Which of the following needle gauge ranges should a phlebotomist select when performing a venipuncture for blood donation?
16- to 18-gauge
19- to 21-gauge
22- to 24-gauge
25- to 28-gauge
The Correct Answer is A
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.
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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 B
Explanation
Choice A reason:
Cleaning the site is a step that should be completed before anchoring the vein. The site should be cleaned with an antiseptic to reduce the risk of infection. Once the vein is anchored, cleaning the site again could displace the vein and compromise the anchoring.
Choice B reason:
After anchoring the vein, the phlebotomist should perform the procedure, which involves inserting the needle into the vein at the appropriate angle. Once the needle is in place and blood is seen in the tubing, the phlebotomist can proceed to collect the necessary amount of blood into the vacutainers or syringe.
Choice C reason:
Examining the needle is not the next step after anchoring the vein. The needle should be examined before the procedure begins to ensure it is the correct size and gauge for the venipuncture and that there are no defects.
Choice D reason:
Reapplying the tourniquet is not necessary at this point in the procedure. The tourniquet should already be in place to engorge the vein, making it easier to anchor and access. Reapplying it could cause discomfort or even disrupt the already anchored vein.
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