Which of the following is the first step a phlebotomist should take to prevent the spread of infection?
Wearing gloves for any patient contact
Washing hands with antimicrobial soap and water
Applying antiseptic to the puncture sites prior to venipuncture
Decontaminating the equipment before use
The Correct Answer is B
Choice A reason:
Wearing gloves is an important step in preventing the spread of infection, but it is not the first step. Gloves provide a barrier between the phlebotomist's hands and the patient, which can help prevent the transmission of pathogens. However, gloves can still become contaminated, and if hand hygiene is not performed before donning gloves, pathogens can be transmitted when gloves are changed or removed.
Choice B reason:
Hand hygiene is widely recognized as the single most important practice in preventing the spread of infections. It is the first line of defense against the transmission of infectious agents. Washing hands with antimicrobial soap and water mechanically removes pathogens, and the antimicrobial agents in the soap can kill or inhibit the growth of microorganisms. This step is crucial before any patient contact, especially before invasive procedures like venipuncture.
Choice C reason:
Applying antiseptic to the puncture sites prior to venipuncture is a critical step in the prevention of infection at the site of the blood draw. This practice is essential for eliminating skin flora that could potentially enter the bloodstream during venipuncture. However, this is not the first step, as effective hand hygiene should precede any patient contact or procedure.
Choice D reason:
Decontaminating equipment before use is a necessary step to ensure that no infectious agents are transmitted via medical instruments. This includes cleaning and sterilizing equipment that comes into direct contact with the patient. While this is a vital part of infection control, it follows hand hygiene in the sequence of steps a phlebotomist should take.
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Related Questions
Correct Answer is B
Explanation
Choice A Reason:
Hemostasis is the process of blood clotting and the cessation of bleeding. While it is a desired outcome following any puncture, squeezing the puncture site would not typically cause hemostasis as a complication. It is the body's natural response to injury to prevent excessive blood loss.
Choice B Reason:
Hemolysis refers to the rupture of red blood cells, which can occur when excessive pressure is applied to a puncture site during a capillary blood collection. This pressure can cause the cells to burst, releasing their contents into the plasma, which can interfere with various laboratory tests and lead to inaccurate results.
Choice C Reason:
Homeostasis is the body's ability to maintain a stable internal environment despite changes in external conditions. It is not a complication but rather a regulatory process. Squeezing a puncture site does not directly relate to homeostasis as a complication.
Choice D Reason:
Hypobilirubinemia is a condition where there is less than the normal amount of bilirubin in the blood. It is not a complication associated with squeezing a puncture site. Bilirubin levels are typically affected by liver function and red blood cell breakdown, not by the mechanical action of squeezing a site.
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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