A phlebotomist is preparing to perform venipuncture on a patient who had a right-sided mastectomy. Which of the following is the correct site to perform the collection?
Left antecubital
Right cephalic
Left femoral artery
Right basilic
The Correct Answer is A
Choice A reason:
The left antecubital area is the correct site to perform venipuncture on a patient who has had a right-sided mastectomy. It is recommended to avoid the side of the mastectomy due to the risk of lymphedema and other complications associated with the removal of lymph nodes during the surgery. The left antecubital fossa, which is the area in front of the elbow, is a common site for venipuncture and is generally safe for use when the right side cannot be used.
Choice B reason:
The right cephalic vein should be avoided in a patient with a right-sided mastectomy. Venipuncture on the same side as the mastectomy can increase the risk of complications, including lymphedema, which is a condition characterized by swelling due to lymph fluid accumulation. Therefore, the right cephalic vein is not an appropriate choice.
Choice C reason:
The left femoral artery is not a venipuncture site; it is an arterial site. Venipuncture refers to accessing a vein, not an artery, for blood collection. Additionally, arterial puncture is a more invasive procedure typically reserved for arterial blood gas analysis and is not performed for routine venipuncture.
Choice D reason:
Similar to choice B, the right basilic vein should be avoided for venipuncture in a patient who has had a right-sided mastectomy. The basilic vein is located on the inner side of the arm and using it could pose the same risks as using the right cephalic vein, including the potential for lymphedema.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
For blood donation, a 16- to 18-gauge needle is typically used because it is large enough to allow the rapid flow of blood without causing hemolysis (destruction of red blood cells). The larger gauge needle also helps in minimizing the time the donor has to spend during the donation process. Using a needle that is too small could slow down the blood flow and potentially damage the blood cells, which is not ideal for the recipient of the blood donation.
Choice B Reason:
A 19- to 21-gauge needle is commonly used for routine venipuncture but is not ideal for blood donation. These needles are smaller than the 16- to 18-gauge needles and would not facilitate the quick collection of the volume of blood typically required for a donation. They are more suitable for collecting blood samples for testing rather than for donation purposes.
Choice C Reason:
A 22- to 24-gauge needle is even smaller and is often used for patients with smaller veins, such as children or elderly patients. These needles would not be appropriate for blood donation as they could significantly slow the blood flow and increase the donation time, which could be uncomfortable for the donor.
Choice D Reason:
A 25- to 28-gauge needle is the smallest size commonly used in medical practice and is suitable for patients with extremely small or fragile veins. These needles would be impractical for blood donation due to their small size, which would not allow for the efficient flow of blood required for a donation.
Correct Answer is A
Explanation
Choice A Reason:
Stopping the procedure is the first and most critical action a phlebotomist should take if a patient slumps over during blood collection. The patient's safety is the primary concern, and continuing the procedure could cause further harm. The phlebotomist should immediately remove any needles or equipment from the patient to prevent injury.
Choice B Reason:
Alerting the supervisor is an important step, but it should come after ensuring the patient is safe and the procedure has been stopped. The supervisor will need to be informed of the incident to help manage the situation and provide assistance as needed.
Choice C Reason:
Documenting the incident is a necessary step for legal and medical records. However, it is not the first action to take. The patient's immediate well-being takes precedence over documentation, which can be completed after the situation is under control and the patient is stable.
Choice D Reason:
Sliding the patient to the floor may be necessary if the patient is at risk of falling from the chair. However, this should only be done after the procedure has been stopped, and if it is safe to move the patient. If the patient is unconscious, the phlebotomist may need to initiate CPR, which is best performed on a flat surface.
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