Which of the following needles should a phlebotomist use for a venipuncture using a winged infusion set and a 5 mL syringe?
23-gauge
18-gauge
25-gauge
27-gauge
The Correct Answer is A
Choice A reason:
A 23-gauge needle is commonly used for venipuncture with a winged infusion set and a small volume syringe like a 5 mL syringe. This size provides a balance between patient comfort and the ease of drawing blood without causing hemolysis or excessive damage to blood cells. It is large enough to allow blood to flow easily into the syringe but small enough to minimize discomfort and the risk of bruising.
Choice B reason:
An 18-gauge needle is quite large and is typically used for situations requiring rapid administration of fluids or for blood donation where larger volumes are collected quickly. It is not ideal for a standard venipuncture, especially with a small syringe, as it can cause more pain and increase the risk of bruising.
Choice C reason:
A 25-gauge needle is on the smaller side and may be used for patients with very fragile veins or for pediatric patients. However, it may not be the best choice for a 5 mL syringe as it could make the blood draw process slower and more difficult, potentially leading to clotting in the needle or syringe.
Choice D reason:
A 27-gauge needle is very small and is typically used for subcutaneous injections, such as insulin injections, rather than for venipuncture. It would be too small for an efficient blood draw with a 5 mL syringe, as it would likely cause the blood to hemolyze or clot before the draw is completed.
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Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Using only one patient identifier is not sufficient to ensure patient safety and accuracy in healthcare settings. It increases the risk of misidentification, which can lead to serious medical errors. Therefore, one identifier is not the standard practice for patient verification before a blood draw.
Choice B Reason:
While two identifiers are commonly used in many healthcare settings as a minimum requirement, they may not always provide enough differentiation, especially in larger facilities where patient names may be similar. Two identifiers are often the minimum standard, but they are not the most comprehensive approach.
Choice C Reason:
Three unique patient identifiers provide a more robust method for verifying a patient's identity, significantly reducing the likelihood of errors. According to the Clinical and Laboratory Standards Institute (CLSI), three identifiers are recommended to ensure the correct patient is being collected. This may include the patient's full name, date of birth, and medical record number or another unique identifier.
Choice D Reason:
While using four unique identifiers could further reduce the risk of patient misidentification, it is not typically required as the standard minimum. Three identifiers are generally considered adequate for most healthcare settings to ensure patient safety and proper identification.
Correct Answer is B
Explanation
Choice A Reason:
Prepping the site with povidone iodine is not typically associated with hemoconcentration. Povidone iodine is used as an antiseptic to clean the skin before venipuncture to prevent infection. While it's important to allow it to dry to avoid sample contamination, it does not cause hemoconcentration.
Choice B Reason:
Leaving the tourniquet in place for more than 2 minutes can lead to hemoconcentration. A tourniquet is applied to engorge the veins, making them easier to puncture. However, prolonged application can result in fluid being forced out of the vein into the tissue, increasing the concentration of cells and larger molecules in the blood. This can affect certain laboratory test results by artificially increasing the levels of cellular components.
Choice C Reason:
Not refrigerating the specimen within 30 minutes does not cause hemoconcentration. However, it can affect the stability of certain analytes in the blood sample. Refrigeration is necessary for preserving the integrity of certain components of the blood until analysis, but it is unrelated to the concentration of cells within the sample at the time of collection.
Choice D Reason:
Removing the needle before the tourniquet is released does not cause hemoconcentration. This action might lead to other complications, such as hematoma formation, but it does not affect the concentration of cellular elements in the collected sample.
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