Critical Thinking Questions: Chapter 8
Venipuncture Procedures
NAACLS Entry Level Competency 6.00
Objective #1
The only phlebotomist on duty one evening receives orders to collect a STAT hemoglobin and hematocrit in the ER, STAT blood cultures on another ER patient, and STAT glucose in the ICU. Which STAT specimen should he collect first? Explain your answer.
NAACLS Entry Level Competency 6.00
Objective #2
A phlebotomist arrives to collect a blood specimen from an inpatient. The patient is not wearing an ID band. There is an ID band attached to the nightstand next to the bed. The information on that ID band matches the requisition. The name and date of birth stated by the patient also match the requisition. What should the phlebotomist do?
NAACLS Entry Level Competency 6.00
Objective #2
A phlebotomist has an order to collect a blood specimen from an inpatient. The name of the physician on the requisition does not match the physician’s name on the patient’s ID band. What should the phlebotomist do?
NAACLS Entry Level Competency 6.00
Objective #2
A phlebotomist is about to collect a fasting glucose specimen from an outpatient. The patient is chewing gum but assures the phlebotomist that it is sugarless gum. When the phlebotomist asks if the patient is fasting, the patient admits to having had a cup of black coffee. How should the phlebotomist proceed?
NAACLS Entry Level Competency 6.00
Objective #2
After trying twice unsuccessfully to collect a specimen from a patient, the phlebotomist now sees an excellent wrist vein that she had not noticed before. What should the phlebotomist do?
NAACLS Entry Level Competency 9.3
Objective #3
A phlebotomist has an order to collect blood cultures from a 7-year-old child. The child is crying and squirming in the chair. The child’s mother is getting frustrated and upset. How should this situation be handled? What method of restraint should be used, and what equipment should be used to collect the specimen?
NAACLS Entry Level Competency 7.0 and 7.1
Objective #1
A phlebotomist is assigned to answer the telephone in the laboratory. A physician calls to “add-on” a test to previous orders that have already been collected. The phlebotomist does not know if there is enough specimen remaining to run the additional test, so she tells the doctor that he needs to write new orders and the patient’s specimen will need to be redrawn. How should the phlebotomist have handled this situation ?
NAACLS Entry Level Competency 6.9
Objective #4
A request for bloodwork was received in the laboratory. A newly hired phlebotomist goes to the patient’s room to collect the blood. She notices a large vein on the left arm and applies the tourniquet. When she palpates the vein, she feels a vibration or “buzzing”. Should she draw from this vein ? What is she palpating ? What should she have done differently ? Why does this patient require dialysis ?
NAACLS Entry Level Competency 6.0, 6.3, 6.9, 6.10, 6.11, 9.0, 9.1, and 9.3
Objective #3
A phlebotomist has orders to collect blood from an outpatient. She notices the patient is elderly, so when she goes to the waiting room she yells loudly for Mrs. Smith. She gives Mrs. Smith a urine collection cup and directs her to collect a specimen, then come to the drawing room. When the patient finally sits down in the drawing chair, the phlebotomist notices that she is well beyond the 5 minute limit per patient that her supervisor requires. So, she ties the tourniquet tightly, palpates a vein, cleans the arm, assembles her equipment, and inserts the needle before the alcohol is dry. The vein rolls so she redirects the needle. Finally blood slowly enters the ETS tube, but she manages to fill all the tubes needed. When releasing the tourniquet, she notices petechiae on the patient’s arm. She places a cotton ball on the arm and holds it in place with tape. She directs the patient to the exit. What errors has the phlebotomist made and what complications might be expected in the patient ?
Phlebotomy Essentials Critical Thinking Questions for Chapter 8.
© 2016 Wolters Kluwer.
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