Activity 3

Cards (23)

  • Venipuncture
    process of accessing intravenous flow for the purpose of therapy or obtaining venous blood for sampling
    1. Patient to make a fist, but not pump hands:
    2. make a fist for veins to be more prominent
    3. not pumping to prevent hemoconcentration
    4. Tourniquet:
    5. makes vein easier to feel or palpate
    6. 3-4 inches above intended puncture site
    7. must not be applied more than 1 minute
  • the patient should be either lying down or sitting in a special phlebotomy chair
  • phlebotomy chair
    has a movable arm support that helps in positioning the patient's arm
  • Never attempt phlebotomy when a patient is standing
  • If only armless chair is available, place patient arm on the his or her thigh for proper support
  • Supine position is the most common phlebotomy position in inpatient in hospital beds
  • H pattern
    ~70% of the population
  • median cubital vein
    near center
  • cephalic vein
    lateral aspect of the af
  • basilic vein
    medial aspect of the af
  • m pattern
    forms when cephalic and basilic veins divide into two branches forming v-shape
  • median vein
    at the very center of the pattern
  • median cephalic vein
    branches from the median vein to the lateral aspect of the arm
  • median basilic vein
    branches from the median vein to the medial aspect of the arm
  • tourniquet application
    1. position the tourniquet under the arm while grasping the ends above the arm and venipuncture area. the tourniquet should bet 3-4 inches above the site.
    2. cross the left and over the right end and apply a small amount of tension to the tourniquet.
    3. using the right middle finger or index finger, tuck the left and under the right end.
    4. a loose end of the tourniquet will be pointing toward the shoulder and the loop will be pointed toward the hand.
  • palpating the venipuncture site
    • Determine size, depth, and direction of the vein
    • Palpate using the tip of the index finger
    • Select vein that is large, and does not roll from side-to-side or move easily
    • An appropriate vein for venipuncture will bounce and have resilience to it
    • Avoid veins that exhibit sclerosis, or feels hard and cordlike
  • petechiae
    small, nonraised red spots in the skin due to a minute hemorrhage, can result if tourniquet is left on too long
  • choking precautions
    patients should not be drinking, eating, or chewing gum during phlebotomy
  • hematoma
    mass of blood caused by leakage of blood into the tissues (tourniquet is left too long, or left after needle is taken out; bevel went through and through the vein)
  • hemoconcentration
    rapid increase in the ration of blood components to plasma
  • specimen considerations: Avoid the following sites for venipuncture:
    edematous or full of swelling, iv site, mastectomy site (lyphostasis)
  • Special considerations for various population groups:
    children, geriatric, patients with hiv or hepatitis, psychiatric patients