A dialysis patient in the ICU has a shunt placement in the right forearm and an IV placed in the left hand. Which of the following options best describes the optimal site for the collection of a CBC?
The right antecubital fossa
The right hand
The left antecubital fossa
Capillary collection from the left hand
The Correct Answer is D
Choice A Reason:
The right antecubital fossa is not the optimal site for blood collection in this case because the presence of a shunt in the right forearm can complicate the procedure and potentially damage the shunt, which is a critical access point for dialysis treatments.
Choice B Reason:
The right hand should also be avoided for blood collection due to the shunt placement in the right forearm. Using the same arm as the shunt for venipuncture could lead to complications such as infection, clotting, or accidental damage to the shunt.
Choice C Reason:
The left antecubital fossa might seem like a viable option; however, with an IV placed in the left hand, it is generally recommended to avoid using the same limb for blood collection to prevent contamination of the sample and reduce the risk of infection at the IV site.
Choice D Reason:
Capillary collection from the left hand is the most appropriate choice in this scenario. It avoids the arm with the shunt and the IV, reducing the risk of complications. Capillary blood collection is a suitable alternative when venipuncture sites are limited, and it can provide an adequate sample for a CBC.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Hemophilia is a genetic disorder that impairs the body's ability to make blood clots, a process needed to stop bleeding. This condition is not caused by shaking a blood collection tube; it is an inherited disorder typically caused by a mutation in one of the clotting factor genes.
Choice B Reason:
Hemoconcentration refers to an increase in the concentration of cells and solids in the blood, usually resulting from a loss of plasma. While this can occur due to various reasons, such as dehydration, it is not caused by shaking a blood collection tube. Shaking a tube does not change the ratio of cells to plasma in the blood.
Choice C Reason:
Hemolysis is the rupture of red blood cells, which can occur when a blood sample is handled roughly, such as by excessive shaking. This can cause the cells to break open and release their contents into the plasma, which can interfere with laboratory tests and lead to inaccurate results.
Choice D Reason:
Hemostasis is the process by which the body stops bleeding, which involves the clotting of blood. This process is not caused by shaking a blood collection tube. Hemostasis is a complex process that involves blood vessels, platelets, and clotting factors.
Correct Answer is D
Explanation
Choice A reason:
The axillary vein is not commonly used for routine venipuncture due to its location in the armpit area, where it is more difficult to access and poses a higher risk of complications.
Choice B reason:
The median cubital vein is often the vein of choice for venipuncture due to its size and accessibility. However, in the case of a patient with bilateral scarring on the forearms, this vein may be compromised, making it a less suitable option.
Choice C reason:
The basilic vein, while also a common site for venipuncture, is located on the inner aspect of the arm and may be affected by the scarring on the patient's forearms. Additionally, it is closer to nerves and arteries, which increases the risk of complications.
Choice D reason:
The dorsal hand veins are a good alternative for venipuncture when the more common sites are not available, such as in the case of a patient with bilateral scarring on the forearms. These veins are usually more superficial and can be accessed with minimal risk of complications.
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