Which of the following is the correct angle of insertion when performing venipuncture using the evacuated tube method?
50°
30°
90°
75°
The Correct Answer is B
Choice A Reason:
An angle of 50° is too steep for venipuncture and increases the risk of going through the vein and causing injury to structures beneath it. A steeper angle can also make it more difficult to control the depth of the needle, leading to an increased chance of puncturing the posterior wall of the vein.
Choice B Reason:
An angle of 30° is the recommended angle for venipuncture as it allows for a smooth entry into the vein without going too deep. This angle helps to ensure that the needle enters the vein in a controlled manner and minimizes the risk of injury to the patient. It also provides a good balance between ease of entry and control over the needle's depth.
Choice C Reason:
An angle of 90° is not recommended for venipuncture because it is perpendicular to the skin, which greatly increases the risk of passing through the vein entirely and causing injury. This angle does not allow for any control over the depth of the needle and is likely to cause discomfort or pain to the patient.
Choice D Reason:
An angle of 75° is also too steep for safe venipuncture. Similar to a 50° angle, it increases the risk of penetrating the posterior wall of the vein and potentially damaging surrounding tissues or arteries. It is important to use a lower angle to ensure the safety and comfort of the patient during the procedure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
The recommended heel stick depth of 2.0 mm is based on the need to minimize the risk of injury to the infant. Penetrating deeper than this can increase the likelihood of hitting bone, which in infants can be as close as 2.0 mm under the skin of the plantar surface of the heel. This depth is sufficient to obtain a blood sample without risking injury to deeper tissues or bone.
Choice B Reason:
A depth of 2.5 mm may be too deep for some infants, especially preterm or very small infants, where the calcaneus (heel bone) is closer to the surface. While this depth might still be safe for some infants, it does not provide the same margin of safety as the 2.0 mm recommendation and could potentially lead to bone puncture or other injuries.
Choice C Reason:
A depth of 3.0 mm significantly increases the risk of bone puncture, especially in infants with less subcutaneous fat or in those who are preterm. This depth could easily breach the protective layer of skin and subcutaneous tissue, leading to a higher risk of osteomyelitis, an infection of the bone, which can be a serious complication in infants.
Choice D Reason:
A depth of 3.5 mm is considered too deep for a heel stick procedure and is likely to cause injury to the infant. This depth would almost certainly penetrate the bone in most infants, leading to severe pain, potential for infection, and other complications. It is well beyond the safe range recommended by CLSI and should be avoided.
Correct Answer is B
Explanation
Choice A Reason:
While informing the patient of the procedure is important, it is not the immediate next step after greeting. The technician should first ensure the patient's safety and comfort before proceeding with the details of the blood draw.
Choice B Reason:
Asking if the patient has a latex allergy is crucial as it directly pertains to patient safety. Many medical supplies, including gloves and tourniquets used during phlebotomy, may contain latex, which can cause allergic reactions in sensitive individuals. Identifying an allergy before any contact ensures that the technician can take necessary precautions to prevent an allergic reaction.
Choice C Reason:
Stating the technician's name to the patient helps build rapport but is not as critical as ensuring the patient's safety. It is a part of good communication and patient care practices but should follow after confirming any potential allergies or other immediate health concerns.
Choice D Reason:
Asking the patient which arm they prefer for the blood draw is a part of the procedure that involves patient preference and comfort. However, this should come after ensuring there are no allergies that could lead to complications during the draw.
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