Index and middle finger are pulling the skin parallel to the arm just below the site.
Index finger is pulling the skin above the site and thumb is pulling toward the wrist.
Thumb is 1 to 2 in. Below the intended site and is pulling the skin toward the wrist.
Thumb is next to the intended vein and pressing heavily downward into the tissue.
Acting confident and assured in beside manner
Being professional in dress and personal appearance
Collecting a specimen before the requested time
Remaining at ease while interacting with the patient
A civil action malpractice lawsuit.
Being dismissed from the facility.
No reprimand if no one was hurt.
Temporary suspension of duties.
Anxiety about admission to the hospital.
Inability to watch while others are drawn.
Intense fear of needles and being stuck.
Personal preference for smaller needles.
All of the above.
Allow the paitent to sit in the waiting room for half an hour before collection.
Choose the most skilled phlebotomist available to perform the venipuncture.
Have the patient wear an eye mask or close his or her eyes during the procedure.
Thoroughly explain every detail of the draw before doing the venipuncture.
Allowing the alcohol to evaporate completely.
Rubbing it in between and around the fingers.
Using a very generous amount of the sanitizer.
All of the above.
At a 45-degree angle to the surface of the arm.
Using a smooth, steady motion forward,
With a deliberate and rapid forward jab.
With the bevel of the needle face down.
Anchor the vein while inserting the needle.
Increase the angle needed to enter the vein.
Redirect the needle to gain entry to the vein.
Thread part of the needle with the lumen.
Assess a patient's condition after surgery.
Determine patient suitability for surgery.
Draw it at the best time for accurate results.
Establish a clinical diagnosis or prognosis.
Basic metabolic panel, potassium, and glucose.
Blood cultures, cardiac enzymes, and cortisol.
Calcium, ferritin, and complete blood count.
Creatinine, lactic acid, and reticulocyte count.
Assess a patient after outpatient surgery.
Eliminate the effects of diet on test results.
Determine patient eligibility for surgery.
Standardize test results on critical patients.
Disrupt the platelet plug when the arm is eventually lowered
Enable the site to quickly stop bleeding after needle removal.
Increase the possibility of bruising and hematoma formation.
Keep the wound open, especially if it is at the side of the arm.
Health facility number.
Patient date of birth.
Patient ID number.
Compromised patient care and treatment.
Erroneous and meaningless test results.
Misinterpreted test results by the physician.
All of the above.
Prior draw times.
Credit information and employer
DNA information and next of kin,
Health status and lab test results
Medical record number and name.
Alphabetical order by name and then by test requested.
Collection priority, date and time, and patient location.
Difficulty of draw and type of equipment needed.
Proximity of the patient's room to the laboratory.
Accessioning the specimen.
Bar-coding specimen labels.
As soon as it is possible to do so.
Immediately, without any hesitation.
On the next closest scheduled sweep.
Within 1 hour of the test request.
The patient is in critical condition and needs immediate attention.
The patient requires a test in which timing of collection is critical.
Results are needed soon for an appropriate response.
Results from blood work are needed for medication.
Has been admitted to the hospital.
Is an ambulatory outpatient.
Is being assessed after surgery.
Will soon be going to surgery.
For collection at a specific time and place.
In the course of establishing a diagnosis.
To assess a patient's condition after surgery.
To specifically eliminate the effects of a diet.
Cannot have any food or drink.
Cannot have anything but water.
Is in critical but stable condition.
Is recovering from minor surgery.
H & H
Knock lightly, open the door slowly, and ask whether it is all right to enter.
Knock softly and wait for someone in the room to come to the door.
Leave to draw another patient in the same area and come back later.
Open the door, announce yourself, and quickly proceed into the room.
Ask the patient's nurse to collect the specimen from the IV.
Ask the patient's nurse what to do when the sign is posted.
Collect a CBC from the right arm without using a tourniquet.
Collect the specimen from the left hand by finger puncture.
Convey important information without alarming the public.
Transmit messages over the facility's public access system.
Use numbers or words to represent important information.
All of the above.
Do not alert the nurse.
Do not call 911.
Do not call relatives.
Do not resuscitate.
Ask another phlebotmist to draw the specimen.
Come back at a later time to collect the specimen.
Determine the problem is before
Go ahead and draw the specimen without comment.
Call out the patient's name softly and shake the bed gently.
Cancel the test and ask the nurse to resubmit the requisition.
Check back every 15 minuets until the patient has awakened.
Fill out a form stating the specimen was not obtained and why.
Awakens a sleeping patient and raises the head of the patient's bed.
Collects a specimen in dim lighting conditions in the patient's room.
Draws a specimen from an unconscious patient without assistance.
