A phlebotomist observes a hematoma developing at the site of a venous blood draw. What should the phlebotomist do?
Observe the site to see whether the hematoma worsens.
Ask the patient to apply pressure to the area.
Release the tourniquet and stop the draw.
Call for a nurse and assess the patient's condition.
The Correct Answer is C
Choice A reason:
Simply observing the site to see if the hematoma worsens is not an appropriate response. While monitoring the development of a hematoma is part of the process, it is not a proactive measure to address the immediate issue. The phlebotomist must take action to prevent further injury or complication.
Choice B reason:
Asking the patient to apply pressure may be part of the post-venipuncture care, especially after the needle has been removed, to aid in stopping any bleeding. However, this does not address the immediate concern of a developing hematoma during the draw.
Choice C reason:
Releasing the tourniquet and stopping the draw is the correct action to take when a hematoma is observed. This response is in line with the standard procedure for when a complication arises during venipuncture. Stopping the draw helps prevent further blood from pooling and exacerbating the hematoma.
Choice D reason:
While calling for a nurse and assessing the patient's condition is important, especially if the phlebotomist needs assistance or the patient shows signs of distress, it should not be the first action taken. The immediate response should be to address the hematoma by stopping the draw.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
When performing a capillary blood collection, such as a fingerstick, the lancet should be positioned perpendicular to the fingerprint grooves. This orientation helps to ensure that the incision is made across the ridges of the fingerprint, which can facilitate a better blood flow and make it easier to collect an adequate sample without needing to squeeze the finger excessively, which could hemolyze the sample.
Choice B reason:
Positioning the lancet parallel to the nail bed is not recommended because it can result in a cut that runs along the length of the fingerprint grooves, which may not bleed as freely and could also be more painful for the patient.
Choice C reason:
Using the lancet along the lateral portion of the first digit is not part of the standard aseptic technique protocol for capillary blood collection. The first digit, or thumb, has a pulse and should generally be avoided because it can be more sensitive and is more prone to bruising.
Choice D reason:
The medial portion of the fifth digit, or the little finger, is also not a recommended site for capillary blood collection with a lancet. The little finger is typically smaller and may not provide an adequate site for blood collection, and similar to the thumb, it can be more sensitive and prone to injury.
Correct Answer is C
Explanation
Choice A Reason:
Notifying the provider about the error is an important step, but it does not correct the error in the patient's chart. Communication with the provider ensures that they are aware of the mistake and can make informed decisions regarding patient care. However, the physical correction of the documentation is also necessary to maintain accurate medical records.
Choice B Reason:
Asking an administrator to erase the error is not a recommended practice. Erasing or using correction fluid can make the chart appear tampered with, which can have legal implications. It is essential that the original entry remains visible to preserve the integrity of the medical record.
Choice C Reason:
Striking a line through the error and initialing is the correct method for correcting a written error in a patient's chart¹². This approach allows the original entry to remain legible, which is crucial for legal and clinical reasons. It also shows that the correction was made by an authorized individual, as the initials indicate who made the change.
Choice D Reason:
Erasing the error and entering the correct information is not an acceptable practice for the same reasons as choice B. It is important not to remove or conceal the original entry, as this could be considered falsifying medical records.
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