During a venipuncture, the needle is in the vein and blood flow is established. When the second tube is attached, blood flow stops. Which of the following actions should the phlebotomist take?
Withdraw the needle completely.
Rotate the bevel of the needle.
Increase tourniquet pressure.
Activate a new evacuated tube.
The Correct Answer is D
Choice A Reason:
Withdrawing the needle completely would be an incorrect action because it would end the procedure prematurely and require a new venipuncture, causing unnecessary discomfort to the patient. It should only be done if the venipuncture has been completed or if there is a need to stop due to a complication.
Choice B Reason:
Rotating the bevel of the needle could potentially reposition the needle for better blood flow if it has become occluded or is not properly aligned with the vein. However, this action should be done with caution to avoid causing injury to the vein or discomfort to the patient.
Choice C Reason:
Increasing tourniquet pressure is not advisable once blood flow has been established, as it could cause damage to the vein or hemolysis of the blood sample. The tourniquet should be released once the blood starts flowing into the first tube to avoid these issues.
Choice D Reason:
Activating a new evacuated tube is the correct action to take when blood flow stops upon attaching a second tube. This could indicate a problem with the vacuum in the tube rather than with the needle or the venipuncture site. Trying a new tube can resolve the issue without needing to adjust the needle or the patient's position.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
When performing a capillary blood collection, such as a fingerstick, the lancet should be positioned perpendicular to the fingerprint grooves. This orientation helps to ensure that the incision is made across the ridges of the fingerprint, which can facilitate a better blood flow and make it easier to collect an adequate sample without needing to squeeze the finger excessively, which could hemolyze the sample.
Choice B reason:
Positioning the lancet parallel to the nail bed is not recommended because it can result in a cut that runs along the length of the fingerprint grooves, which may not bleed as freely and could also be more painful for the patient.
Choice C reason:
Using the lancet along the lateral portion of the first digit is not part of the standard aseptic technique protocol for capillary blood collection. The first digit, or thumb, has a pulse and should generally be avoided because it can be more sensitive and is more prone to bruising.
Choice D reason:
The medial portion of the fifth digit, or the little finger, is also not a recommended site for capillary blood collection with a lancet. The little finger is typically smaller and may not provide an adequate site for blood collection, and similar to the thumb, it can be more sensitive and prone to injury.
Correct Answer is D
Explanation
Choice A reason:
The light green tube typically contains lithium heparin and is used for plasma determinations in chemistry. It is not suitable for coagulation studies, such as PT, because heparin is an anticoagulant that would interfere with the test results.
Choice B reason:
The lavender tube contains EDTA, which is an anticoagulant that binds calcium. While it is commonly used for complete blood counts (CBC) and other hematology tests, it is not appropriate for coagulation studies because the binding of calcium would affect the clotting process required for a PT test.
Choice C reason:
The royal blue tube can come with different additives or be additive-free, depending on the color of the closure. It is primarily used for trace element testing, toxicology, and nutrient determinations. The additives in a royal blue tube could potentially contaminate the sample and interfere with the PT test.
Choice D reason:
The light blue tube contains sodium citrate, which is the appropriate anticoagulant for coagulation studies like PT. Sodium citrate works by binding calcium in the blood, preventing clotting. The PT test measures the time it takes for a clot to form after re-calcification, making the light blue tube the correct choice for this test.
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