When using a butterfly needle for venipuncture on dorsal hand veins, which of the following actions should the phlebotomist take?
Position the needle at a 45° angle to the skin.
Hold the needle by the wings of the butterfly.
Instruct the patient to hold the collection tubes.
Apply the tourniquet at the antecubital area.
The Correct Answer is B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
For blood donation, a 16- to 18-gauge needle is typically used because it is large enough to allow the rapid flow of blood without causing hemolysis (destruction of red blood cells). The larger gauge needle also helps in minimizing the time the donor has to spend during the donation process. Using a needle that is too small could slow down the blood flow and potentially damage the blood cells, which is not ideal for the recipient of the blood donation.
Choice B Reason:
A 19- to 21-gauge needle is commonly used for routine venipuncture but is not ideal for blood donation. These needles are smaller than the 16- to 18-gauge needles and would not facilitate the quick collection of the volume of blood typically required for a donation. They are more suitable for collecting blood samples for testing rather than for donation purposes.
Choice C Reason:
A 22- to 24-gauge needle is even smaller and is often used for patients with smaller veins, such as children or elderly patients. These needles would not be appropriate for blood donation as they could significantly slow the blood flow and increase the donation time, which could be uncomfortable for the donor.
Choice D Reason:
A 25- to 28-gauge needle is the smallest size commonly used in medical practice and is suitable for patients with extremely small or fragile veins. These needles would be impractical for blood donation due to their small size, which would not allow for the efficient flow of blood required for a donation.
Correct Answer is B
Explanation
Choice A Reason:
The timeline of the individual prior to specimen collection is important for context but is not typically part of the chain of custody documentation. The chain of custody focuses on the handling of the specimen rather than the activities of the individual before the collection.
Choice B Reason:
The identity of each person who handles the specimen is a critical element of the chain of custody. This information ensures that the specimen can be tracked at every stage from collection to analysis, and any potential tampering can be identified and addressed.
Choice C Reason:
While the physical and mental status of the individual may be noted in medical records or police reports, it is not a standard part of the chain of custody for a blood alcohol test. The chain of custody's purpose is to track the specimen, not the condition of the individual.
Choice D Reason:
The condition of the specimen every hour is not required in the chain of custody documentation. What is necessary is the documentation of any changes in the condition of the specimen that could affect the integrity of the results, such as temperature excursions or signs of tampering.
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