Which of the following locations should a phlebotomist use to anchor a vein during a venipuncture using the evacuated tube method?

Choice A reason:
Septicemia, also known as sepsis, is a serious bloodstream infection that can be life-threatening. It is not a disorder that is screened for at birth because it is not a congenital condition but rather an infection that can occur at any time when bacteria enter the bloodstream.

Choice B reason:
Bacteremia refers to the presence of bacteria in the bloodstream and, like septicemia, is not a congenital disorder. It is not typically screened for at birth as it is an acquired condition that can occur after exposure to bacteria.

Choice C reason:
Phenylketonuria (PKU) is a genetic disorder that results in an inability to metabolize the amino acid phenylalanine. Untreated, PKU can lead to intellectual disability, seizures, and other serious health problems. Newborn screening for PKU is required in every state in the U.S. because early detection and dietary treatment can prevent the severe consequences of the disorder.

Choice D reason:
Proteinuria is the presence of abnormal amounts of protein in the urine, which can be a sign of kidney disease. It is not a condition that is screened for at birth as part of the standard newborn screening panel.

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.