While preparing to collect a specimen, startles a patient who is asleep.
Have someone assist you just in case the patient moves.
Identify yourself and inform the patient of your intent.
Move the patient to a special phlebotomy collection area.
Talk the the patient as you would to a patient who is alert.
Ask the patient's nurse to collect the stat specimen immediately.
Come back later when you know the physician is no longer there.
Introduce yourself and ask for permission to draw the specimen.
Say "excuse me" to both and proceed to collect the specimen.
Ask them to wait outside of the room until you are finished.
Come back later to collect the specimen when they have left.
Have the patient's nurse tell everyone that they should leave.
Tell them to quietly watch from the opposite side of the bed.
Ask the nurse to have the patient brought to the lab when the patient is available.
Fill out a delay slip stating you were unable to collect the specimen.
Report the situation to a supervisor and tell him or her to cancel the request.
Return to the lab and put the request in the stack for the next sweep.
Type and screen
Ask him, Are you John Doe?" If he says yes, collect the specimen.
Ask him for his name and date of birth and match it to the requisition.
Check his ID band. If it matches the requisition, draw the specimen.
Have the nurse verify the patient's name after you check his ID band.
Medical record number
Name of the physician
Room and bed number
Test collection priority
Collect the specimen and report the error to the patient's nurse.
Do not collect the specimen until the difference is resolved.
Draw the specimen because the medical record number matches.
Make the correction on the requisition and draw the specimen.
Ask the nurse to verify the patient's ID and collect the specimen.
Complete the required procedure and then file an incident report.
Do not start any procedure until the nurse attaches an ID bracelet.
Make a computer entry to will alert other phlebotmists of this issue.
Assign a name to the patient, such as Jane Doe.
Assign a number to the patient until she is admitted.
Use a three-part identification band with special tube labels.
Wait to process the specimens until the patient can be identified.
Collect a timed specimen late
Fail to obtain the desired specimen
Misidentify the patient's specimen
Unknowingly give a patient a bruise
Ask the patient to state her name; if it matches the requisition, continue.
Ask the patient's nurse to attach an ID band and proceed when it is attached.
Go to the nurses' station, get an ID bracelet, attach it, and then proceed.
Tell the nurse that you will not collect the specimen and return to the lab.
A geriatric patient
A very young child
A mentally incompetent patient
A non-English-speaking patient
Ask the woman to state her complete name and date of birth to confirm her identity.
Assume that you do not have to verify her identity because the receptionist already did.
Conclude that she must be the right one because she is the only one in the waiting room.
Decide that she must be the right one because she answered you when you called the name.
Divert attention from any discomfort associated with the draw.
Increase the patient's confidence in the phlebotmist's abilities.
Keep the patient from fainting during the venipuncture procedure.
Redirect the patient's thoughts away from what is going to happen.
Ask the patient's nurse to draw the specimen as you stand by to assist.
Be as professional as you can and collect the specimen in a normal way.
Do not speak to the patient; just get the necessary blood work and leave.
Refuse to draw blood from the patient and leave the request for another phlebotomist.
Advising the patient of his or her prognosis
Explaining what disorders the test can detect
Informing the patient that you are a student
Notifying the patient of future venipunctures
Explain that it is best to discuss the test with the physician.
If the test is for glucose say, "Yes, it is" but do not elaborate.
Say, "HIPAA confidentiality rules won't let me tell you."
Tell the patient that it is not for a glucose test even if it is.
Convince the patient to cooperate and collect the sample anyway.
Have the nurse physically restrain the patient and draw the specimen.
Notify the patient's nurse and document the patient's refusal,
Return to the lab, cancel the test request, and inform the physician.
Check with the patient's nurse to see if the specimen should be collected or the draw rescheduled.
Collect the specimen, but write "nonfasting" on the lab slip and the specimen.
Do not draw the blood, fill out an incident slip, and leave a copy for the nurse.
Proceed to collect the specimen, since the patient had not quiet finished eating.
Be more apt to allow sufficient time for the alcohol to dry.
Have a better idea of what equipment you will need to use.
Waste less equipment by knowing exactly what is needed.
All of the above.
After drawing your last patient.
Before and after each patient.
Only after drawing the patient.
Only before putting on gloves.
Clean them with a hand sanitizer.
Cover them up with clean gloves.
Wash them with soap and water.
Wipe them with an alcohol pad.
Explain what are you going to do to the child in simple terms.
Restrain the child and draw the specimen without explanation.
Tell the child that you will give him a treat if he does not cry.
Tell the child to relax and not to worry because it will not hurt.
Could hurt if you watch, so look the other way.
Is painless and will be over just before you know it.
Might hurt just a little, but only for a short time.
