A dialysis patient in the ICU has a shunt placement in the right forearm and an IV placed in the left hand. Which of the following options best describes the optimal site for the collection of a CBC?

Choice A reason:
The laboratory accession number is a unique identifier assigned to a patient's specimen once it is received by the laboratory. While it is an important piece of information, it is not provided by the physician's office to the phlebotomist for specimen collection. Instead, it is generated by the laboratory after the specimen is collected and submitted for analysis.

Choice B reason:
The Physician's NPI (National Provider Identifier) number is a unique identification number for covered health care providers in the United States. While it is used for billing and identification purposes, it is not the information that the physician's office needs to provide to a phlebotomist for the purpose of specimen collection.

Choice C reason:
The laboratory requisition form is the correct document that should be provided by the physician's office. This form contains the patient's demographic information, the tests ordered by the physician, special instructions for specimen collection, and any other pertinent information required for proper specimen handling and testing.

Choice D reason:
The physician's encounter form typically contains details of the patient's visit, including services provided, diagnoses, and billing information. It is not specifically used for laboratory specimen collection and therefore is not the information that should be provided to a phlebotomist for this purpose.

Choice A Reason:
An angle of 50° is too steep for venipuncture and increases the risk of going through the vein and causing injury to structures beneath it. A steeper angle can also make it more difficult to control the depth of the needle, leading to an increased chance of puncturing the posterior wall of the vein.

Choice B Reason:
An angle of 30° is the recommended angle for venipuncture as it allows for a smooth entry into the vein without going too deep. This angle helps to ensure that the needle enters the vein in a controlled manner and minimizes the risk of injury to the patient. It also provides a good balance between ease of entry and control over the needle's depth.

Choice C Reason:
An angle of 90° is not recommended for venipuncture because it is perpendicular to the skin, which greatly increases the risk of passing through the vein entirely and causing injury. This angle does not allow for any control over the depth of the needle and is likely to cause discomfort or pain to the patient.

Choice D Reason:
An angle of 75° is also too steep for safe venipuncture. Similar to a 50° angle, it increases the risk of penetrating the posterior wall of the vein and potentially damaging surrounding tissues or arteries. It is important to use a lower angle to ensure the safety and comfort of the patient during the procedure.