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:
A 23-gauge needle is commonly used for venipuncture with a winged infusion set and a small volume syringe like a 5 mL syringe. This size provides a balance between patient comfort and the ease of drawing blood without causing hemolysis or excessive damage to blood cells. It is large enough to allow blood to flow easily into the syringe but small enough to minimize discomfort and the risk of bruising.
Choice B reason:
An 18-gauge needle is quite large and is typically used for situations requiring rapid administration of fluids or for blood donation where larger volumes are collected quickly. It is not ideal for a standard venipuncture, especially with a small syringe, as it can cause more pain and increase the risk of bruising.
Choice C reason:
A 25-gauge needle is on the smaller side and may be used for patients with very fragile veins or for pediatric patients. However, it may not be the best choice for a 5 mL syringe as it could make the blood draw process slower and more difficult, potentially leading to clotting in the needle or syringe.
Choice D reason:
A 27-gauge needle is very small and is typically used for subcutaneous injections, such as insulin injections, rather than for venipuncture. It would be too small for an efficient blood draw with a 5 mL syringe, as it would likely cause the blood to hemolyze or clot before the draw is completed.
Correct Answer is C
Explanation
Choice A reason:
A 16-gauge needle is quite large and is typically used for rapid fluid administration or blood donation in adults. It is not suitable for pediatric patients due to the size of their veins and the potential for causing trauma and discomfort.
Choice B reason:
An 18-gauge needle is also large and commonly used for adult patients in situations where larger volumes of blood are needed quickly. For a 6-year-old patient, this gauge would be too large and could cause significant pain and increase the risk of damaging the vein.
Choice C reason:
A 23-gauge needle is recommended for pediatric patients, including those who are 6 years old. It is small enough to minimize discomfort and the risk of injuring the vein, yet it allows for adequate blood flow for collection³. This size needle is often used with a winged infusion set, which is suitable for the smaller, more fragile veins of pediatric patients.
Choice D reason:
A 27-gauge needle is very small and is typically used for intradermal injections or for very small veins, such as those in neonates. While it would cause minimal discomfort, it may not provide an adequate flow rate for venipuncture in a 6-year-old patient.
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