Venipuncture

What size needle is used for patients with very deep veins?

1 1/2 inch

What size needle is used for routine venipuncture?

1 inch

The tourniquet must not be left in place for more than ___ minute.

1 minute

Needle lengths range from:

1 to 1 1/2 inches

Anchor the vein ____ inches below the puncture site.

1-2 inches

What is the ratio of anticoagulant to blood in the light blue tubes?

1-part anticoagulant to 9-parts blood

According to CLSI, if blood must be drawn above the IV site, what must you do?

1. Ask the nurse to turn off the IV pump. Ensure that the IV flow has completely stopped. 2. Wait at least 2 minutes before applying the tourniquet. 3. Collect the sample. (Some facilities require that you discard the first 5ml of blood) 4. Notify the nurse to restart the IV. 5. Document that the sample was taken above an active IV site and the type of fluid being infused.

Puncture the skin at an angle of ______?

15-30 degree angle

What is the maximum number of attempts on a venipuncture?

2

You must verify a minimum of ___ patient identifiers.

2

The most frequently used gauges for phlebotomy are:

20g (yellow top), 21g (green top), 22g (black top)

How long should pressure be applied to the puncture site?

3 to 5 minutes

How many times should you invert tubes containing an additive?

3-10 times.

Insert the needle in the same direction as the vein at an angle of ____ or less.

30 degrees

How long should you directly observe the puncture site before bandaging?

5 to 10 seconds

What is the jelly stuff at the bottom of the tube called?

Agar

Any substance that is added into a tube by the manufacturer is called?

An additive

What is the preferred site for the venipuncture?

Antecubital fossa

Most common additive found in tubes that prevents clotting by binding or inactivating one of the elements necessary for clotting to occur and always produces a plasma specimen when centrifuged.

Anticoagulant

Mechanical process by which fluids are separated from solids.

Centrifugation

Who established the specific "Order of the Draw"?

Clinical Laboratory Standards Institute (CLSI)

An additive found in most plastic tubes that produce serum. Clot activators help the clotting process start and go completion.

Clot activator

Failure to mix or inadequate mixing of samples collected into a tube with anticoagulant.

Clotted

What color tube(s) should you use for a rainbow?

Every color tube that you have.

What is syncope?

Fainting

True or False: Serum contains clotting factors.

False

True or False: It is okay to label the tubes before collecting the sample.

False, never label the tubes before collecting the sample

True or false: All phlebotomy procedures must be performed with the bevel of the needle facing downwards.

False, upwards.

A number that indicates the diameter of the lumen?

Gauge

What is the use of glucose by blood cells?

Glycolysis

An additive that prevents glycolysis.

Glycolytic inhibitor

When blood collects below the skin's surface resulting in the formation of a bruise.

Hematoma

Red cells have been ruptured thereby causing hemoglobin to be released into the serum/plasma.

Hemolysis

A plastic sleeve into which the double pointed blood collection needle is screwed.

Holder or hub

The circular, hollow space inside the needle.

Lumen

What is the correct order of vein selection?

Median cubital, cephalic, basilic

The sheath makes it possible to draw several tubes of blood by preventing leakage of blood as tubes are changed, this is called?

Multi-draw or multi-sample needle

Can you tell the patient what tests are ordered or share the results of testing?

NO

Does the Order of the Draw (OOD) eliminate carryover?

No but it reduces the effect it may cause on certain test results

What Act requires that blood collection equipment be equipped with a safety device that can be activated with one hand to cover the needle immediately following use?

OSHA's Needle Stick Safety and Prevention Act

Where is the basilic vein located?

On the little finger side of the antecubital fossa

Where is the cephalic vein located?

On the thumb side of the antecubital fossa

Plasma contains all the clotting factor except?

One. The one that is missing will depend upon the type of anticoagulant in the tube.

Allowing the sample to sit upright for at least 30 min and omitting the clotting process produces?

Plasma

Liquid portion of anticoagulated blood is called?

Plasma

The clear liquid portion of a spun anticoagulated specimen.

Plasma

What tubes have anticoagulants?

Plasma tubes

Additive found in some tubes that create a permanent, physical barrier between the liquid portion of the sample and the cellular elements during centrifugation.

Polymer gel

QNS stands for?

Quantity non-sufficient

Allowing the sample to sit upright for at least 30 min to clot produces?

Serum

Liquid portion of clotted blood is called?

Serum

The clear, liquid portion of a specimen that has clotted?

Serum

What is an SST?

Serum Separator Tube

What anticoagulant is in the light blue tube?

Sodium citrate

What additive is found in gray stopper tubes and is a glycolytic inhibitor?

Sodium fluoride

What is the Order of the Draw based on?

The additive present in each tube and the test to be performed on subsequent tubes.

Why is the order of the draw critical in every multi-draw venipuncture?

The potential for carryover

What happens if you draw blood above an IV line?

The sample will be contaminated with IV fluids

True or False: According to CLSI, written permission must be obtained from the physician prior to drawing blood from the lower extremities such as the ankle or foot.

True

True or False: Any tube that is not red is plasma.

True

True or False: Never draw blood from the same side as a mastectomy.

True

True or False: Plasma specimens can be spun down immediately.

True

True or False: The cap of the needle is color coded to indicate the gauge.

True

True or False: The higher the gauge, the smaller the lumen.

True

True or False: Tubes are prefilled with the precise amount of additive required to mix with the amount of blood that will fill the tube.

True

True or False: You must label specimens immediately after collection and in the presence of the patient.

True

True or False: mL is the same thing as cc?

True

What consists of a double-pointed needle, a tube holder, and a series of vacuum tubes with rubber stoppers of various colors?

Vacuum System

An anticoagulated specimen where the cellular elements must stay mixed with the plasma for testing purposes.

Whole blood

Can a patient refuse a blood draw?

Yes

If a test requires serum, how long should the tube sit upright while the clotting process occurs?

at least 30 minutes

The slanted opening at the end of the needle.

bevel

The basilic vein lies close to the _____ and ____. It should be used only if necessary.

brachial nerve and artery

All coagulation tests are collected in what color tube?

light blue

The most common anticoagulants used?

sodium citrate, heparin, ethylenediaminetetraacetic acid (EDTA), and potassium oxalate

You palpate the veins to determine:

their direction, depth, and size.