Which of the following parameters should a phlebotomist consider when selecting a blood collection method?
Patient condition, patient age, blood volume required
Patient height, patient gender, patient medications
Ordering physician, number of tests ordered, diagnosis
Time of day, timing of specimen, test status
The Correct Answer is A
Choice A Reason:
The patient's condition is a critical factor as it can influence the ease of blood collection and the choice of collection site. For example, a dehydrated patient may have less accessible veins. Patient age is also important; pediatric and geriatric patients may require different approaches due to vein size and fragility. The blood volume required for testing must be considered to ensure sufficient sample size without compromising patient safety, adhering to guidelines that limit blood collection to a certain percentage of the patient's total blood volume.
Choice B Reason:
While patient height and gender may influence the choice of blood collection site, they are not as critical as the factors listed in choice A. Patient medications are important to consider, as some medications may affect coagulation or the integrity of the sample.
Choice C Reason:
The ordering physician's preferences may be considered, but they are not a primary factor in the method of collection. The number of tests ordered and the diagnosis can influence the volume of blood needed but are secondary to the patient's condition and safety considerations.
Choice D Reason:
The time of day and the timing of the specimen collection can be important for certain tests that are time-sensitive or influenced by diurnal variations. The test status, whether routine or stat, may affect the urgency of collection but not necessarily the method of collection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
Contacting the physician by paging or calling right away is the most appropriate action when critical values are confirmed on a laboratory test. Critical values are defined as those that indicate the patient is in danger of death unless treatment is initiated immediately. Immediate notification of the responsible licensed caregiver is required so that appropriate clinical action can be taken for the patient. This is a standard procedure compliant with CLIA regulation 493.1109(f) and is essential for patient safety.
Choice B Reason:
Leaving a message at the physician's office number is not an adequate response to confirmed critical values. Messages can be overlooked or not checked until the next business day, which could delay necessary urgent medical interventions.
Choice C Reason:
Calling the physician's office on the next business day is not acceptable when dealing with critical values. The urgency of critical results requires immediate action, and waiting until the next business day could result in significant harm or death to the patient.
Choice D Reason:
Faxing the results to the physician's office with a stat fax cover is not sufficient for immediate communication of critical values. While the fax may indicate urgency, there is no guarantee that the fax will be seen immediately by the physician or their staff. Direct communication through paging or calling ensures that the critical information is relayed without delay.
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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