e. Evaluate feet or legs. However, if patient has been bedridden for extended periods of time, this may increase chances of phlebitis. A doctor’s written permission must be obtained to draw from ankles or feet. f. Extended IV therapy may cause veins to be damaged or occluded. 11. Damaged, Sclerosed or Occluded veins a. Sclerosed or hardened veins due to inflammation or disease. b. Occluded veins are blocked due to extended IV therapy, chemotherapy or disease. c. Patients whose veins have been repeatedly punctured often become scarred and feel hard when palpated. d. Blood is not drawn easily; best to avoid these sites. 12. Collapsed Veins a. Usually caused by excessive pressure when collecting blood sample. 1) May be caused by pulling syringe plunger back too quick or too hard. Pull plunger using gentle pressure. 2) Using vacuum collection device on small veins. Use tubes with smaller volume (pedi tubes) and a smaller needle (butterfly needle). b. Carefully evaluate the veins before venipuncture and select the patient’s appropriate equipment for the vein selected. B. Physical Disposition 1. The refers to the physical condition in the early morning basal state patient’s hours approximately 12 hours after the last meal. Many factors can affect the basal state. a. Results of lab tests are more reliable because normal or reference values are most often determined from specimens collected during this time. b. It is recommended that specimens collected for determination of concentrations of the following analytes be collected during this time: 1) Glucose 2) Cholesterol 3) Triglycerides
e. Evaluate feet or legs. However, if patient has been bedridden for extended periods of time, this may increase chances of phlebitis. A doctor’s written permission must be obtained to draw from ankles or feet. f. Extended IV therapy may cause veins to be damaged or occluded. 11. Damaged, Sclerosed or Occluded veins a. Sclerosed or hardened veins due to inflammation or disease. b. Occluded veins are blocked due to extended IV therapy, chemotherapy or disease. c. Patients whose veins have been repeatedly punctured often become scarred and feel hard when palpated. d. Blood is not drawn easily; best to avoid these sites. 12. Collapsed Veins a. Usually caused by excessive pressure when collecting blood sample. 1) May be caused by pulling syringe plunger back too quick or too hard. Pull plunger using gentle pressure. 2) Using vacuum collection device on small veins. Use tubes with smaller volume (pedi tubes) and a smaller needle (butterfly needle). b. Carefully evaluate the patient’s veins before venipuncture and select the appropriate equipment for the vein selected. B. Physical Disposition 1. The basal state refers to the patient’s physical condition in the early morning hours approximately 12 hours after the last meal. Many factors can affect the basal state. a. Results of lab tests are more reliable because normal or reference values are most often determined from specimens collected during this time. b. It is recommended that specimens collected for determination of concentrations of the following analytes be collected during this time: 1) Glucose 2) Cholesterol 3) Triglycerides
phb_unit8LecComplicationsInSpecimenCollectionDec_31_2012.docx