Hurts only if the phlebotmist is inexperienced.
Downward in a straight line from shoulder to wrist, palm up
Extended straight forward at about waist height and palm up
Held out at an angle, bend at the elbow, and the palm up
Straight down to the elbow, parallel elbow to wrist, palm up
Allowed to sit up in order to carefully watch the draw.
Asked to lie down, or sit in a reclining drawing chair.
Drawn in a separate roam that has first-aid equipment.
Permitted to sit in a chair if accompanied by an adult.
Asking visitors to leave the room while you draw a specimen.
Drawing a patient who is lying in bed talking on a cell phone.
Lowering a bed rail to make access to the patient's arm easier.
Pulling the curtain between the bed while drawing on a specimen.
About 3 to 4 in. Above the venipuncture site
Distal to the venipuncture site on the forearm
Distal to the wrist bone if drawing a hand vein
Immediately above the venipuncture site.
Arterial flow below it may be stopped.
Blood below it may hemoconcentrate.
The pressure can cause the arm to ache.
All the of above.
Having a patient pump his or her fist
Lowering the arm alongside the chair
Palpating the antecubital area firmly
Using warmth to increase blood flow
A vein has a lot less resilience.
A vein pulses and feels larger.
An artery has a distinct pulse.
An artery is more superficial.
Bouncy and resilient
Hard and cord-like
Pulsating and firm
Soft and pliable
Coagulation tests are requested.
The patient is partially paralyzed.
The physician gives permission.
There are no other suitable sites.
Avoid drawing the basilic vein the the antecubital area.
Do not select a site that is near where you feel a pulse.
Do not select a vein that overlies or is close to an artery.
All of the above.
Apply a tourniquet on the right arm over a towel and do the draw.
Ask the patient's nurse to collect the specimen from the IV line.
Collect from the left antecubital area without using a tourniquet.
Collect the specimen by capillary puncture from the left hand.
Insert the needle where you think it is and probe until you find it.
Keep the tourniquet on while cleaning the sire and during the draw.
Look for visual clues on the skin to remind you where the vein is.
Mark the spot using a felt-tipped pen and clean it off when finished.
Allow arterial blood flow to return to normal.
Decrease hemoconcentration of the specimen.
Increase the venous flow to the vein selected.
All of the above.
Cleanse the area thoroughly with disinfectant using concentric circles.
Cleanse with a circular motion from the center to the periphery.
Scrub with an alcohol sponge as vigorously as you can for 1 minute.
Wipe using concentric circles from the outside area to the center.
It allows the process of evaporation to help destroy any microbes.
It avoids a stinging sensation when the needle penetrates the skin.
It gives the phlebotomist time to prepare equipment and supplies.
It prevents hemolysis of the specimen from alcohol to in the needle.
The ETS tube will fail to fill with blood because of loss of tube vacuum.
Nothing; the line is actually a fill guideline for all evacuated tubes.
The needle sleeve stops penetration of the tube until fully advanced.
There will be transfer of the tube additive to the needle at that point.
The presence of external contamination.
Flaws that could damage a vein.
Proper positioning of the bevel.
That the needle is out of date.
Clean the site, prepare equipment, put on gloves, apply tourniquet
Sanitize hands, select vein, release tourniquet, verify diet restrictions
Select the site, apply tourniquet, prepare equipment, clean the site
Select vein, clean the site, position the patient, put on your gloves
Clean the site and try again using the same needle.
Stop and obtain a new needle before trying again.
Try it again immediately using that same needle.
Wipe the needle across an alcohol pad and retry.
Less than 15 degrees
30 degrees or less
35 to 45 degrees
45 to 60 degrees
As you prefer.
Bevel facing up.
Bevel site down.
Blood will enter the ETS hub.
The needle will start to vibrate.
You will feel a slight "give."
You will hear a hissing sound.
After the last tube has been filled completely
After the needle is withdrawn and covered
NsAs soon as blood begins to flow into the tube
As soon as the needle penetrates the skin
Red cell count
Collect sterile specimens before all other specimens.
Draw a "clear" tube before special coagulation tests.
Fill each tube until the normal vacuum is exhausted.
Position the arm so tubes fill from the stopper end first.
The specimen yields enough serum for the required tests.
There is a proper ratio of blood to anticoagulant additive.
There is an adequate amount of blood to perform the test.
Tissue fluid contamination of the specimen is minimized.
Avoid microclot formation.
Do not collect the green tube until the next collection sweep.
Draw several millimeters into a discard tube, then fill the green one.
Draw the green one next and hope that there is no carryover.
It is acceptable to draw the EDTA before the green stopper.
2 or 3
5 to 10
8 to 12
Blood will not contaminate your gloved hand.
