General Practice Flashcards

Simon is getting ready to take a sample of blood. Simon notices the existence of petechiae dispersed across both of the patient's arms when examining the patient's arm for a likely site. Simon is aware of what this means. Before leaving the patient, he takes extra time to ensure that the venipuncture site has ceased bleeding. Why did Simon act this way?

Answer: Petechiae indicate possible clotting problems

Petechiae are small, pinpoint hemorrhages under the skin, indicating capillary fragility or a platelet disorder. Their presence suggests a potential problem with the patient's clotting ability. Therefore, Simon's caution to ensure complete cessation of bleeding is appropriate to prevent prolonged bleeding or hematoma formation at the venipuncture site.

Which of the following is not a special factor that patient care professionals should consider while performing phlebotomy procedures on old residents?

Answer: Provide a protective environment

While providing a safe environment is a general nursing principle, it is not a *special factor* primarily related to the unique challenges of performing phlebotomy on older residents. Special considerations for phlebotomy in this population typically focus on physiological changes like thin, fragile veins, reduced visual acuity, and mobility issues that directly impact the venipuncture process itself.

Which of the following does not require extra attention while dealing with young children?

Answer: Use protective restraints where necessary

While protective restraints might be used in rare, extreme circumstances for safety, they are not a routine or preferred 'extra attention' point for *all* young children during phlebotomy. The primary focus should be on accurate blood volume monitoring, providing a comforting and protective environment, and ensuring warmth to minimize distress and ensure a successful procedure. Restraints are a last resort and should be used minimally.

For an arterial puncture, Ken is gathering the necessary tools. He has accumulated the following supplies: sterile gauze, betadine wipes, a syringe, and a 1,000 IU/ml heparin solution. What is Ken's missing?

Answer: Container of ice water

Arterial blood gas (ABG) samples must be placed in a container of ice water immediately after collection. This is crucial to slow down the metabolic activity of blood cells, which would otherwise continue to consume oxygen and produce carbon dioxide, altering the gas values (e.g., pH, pO2, pCO2) and leading to inaccurate results if not chilled.

What distinguishes hypovolemic shock from fainting?

Answer: Hypovolemic shock is a medical emergency and Fainting may be caused by an emotional reaction or pain

Hypovolemic shock is a life-threatening medical emergency caused by severe fluid or blood loss, requiring immediate intervention to restore circulating volume. Fainting (syncope), while concerning, is often a temporary loss of consciousness due to a transient decrease in blood flow to the brain, frequently triggered by non-life-threatening factors like emotional stress, pain, or prolonged standing.

Leo just completed his first syringe-assisted venipuncture with great success! He was cautious to avoid lifting the plunger too quickly or pressing it down too hard when transferring the specimen or the blood from the syringe to the specimen container. What function do the extra safety measures taken when administering a needle serve?

Answer: To prevent hemolysis

Lifting the plunger too quickly or pressing it down too hard when transferring blood from a syringe creates excessive pressure and turbulence. This mechanical stress can damage and rupture red blood cells, a process known as hemolysis. Hemolysis renders the specimen unsuitable for many laboratory tests, as it can falsely elevate or decrease certain analyte levels.

Riley is ready to venipuncture a patient who has had a right-side mastectomy. What particular safety measures should Riley take for this patient?

Answer: Riley should avoid the right arm

After a mastectomy, especially with lymph node dissection, the affected arm is at increased risk for lymphedema and infection due to impaired lymphatic drainage. Performing venipuncture on that arm can exacerbate lymphedema, introduce infection, or cause discomfort. Therefore, the phlebotomist should always avoid the arm on the side of the mastectomy.