The nurse attempts to withdraw a blood specimen; but, after the venipuncture, blood does not flow into the Vacutainer® tube. Which is a suitable nursing response?
1. Apply pressure to vein above venipuncture.
2. Remove needle and repeat the venipuncture.
3. Tighten the tourniquet to build up more blood.
4. Move needle slightly to observe for blood flow.
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4. Without removing it, adjust the needle slightly and observe for blood flow. Usual-ly, this occurs because the phlebotomist pierces through the entire vein and blood does not flow because the needle's lumen is outside the vein; thus, the nurse slowly withdraws the needle a very short distance, and blood usually starts to flow once the needle is in the vein. Consult agency policy for the number of adjustments and the number of retakes the nurse can perform if unsuccessful on the first venipuncture. If the vacuum in the tube is lost, the nurse can replace the Vacutainer® tube without removing the needle to avoid a second venipuncture.
1. Applying pressure to the vein is likely to compress the vein and occlude blood flow.
2. The nurse should try adjusting the needle slightly or attaching another Vacutainer® tube before a second venipuncture.
3. Tightening the tourniquet occludes blood flow to a greater degree; if the needle is not in the vein, this is a redundant measure.
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