Phlebotomy Equipment, Site Selection, and Procedures

Comprehensive set of 50 flashcards reviewing phlebotomy equipment, site selection, venipuncture and dermal puncture procedures, and patient care guidelines based on the lecture text.

What system is used to perform routine venipunctures?

The evacuated tube system

What three main components comprise the evacuated tube system?

A double-ended needle, vacuum tubes, and a tube holder

When using a blood pressure cuff as a tourniquet, to what pressure should it be inflated?

$$40\,\text{mm Hg}$$

How far above the venipuncture site should a tourniquet be applied?

$$3\text{ to }4\,\text{inches}$$

What is the maximum recommended time a tourniquet should remain tied on a patient's arm?

Less than $1\,\text{min}$

What condition is caused by leaving a tourniquet in place for longer than one minute?

Hemoconcentration

What are three alternative names for straight needles used in routine blood collection?

Double-ended needles, safety needles, or eclipse needles

What is another name for a winged infusion set?

Butterfly

What covers the tube-end needle in an evacuated tube system to prevent blood leakage before insertion?

A rubber sheath

Which blood collection system uses manual pressure and allows adjustment of withdrawal speed for fragile veins?

Syringe system

What type of base connects a syringe needle to its adapter?

Luer-Lok base

What needle gauge is used for most routine venipunctures?

$$21\text{ gauge}$$

What needle gauge is frequently used when a patient has smaller veins?

$$22\text{ gauge}$$

What range of needle gauges is typically used for blood donation?

$$16\text{ to }18\text{ gauge}$$

Why should a 25-gauge needle generally be avoided for adult venipunctures?

It can hemolyze the sample, resulting in inaccurate test results

What type and concentration of alcohol pads are typically used for site cleansing before routine venipuncture?

$70\%$ isopropyl or ethyl alcohol pads

What solutions are used to cleanse the site when drawing blood cultures?

$1\%\text{ to }10\%$ povidone-iodine swab sticks or chlorhexidine gluconate

Why should cotton balls be avoided for post-venipuncture care?

They can rip off a scab or leave fibers on the insertion site

How long must serum tubes be allowed to clot before being centrifuged?

$$30\text{ to }60\text{ minutes}$$

What liquid specimen portion is yielded when red, gold, or serum separator tubes are centrifuged?

Serum

What is the consequence of using expired blood collection tubes regarding vacuum pressure?

The vacuum is reduced, which could result in a lower volume of blood collected

What is the primary anatomical region used for venipuncture?

Antecubital region of the arm

What is the first-choice vein for routine venipuncture in the antecubital region?

Median cubital vein

What is the second-best vein choice for venipuncture in the antecubital region?

Cephalic vein

Why is the basilic vein considered the least desirable choice in the antecubital region?

It is located close to the median nerve and brachial artery, and rolls more easily

On what hand/arm site should venipuncture never be performed due to nerve and tendon injury risks?

Inside of the wrist

Leg or ankle venipunctures are strictly prohibited for patients diagnosed with which medical condition?

Diabetes mellitus

How should a phlebotomist adapt arm placement for a patient with arthritis?

Provide extra padding by using a towel or pillow to cushion their arm

How should an infant be positioned during blood collection to reduce choking risks?

On their side

What is the maximum percentage of blood volume that should be collected from an infant in a short period of time?

No more than $10\%$

What range represents the maximum percentage of blood volume that can be collected from an infant or child over a 24-hour period?

$$1\%\text{ to }5\%$$

By what number must an infant's weight in pounds be divided to convert it to kilograms?

$$2.2$$

How is an infant's total blood volume in milliliters calculated after converting weight to kilograms?

Multiply the sum in kilograms by $100$

If a patient reports a history of syncope, in what position must they be placed for venipuncture?

Reclined position

What patient hand action during vein palpation should be avoided because it elevates potassium levels?

Vigorously opening and closing the hand ("pumping" the hand)

How can a phlebotomist distinguish an artery from a vein during palpation?

An artery will have a felt pulse when pausing a finger on it for a second

What diameter around the insertion site should be scrubbed with alcohol?

$2\text{ to }3\text{ inches}$ in diameter

How long must an alcohol-cleansed site be allowed to air dry before needle insertion?

$$30\text{ seconds to }1\text{ minute}$$

What is the proper angle of insertion for a straight venipuncture needle?

$$15^\circ\text{ to }30^\circ$$

How far below the venipuncture site should the vein be anchored using the nondominant thumb?

$1\text{ to }2\text{ inches}$ below

What term refers to the process of stopping blood flow in the body?

Hemostasis

What angle of insertion should be used when performing venipuncture with a butterfly needle?

Approximately $10^\circ\text{ to }15^\circ$

What indicates that a butterfly needle has successfully entered the vein?

A flash of blood in the tubing

How long must direct pressure be applied if a hematoma starts forming during venipuncture?

$$5\text{ minutes}$$

What must a phlebotomist do if a patient explicitly asks them to stop the blood collection?

Stop the collection immediately

What single-use device containing a small needle and spring is used for capillary blood collection?

Lancet

Which specific fingers are recommended for performing a capillary puncture on an adult?

The second or third finger (middle or ring finger) on the nondominant hand

What is the maximum recommended lancet size for preterm and low-birth weight infants?

Lancets no larger than $0.85\,\text{mm}$

What is the maximum recommended lancet size for average-weight newborns and older children?

Lancets no larger than $2\,\text{mm}$

What step must be taken with the first drop of blood during a capillary puncture?

Wipe away the first drop of blood using clean gauze