NHA Certified Phlebotomy Technician (CPT)Patient PreparationHard
A phlebotomy technician is preparing to draw blood from an elderly patient with visible petechiae on both arms. Which of the following is the MOST appropriate action?
- AProceed with the venipuncture at a site away from the petechiae.
- BAvoid applying a tourniquet and perform a butterfly draw.
- CConsult with the nursing staff or physician before proceeding.
- DApply a tourniquet more loosely than usual to prevent further bruising.
Show answer & explanationAnswer & explanation
Correct answer: C. Consult with the nursing staff or physician before proceeding.
Petechiae indicate capillary fragility or a platelet disorder. Drawing blood in such a patient can lead to excessive bleeding, hematoma formation, or further skin damage. It is crucial to consult with nursing staff or a physician to assess the patient's coagulation status and determine the safest approach.
Why the other options are wrong
- A. While avoiding petechiae is good, the underlying cause of petechiae warrants further investigation before any venipuncture.
- B. Avoiding a tourniquet might be an option, but it's part of a broader decision that should involve the medical team.
- D. Applying a tourniquet loosely may not provide adequate venous distention for a successful draw and doesn't address the underlying issue.
Petechiae and Venipuncture
Small red or purple spots on the skin caused by minor hemorrhage. Indicates potential bleeding risk.
- Sign of capillary fragility or platelet dysfunction.
- Requires caution for venipuncture.
- Consult medical staff before proceeding to assess bleeding risk.
Memory trick: Spots on the skin? Get a doctor to chime in!