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 D
Explanation
Choice A Reason:
A red-top tube is used for serum determinations in chemistry and should be allowed to clot completely, typically for 30 minutes, before centrifugation. Shipping after only 15 minutes may result in incomplete clotting and potentially inaccurate test results.
Choice B Reason:
Serum should not be separated from a lavender-top tube, as this type of tube contains EDTA and is used for whole blood tests, not serum. This indicates a misunderstanding of the tube's purpose and could lead to compromised test results.
Choice C Reason:
A tiger-top tube, also known as a serum separator tube, is used for various chemistry tests. However, bilirubin is light-sensitive, and specimens for bilirubin testing should be protected from light, not shipped in a clear bag. This could lead to degradation of the bilirubin and inaccurate results.
Choice D Reason:
A green-top tube contains heparin and is used for plasma determinations. Ammonia testing requires the plasma to be placed on ice immediately after collection to inhibit the continued production of ammonia from red blood cells. Therefore, shipping in an icy water mixture is the correct procedure to ensure accurate ammonia levels.
In conclusion, the proper preparation and transport of blood specimens are crucial for the accuracy of laboratory tests. The green-top tube for ammonia testing, shipped in an icy water mixture, is the only option that follows the correct protocol for specimen handling and transport.
Correct Answer is A
Explanation
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.
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