During a venipuncture, the needle is in the vein and blood flow is established. When the second tube is attached, blood flow stops. Which of the following actions should the phlebotomist take?
Withdraw the needle completely.
Rotate the bevel of the needle.
Increase tourniquet pressure.
Activate a new evacuated tube.
The Correct Answer is D
Choice A Reason:
Withdrawing the needle completely would be an incorrect action because it would end the procedure prematurely and require a new venipuncture, causing unnecessary discomfort to the patient. It should only be done if the venipuncture has been completed or if there is a need to stop due to a complication.
Choice B Reason:
Rotating the bevel of the needle could potentially reposition the needle for better blood flow if it has become occluded or is not properly aligned with the vein. However, this action should be done with caution to avoid causing injury to the vein or discomfort to the patient.
Choice C Reason:
Increasing tourniquet pressure is not advisable once blood flow has been established, as it could cause damage to the vein or hemolysis of the blood sample. The tourniquet should be released once the blood starts flowing into the first tube to avoid these issues.
Choice D Reason:
Activating a new evacuated tube is the correct action to take when blood flow stops upon attaching a second tube. This could indicate a problem with the vacuum in the tube rather than with the needle or the venipuncture site. Trying a new tube can resolve the issue without needing to adjust the needle or the patient's position.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
A patient's room number is not considered a unique identifier by the Joint Commission standards. Room numbers can change if patients are moved, and they do not reliably identify an individual.
Choice B Reason:
A patient's bed label is also not a unique identifier. Bed labels can be switched, and similar to room numbers, they are not specific to the individual patient.
Choice C Reason:
A patient's inpatient chart typically contains multiple unique identifiers, such as the patient's name, an assigned identification number, date of birth, or other person-specific identifiers. These are considered acceptable by the Joint Commission for verifying patient identity, ensuring that the service or treatment is intended for that individual.
Choice D Reason:
Patient's verbal confirmation alone is not sufficient for establishing correct inpatient identification. While it can be used as one method of identification, it should be supplemented with another identifier to meet the Joint Commission's requirement of using at least two patient identifiers.
Correct Answer is A
Explanation
Choice A Reason:
The median cubital vein is often the first choice for venipuncture due to its size and accessibility. It is located in the antecubital fossa and is usually well anchored by surrounding tissues, which makes it less likely to roll during needle insertion. This vein is also less painful for patients when punctured due to its location and the type of surrounding tissue.
Choice B Reason:
The basilic vein is another option for venipuncture, but it is not typically the first choice. It is located on the medial aspect (inner side) of the arm and is more prone to rolling and injury because it is not as well anchored as the median cubital vein. Additionally, the basilic vein is located near nerves and arteries, which increases the risk of complications during venipuncture.
Choice C Reason:
The cephalic vein runs along the lateral aspect (outer side) of the arm and can be used for venipuncture. However, it is often more difficult to locate and has a tendency to roll, which can make venipuncture more challenging. It is usually considered after the median cubital vein.
Choice D Reason:
Veins on the underside of the wrist should generally be avoided for routine venipuncture because they are often smaller, can be more painful due to the proximity to nerves and tendons, and have a higher risk of complications. These veins are considered only when other sites are not available or are unsuitable for venipuncture.
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