When a phlebotomist performs a heel stick for the purposes of obtaining a PKU test, it is important to:
Wrap the site with a heel warmer for 30 minutes.
Wipe away the first drop of blood.
Keep a pressure dressing on the site for the day.
Target the central arch area of the foot for the least amount of discomfort.
The Correct Answer is B
Choice A Reason:
Wrapping the site with a heel warmer for 30 minutes is a preparatory step before the heel stick procedure. It is used to increase blood flow to the area to make the collection easier. However, it is not the action to take after the blood has been collected. The heel warmer should be removed before performing the heel stick.
Choice B Reason:
Wiping away the first drop of blood is the correct procedure. The initial drop may be contaminated with tissue fluids or alcohol if the site was cleaned prior to the stick, which can affect the accuracy of the test results. Therefore, the first drop should be wiped away, and subsequent blood should be used for the PKU test.
Choice C Reason:
Keeping a pressure dressing on the site for the entire day is not necessary and is not part of the standard heel stick procedure. After the blood is collected, a small bandage is typically applied to stop any bleeding. The site should be monitored for a short time for any signs of continued bleeding or bruising, but a pressure dressing for the day is excessive.
Choice D Reason:
Targeting the central arch area of the foot for the heel stick is incorrect and can be harmful. The recommended area for a heel stick is the lateral portions of the heel to minimize discomfort and avoid injury to the bone or nerves. The central arch area should be avoided to prevent potential harm.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
While informing the patient of the procedure is important, it is not the immediate next step after greeting. The technician should first ensure the patient's safety and comfort before proceeding with the details of the blood draw.
Choice B Reason:
Asking if the patient has a latex allergy is crucial as it directly pertains to patient safety. Many medical supplies, including gloves and tourniquets used during phlebotomy, may contain latex, which can cause allergic reactions in sensitive individuals. Identifying an allergy before any contact ensures that the technician can take necessary precautions to prevent an allergic reaction.
Choice C Reason:
Stating the technician's name to the patient helps build rapport but is not as critical as ensuring the patient's safety. It is a part of good communication and patient care practices but should follow after confirming any potential allergies or other immediate health concerns.
Choice D Reason:
Asking the patient which arm they prefer for the blood draw is a part of the procedure that involves patient preference and comfort. However, this should come after ensuring there are no allergies that could lead to complications during the draw.
Correct Answer is D
Explanation
Choice A reason:
Heparin is an anticoagulant, not a clot activator. It works by inhibiting thrombin and preventing the conversion of fibrinogen to fibrin, thus preventing clot formation. It is commonly found in green-top tubes and is suitable for collecting plasma samples for tests like electrolyte levels and coagulation studies.
Choice B reason:
Oxalate is also an anticoagulant that prevents clotting by precipitating calcium. It is not used to promote clot formation but rather to maintain a blood sample in a non-coagulated state for various tests.
Choice C reason:
Citrate functions similarly to heparin and oxalate as an anticoagulant. It chelates calcium ions in the blood, inhibiting the coagulation process. Citrate is often used in blue-top tubes and is ideal for collecting plasma samples for coagulation studies.
Choice D reason:
Silica is a clot activator. It is commonly used in serum separator tubes (SSTs) with a gold or red speckled top. The silica particles provide a surface for the rapid formation of the clot, allowing for the separation of serum from the blood cells. This is essential when serum is needed for testing.
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