancet: The BD Microtainer Contact-Activated. a. attend instructional classes. Step 6: Draw Blood. Cleanse the venipuncture site. . Certain other sites should also be avoided. Wait 2 minutes before . Select the venipuncture site carefully, using a distal vein so you can perform successive proximal venipunctures if necessary. Areas in which two veins join should be avoided where possible, as valves are often present. The information given here supplements that given in Chapters 2 and 3. b. perform many procedures on real patients. 7.An angle of less than 15 degrees is used when performing venipuncture. What precautions should you take when performing a venipuncture to avoid exposure to blood? 3. The CLSI standards recommend cleansing the site with friction using a clean gauze pad with 70% isopropyl alcohol solution or a commercially prepared alcohol pad. Areas of broken, bruised or erythematous skin should be avoided. Avoid vigorous shaking. Common Venipuncture Sites: 13. The donation sites should be organized in a way that ensures the safety of blood donors, staff and donated blood units, and avoids errors in the blood donation process. (See picture.) Which one of the following steps would a veterinary assistant perform during venipuncture of the cephalic vein? Have the patient ball up their hand (form a fist). 10. Before beginning any procedure, identify the patient accurately [3]. Abdomen is site for most rapid absorption 3. keep candy and sugar available at all times 1. While performing a venipuncture, the medical assistant removes the filled tubes, but forgets to remove the tourniquet prior to needle withdrawal. Areas that should be avoided for venipuncture include all of the following EXCEPT: a. hematomas b. deep cephalic veins c. edematous tissue d. tattoos Step-by-step solution Step 1 of 4 The hematoma's presence specifies that within the tissue the blood has accrued surrounding the vein in the process of venipuncture. D. remove the tourniquet before removing the needle from the puncture site. 3.1. When using a syringe inserted into the line, blood must be withdrawn slowly to avoid hemolysis. Foot veins are a last resort because of the higher probability of complications. The ideal sites for venipuncture are typically in the cubital fossa of the forearm, which has the shape of an isosceles triangle with the biceps forming the base, and the lateral and medial groups of the antebrachial muscles forming the sides respectively 26) . 16). • Avoid drawing the syringe plunger back too forcibly. 11. C. avoiding the introduction of air bubbles into the column of blood in a capillary collection tube. The proper collection of capillary blood includes. How to perform proper venipunture and exam exercise venipuncture using vacuum collection system skills 30 points objectives 10. Never apply a tourniquet to an arm located on the same side of the body as a mastectomy or stroke If the arm contains an IV drip, it is preferable to draw from the other arm. Heel - This site is used for infants, less than one year old, whose fingers are too tiny. Be careful not to withdraw the needle completely or else you risk losing the tube's vacuum and starting a hematoma when the bevel exits the skin. Venipuncture—"veni," meaning vein, and "puncture," meaning to pierce—is the act of drawing blood from a vein with a needle. Veins on the underside of the wrist should be avoided. Areas of broken, bruised or erythematous skin should be avoided. From Venipuncture Avoiding nerve damage when performing a venipuncture requires using correct procedure during the blood draw. Lines - Drawing from an intravenous line may avoid a difficult venipuncture, but introduces problems. 70% alcohol is allowed to dry on the venipuncture site because it kills most of the existing bacteria that could possibly contaminate the sample. Vein sites metacarpal, cephalic, basilic, and median veins and their branches. Unacceptable Sites for Venous Blood Collection If the antecubital area of the patient's arm is compromised or inaccessible, an alternate site must be chosen for venipuncture such as the top of the hand. 2. 3. Venipunctures, performed correctly, carry a low risk of any type of injury. 4. Do not withdraw needle from reg vial, draw up appropriate units 3. The tourniquet should be left on the patient's arm for at least 2 minutes before performing a venipuncture. 4. Take into account the points given below, which are specific to . Apply the tourniquet for no longer than 1 min. COLLECTION & HANDLING TIPS » Routine Venipuncture. D. bathe the animal as little as possible to avoid irritating the skin. from the needle in the holder. finger should be avoided. Procedure for Capillary Puncture of the Finger: The best site for a finger puncture is just off the center of the finger pad of. Document that the venipuncture was performed distal to (below) an infusion site. Serum is obtained from whole blood that has been centrifuged. 10). 21G. 2. Compress the venipuncture site for approximately 30 seconds. List the steps necessary to perform a capillary puncture in chronological order. The adverse events that have been best documented are in blood transfusion services, where poor venepuncture practice or anatomical abnormality has resulted in haematoma . Briefly list the steps involved in performing the venipuncture after the vein has been located by palpation and the tourniquet has been removed: Wait 2 minutes before reapplying the tourniquet Sanitize hands and put gloves on and cleanse antecubital area with alcohol wipes Do not touch the area after cleaning the area. . Venipuncture requires good skills in order to perform the procedure not only . Take enough time to assess the vein before beginning the venipuncture procedure. Hemoconcentration is a decrease in plasma volume and an abundance of blood cells . C. The bend of the elbow, the outer side of the arm. 9. Clean the site to be punctured with an alcohol sponge. 4. Now you can perform the venipuncture. Assess the patient for such . Once the two minutes have passed, apply the tourniquet beneath the IV site. The CLSI standards recommend cleansing the site with friction using a clean gauze pad with 70% isopropyl alcohol solution or a commercially prepared alcohol pad. 13). Define blood culture. Therefore, we try to avoid any breaks in the skin (that can lead to infection) or any . Median cubital vein A superficial vein, most commonly used for venipuncture, it lies over the cubital fossa and serves as an anastomosis between the cephalic and basilic veins. 10. If a patient is very angry and yells that the lab tests are a " waste of time , " which of t he following is the best first response ? 2.

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