After greeting the patient, a phlebotomy technician is preparing to perform a blood draw on a patient in an inpatient facility. Which of the following actions should the technician take next?

Choice A Reason:
The age of the newborn is important for certain metabolic screenings, as some metabolites may not be present or at measurable levels immediately after birth. However, the requirement for the newborn to be at least 3 days old is not a standard for all blood spot collections for inborn errors of metabolism (IEM). Some screenings are performed within 24 to 48 hours after birth.

Choice B Reason:
While it is important that the circles on the filter paper are adequately filled to ensure there is enough blood for the test, the requirement for them to be at least half filled is not specified in the guidelines. The focus is usually on ensuring the blood spot is of the right size and properly saturated through the filter paper.

Choice C Reason:
The inclusion of the first drop of blood is not typically a requirement. In fact, the first drop is often wiped away to avoid contamination with tissue fluids that could affect the test results. Subsequent drops are used to fill the circles on the filter paper.

Choice D Reason:
The specimen must be completely dried before the test can be processed to prevent degradation or hemolysis of the blood sample. This is a critical step in the preparation of the sample for accurate testing of IEM. The drying process helps preserve the integrity of the metabolites to be analyzed.

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.