A phlebotomist is preparing to collect a blood specimen from a patient who has self-reported needle phobia. Which of the following actions should the phlebotomist take?
Encourage the patient to chew gum during the procedure.
Instruct the patient to lie supine during the procedure.
Place the patient's elbow joint at 90 degrees of flexion.
Warm the site for 10 minutes before venipuncture.
The Correct Answer is D
Choice A Reason:
Encouraging the patient to chew gum during the procedure may serve as a distraction, which can be helpful for some patients. However, this is not a widely recommended practice for reducing needle phobia. Distraction techniques can be beneficial, but they should be tailored to the individual patient's preferences and should not interfere with the procedure.
Choice B Reason:
Instructing the patient to lie supine during the procedure can help prevent fainting and reduce anxiety for some patients. This position is often used for patients who have a history of fainting or feel dizzy during blood draws. However, it is not specifically targeted at managing needle phobia.
Choice C Reason:
Placing the patient's elbow joint at 90 degrees of flexion is a standard practice to stabilize the arm and provide an optimal angle for venipuncture. While this is a necessary step in the procedure, it does not directly address the patient's needle phobia.
Choice D Reason:
Warming the site for 10 minutes before venipuncture is a technique used to enhance vein visibility and elasticity, making the venipuncture easier and potentially less painful. This can be particularly helpful for patients with needle phobia, as a smoother and quicker procedure may reduce anxiety and discomfort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
A 16-gauge needle is quite large and is typically used for rapid fluid administration or blood donation in adults. It is not suitable for pediatric patients due to the size of their veins and the potential for causing trauma and discomfort.
Choice B reason:
An 18-gauge needle is also large and commonly used for adult patients in situations where larger volumes of blood are needed quickly. For a 6-year-old patient, this gauge would be too large and could cause significant pain and increase the risk of damaging the vein.
Choice C reason:
A 23-gauge needle is recommended for pediatric patients, including those who are 6 years old. It is small enough to minimize discomfort and the risk of injuring the vein, yet it allows for adequate blood flow for collection³. This size needle is often used with a winged infusion set, which is suitable for the smaller, more fragile veins of pediatric patients.
Choice D reason:
A 27-gauge needle is very small and is typically used for intradermal injections or for very small veins, such as those in neonates. While it would cause minimal discomfort, it may not provide an adequate flow rate for venipuncture in a 6-year-old patient.
Correct Answer is A
Explanation
Choice A reason:
The lateral section of the plantar heel is the recommended site for capillary blood collection in infants, particularly those under 6 months of age. This area is preferred because it is sufficiently vascularized for blood collection and poses less risk of injury to bones and nerves compared to other areas.
Choice B reason:
The central area of the heel is not recommended for capillary blood collection in infants due to the higher risk of injury to the calcaneus (heel bone) and potential for calcaneal osteomyelitis, an infection of the bone.
Choice C reason:
The posterior curvature of the heel is also not an appropriate site for capillary blood collection in infants. This area has a higher likelihood of causing pain and injury, as well as being less accessible for a proper puncture technique.
Choice D reason:
The palmer surface of the distal phalanx (fingertip) is not a recommended site for capillary blood collection in infants under 1 year of age. The fingertips of infants are small and more prone to injury, and the procedure may be more painful compared to a heel stick.
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