A phlebotomist should recognize that the Clinical and Laboratory Standards Institute (CLSI) recommends that a heel stick depth should not penetrate deeper than which of the following depths for an infant patient?
2.0 mm
2.5 mm
3.0 mm
3.5 mm
The Correct Answer is A
Choice A Reason:
The recommended heel stick depth of 2.0 mm is based on the need to minimize the risk of injury to the infant. Penetrating deeper than this can increase the likelihood of hitting bone, which in infants can be as close as 2.0 mm under the skin of the plantar surface of the heel. This depth is sufficient to obtain a blood sample without risking injury to deeper tissues or bone.
Choice B Reason:
A depth of 2.5 mm may be too deep for some infants, especially preterm or very small infants, where the calcaneus (heel bone) is closer to the surface. While this depth might still be safe for some infants, it does not provide the same margin of safety as the 2.0 mm recommendation and could potentially lead to bone puncture or other injuries.
Choice C Reason:
A depth of 3.0 mm significantly increases the risk of bone puncture, especially in infants with less subcutaneous fat or in those who are preterm. This depth could easily breach the protective layer of skin and subcutaneous tissue, leading to a higher risk of osteomyelitis, an infection of the bone, which can be a serious complication in infants.
Choice D Reason:
A depth of 3.5 mm is considered too deep for a heel stick procedure and is likely to cause injury to the infant. This depth would almost certainly penetrate the bone in most infants, leading to severe pain, potential for infection, and other complications. It is well beyond the safe range recommended by CLSI and should be avoided.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Warfarin does not typically require a fasting state before blood is drawn for testing. The medication's effect on clotting factors is independent of food intake. Therefore, a fasting requirement is not anticipated for patients taking warfarin unless specified for other concurrent tests.
Choice B Reason:
There is no need for an alternate antiseptic due to warfarin use. Standard antiseptic procedures are sufficient when drawing blood from patients on warfarin. The choice of antiseptic would be more influenced by patient allergies or specific institutional protocols.
Choice C Reason:
Patients on warfarin have an increased bleeding time because the medication is an anticoagulant, which means it works to prevent blood clots by thinning the blood. This can lead to prolonged bleeding after a venipuncture, and phlebotomists should be prepared to apply pressure for a longer time to ensure hemostasis.
Choice D Reason:
Placing a specimen on ice is not a standard procedure for blood samples taken for warfarin monitoring, which is typically done through a PT/INR test. This test measures the time it takes for blood to clot and is not affected by temperature in the same way that tests for certain enzymes or gases might be.
Correct Answer is C
Explanation
Choice A Reason:
CLIA, or the Clinical Laboratory Improvement Amendments, sets standards for all laboratory testing to ensure the accuracy, reliability, and timeliness of patient test results. While CLIA provides a framework for laboratory operation, it does not offer specific guidelines for chemical spill cleanup.
Choice B Reason:
OSHA, or the Occupational Safety and Health Administration, provides regulations to ensure worker safety, including protocols for handling hazardous materials. However, OSHA itself does not provide the specific cleanup procedures; instead, it requires workplaces to follow certain safety practices.
Choice C Reason:
SDS, or Safety Data Sheets, provide detailed information on chemicals, including their properties, health hazards, protective measures, and safety precautions, including spill response and cleanup procedures. In the event of a chemical spill, the SDS contains the most direct instructions for safe and effective cleanup, making it the primary reference for a phlebotomist in this situation.
Choice D Reason:
The CDC, or Centers for Disease Control and Prevention, focuses on public health and disease prevention. While the CDC provides guidelines for infection control and laboratory safety, it is not the primary resource for chemical spill cleanup procedures.
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