A patient has bilateral scarring on their forearms from past burn injuries and needs a venipuncture procedure. Which of the following veins should the phlebotomist use for the venipuncture draw?
Axillary
Median cubital
Basilic
Dorsal hand
The Correct Answer is D
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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Correct Answer is D
Explanation
Choice A reason:
Turning the patient's hand palm down is not typically recommended as it can make the veins less accessible and may cause discomfort to the patient. The veins on the back of the hand are more superficial and can be more easily accessed when the hand is palm up.
Choice B reason:
Placing the patient in a supine position is not necessary for all venipuncture procedures and is usually reserved for patients who have a history of fainting or for those who are already lying down due to their medical condition. It is not a position that specifically increases comfort during the procedure.
Choice C reason:
Bending the patient's arm at the elbow can actually hinder the blood draw process as it may cause the veins to be less prominent and can lead to discomfort or movement during the venipuncture, potentially causing injury or an unsuccessful draw.
Choice D reason:
Positioning the patient's hand at waist level is the correct choice as it allows the arm to be in a natural, relaxed position, which can help the veins to be more prominent and accessible. It also helps in reducing the patient's anxiety as the arm is not in an awkward or strained position.
Correct Answer is B
Explanation
Choice A reason:
The date of birth is a common identifier, but it is not unique to an individual, as multiple patients may share the same birth date. While it is useful in conjunction with other identifiers, on its own, it does not provide a definitive identification.
Choice B reason:
The record number, often referred to as the medical record number, is a unique identifier assigned to each patient within a healthcare system. It is used to track patient information across different visits and services, making it the most reliable standalone identifier if the patient's name is not available.
Choice C reason:
An address can change over time and may not be unique, especially in large apartment buildings or for patients who are homeless or transient. It is also not specific enough to reliably identify a patient, as multiple individuals can reside at the same address.
Choice D reason:
The social security number is a unique identifier, but due to privacy concerns and the risk of identity theft, it is not the preferred method for patient identification in healthcare settings. Additionally, not all patients may have a social security number, such as non-residents or newborns.
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