It will not hurt when you pull out the needle.
Pressure is adequate and bruising is prevented.
The patient does not see you pull out the needle.
Are not sufficiently porous to soak up all of the blood at the site.
Attract more airborne contaminants and are therefore less sterile.
Can irritate a patient's skin because they have loose cotton fibers.
May pull the platelet plug away from the puncture site upon removal.
Needle to bend.
Patient to faint.
Skin to be split.
All of the above.
After some pressure has been applied to the site.
As you are dropping the needle in the sharps container.
Immediately after the needle is withdrawn.
While the tube is still engaged in the holder.
Establish blood flow, release tourniquet, fill and mix tubes, remove needle
Fill and mix all of the tubes, release tourniquet, remove needle, apply pressure
Fill the tubes, remove needle, release tourniquet, mix tubes, apply pressure
Release tourniquet, fill tubes, remove needle, apply pressure, mix all tubes
Disposing of the needle and tube holder in the sharpes container as one unit.
Ejecting the needle from the tube holder so that the holder can be reused.
Removing the needle from the holder after engaging the needle safety device.
Unscrewing the needle from the holder by using a slot in the sharps container.
At the bedside immediately after collection.
Before the blood specimens are collected.
In the lab processing area after collection.
Outside the patient's room after collection.
Patient room number and bed
Patient's first and last name
Phlebotomist's initials or ID
The date and time of the draw
Avoid confusing multiple specimens from the same patient.
Avoid confusing specimens from patients with the same name.
Be used for an accession number in processing the specimen.
Be used for insurance identification and payment purposes.
Do not carry a heavy bag or large purse on that arm.
Do not drink or eat for 2 hours after collection.
Do not lift any heavy objects for at least 1 hour.
Leave the bandage on for minimum of 15 minutes.
The patient adamantly refuses to have blood taken.
The patient was unavailable at the designated time.
You made an attempt but were unable to obtain the blood.
You did not have the right equipment on your tray.
Ask another phlebotomist to collect the fasting specimen.
Ask the patient to come back later so that you can try again.
Call the supervisor for permission to make a third attempt.
Make a third attempt on the newly discovered large vein.
A tourniquet is not required.
Above the antecubital fossa.
Just distal to the wrist bone.
Proximal to the wrist bone.
Needle safety feature.
Winged infusion set.
Blood flows faster than with the ETS needles.
Butterflies are less expensive than other needles.
Butterflies make it easier to draw difficult veins.
There is greater choice in butterfly needle size.
A large amount of blood is needed.
The patient's veins are very fragile.
There are no butterfly needles left.
You need the blood to flow faster.
Filling tubes with a transfer device at an angle.
Leaving the tourniquet on until the last tube.
Mixing anticoagulant tubes several extra times.
Using a large-volume tube with a 23-gauge needle.
A "flash" of blood will appear in the hub of the needle.
Blood will automatically pump into the syringe barrel.
There will be a very slight vibration in the needle.
You cannot tell when you are in the vein with a syringe.
Correct order of draw.
Establishing rapport which the child
Greeting the parents and the child
Telling the child it will not hurt
Telling the child what to expect
Children like the idea of using a butterfly.
Children's veins are often very sclerosed.
Flexible tubing allows for arm movement.
It eliminates excessive bleeding.
Force blood through the needle into the tubes by pushing the syringe plunger.
Hold the tube steady in your hand while the syringe needle penetrates the stopper.
Place the evacuated tube in a rack before penetrating stopper with the needle.
Use a specially designed engineering device called a syringe transfer device.
Allowing the child to sit with one arm bracing the other.
Cradling the child close to the chest of the immobilizer.
Grasping the child's wrist firmly in a palm-up position.
Using two people: an immobilizer and a blood drawer.
Assuring the child that it won't be painful.
Explaining all of the tests being collected.
Explaining the importance of holding still.
Offering the child a reward for not crying.
How deep the selected vein is.
The size and condition of the vein.
The type of test being collected.
Your personal preference.
After the next tube is placed in the tube holder.
As soon as it is removed from the tube holder.
When all of the other tubes have been collected.
While the very next tube is being collected.
An ankle or foot vein on either of her legs.
The left forearm or hand, using a butterfly.
The right arm below the antecubital fossa.
The right hand, using a capillary puncture.
Address all questions to a relative or attendent if the patient is hard of hearing.
Apply a pressure bandage in case the patient does not hold adequate pressure.
Raise the pitch of your voice sharply to make certain you are heard properly.
Refrain from drawing on older patients if you have a cold, or else wear a mask.
End stages of renal disease.
Parkinson's disease effects.
Problems with coagulation.
Rheumatoid arthritis effects.