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 B
Explanation
Choice A Reason:
Positioning the needle at a 45° angle to the skin is not the recommended approach for venipuncture using a butterfly needle on dorsal hand veins. The correct angle for insertion is usually less than 45°, often around 15-30°, to ensure a shallow entry and reduce the risk of going through the vein.
Choice B Reason:
Holding the needle by the wings of the butterfly is the correct technique. This allows for better control and stability during insertion. The wings are designed to be held between the thumb and forefinger, providing an easy grip for the phlebotomist to maneuver the needle with precision.
Choice C Reason:
Instructing the patient to hold the collection tubes is not standard practice and could lead to pre-analytical errors. The phlebotomist should maintain control of the tubes to ensure proper blood flow and fill volume, as well as to prevent contamination or accidents.
Choice D Reason:
Applying the tourniquet at the antecubital area is not specific to the use of a butterfly needle for venipuncture on dorsal hand veins. While a tourniquet is used to engorge the veins and make them more prominent, its placement may vary depending on the selected puncture site and is not the action in question here.
Correct Answer is D
Explanation
Choice A reason:
Turning the patient's hand palm down is not typically recommended as it can make the veins less accessible and may cause discomfort to the patient. The veins on the back of the hand are more superficial and can be more easily accessed when the hand is palm up.
Choice B reason:
Placing the patient in a supine position is not necessary for all venipuncture procedures and is usually reserved for patients who have a history of fainting or for those who are already lying down due to their medical condition. It is not a position that specifically increases comfort during the procedure.
Choice C reason:
Bending the patient's arm at the elbow can actually hinder the blood draw process as it may cause the veins to be less prominent and can lead to discomfort or movement during the venipuncture, potentially causing injury or an unsuccessful draw.
Choice D reason:
Positioning the patient's hand at waist level is the correct choice as it allows the arm to be in a natural, relaxed position, which can help the veins to be more prominent and accessible. It also helps in reducing the patient's anxiety as the arm is not in an awkward or strained position.
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