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Withdrawing Blood

Withdrawing Blood
      
          Blood samples for laboratory testing may be obtained in several ways. The most common procedure is venipuncture, withdrawl  of blood from a vein using a needle and collecting tube, which contains various additives, A tourniquet is wrapped around the arm above the venipuncture site, which causes blood to accumulate in the vein. This increased blood volume makes the vein stand out. Opening and closing the fistful.

           A common site for venipuncture is the median cubital vein anterior drawing blood is through a finger or heel stick. Diabetic patients who monitor their daily blood sugar typically perform a finger stick, and it is often used for drawing blood from infants and children. in an arterial stick, blood is withdrawn from an artery; this test is used to determine the level of oxygen in oxygenated blood.

Equipment :                                                                   
  • Tourniqate 
  • Spirit swab
  • Dry swab
  • Gloves
  • syringe
Procedure :

1. Arrange the equipment to be used for sample collection.

2. Perform the hand hygiene.
3. Identify and prepare the patient.

 

4. Select the site, preferably at the antecubital area ( bend of elbow), Warm the hand with a hot pack, 
    or hanging the hand down may make it easier to see the veins.
               Do not touch the hand after applying the alcohol.

5. Apply a tourniqute 4-5 fingers over the selected area.

6.Tell the patient to form a fist so the veins are prominanat.

7. Wear the gloves ( sterile or Non sterile )

8.Disinfect the site with 70% isopropyl alcohol for 30 sec and allow to dry completely.

9. Hold the vein by placing the thumb finger below the vein puncture site.

10. Insert the needle with 30 degree angle.

11. After collecting the required amount of blood remove the tourniqute before withdrawing the
      needle.

12. withdraw the needle immideately apply the dry and clean cotton over the puncture site.

13. Discard the needle and used equipment in the puncture resistant container.

14. Remove the gloves and perform the hand washing.


A. If tubes does not have a rubber stopper, Push the plunger into the container slowly to prevent
     hemolysis.
B. Place the stopper in the container.
C. Mix with additatives according to the laboratory instructions send to lab

Multiple choice Questions :


1.How much % of alcohol is used to disinfect the site    
a) 50%
b) 60%
c) 70%
d) 80%

Answer : C

2. Which vein is best to withdraw the blood
a) Cephalic vein
b) Basilic vein
c) Ante cubital Vein
d) median vein of forearm

Answer : C

3. Why the blood has to push slowly from syringe to vacutainer after collecting from vein
a) To prevent hemolysis
b) To prevent clotting
c) To Mix with aditatives
d) To prevent blood loss

Answer : A

4. How much distance has to maintain  from veinpuncture site to tourniquet in withdrawing blood
    procedure
a) 4 fingers above
b) 6 fingers above
c) 3 finger above
d) 5 fingers above

Answer : a

5. In which angle the needle is inserted to withdraw the blood
a) 40 degree angle
b) 30 degree angle
c) 45 degree angle
d) 35 degree angle

Answer : B

staff nurse multiple questions

1.Before giving blood transfusion a nurse must note the date, time of collection and must be aware that Packed Rbc can be stored up to
A) 25 days
B) 35 days
c) 45 days
d) 55 days

Case study on acute gastro entiritis

Patient came to the complaints of loose motions

Vitals checked and record

Pan 40 mg
Emcet 4 mg
Ns 500 ml bowls
Ns 500 ml 75 ml hour

Diagnosis acute he

Pan 40mg
Emcet 4 mg
Metrogyle 100 ml
I monocef 1 g
T.

Investigation

Sr e ( na.k.cl)
Stool for cculture

Case study on potassium chloride

 Patient came to hospital with the complaints of decreased level of potassium

K 2.35 ( 3.5-5.5)

Vitals normal BP 110/80

Treatment

Potassium chloride 20 ml in 300 ml of ns up to 4 hours

Mgso4 2 g

Syp potklore . keylite potassium syrup

Advised for potassium for tomorrow

Vitals after 1 hour BP 160/ 100

Objectives of PICU

OBJECTIVES OF PICU

GENERAL OBJECTIVES :-

          By the end of my clinical experience in PICU. I will able to learn indepth knowledge and apply the skills in practice while providing care to the patient.

SPECIFIC OBJECTIVES :-

          By the end of my clinical experience in PICU. I will be able to
  • To know the physical setup of PICU.
  • To evaluate and manage the pediatric patient present with critically ill.
  • Be familiar with criteria for admission or transfer of PICU settings.
  • To know the indication for and be able to perform the procedures.
  • Management of pediatric airway.

               - Pediatric ventilator management.
              - Placement of peripheral IV.
  • Placement of cerebral venous catheter.
  • Arterial blood gas.
  • Evaluate and properly management of

              - Respiratory distress
              - Shock
              - Altered mental status.
  • Calculate and maintaince of fluid equipment.
  • Identify the active problems.
  • calculate and measuring drugs.
  • Maintain good therapeutic relationship with patient and family members.

For more objectives visit