NHA Certified Phlebotomy Technician (CPT)Patient PreparationHard
A phlebotomy technician is preparing to draw blood from a patient who has an intravenous (IV) line in their right arm. The patient's left arm has extensive scarring from previous surgeries. Where should the technician ideally draw blood from?
- AFrom the dorsal side of the hand on the left arm.
- BFrom the right arm, distal to the IV insertion site.
- CConsult the nurse for alternative options or to temporarily stop the IV.
- DFrom the left arm, attempting to find a suitable vein despite scarring.
Show answer & explanationAnswer & explanation
Correct answer: C. Consult the nurse for alternative options or to temporarily stop the IV.
Drawing distal to an IV can lead to contamination of the sample with IV fluids, diluting the results. Extensive scarring makes venipuncture difficult and painful, often leading to unsuccessful draws. In such complex cases, the best approach is to consult with the nurse to explore options like temporarily stopping the IV, drawing from an alternative site identified by nursing, or having the nurse draw from a central line if applicable.
Why the other options are wrong
- A. The dorsal side of the hand on the left arm might be an option, but given the 'extensive scarring' on the left arm, consulting the nurse is safer to ensure the best and safest site.
- B. Drawing distal to an IV is generally avoided due to potential dilution of the sample and inaccurate results.
- D. Scarred areas are difficult for venipuncture, painful for the patient, and can lead to hemolysis or nerve damage.
Challenging Site Selection
Situations requiring careful consideration and often consultation for venipuncture site.
- IV lines: avoid drawing above or below; never draw from an IV.
- Scarred areas: difficult, painful, risk of complications.
- Always consult nursing/physician for complex cases.
Memory trick: When veins are tricky, consult the clinical picky!