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Phlebotomy Ch.9: Lecture 1 (Test requisitions (when receive it (examine it…
Phlebotomy Ch.9: Lecture 1
Test requisitions
this order is used to determine what type of sample to collect from a patient
must have patient's name, date of birth, sex, race, possibly hospital id number, room and bed #, the test status, and ICO-9 code
allows you to identify the patient correctly
tells what specimen should be collected
allows you to gather your equipment before you encounter the patient
when receive it
examine it to make sure it has the required info: full name, DOB, ordering physician, and test codes
check for duplicates
prioritize the requisitions
collect all equipment you will need for the tests that you are collecting
Routine Venipuncture
Greet and identify pt
knock before entering the room and announce yourself if there is a curtain
let the patient know what the physician has ordered
be positive on patient identification and ask him/her their full name
Check the requisition info against the pt has told you
match the name and hospital ID # that is unique to pt
armband must be attached to the pt
do not draw pt blood until armband has been placed on pt's arm or ankle
out pt's don't have armbands so ask pt to state name and date of birth; compare that info with requisition
ask them if they are taking any medication
pt's on blood thinners may require extra pressure post
Position and prepare the pt
never draw blood from a standing patient
seat outpatients in a phlebotomy chair with arm support
for inpatients return bed railings to the same to the same position in which you found them
all foreign objects should be removed from pt mouth to avoid choking
explain procedure and get verbal consent before
verify pretest fasting by asking the pt when was the last time they had anything to eat or drink
assemble your equipment in front of the patient
Steps 4-6
Apply the tourniquet about 3-4 in above the puncture site
form an x and then tuck from the top
the tourniquet should not be on the arm for longer than a minute
when improper it can cause complications
hemoconcentration
an increase in the ratio of formed elements to plasma
hemolysis
destruction of red blood cells
petechiae
small red spots on the skin caused by blood leaking into the epithelial
Select the Site
median cubital vein
well anchored; first choice in the antecubital fossa
Cephalic vein
on the thumb side of the arm; second choice
Basilic vein
on the little finger side of the arm; third choice
you may puncture the brachial artery if you go too deep
Palpate the vein
touch the vein gently, pushing up and down to feel for the bouncy vein
Determine the depth, diameter, and direction of the vein
can have pt make a fist to make vein appear
or gently massage the arm or use a warm towel over the area
Step 7-9
clean the site with 70% isopropyl alcohol in concentric circles working in to out; allow the site to dry to act
Reapply the tourniquet if it was removed during the cleansing process
Remove the cap and examine the needle tip for any defects