A phlebotomist should recognize that the Clinical and Laboratory Standards Institute (CLSI) recommends that a heel stick depth should not penetrate deeper than which of the following depths for an infant patient?
2.0 mm
2.5 mm
3.0 mm
3.5 mm
The Correct Answer is A
Choice A Reason:
The recommended heel stick depth of 2.0 mm is based on the need to minimize the risk of injury to the infant. Penetrating deeper than this can increase the likelihood of hitting bone, which in infants can be as close as 2.0 mm under the skin of the plantar surface of the heel. This depth is sufficient to obtain a blood sample without risking injury to deeper tissues or bone.
Choice B Reason:
A depth of 2.5 mm may be too deep for some infants, especially preterm or very small infants, where the calcaneus (heel bone) is closer to the surface. While this depth might still be safe for some infants, it does not provide the same margin of safety as the 2.0 mm recommendation and could potentially lead to bone puncture or other injuries.
Choice C Reason:
A depth of 3.0 mm significantly increases the risk of bone puncture, especially in infants with less subcutaneous fat or in those who are preterm. This depth could easily breach the protective layer of skin and subcutaneous tissue, leading to a higher risk of osteomyelitis, an infection of the bone, which can be a serious complication in infants.
Choice D Reason:
A depth of 3.5 mm is considered too deep for a heel stick procedure and is likely to cause injury to the infant. This depth would almost certainly penetrate the bone in most infants, leading to severe pain, potential for infection, and other complications. It is well beyond the safe range recommended by CLSI and should be avoided.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Taking the specimen temperature before 4 minutes is the correct procedure according to the Department of Transportation (DOT) guidelines. The DOT Rule 49 CFR Part 40 Section 40.65 states that the temperature of the specimen must be checked no later than four minutes after the employee has given the specimen. The acceptable temperature range is 32–38 °C/90–100 °F, which helps to verify the validity of the specimen.
Choice B Reason:
Taking the specimen temperature at 5 minutes is not within the DOT guidelines. The temperature must be taken before 4 minutes have passed to ensure the specimen's integrity and to comply with the regulatory requirements.
Choice C Reason:
At 15 minutes, the temperature check would be too late. The DOT guidelines specify that the temperature should be checked no later than four minutes after collection to ensure the specimen has not been tampered with and is within the acceptable temperature range.
Choice D Reason:
After 30 minutes, the temperature of the urine specimen would not reflect the body temperature at the time of collection, which is necessary for the validity of the test. This delay could allow for the temperature to fall outside of the acceptable range, potentially invalidating the specimen.
Correct Answer is B
Explanation
Choice A Reason:
Pernicious anemia is a type of anemia caused by a deficiency of vitamin B12, which is not directly related to the volume of blood drawn. It is typically associated with the inability to absorb vitamin B12 from the gastrointestinal tract and is not a consequence of drawing blood.
Choice B Reason:
Iatrogenic anemia is the correct answer. It is a condition that can occur when too much blood is drawn from an infant, leading to anemia caused by medical intervention. Infants have a limited blood volume, and removing more than the recommended amount can significantly decrease their red blood cell count, resulting in anemia.
Choice C Reason:
Hyperthermia refers to an abnormally high body temperature, which is not a direct result of drawing blood. It is more commonly associated with environmental factors, infections, or other medical conditions that cause the body's temperature regulation to fail.
Choice D Reason:
Hypothermia is a condition where the body temperature drops below the normal range, which is also not a direct consequence of drawing blood. It is typically caused by prolonged exposure to cold temperatures and is unrelated to the volume of blood drawn from an infant.
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