When drawing blood on a preschooler, the phlebotomist should:
Explain the procedure to the parent and child.
Not tell the child when the needle insertion is coming.
Obtain a heel stick.
Obtain a thumb stick.
The Correct Answer is A
Choice A Reason:
Explaining the procedure to both the parent and the child is crucial. It helps in preparing the child psychologically and ensures that the parent is informed and can provide support during the process. Clear communication can reduce anxiety and make the child more cooperative. It is also a part of informed consent, where the parent understands what the procedure entails and why it is necessary¹².
Choice B Reason:
Choosing not to tell the child when the needle insertion is coming might seem like a way to avoid causing them anticipatory anxiety. However, this approach can lead to mistrust. Children need to be prepared for what to expect, and surprising them can be more traumatic in the long run. It is better to be honest and use age-appropriate language to describe the sensation as a 'quick pinch' or 'poke'¹².
Choice C Reason:
Obtaining a heel stick is a common method for blood collection in infants, particularly newborns, as their veins are not as developed. However, for preschoolers, venipuncture is usually the preferred method because they have more developed veins, and it allows for a larger volume of blood to be collected if needed³.
Choice D Reason:
Obtaining a thumb stick is not a standard practice for blood collection in preschoolers. The thumb has bones and tendons close to the surface, which can increase the risk of injury. The preferred sites are the antecubital fossa of the arm or the back of the hand where the veins are more accessible and there is less risk of hitting bone³.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Reporting the exposure to the supervisor is the immediate and required action after experiencing a needlestick injury. The supervisor will then guide the phlebotomist through the institution's post-exposure protocol, which includes immediate care of the wound, evaluation of the exposure, and initiation of post-exposure prophylaxis (PEP) if necessary. This step is crucial to ensure that the risk of HIV transmission is minimized and that the phlebotomist receives appropriate medical attention and follow-up.
Choice B reason:
Reporting the exposure to the Centers for Disease Control and Prevention (CDC) is not the immediate action required. The CDC provides guidelines and recommendations for handling such incidents, but the initial report and response are managed at the healthcare facility level. The CDC may be involved in the tracking of such incidents on a larger scale or providing statistical data, but they are not the first point of contact.
Choice C reason:
Sending the patient for further sexually transmitted infection (STI) testing is not an immediate action required following a needlestick injury. The patient's HIV status is already known, and the focus should be on the treatment and protection of the healthcare worker who experienced the needlestick. Any additional testing of the patient would be unrelated to the immediate management of the injury.
Choice D reason:
Saving the collection device for future evaluation is not a standard procedure. While the device may be retained as part of the incident investigation to determine how the injury occurred and to improve safety measures, the immediate concern is the treatment of the injured healthcare worker. The device itself does not play a role in the post-exposure management of the worker.
Correct Answer is C
Explanation
Choice A Reason:
Notifying the provider about the error is an important step, but it does not correct the error in the patient's chart. Communication with the provider ensures that they are aware of the mistake and can make informed decisions regarding patient care. However, the physical correction of the documentation is also necessary to maintain accurate medical records.
Choice B Reason:
Asking an administrator to erase the error is not a recommended practice. Erasing or using correction fluid can make the chart appear tampered with, which can have legal implications. It is essential that the original entry remains visible to preserve the integrity of the medical record.
Choice C Reason:
Striking a line through the error and initialing is the correct method for correcting a written error in a patient's chart¹². This approach allows the original entry to remain legible, which is crucial for legal and clinical reasons. It also shows that the correction was made by an authorized individual, as the initials indicate who made the change.
Choice D Reason:
Erasing the error and entering the correct information is not an acceptable practice for the same reasons as choice B. It is important not to remove or conceal the original entry, as this could be considered falsifying medical records.
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