Hemoconcentration of a venous blood sample is most often caused when:
The site is prepped with povidone iodine.
The tourniquet is in place for more than 2 minutes.
The specimen is not refrigerated within 30 minutes.
The needle is removed before the tourniquet.
The Correct Answer is B
Choice A Reason:
Prepping the site with povidone iodine is not typically associated with hemoconcentration. Povidone iodine is used as an antiseptic to clean the skin before venipuncture to prevent infection. While it's important to allow it to dry to avoid sample contamination, it does not cause hemoconcentration.
Choice B Reason:
Leaving the tourniquet in place for more than 2 minutes can lead to hemoconcentration. A tourniquet is applied to engorge the veins, making them easier to puncture. However, prolonged application can result in fluid being forced out of the vein into the tissue, increasing the concentration of cells and larger molecules in the blood. This can affect certain laboratory test results by artificially increasing the levels of cellular components.
Choice C Reason:
Not refrigerating the specimen within 30 minutes does not cause hemoconcentration. However, it can affect the stability of certain analytes in the blood sample. Refrigeration is necessary for preserving the integrity of certain components of the blood until analysis, but it is unrelated to the concentration of cells within the sample at the time of collection.
Choice D Reason:
Removing the needle before the tourniquet is released does not cause hemoconcentration. This action might lead to other complications, such as hematoma formation, but it does not affect the concentration of cellular elements in the collected sample.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
A patient's room number is not a unique identifier as it is subject to change. Patients may be moved to different rooms during their hospital stay, and room numbers are not specific to individuals.
Choice B reason:
A patient's bed label is also not a unique identifier. Like room numbers, bed labels can change if patients are moved within the hospital for various reasons, such as changes in their medical condition or room availability.
Choice C reason:
The patient's inpatient chart demographic information is the correct unique identifier to use. This typically includes the patient's name, date of birth, and a unique medical record number assigned by the healthcare facility. These details are specific to the individual and do not change, making them reliable for patient identification.
Choice D reason:
A patient's verbal confirmation alone is not sufficient as a unique identifier. While it is important to engage the patient in the identification process, verbal confirmation must be used in conjunction with other identifiers to ensure accuracy, as patients may be confused or unable to communicate effectively.
Correct Answer is C
Explanation
Choice A reason:
Simply observing the site to see if the hematoma worsens is not an appropriate response. While monitoring the development of a hematoma is part of the process, it is not a proactive measure to address the immediate issue. The phlebotomist must take action to prevent further injury or complication.
Choice B reason:
Asking the patient to apply pressure may be part of the post-venipuncture care, especially after the needle has been removed, to aid in stopping any bleeding. However, this does not address the immediate concern of a developing hematoma during the draw.
Choice C reason:
Releasing the tourniquet and stopping the draw is the correct action to take when a hematoma is observed. This response is in line with the standard procedure for when a complication arises during venipuncture. Stopping the draw helps prevent further blood from pooling and exacerbating the hematoma.
Choice D reason:
While calling for a nurse and assessing the patient's condition is important, especially if the phlebotomist needs assistance or the patient shows signs of distress, it should not be the first action taken. The immediate response should be to address the hematoma by stopping the draw.
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