A large spill has occurred in a laboratory involving venous blood. Which of the following actions should the phlebotomist take?
Cover the spill until maintenance arrives.
Pour bleach on the spill and let it soak for 60 seconds.
Evacuate the laboratory.
Apply a liquid thickening agent on top of the spill.
The Correct Answer is B
Choice A Reason:
Covering the spill until maintenance arrives is not an appropriate response to a blood spill. This action does not neutralize any potential pathogens present in the blood, which could pose a risk of infection to others. Immediate cleanup is necessary to prevent the spread of infectious diseases, and simply covering the spill does not meet the Occupational Safety and Health Administration (OSHA) guidelines for bloodborne pathogens, which require the spill to be cleaned with an appropriate disinfectant.
Choice B Reason:
Pouring bleach on the spill and allowing it to soak for 60 seconds is the recommended action because bleach is a powerful disinfectant that can kill a wide range of pathogens, including those that might be present in venous blood. The Centers for Disease Control and Prevention (CDC) recommends a 1:10 dilution of household bleach for effectively disinfecting blood spills. After pouring the bleach, it is important to let it soak for an adequate amount of time, usually around 10 minutes, to ensure that all pathogens are killed.
Choice C Reason:
Evacuating the laboratory is not a necessary action for a blood spill unless the spill is extensive and poses additional risks that cannot be mitigated by standard cleanup procedures. In most cases, following the proper spill cleanup protocol, which includes wearing personal protective equipment (PPE) and using an EPA-registered disinfectant, is sufficient to handle the situation without needing to evacuate the area.
Choice D Reason:
Applying a liquid thickening agent on top of the spill is not a standard practice for blood spill cleanup. While a thickening agent might contain the spill, it does not disinfect the area. The priority in such situations is to disinfect and remove any potential infectious agents. Therefore, the use of a thickening agent would not be in compliance with the recommended procedures for blood spill cleanup by OSHA and the CDC.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
A patient's room number is not considered a unique identifier by the Joint Commission standards. Room numbers can change if patients are moved, and they do not reliably identify an individual.
Choice B Reason:
A patient's bed label is also not a unique identifier. Bed labels can be switched, and similar to room numbers, they are not specific to the individual patient.
Choice C Reason:
A patient's inpatient chart typically contains multiple unique identifiers, such as the patient's name, an assigned identification number, date of birth, or other person-specific identifiers. These are considered acceptable by the Joint Commission for verifying patient identity, ensuring that the service or treatment is intended for that individual.
Choice D Reason:
Patient's verbal confirmation alone is not sufficient for establishing correct inpatient identification. While it can be used as one method of identification, it should be supplemented with another identifier to meet the Joint Commission's requirement of using at least two patient identifiers.
Correct Answer is C
Explanation
Choice A Reason:
Shaking the tubes vigorously can cause hemolysis, which is the rupture of red blood cells, leading to inaccurate test results. It is not recommended as it does not provide gentle mixing and can damage the blood cells.
Choice B Reason:
Moving the tubes in a figure-eight motion is not a standard practice for mixing blood samples. This method may not provide the consistent and gentle inversion needed to mix the anticoagulant with the blood effectively.
Choice C Reason:
Rolling the tubes between the palms of the hands 4 to 8 times after collection is the recommended method. This technique allows for gentle and thorough mixing of the blood with the anticoagulant, preventing clotting without causing hemolysis. The number of inversions ensures that the anticoagulant coats the inner surface of the tube and mixes with the blood, which is essential for accurate laboratory results.
Choice D Reason:
Passing the tubes from hand to hand is not an effective method for mixing blood samples. This action may not provide the necessary inversion and can lead to inadequate mixing, resulting in clotted specimens.
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