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 D
Explanation
Choice A reason:
The patient's insurance provider name is not typically required on a CBC specimen label. While insurance information is crucial for billing purposes, it does not serve as an identifier for the specimen itself and is therefore not documented on the label.
Choice B reason:
The phlebotomist's full name is not a requirement for a CBC specimen label. The focus of documentation on the label is on patient identification and specimen integrity, not the identity of the healthcare professional collecting the specimen.
Choice C reason:
A phlebotomist's certification number is also not required on a CBC specimen label. While the phlebotomist's credentials are important for their professional status, they are not part of the necessary documentation for a specimen label.
Choice D reason:
The patient's identification number is a critical piece of information that must be documented on a CBC specimen label. This unique identifier links the specimen to the patient's medical record, ensuring that the test results are accurately recorded in the patient's health history.
Correct Answer is A
Explanation
Choice A Reason:
The evacuated tube system is designed for the collection of multiple blood specimens using interchangeable tubes. This system utilizes a double-pointed needle, one end of which goes into the patient's vein and the other into a vacuum tube. As the blood is drawn, it automatically fills the tube until the vacuum is exhausted. The phlebotomist can then easily replace the filled tube with another without removing the needle from the patient's vein, allowing for multiple samples to be taken during a single venipuncture.
Choice B Reason:
The hypodermic needle and syringe system is typically used for manual blood draws when the evacuated tube system is not suitable, such as with small or fragile veins. This system does not use interchangeable tubes; instead, the blood is drawn into a syringe and then transferred into the appropriate tubes, which can be time-consuming and increase the risk of hemolysis or contamination.
Choice C Reason:
A winged infusion set, also known as a butterfly needle, is often used for patients with difficult veins. Like the hypodermic needle and syringe system, it does not inherently allow for the use of interchangeable multi-sample tubes. Blood is collected into a syringe or a single tube attached to the butterfly needle, and changing tubes usually requires a new puncture for each sample.
Choice D Reason:
The lancet microcollection system is used for capillary blood collection, typically from a fingerstick or heelstick. It is used for small volume samples and does not accommodate interchangeable multi-sample tubes. This method is commonly used for pediatric patients or when only a small amount of blood is needed.
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