A patient suspected of having a severe medication reaction goes into shock. Which of the following first aid measures should the phlebotomist take?
Keep the patient as upright as possible.
Provide a cooling blanket.
Administer oral fluids.
Maintain an open airway.
The Correct Answer is D
Choice A Reason:
Keeping the patient as upright as possible is not recommended in cases of shock. When a patient is in shock, it is important to lay them down and elevate their legs slightly, unless this position causes pain or further injury. This position helps improve blood flow to the brain.
Choice B Reason:
Providing a cooling blanket is not a standard first aid measure for shock due to a medication reaction. A cooling blanket may be used in cases of hyperthermia or heatstroke to reduce body temperature, but not typically for shock, which requires maintaining normal body temperature and preventing chilling.
Choice C Reason:
Administering oral fluids to a patient in shock is not advisable. During shock, a patient may have an impaired swallowing reflex or be unconscious, increasing the risk of aspiration. It is best to avoid giving anything by mouth until medical personnel arrive.
Choice D Reason:
Maintaining an open airway is crucial for a patient in shock. Ensuring that the airway is clear allows the patient to breathe effectively, which is essential for delivering oxygen to the tissues and organs. If the patient is unconscious or has an altered level of consciousness, the phlebotomist should check for breathing and begin CPR if necessary.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Having the bevel down at a 30° angle is not the correct needle position for venipuncture. The bevel of the needle should be facing up to allow for a smoother insertion and to minimize the risk of damaging the vein or causing discomfort to the patient.
Choice B reason:
Positioning the bevel up at a 45° angle is not recommended for venipuncture as this angle is too steep and could lead to the needle penetrating through the vein, potentially causing a hematoma or other complications.
Choice C reason:
The bevel up at a 30° angle is the correct position for venipuncture. This position allows the phlebotomist to insert the needle with the bevel facing upwards, which is the sharpest part of the needle, ensuring a clean entry into the vein. The 30° angle is shallow enough to enter the vein without going through it and causing injury.
Choice D reason:
A bevel down at a 45° angle is incorrect for the same reasons as choice B. Additionally, with the bevel down, the non-beveled side, which is duller, would make the initial contact with the skin, potentially causing more pain and making it more difficult to penetrate the vein.
Correct Answer is B
Explanation
Choice A reason:
The order of citrate, heparin, EDTA, and fluoride is not the correct sequence for blood collection. The correct order is essential to prevent cross-contamination of additives between tubes, which could interfere with test results. Citrate tubes should be drawn first to ensure that the blood does not clot prematurely, but heparin should not follow immediately after citrate.
Choice B reason:
Citrate tubes, which contain sodium citrate, are used for coagulation tests and must be drawn first to ensure the proper blood-to-additive ratio. EDTA tubes are drawn next because EDTA binds calcium and prevents clotting, making it ideal for complete blood counts and other hematology studies. Heparin tubes, which prevent clotting by inhibiting thrombin and thromboplastin, are drawn after EDTA. Lastly, fluoride tubes, which contain a glycolysis inhibitor, are drawn to preserve glucose levels and are typically used for glucose and lactate testing.
Choice C reason:
Starting with fluoride is not recommended as it could lead to contamination of the EDTA and heparin tubes with fluoride, which could affect the results of certain tests, such as calcium determinations in heparin tubes. The order of draw is designed to minimize such risks.
Choice D reason:
This sequence is incorrect because fluoride tubes are not drawn before EDTA and heparin tubes. The presence of fluoride could potentially contaminate the subsequent tubes and alter the results of the tests that require heparin or EDTA as an anticoagulant.
In phlebotomy, following the correct order of draw is crucial. The order is established based on the type of additive in each tube and its potential to interfere with tests conducted in subsequent tubes. The standard order is: blood cultures, citrate tubes, serum tubes with or without clot activator and gel, heparin tubes with or without gel, EDTA tubes, and lastly, fluoride tubes. This sequence helps prevent cross-contamination and ensures the accuracy of laboratory results, which are critical for patient diagnosis and treatment.
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