Which of the following should a phlebotomist anticipate for a patient who has been taking warfarin?

Choice A Reason:
Hemostasis is the process of blood clotting and the cessation of bleeding. While it is a desired outcome following any puncture, squeezing the puncture site would not typically cause hemostasis as a complication. It is the body's natural response to injury to prevent excessive blood loss.

Choice B Reason:
Hemolysis refers to the rupture of red blood cells, which can occur when excessive pressure is applied to a puncture site during a capillary blood collection. This pressure can cause the cells to burst, releasing their contents into the plasma, which can interfere with various laboratory tests and lead to inaccurate results.

Choice C Reason:
Homeostasis is the body's ability to maintain a stable internal environment despite changes in external conditions. It is not a complication but rather a regulatory process. Squeezing a puncture site does not directly relate to homeostasis as a complication.

Choice D Reason:
Hypobilirubinemia is a condition where there is less than the normal amount of bilirubin in the blood. It is not a complication associated with squeezing a puncture site. Bilirubin levels are typically affected by liver function and red blood cell breakdown, not by the mechanical action of squeezing a site.

Choice A reason:
Capturing the initial stream of urine, also known as the "first catch," is not recommended for a urine culture. This part of the urine stream can contain contaminants from the urethral opening and is not ideal for culture testing, which requires a clean sample.

Choice B reason:
Cleaning the genital area prior to collection is crucial for obtaining a clean-catch urine specimen. This reduces the risk of contamination from bacteria that are normally present on the skin around the urinary opening. Patients should be instructed to use antiseptic wipes to clean the area before collecting the urine sample.

Choice C reason:
Filling the container to capacity is not necessary and is not a specific instruction for urine culture collection. The focus should be on obtaining a midstream sample after the genital area has been cleaned, which provides a more accurate representation of the urine for culture purposes.

Choice D reason:
Labeling the lid prior to collection is an important step in the process to ensure proper identification of the specimen. However, it is not the primary instruction related to the actual collection of the urine sample. The label should include the patient's name, date, and time of collection and should be done after the sample is collected to avoid confusion or contamination.