Phlebotomy Procedures
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| 1 Rationale | Blood collection for arterial blood gas analysis using the radial artery.
🗑
|
||||
| 2 Equipment | Tincture of iodine solution or chlorhexidine gluconate
🗑
|
||||
| 3 Equipment | 0.5% to 1% lidocaine to numb site
🗑
|
||||
| 4 Equipment | Prefilled heparinized safety syringe, 1 to 5 mL (especially designed plastic syringe for collections for ABG analysis)
🗑
|
||||
| 5 Equipment | Collection w/a plastic syringe requires the sample to be transported at room temperature & analyzed within 30 mins. If analysis will occur after a 30 min delay from collection, collect the blood in a glass syringe & transport it in a slurry of ice water.
🗑
|
||||
| 6 Equipment | Safety needles (20- to 22-gauge, for collections for ABG analysis)
🗑
|
||||
| 7 Equipment | Safety needles (25- to 26-gauge, for lidocaine administration)
🗑
|
||||
| 8 Equipment | Safety syringe for lidocaine administration (1- or 2-mL plastic syringe)
🗑
|
||||
| 9 Equipment | Plastic bag or cup with crushed ice and water
🗑
|
||||
| 10 Equipment | Waterproof ink pen
🗑
|
||||
| 11 Equipment | Oxygen-measuring device to record bon laboratory requisition the oxygen concentration on patient receiving oxygen
🗑
|
||||
| 12 Equipment | Thermometer to record patient's temperature on laboratory requisition
🗑
|
||||
| 13 Equipment | Mask
🗑
|
||||
| 14 Equipment | Protective laboratory coat or smock.
🗑
|
||||
| 15 Preparation | Gather and organize the necessary equipment and supplies for a successful arterial puncture
🗑
|
||||
| 16 Preparation | Properly identify the patient and inform him or her of the arterial puncture procedure
🗑
|
||||
| 17 Preparation | Determine that the patient has been in a stable state for at least the previous 30 min (no respiratory changes)
🗑
|
||||
| 18 Preparation | Attempt to calm the patient before collecting the specimen if the patient appears anxious. The anxiety can lead to hyperventilation (rapid breathing) which can falsely alter ABG levels
🗑
|
||||
| 19 Preparation | Before proceeding, determine whether the patient is receiving anticoagulant therapy or is allergic to iodine or lidocaine, and record the patient's temperature, oxygen concentration from the respirator, & respiratory rate
🗑
|
||||
| 20 Procedure | Wash your hands; put on gloves, a facial mask, and a protective laboratory coat; and then palpate the radial artery in the forearm. The radial artery in the patient's nondominant hand is usually the best choice
🗑
|
||||
| 21 Procedure | With the forefinger or first two fingers, press at these sites to find the artery. Never use your thumb (has a pulse). Avoid any site that has a hematoma or that was previously used for an arterial puncture
🗑
|
||||
| 22 Procedure | Position the patient's arm with the wrist slightly extended and rotated. Check for adequate collateral circulation using the modified Allen test
🗑
|
||||
| 23 Procedure | Once the radial artery site is chosen, clean the area well with tincture of iodine or chlorhexidine. Do not touch the site after it is cleansed.
🗑
|
||||
| 24 Procedure | If the patient desires a local anesthetic, fill a 1-mL syringe with lidocaine and inject the lidocaine with the 25- to 26- gauge needle subcutaneously around the anticipated puncture site
🗑
|
||||
| 25 Procedure | No tourniquet is required because the artery has its own strong BP. Use a prefilled heparinized safety syringe (1 to 5 mL) with a needle to withdraw the sample
🗑
|
||||
| 26Procedure | Hold syringe/collection device like a dart. Pull skin taut w/a finger of the other hand over the artery, and pierce the pulsating artery at a high angle, usually 30°-45° against the bloodstream. Blood pulsates quickly into syringe under its own pressure.
🗑
|
||||
| 27 Procedure | When apprx 1mL of blood is collected, withdraw needle carefully to avoid bubbles. Apply gauze pressure at least 5min. If pt is receiving anticoagulant therapy (ie, Coumadin), gauze pressure 10-15mins.
🗑
|
||||
| 28 Procedure | Engage the safety syringe cover to cover the needle exposure, gently mix the blood in the syringe with the heparin, and label the syringe. Mix the blood gently by inverting the syringe at least 5x.
🗑
|
||||
| 29 Procedure | Before leaving the patient, clean the puncture site with an alcohol pad to remove the excess iodine or chlorhexidine solution; leave a pressure bandage on the site
🗑
|
||||
| 30 Procedure | If bleeding from the site persists, apply more manual pressure and ring for assistance from the patient's primary nurse. Never leave a patient who is bleeding, particularly after an arterial puncture
🗑
|
||||
| 31 After the Procedure | Notify the primary nurse after an arterial puncture is performed so that the area may be checked frequently for deep or superficial bleeding
🗑
|
||||
| 32 After the Procedure | Discard blood-soaked gauze pads, contaminated items, and gowns or gloves used in isolation rooms in approximate biohazardous waste containers
🗑
|
||||
| 33 After the Procedure | Dispose of gowns and gloves that are not from isolation rooms in the appropriate containers
🗑
|
||||
| 34 After the Procedure | Wash or sanitize your hands
🗑
|
||||
| 35 After the Procedure | Thank the patient for cooperating and depart with all specimens and all remaining supplies. Do not leave anything at the patient's bedside
🗑
|
||||
| 36 After the Procedure | Deliver the blood specimen with the laboratory test to the laboratory immediately
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
DenmarkH0ttie
Popular Phlebotomy sets