Which of the following actions should a phlebotomist take when interacting with a patient who has a "Contact Precautions" sign on their door?
Don a gown prior to entering the patient's room and remove it before leaving the room.
Don a face shield prior to entering the patient's room and remove it after leaving the room.
Don a mask prior to entering the patient's room and remove it before leaving the room.
Don gloves after cleaning and evaluating the patient's venipuncture site.
The Correct Answer is A
Choice A Reason:
When a patient is under "Contact Precautions," it is recommended that healthcare workers don a gown upon entering the patient's room. This is to prevent the spread of infection through contact with the patient or their environment. The gown should be removed before leaving the room to avoid contaminating other areas.
Choice B Reason:
While a face shield may be necessary for certain procedures, it is not specifically required for "Contact Precautions." The primary concern with contact precautions is preventing the transmission of infections through touch, not through droplets, which is what a face shield would protect against.
Choice C Reason:
Donning a mask is not a standard requirement for "Contact Precautions" unless there is a risk of droplet transmission. In this scenario, the precautions are specifically for contact, and therefore, a mask alone would not be sufficient.
Choice D Reason:
Gloves should be donned before any potential contact with the patient or their immediate environment, not just after cleaning and evaluating the venipuncture site. Gloves are a critical component of PPE when dealing with patients under "Contact Precautions."
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Correct Answer is D
Explanation
Choice A reason:
While maintaining compliance with Clinical Laboratory Improvement Amendments (CLIA) standards is important, it is not the primary reason for explaining the venipuncture procedure to the patient. CLIA standards primarily deal with laboratory testing and do not specifically require the explanation of procedures to patients.
Choice B reason:
Evaluating the patient's understanding is a beneficial practice as it ensures that the patient is informed and can participate in their own care. However, it is not the primary legal or ethical requirement for explaining the procedure.
Choice C reason:
Maintaining compliance with Occupational Safety and Health Administration (OSHA) standards is crucial for ensuring the safety of both the healthcare provider and the patient. OSHA standards require that certain safety protocols be followed, but they do not specifically mandate that the procedure be explained to the patient for the purpose of obtaining consent.
Choice D reason:
Obtaining the patient's consent is the primary reason a phlebotomist should explain the procedure prior to venipuncture. Informed consent is a fundamental ethical and legal principle in healthcare. It involves informing the patient about the procedure, its risks, benefits, and alternatives, and ensuring that the patient understands this information before agreeing to proceed. This process respects the patient's autonomy and right to make decisions about their own healthcare.
Correct Answer is A
Explanation
Choice A reason:
The left antecubital area is the correct site to perform venipuncture on a patient who has had a right-sided mastectomy. It is recommended to avoid the side of the mastectomy due to the risk of lymphedema and other complications associated with the removal of lymph nodes during the surgery. The left antecubital fossa, which is the area in front of the elbow, is a common site for venipuncture and is generally safe for use when the right side cannot be used.
Choice B reason:
The right cephalic vein should be avoided in a patient with a right-sided mastectomy. Venipuncture on the same side as the mastectomy can increase the risk of complications, including lymphedema, which is a condition characterized by swelling due to lymph fluid accumulation. Therefore, the right cephalic vein is not an appropriate choice.
Choice C reason:
The left femoral artery is not a venipuncture site; it is an arterial site. Venipuncture refers to accessing a vein, not an artery, for blood collection. Additionally, arterial puncture is a more invasive procedure typically reserved for arterial blood gas analysis and is not performed for routine venipuncture.
Choice D reason:
Similar to choice B, the right basilic vein should be avoided for venipuncture in a patient who has had a right-sided mastectomy. The basilic vein is located on the inner side of the arm and using it could pose the same risks as using the right cephalic vein, including the potential for lymphedema.
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